code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
APC,0701,Sr89 strontium,,,2167.52,7724.91,5
APC,0702,"Inj, balfaxar, per i.u",,,2.48,3.35,5
APC,0703,Inj daxibotulinumtoxinA-lanm,,,3.88,5.86,5
APC,0704,"Inj, aflibercept hd, 1 mg",,,415.51,580.13,5
APC,0705,"Inj, avacincaptad peg 0.1 mg",,,136.38,195.85,5
APC,0706,Inj talquetamab-tgvs 0.25 mg,,,84.24,135.3,5
APC,0707,"Cantharidin top, applicator",,,886.27,1219.86,5
APC,0708,"Inj, elranatamab-bcmm, 1 mg",,,222.7,342.94,5
APC,0709,Flortaucipir inj 1 millicuri,,,4619.65,6911.99,5
APC,0710,Inj velmanase alfa-tycv 1 mg,,,550.38,866.77,5
APC,0711,"Inj, artesunate, 1mg",,,64.54,96.55,5
APC,0713,Inj roctavian ml 2x10^13vc g,,,14951.98,23388.45,5
APC,0714,Inj delandistrogene mox rokl,,,4140816.36,6178803.75,5
APC,0715,Pegunigalsidase alfa-iwxj,,,278.36,425.08,5
APC,0716,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1241.4,1910.46,5
APC,0717,"Instill adstiladrin, tx dose",,,78888.6,118011.14,5
APC,0718,"Inj, carmustine (accord)",,,323.38,483.84,5
APC,0719,Inj cyclophos dr.reddy's 5mg,,,11.34,16.96,5
APC,0720,"Inj glofitamab gxbm, 2.5 mg",,,3363.3,5156.76,5
APC,0721,Inj ronzanolixizum-noli 1 mg,,,28.39,43.16,5
APC,0722,"Dexmedetomidine film, 1 mcg",,,0.97,1.31,5
APC,0723,Inj efgart-alfa 2mg hya-qvfc,,,41.25,63.13,5
APC,0726,Dexrazoxane HCl injection,,,104.3,147.08,5
APC,0731,Sargramostim injection,,,75.05,101.32,5
APC,0736,Amphotericin b liposome inj,,,29.04,40.02,5
APC,0738,Rasburicase,,,462.33,703.34,5
APC,0742,Anacaulase-bcdb 8.8% gel 1 g,,,72.64,108.63,5
APC,0752,Dactinomycin injection,,,351.31,611.72,5
APC,0759,"Naltrexone, depot form",,,5.13,7.89,5
APC,0800,Leuprolide acetate,,,2014.27,3223.72,5
APC,0807,Aldesleukin injection,,,6601.07,9876.63,5
APC,0810,Goserelin acetate implant,,,840.22,1366.87,5
APC,0812,Carmustine injection,,,394.42,556.2,5
APC,0820,Daunorubicin injection,,,30.43,41.08,5
APC,0825,Nelarabine injection,,,90.31,148.79,5
APC,0827,Floxuridine injection,,,4803.97,7690.79,5
APC,0840,Inj melpha hydroch nos 50 mg,,,158.63,258.09,5
APC,0843,Pegaspargase injection,,,33707.9,52956.03,5
APC,0844,Pentostatin injection,,,3164.99,4859.19,5
APC,0856,Porfimer sodium injection,,,29722.81,45139.25,5
APC,0858,Inj cladribine,,,17.65,23.95,5
APC,0864,Mitoxantrone hydrochl,,,39.5,91.87,5
APC,0874,Synvisc or synvisc-one,,,11.4,15.39,5
APC,0875,Euflexxa inj per dose,,,151.06,209.51,5
APC,0877,Orthovisc inj per dose,,,153.05,213.39,5
APC,0887,Azathioprine parenteral,,,293.46,473.34,5
APC,0890,Lymphocyte immune globulin,,,4941.46,9567.03,5
APC,0901,Alpha 1 proteinase inhibitor,,,6.15,10.17,5
APC,0902,"Injection,onabotulinumtoxinA",,,7.98,12.11,5
APC,0903,Cytomegalovirus imm IV /vial,,,2259.94,3369.63,5
APC,0925,Factor viii,,,1.46,2.03,5
APC,0927,Factor viii recombinant,,,1.93,3.01,5
APC,0928,Factor ix complex,,,2.06,3.16,5
APC,0929,Anti-inhibitor,,,2.92,4.5,5
APC,0931,Factor IX non-recombinant,,,1.75,2.61,5
APC,0932,Factor ix recombinant nos,,,2.31,3.44,5
APC,0943,Octagam injection,,,61.01,88.55,5
APC,0944,Gammagard liquid injection,,,61.88,84.43,5
APC,0946,Hepagam b im injection,,,85.49,124.15,5
APC,0947,Flebogamma injection,,,69.87,103.88,5
APC,0948,Gamunex-C/Gammaked,,,60.77,91.22,5
APC,0963,"Albumin (human), 5%, 250 ml",,,66.09,98.88,5
APC,0964,"Albumin (human), 25%, 20 ml",,,26.44,39.56,5
APC,1015,Injection glatiramer acetate,,,215.27,311.71,5
APC,1064,"I131 iodide cap, rx",,,28.8,43.09,5
APC,1138,"Hepagam b intravenous, inj",,,85.49,124.15,5
APC,1139,Protein c concentrate,,,18.74,28.03,5
APC,1142,Supprelin LA implant,,,56469.54,83876.64,5
APC,1150,"I131 iodide sol, rx",,,26.0,38.91,5
APC,1168,"Inj, temsirolimus",,,40.11,54.15,5
APC,1178,Busulfan injection,,,1.46,2.13,5
APC,1203,Verteporfin injection,,,14.36,21.5,5
APC,1207,"Octreotide injection, depot",,,267.57,379.29,5
APC,1213,Antihemophilic viii/vwf comp,,,1.53,2.33,5
APC,1214,Inj IVIG privigen 500 mg,,,60.49,94.53,5
APC,1232,Mitomycin injection,,,33.66,71.45,5
APC,1235,Valrubicin injection,,,1789.43,2465.49,5
APC,1237,Inj iron dextran,,,22.0,33.74,5
APC,1263,Antithrombin iii injection,,,4.8,7.64,5
APC,1268,Xyntha inj,,,1.85,3.12,5
APC,1274,Edetate calcium disodium inj,,,7578.61,11939.26,5
APC,1281,Bevacizumab injection,,,2.26,3.41,5
APC,1289,AbobotulinumtoxinA,,,10.75,16.3,5
APC,1295,Sm 153 lexidronam,,,5372.87,8038.98,5
APC,1296,Degarelix injection,,,5.2,8.29,5
APC,1297,"Ferumoxytol, non-esrd",,,0.42,0.6,5
APC,1311,Canakinumab injection,,,159.15,263.81,5
APC,1312,Hizentra injection,,,16.48,26.71,5
APC,1327,Imiglucerase injection,,,54.31,80.47,5
APC,1331,Olanzapine long-acting inj,,,3.63,5.43,5
APC,1340,"Collagenase, clost hist inj",,,88.61,141.41,5
APC,1352,Wilate injection,,,1.59,2.39,5
APC,1353,Belimumab injection,,,67.43,104.46,5
APC,1413,Lumizyme injection,,,251.48,384.89,5
APC,1415,Glassia injection,,,6.94,10.5,5
APC,1416,Factor xiii anti-hem factor,,,12.65,20.04,5
APC,1417,Gel-one,,,665.53,986.05,5
APC,1420,Aflibercept injection,,,1023.52,1437.47,5
APC,1421,Imported lipodox inj,,,658.53,985.3,5
APC,1426,Eribulin mesylate injection,,,147.78,228.26,5
APC,1431,Centruroides immune f(ab),,,5982.18,9076.76,5
APC,1433,Calcitonin salmon injection,,,802.17,1971.92,5
APC,1440,Inj desmopressin acetate,,,5.83,9.11,5
APC,1442,Non-HEU TC-99M add-on/dose,,,12.45,18.62,5
APC,1443,Icatibant injection,,,188.82,254.91,5
APC,1446,Visualization adjunct,,,10.63,16.25,5
APC,1458,Phentolaine mesylate inj,,,457.13,804.88,5
APC,1468,Inj Aripiprazole Ext Rel 1mg,,,8.81,13.56,5
APC,1469,Inj filgrastim excl biosimil,,,1.24,1.86,5
APC,1471,"Injection, Pertuzumab, 1 mg",,,20.07,31.7,5
APC,1472,Inj beta interferon im 1 mcg,,,70.02,109.73,5
APC,1474,Certolizumab pegol inj 1mg,,,5.79,7.82,5
APC,1475,Golimumab for iv use 1mg,,,13.82,20.57,5
APC,1476,Obinutuzumab inj,,,92.88,147.17,5
APC,1478,Inj human fibrinogen con nos,,,1.8,2.82,5
APC,1480,"Elosulfase alfa, injection",,,365.98,575.09,5
APC,1482,"Darbepoetin alfa, esrd use",,,3.78,5.45,5
APC,1485,"Ferumoxytol, esrd use",,,0.42,0.6,5
APC,1486,Factor ix fc fusion recomb,,,4.47,6.7,5
APC,1488,"Injection, ramucirumab",,,88.5,138.54,5
APC,1489,"Injection, vedolizumab",,,27.72,39.71,5
APC,1490,Inj pembrolizumab,,,72.49,112.32,5
APC,1491,New Technology - Level 1A ($0-$10),,,6.23,9.32,5
APC,1492,New Technology - Level 1B ($11-$20),,,19.3,28.87,5
APC,1493,New Technology - Level 1C ($21-$30),,,31.75,47.51,5
APC,1494,New Technology - Level 1D ($31-$40),,,44.2,66.14,5
APC,1495,New Technology - Level 1E ($41-$50),,,56.66,84.78,5
APC,1496,New Technology - Level 1A ($0-$10),,,6.23,9.32,5
APC,1497,New Technology - Level 1B ($11-$20),,,19.3,28.87,5
APC,1498,New Technology - Level 1C ($21-$30),,,31.75,47.51,5
APC,1499,New Technology - Level 1D ($31-$40),,,44.2,66.14,5
APC,1500,New Technology - Level 1E ($41-$50),,,56.66,84.78,5
APC,1502,New Technology - Level 2 ($51 - $100),,,94.01,140.66,5
APC,1503,New Technology - Level 3 ($101 - $200),,,187.4,280.39,5
APC,1504,New Technology - Level 4 ($201 - $300),,,311.92,466.69,5
APC,1505,New Technology - Level 5 ($301 - $400),,,436.44,653.01,5
APC,1506,New Technology - Level 6 ($401 - $500),,,560.96,839.31,5
APC,1507,New Technology - Level 7 ($501 - $600),,,685.48,1025.62,5
APC,1508,New Technology - Level 8 ($601 - $700),,,809.99,1211.93,5
APC,1509,New Technology - Level 9 ($701 - $800),,,934.51,1398.23,5
APC,1510,New Technology - Level 10 ($801 - $900),,,1059.03,1584.55,5
APC,1511,New Technology - Level 11 ($901 - $1000),,,1183.55,1770.85,5
APC,1512,New Technology - Level 12 ($1001 - $1100),,,1308.07,1957.16,5
APC,1513,New Technology - Level 13 ($1101 - $1200),,,1432.59,2143.46,5
APC,1514,New Technology - Level 14 ($1201- $1300),,,1557.11,2329.77,5
APC,1515,New Technology - Level 15 ($1301 - $1400),,,1681.63,2516.07,5
APC,1516,New Technology - Level 16 ($1401 - $1500),,,1806.15,2702.39,5
APC,1517,New Technology - Level 17 ($1501-$1600),,,1930.66,2888.69,5
APC,1518,New Technology - Level 18 ($1601-$1700),,,2055.18,3075.0,5
APC,1519,New Technology - Level 19 ($1701-$1800),,,2179.7,3261.3,5
APC,1520,New Technology - Level 20 ($1801-$1900),,,2304.22,3447.61,5
APC,1521,New Technology - Level 21 ($1901-$2000),,,2428.74,3633.91,5
APC,1522,New Technology - Level 22 ($2001-$2500),,,2802.3,4192.84,5
APC,1523,New Technology - Level 23 ($2501-$3000),,,3424.89,5124.38,5
APC,1524,New Technology - Level 24 ($3001-$3500),,,4047.48,6055.9,5
APC,1525,New Technology - Level 25 ($3501-$4000),,,4670.08,6987.44,5
APC,1526,New Technology - Level 26 ($4001-$4500),,,5292.67,7918.99,5
APC,1527,New Technology - Level 27 ($4501-$5000),,,5915.27,8850.51,5
APC,1528,New Technology - Level 28 ($5001-$5500),,,6537.86,9782.05,5
APC,1529,New Technology - Level 29 ($5501-$6000),,,7160.45,10713.59,5
APC,1530,New Technology - Level 30 ($6001-$6500),,,7783.05,11645.11,5
APC,1531,New Technology - Level 31 ($6501-$7000),,,8405.64,12576.66,5
APC,1532,New Technology - Level 32 ($7001-$7500),,,9028.24,13508.2,5
APC,1533,New Technology - Level 33 ($7501-$8000),,,9650.83,14439.72,5
APC,1534,New Technology - Level 34 ($8001-$8500),,,10273.42,15371.26,5
APC,1535,New Technology - Level 35 ($8501-$9000),,,10896.02,16302.8,5
APC,1536,New Technology - Level 36 ($9001-$9500),,,11518.61,17234.33,5
APC,1537,New Technology - Level 37 ($9501-$10000),,,12141.21,18165.87,5
APC,1539,New Technology - Level 2 ($51 - $100),,,94.01,140.66,5
APC,1540,New Technology - Level 3 ($101 - $200),,,187.4,280.39,5
APC,1541,New Technology - Level 4 ($201 - $300),,,311.92,466.69,5
APC,1542,New Technology - Level 5 ($301 - $400),,,436.44,653.01,5
APC,1543,New Technology - Level 6 ($401 - $500),,,560.96,839.31,5
APC,1544,New Technology - Level 7 ($501 - $600),,,685.48,1025.62,5
APC,1545,New Technology - Level 8 ($601 - $700),,,809.99,1211.93,5
APC,1546,New Technology - Level 9 ($701 - $800),,,934.51,1398.23,5
APC,1547,New Technology - Level 10 ($801 - $900),,,1059.03,1584.55,5
APC,1548,New Technology - Level 11 ($901 - $1000),,,1183.55,1770.85,5
APC,1549,New Technology - Level 12 ($1001 - $1100),,,1308.07,1957.16,5
APC,1550,New Technology - Level 13 ($1101 - $1200),,,1432.59,2143.46,5
APC,1551,New Technology - Level 14 ($1201- $1300),,,1557.11,2329.77,5
APC,1552,New Technology - Level 15 ($1301 - $1400),,,1681.63,2516.07,5
APC,1553,New Technology - Level 16 ($1401 - $1500),,,1806.15,2702.39,5
APC,1554,New Technology - Level 17 ($1501-$1600),,,1930.66,2888.69,5
APC,1555,New Technology - Level 18 ($1601-$1700),,,2055.18,3075.0,5
APC,1556,New Technology - Level 19 ($1701-$1800),,,2179.7,3261.3,5
APC,1557,New Technology - Level 20 ($1801-$1900),,,2304.22,3447.61,5
APC,1558,New Technology - Level 21 ($1901-$2000),,,2428.74,3633.91,5
APC,1559,New Technology - Level 22 ($2001-$2500),,,2802.3,4192.84,5
APC,1560,New Technology - Level 23 ($2501-$3000),,,3424.89,5124.38,5
APC,1561,New Technology - Level 24 ($3001-$3500),,,4047.48,6055.9,5
APC,1562,New Technology - Level 25 ($3501-$4000),,,4670.08,6987.44,5
APC,1563,New Technology - Level 26 ($4001-$4500),,,5292.67,7918.99,5
APC,1564,New Technology - Level 27 ($4501-$5000),,,5915.27,8850.51,5
APC,1565,New Technology - Level 28 ($5001-$5500),,,6537.86,9782.05,5
APC,1566,New Technology - Level 29 ($5501-$6000),,,7160.45,10713.59,5
APC,1567,New Technology - Level 30 ($6001-$6500),,,7783.05,11645.11,5
APC,1568,New Technology - Level 31 ($6501-$7000),,,8405.64,12576.66,5
APC,1569,New Technology - Level 32 ($7001-$7500),,,9028.24,13508.2,5
APC,1570,New Technology - Level 33 ($7501-$8000),,,9650.83,14439.72,5
APC,1571,New Technology - Level 34 ($8001-$8500),,,10273.42,15371.26,5
APC,1572,New Technology - Level 35 ($8501-$9000),,,10896.02,16302.8,5
APC,1573,New Technology - Level 36 ($9001-$9500),,,11518.61,17234.33,5
APC,1574,New Technology - Level 37 ($9501-$10000),,,12141.21,18165.87,5
APC,1575,"New Technology - Level 38 ($10,001-$15,000)",,,15565.47,23289.32,5
APC,1576,"New Technology - Level 39 ($15,001-$20,000)",,,21791.41,32604.67,5
APC,1577,"New Technology - Level 40 ($20,001-$25,000)",,,28017.35,41920.01,5
APC,1578,"New Technology - Level 41 ($25,001-$30,000)",,,34243.29,51235.37,5
APC,1579,"New Technology - Level 42 ($30,001-$40,000)",,,43582.2,65208.4,5
APC,1580,"New Technology - Level 43 ($40,001-$50,000)",,,56034.08,83839.1,5
APC,1581,"New Technology - Level 44 ($50,001-$60,000)",,,68485.96,102469.81,5
APC,1582,"New Technology - Level 45 ($60,001-$70,000)",,,80937.84,121100.51,5
APC,1583,"New Technology - Level 46 ($70,001-$80,000)",,,93389.72,139731.23,5
APC,1584,"New Technology - Level 47 ($80,001-$90,000)",,,105841.6,158361.93,5
APC,1585,"New Technology - Level 48 ($90,001-$100,000)",,,118293.48,176992.63,5
APC,1589,"New Technology - Level 38 ($10,001-$15,000)",,,15565.47,23289.32,5
APC,1590,"New Technology - Level 39 ($15,001-$20,000)",,,21791.41,32604.67,5
APC,1591,"New Technology - Level 40 ($20,001-$25,000)",,,28017.35,41920.01,5
APC,1592,"New Technology - Level 41 ($25,001-$30,000)",,,34243.29,51235.37,5
APC,1593,"New Technology - Level 42 ($30,001-$40,000)",,,43582.2,65208.4,5
APC,1594,"New Technology - Level 43 ($40,001-$50,000)",,,56034.08,83839.1,5
APC,1595,"New Technology - Level 44 ($50,001-$60,000)",,,68485.96,102469.81,5
APC,1596,"New Technology - Level 45 ($60,001-$70,000)",,,80937.84,121100.51,5
APC,1597,"New Technology - Level 46 ($70,001-$80,000)",,,93389.72,139731.23,5
APC,1598,"New Technology - Level 47 ($80,001-$90,000)",,,105841.6,158361.93,5
APC,1599,"New Technology - Level 48 ($90,001-$100,000)",,,118293.48,176992.63,5
APC,1608,Etanercept injection,,,984.67,2013.76,5
APC,1609,"Rho(D) immune globulin h, sd",,,42.11,57.72,5
APC,1613,Trastuzumab injection,,,97.05,139.78,5
APC,1630,"Hep b ig, im",,,174.24,250.01,5
APC,1643,"Y90 ibritumomab, rx",,,18397.33,105868.14,5
APC,1656,Factor viii fc fusion recomb,,,2.92,4.52,5
APC,1658,"Injection, belinostat, 10mg",,,62.37,97.77,5
APC,1660,"Injection, oritavancin",,,35.44,53.43,5
APC,1662,Inj tedizolid phosphate,,,2.25,3.65,5
APC,1670,Tetanus immune globulin inj,,,724.42,1104.81,5
APC,1683,Basiliximab,,,5713.88,8731.94,5
APC,1685,"Darbepoetin alfa, non-esrd",,,3.78,5.45,5
APC,1686,"Epoetin alfa, non-esrd",,,9.37,15.92,5
APC,1687,Digoxin immune fab (ovine),,,6086.61,9628.78,5
APC,1688,Ethanolamine oleate,,,612.24,948.24,5
APC,1689,Fomepizole,,,8.02,11.7,5
APC,1690,Hemin,,,40.09,63.68,5
APC,1694,Ziconotide injection,,,12.01,18.89,5
APC,1696,Palifermin injection,,,42.33,66.24,5
APC,1700,Inj secretin synthetic human,,,53.01,75.49,5
APC,1701,Treprostinil injection,,,69.5,101.92,5
APC,1704,"Humate-P, inj",,,1.74,2.77,5
APC,1705,Factor viia recomb novoseven,,,3.13,4.95,5
APC,1710,Clofarabine injection,,,6.93,24.17,5
APC,1712,Paclitaxel protein bound,,,16.62,22.43,5
APC,1745,Radium ra223 dichloride ther,,,205.77,320.86,5
APC,1746,Factor xiii recomb a-subunit,,,21.49,33.82,5
APC,1747,Monovisc inj per dose,,,850.67,1186.02,5
APC,1748,Inj tbo filgrastim 1 microg,,,0.46,0.65,5
APC,1761,"Rolapitant, oral, 1mg",,,1.97,3.46,5
APC,1809,"Injection, alemtuzumab",,,2910.87,4527.06,5
APC,1822,"Injection, zarxio",,,0.45,0.85,5
APC,1823,"Injection, dalbavancin",,,19.44,29.09,5
APC,1824,Ceftaroline fosamil inj,,,4.9,7.87,5
APC,1825,Ceftazidime and avibactam,,,125.24,195.12,5
APC,1826,Hyqvia 100mg immuneglobulin,,,21.79,33.82,5
APC,1827,Factor viii recomb obizur,,,4.01,6.01,5
APC,1829,Penicillin g benzathine inj,,,30.34,55.92,5
APC,1832,Dimethyl sulfoxide 50% 50 ml,,,891.43,1395.14,5
APC,1836,Penicillin g procaine inj,,,50.98,87.92,5
APC,1844,Factor viii pegylated recomb,,,2.61,3.9,5
APC,1846,Factor viii nuwiq recomb 1iu,,,1.55,2.09,5
APC,1847,"Injection, inflectra",,,16.96,37.25,5
APC,1848,Artiss fibrin sealant,,,172.27,264.36,5
APC,1849,Foscarnet sodium injection,,,26.59,84.58,5
APC,1850,Gamma globulin 1 cc inj,,,62.08,91.35,5
APC,1851,Gamma globulin > 10 cc inj,,,281.97,838.02,5
APC,1852,Interferon beta-1a inj,,,2743.32,4104.61,5
APC,1853,Minocycline hydrochloride,,,3.22,4.97,5
APC,1856,Factor viii recomb novoeight,,,1.72,2.87,5
APC,1857,"Inj, factor x, (human), 1iu",,,11.35,18.21,5
APC,1859,Argatroban nonesrd use 1mg,,,1.31,2.11,5
APC,1861,"Inj., bendeka 1 mg",,,16.12,25.14,5
APC,1901,"New Technology - Level 49 ($100,001-$115,000)",,,133858.33,200281.01,5
APC,1902,"New Technology - Level 49 ($100,001-$115,000)",,,133858.33,200281.01,5
APC,1903,"New Technology - Level 50 ($115,001-$130,000)",,,152536.15,228227.07,5
APC,1904,"New Technology - Level 50 ($115,001-$130,000)",,,152536.15,228227.07,5
APC,1905,"New Technology - Level 51 ($130,001-$145,000)",,,171213.97,256173.12,5
APC,1906,"New Technology - Level 51 ($130,001-$145,000)",,,171213.97,256173.12,5
APC,1907,"New Technology - Level 52 ($145,001-$160,000)",,,189891.79,284119.18,5
APC,1908,"New Technology - Level 52 ($145,001-$160,000)",,,189891.79,284119.18,5
APC,2616,"Brachytx, non-str,Yttrium-90",,,21772.24,32576.35,5
APC,2632,Iodine I-125 sodium iodide,,,259.72,388.59,5
APC,2634,"Brachytx, non-str, HA, I-125",,,202.77,303.39,5
APC,2635,"Brachytx, non-str, HA, P-103",,,86.39,129.27,5
APC,2636,"Brachy linear, non-str,P-103",,,65.88,98.58,5
APC,2638,"Brachytx, stranded, I-125",,,46.12,69.01,5
APC,2639,"Brachytx, non-stranded,I-125",,,43.72,65.42,5
APC,2640,"Brachytx, stranded, P-103",,,86.78,129.85,5
APC,2641,"Brachytx, non-stranded,P-103",,,99.33,148.62,5
APC,2642,"Brachytx, stranded, C-131",,,134.31,200.95,5
APC,2643,"Brachytx, non-stranded,C-131",,,120.24,179.9,5
APC,2645,"Brachytx, non-str, Gold-198",,,1081.23,1617.77,5
APC,2646,"Brachytx, non-str, HDR Ir-192",,,426.34,637.91,5
APC,2647,"Brachytx, NS, Non-HDRIr-192",,,702.91,1051.72,5
APC,2648,"Brachytx planar, p-103",,,5.84,8.74,5
APC,2698,"Brachytx, stranded, NOS",,,46.12,69.01,5
APC,2699,"Brachytx, non-stranded, NOS",,,43.72,65.42,5
APC,2731,"Immune globulin, powder",,,102.34,146.79,5
APC,2770,Quinupristin/dalfopristin,,,5.3,7.94,5
APC,4001,Echo guidance radiotherapy,,,173.5,259.61,5
APC,4002,Stereoscopic x-ray guidance,,,65.66,98.25,5
APC,4003,"Radiation treatment delivery, MeV <= 5; simple",,,180.68,270.33,5
APC,4004,"Radiation treatment delivery, 6-10 MeV; simple",,,146.45,219.13,5
APC,4005,"Radiation treatment delivery, 11-19 MeV; simple",,,146.45,219.13,5
APC,4006,"Radiation treatment delivery, MeV>=20; simple",,,145.65,217.93,5
APC,4007,"Radiation treatment delivery, MeV<=5; intermediate",,,259.86,388.81,5
APC,4008,"Radiation treatment delivery, 6-10 MeV; intermediate",,,201.77,301.89,5
APC,4009,"Radiation treatment delivery, 11-19 MeV; intermediate",,,203.35,304.27,5
APC,4010,"Radiation treatment delivery, MeV >=20; intermediate",,,200.15,299.48,5
APC,4011,"Radiation treatment delivery, MeV<=5; complex",,,265.82,397.73,5
APC,4012,"Radiation treatment delivery, 6-10 MeV; complex",,,266.22,398.33,5
APC,4013,"Radiation treatment delivery, 11-19 MeV; complex",,,267.43,400.14,5
APC,4014,"Radiation treatment delivery, MeV >=20; complex",,,265.82,397.73,5
APC,4015,Radiation tx delivery imrt,,,415.06,621.03,5
APC,4016,Delivery comp imrt,,,413.46,618.63,5
APC,5012,Clinic Visits and Related Services,,,160.47,240.09,5
APC,5021,Level 1 Type A ED Visits,,,109.64,164.05,5
APC,5022,Level 2 Type A ED Visits,,,197.19,295.03,5
APC,5023,Level 3 Type A ED Visits,,,344.78,515.87,5
APC,5024,Level 4 Type A ED Visits,,,530.23,793.34,5
APC,5025,Level 5 Type A ED Visits,,,763.42,1142.26,5
APC,5031,Level 1 Type B ED Visits,,,104.68,156.63,5
APC,5032,Level 2 Type B ED Visits,,,137.79,206.17,5
APC,5033,Level 3 Type B ED Visits,,,232.34,347.63,5
APC,5034,Level 4 Type B ED Visits,,,355.56,532.0,5
APC,5035,Level 5 Type B ED Visits,,,502.92,752.49,5
APC,5041,Critical Care,,,1049.21,1569.86,5
APC,5045,Trauma Response with Critical Care,,,1647.6,2465.19,5
APC,5051,Level 1 Skin Procedures,,,247.42,370.2,5
APC,5052,Level 2 Skin Procedures,,,497.49,744.36,5
APC,5053,Level 3 Skin Procedures,,,762.22,1140.45,5
APC,5054,Level 4 Skin Procedures,,,2277.74,3408.02,5
APC,5055,Level 5 Skin Procedures,,,4558.6,6820.72,5
APC,5061,Hyperbaric Oxygen,,,171.71,256.92,5
APC,5071,Level 1 Excision/ Biopsy/ Incision and Drainage,,,876.1,1310.85,5
APC,5072,Level 2 Excision/ Biopsy/ Incision and Drainage,,,2017.5,3018.65,5
APC,5073,Level 3 Excision/ Biopsy/ Incision and Drainage,,,3563.79,5332.26,5
APC,5091,Level 1 Breast/Lymphatic Surgery and Related Procedures,,,4768.17,7134.3,5
APC,5092,Level 2 Breast/Lymphatic Surgery and Related Procedures,,,8120.44,12150.07,5
APC,5093,Level 3 Breast/Lymphatic Surgery and Related Procedures,,,11915.27,17828.01,5
APC,5094,Level 4 Breast/Lymphatic Surgery and Related Procedures,,,21664.22,32414.72,5
APC,5101,Level 1 Strapping and Cast Application,,,196.48,293.98,5
APC,5102,Level 2 Strapping and Cast Application,,,330.7,494.8,5
APC,5111,Level 1 Musculoskeletal Procedures,,,298.7,446.92,5
APC,5112,Level 2 Musculoskeletal Procedures,,,1992.81,2981.72,5
APC,5113,Level 3 Musculoskeletal Procedures,,,4040.15,6045.01,5
APC,5114,Level 4 Musculoskeletal Procedures,,,8895.29,13309.42,5
APC,5115,Level 5 Musculoskeletal Procedures,,,16021.61,23972.06,5
APC,5116,Level 6 Musculoskeletal Procedures,,,22899.07,34262.34,5
APC,5151,Level 1 Airway Endoscopy,,,241.74,361.7,5
APC,5152,Level 2 Airway Endoscopy,,,483.52,723.46,5
APC,5153,Level 3 Airway Endoscopy,,,2147.29,3212.85,5
APC,5154,Level 4 Airway Endoscopy,,,4590.95,6869.13,5
APC,5155,Level 5 Airway Endoscopy,,,8619.78,12897.19,5
APC,5161,Level 1 ENT Procedures,,,289.16,432.65,5
APC,5162,Level 2 ENT Procedures,,,634.11,948.79,5
APC,5163,Level 3 ENT Procedures,,,1844.47,2759.77,5
APC,5164,Level 4 ENT Procedures,,,4038.23,6042.13,5
APC,5165,Level 5 ENT Procedures,,,7366.11,11021.41,5
APC,5166,Cochlear Implant Procedure,,,39606.72,59260.88,5
APC,5181,Level 1 Vascular Procedures,,,769.85,1151.88,5
APC,5182,Level 2 Vascular Procedures,,,1934.32,2894.2,5
APC,5183,Level 3 Vascular Procedures,,,3919.23,5864.07,5
APC,5184,Level 4 Vascular Procedures,,,6731.11,10071.32,5
APC,5191,Level 1 Endovascular Procedures,,,4005.04,5992.48,5
APC,5192,Level 2 Endovascular Procedures,,,7099.46,10622.45,5
APC,5193,Level 3 Endovascular Procedures,,,14121.14,21128.51,5
APC,5194,Level 4 Endovascular Procedures,,,22359.49,33455.01,5
APC,5200,Implantation Wireless PA Pressure Monitor,,,35398.62,52964.57,5
APC,5211,Level 1 Electrophysiologic Procedures,,,1511.65,2261.78,5
APC,5212,Level 2 Electrophysiologic Procedures,,,9448.61,14137.33,5
APC,5213,Level 3 Electrophysiologic Procedures,,,30547.33,45705.92,5
APC,5221,Level 1 Pacemaker and Similar Procedures,,,4531.61,6780.35,5
APC,5222,Level 2 Pacemaker and Similar Procedures,,,10305.15,15418.91,5
APC,5223,Level 3 Pacemaker and Similar Procedures,,,13031.3,19497.86,5
APC,5224,Level 4 Pacemaker and Similar Procedures,,,23747.18,35531.32,5
APC,5231,Level 1 ICD and Similar Procedures,,,27949.73,41819.31,5
APC,5232,Level 2 ICD and Similar Procedures,,,39922.69,59733.65,5
APC,5241,Level 1 Blood Product Exchange and Related Services,,,544.37,814.5,5
APC,5242,Level 2 Blood Product Exchange and Related Services,,,2041.21,3054.13,5
APC,5243,Level 3 Blood Product Exchange and Related Services,,,5833.92,8728.9,5
APC,5244,Level 4 Blood Product Exchange and Related Services,,,73643.32,110187.57,5
APC,5301,Level 1 Upper GI Procedures,,,1167.44,1746.76,5
APC,5302,Level 2 Upper GI Procedures,,,2362.11,3534.27,5
APC,5303,Level 3 Upper GI Procedures,,,4737.36,7088.19,5
APC,5311,Level 1 Lower GI Procedures,,,1135.25,1698.6,5
APC,5312,Level 2 Lower GI Procedures,,,1468.18,2196.74,5
APC,5313,Level 3 Lower GI Procedures,,,3414.79,5109.33,5
APC,5331,Complex GI Procedures,,,7412.37,11090.62,5
APC,5341,Level 1 Abdominal/Peritoneal/Biliary and Related Procedures,,,4394.34,6574.96,5
APC,5342,Level 2 Abdominal/Peritoneal/Biliary and Related Procedures,,,7769.66,11625.23,5
APC,5361,Level 1 Laparoscopy and Related Services,,,7264.88,10869.95,5
APC,5362,Level 2 Laparoscopy and Related Services,,,12963.93,19397.06,5
APC,5371,Level 1 Urology and Related Services,,,302.84,453.12,5
APC,5372,Level 2 Urology and Related Services,,,831.13,1243.55,5
APC,5373,Level 3 Urology and Related Services,,,2550.78,3816.55,5
APC,5374,Level 4 Urology and Related Services,,,4294.62,6425.74,5
APC,5375,Level 5 Urology and Related Services,,,6330.06,9471.25,5
APC,5376,Level 6 Urology and Related Services,,,11514.44,17228.28,5
APC,5377,Level 7 Urology and Related Services,,,16178.01,24206.07,5
APC,5378,Level 8 Urology and Related Services,,,25063.84,37501.36,5
APC,5401,Dialysis,,,871.28,1303.64,5
APC,5411,Level 1 Gynecologic Procedures,,,250.49,374.81,5
APC,5412,Level 2 Gynecologic Procedures,,,378.77,566.74,5
APC,5413,Level 3 Gynecologic Procedures,,,1084.23,1622.28,5
APC,5414,Level 4 Gynecologic Procedures,,,3959.11,5923.75,5
APC,5415,Level 5 Gynecologic Procedures,,,6146.81,9197.06,5
APC,5416,Level 6 Gynecologic Procedures,,,9207.93,13777.21,5
APC,5431,Level 1 Nerve Procedures,,,2431.57,3638.2,5
APC,5432,Level 2 Nerve Procedures,,,7974.27,11931.37,5
APC,5441,Level 1 Nerve Injections,,,367.57,549.97,5
APC,5442,Level 2 Nerve Injections,,,862.32,1290.23,5
APC,5443,Level 3 Nerve Injections,,,1108.58,1658.69,5
APC,5461,Level 1 Neurostimulator and Related Procedures,,,4282.21,6407.19,5
APC,5462,Level 2 Neurostimulator and Related Procedures,,,8172.04,12227.28,5
APC,5463,Level 3 Neurostimulator and Related Procedures,,,15527.88,23233.33,5
APC,5464,Level 4 Neurostimulator and Related Procedures,,,26702.3,39952.85,5
APC,5465,Level 5 Neurostimulator and Related Procedures,,,37945.35,56775.08,5
APC,5471,Implantation of Drug Infusion Device,,,22007.6,32928.49,5
APC,5481,Laser Eye Procedures,,,683.11,1022.1,5
APC,5491,Level 1 Intraocular Procedures,,,2839.94,4249.21,5
APC,5492,Level 2 Intraocular Procedures,,,5009.22,7494.95,5
APC,5493,Level 3 Intraocular Procedures,,,6424.81,9613.01,5
APC,5494,Level 4 Intraocular Procedures,,,17792.88,26622.28,5
APC,5495,Level 5 Intraocular Procedures,,,19132.1,28626.08,5
APC,5496,Level 6 Intraocular Procedures,,,20441.55,30585.33,5
APC,5501,"Level 1 Extraocular, Repair, and Plastic Eye Procedures",,,372.22,556.93,5
APC,5502,"Level 2 Extraocular, Repair, and Plastic Eye Procedures",,,1206.01,1804.47,5
APC,5503,"Level 3 Extraocular, Repair, and Plastic Eye Procedures",,,2904.97,4346.51,5
APC,5504,"Level 4 Extraocular, Repair, and Plastic Eye Procedures",,,4695.6,7025.72,5
APC,5521,Level 1 Imaging without Contrast,,,109.64,164.04,5
APC,5522,Level 2 Imaging without Contrast,,,132.41,198.13,5
APC,5523,Level 3 Imaging without Contrast,,,300.99,450.35,5
APC,5524,Level 4 Imaging without Contrast,,,682.74,1021.53,5
APC,5571,Level 1 Imaging with Contrast,,,221.67,331.66,5
APC,5572,Level 2 Imaging with Contrast,,,444.69,665.37,5
APC,5573,Level 3 Imaging with Contrast,,,983.77,1471.95,5
APC,5591,Level 1 Nuclear Medicine and Related Services,,,500.35,748.65,5
APC,5592,Level 2 Nuclear Medicine and Related Services,,,670.25,1002.84,5
APC,5593,Level 3 Nuclear Medicine and Related Services,,,1625.57,2432.23,5
APC,5594,Level 4 Nuclear Medicine and Related Services,,,1816.22,2717.49,5
APC,5611,Level 1 Therapeutic Radiation Treatment Preparation,,,165.32,247.37,5
APC,5612,Level 2 Therapeutic Radiation Treatment Preparation,,,455.83,682.03,5
APC,5613,Level 3 Therapeutic Radiation Treatment Preparation,,,1703.74,2549.2,5
APC,5621,Level 1 Radiation Therapy,,,136.35,204.01,5
APC,5622,Level 2 Radiation Therapy,,,327.46,489.95,5
APC,5623,Level 3 Radiation Therapy,,,720.3,1077.75,5
APC,5624,Level 4 Radiation Therapy,,,863.92,1292.62,5
APC,5625,Level 5 Radiation Therapy,,,1588.25,2376.39,5
APC,5626,Level 6 Radiation Therapy,,,2186.44,3271.42,5
APC,5627,Level 7 Radiation Therapy,,,9518.83,14242.39,5
APC,5661,Therapeutic Nuclear Medicine,,,279.08,417.57,5
APC,5671,Level 1 Pathology,,,66.53,99.55,5
APC,5672,Level 2 Pathology,,,213.38,319.27,5
APC,5673,Level 3 Pathology,,,447.92,670.19,5
APC,5674,Level 4 Pathology,,,1017.19,1521.97,5
APC,5691,Level 1 Drug Administration,,,57.45,85.96,5
APC,5692,Level 2 Drug Administration,,,88.62,132.6,5
APC,5693,Level 3 Drug Administration,,,262.35,392.53,5
APC,5694,Level 4 Drug Administration,,,413.02,617.97,5
APC,5721,Level 1 Diagnostic Tests and Related Services,,,194.82,291.49,5
APC,5722,Level 2 Diagnostic Tests and Related Services,,,387.75,580.16,5
APC,5723,Level 3 Diagnostic Tests and Related Services,,,660.7,988.56,5
APC,5724,Level 4 Diagnostic Tests and Related Services,,,1266.84,1895.49,5
APC,5731,Level 1 Minor Procedures,,,30.49,45.64,5
APC,5732,Level 2 Minor Procedures,,,48.87,73.13,5
APC,5733,Level 3 Minor Procedures,,,73.96,110.66,5
APC,5734,Level 4 Minor Procedures,,,160.5,240.16,5
APC,5735,Level 5 Minor Procedures,,,496.88,743.45,5
APC,5741,Level 1 Electronic Analysis of Devices,,,46.43,69.48,5
APC,5742,Level 2 Electronic Analysis of Devices,,,114.3,171.01,5
APC,5743,Level 3 Electronic Analysis of Devices,,,373.44,558.76,5
APC,5771,Cardiac Rehabilitation,,,156.78,234.58,5
APC,5781,Resuscitation and Cardioversion,,,814.83,1219.18,5
APC,5791,Pulmonary Treatment,,,253.26,378.94,5
APC,5801,Ventilation Initiation and Management,,,823.19,1231.69,5
APC,5811,Manipulation Therapy,,,31.5,47.13,5
APC,5821,Level 1 Health and Behavior Services,,,37.09,55.5,5
APC,5822,Level 2 Health and Behavior Services,,,115.18,172.34,5
APC,5823,Level 3 Health and Behavior Services,,,200.06,299.35,5
APC,5851,Intensive Outpatient (3 services) for CMHCs,,,138.51,207.25,5
APC,5852,Intensive Outpatient (4 or more services) for CMHCs,,,209.59,313.6,5
APC,5853,Partial Hospitalization (3 services) for CMHCs,,,138.51,207.25,5
APC,5854,Partial Hospitalization (4 or more services) for CMHCs,,,209.59,313.6,5
APC,5861,Intensive Outpatient (3 services) for Hospital-based IOPs,,,335.19,501.53,5
APC,5862,Intensive Outpatient (4 or more services) for Hospital-based IOPs,,,508.72,761.16,5
APC,5863,Partial Hospitalization (3 services) for Hospital-based PHPs,,,335.19,501.53,5
APC,5864,Partial Hospitalization (4 or more services) for Hospital-based PHPs,,,508.72,761.16,5
APC,5871,Dental Procedures,,,2070.29,3097.63,5
APC,5881,Ancillary Outpatient Services When Patient Dies,,,16825.98,25175.57,5
APC,7043,Infliximab not biosimil 10mg,,,40.12,57.93,5
APC,7046,Doxorubicin inj 10mg,,,165.71,223.71,5
APC,7048,Alteplase recombinant,,,113.9,175.96,5
APC,7308,Aminolevulinic acid hcl top,,,494.3,730.49,5
APC,8004,Ultrasound Composite,,,381.65,571.04,5
APC,8005,CT and CTA without Contrast Composite,,,279.61,418.37,5
APC,8006,CT and CTA with Contrast Composite,,,541.81,810.66,5
APC,8007,MRI and MRA without Contrast Composite,,,672.74,1006.57,5
APC,8008,MRI and MRA with Contrast Composite,,,1064.42,1592.62,5
APC,8010,Mental Health Services Composite,,,508.72,761.16,5
APC,8011,Comprehensive Observation Services,,,3296.92,4932.96,5
APC,9002,Tenecteplase injection,,,196.4,320.86,5
APC,9003,Palivizumab,,,896.37,1341.17,5
APC,9004,"Injection, inclisiran, 1 mg",,,15.17,22.94,5
APC,9005,Reteplase injection,,,3458.06,5411.44,5
APC,9006,Tacrolimus injection,,,317.24,490.27,5
APC,9008,"Inj tezepelumab-ekko, 1mg",,,22.55,33.56,5
APC,9009,"Inj, vutrisiran, 1 mg",,,6133.8,9322.14,5
APC,9010,Inj efgartigimod 2mg,,,40.55,59.89,5
APC,9012,Arsenic trioxide injection,,,8.96,15.18,5
APC,9013,Inj risankizumab-rzaa 1 mg,,,18.22,27.84,3
APC,9013,Inj risankizumab-rzaaá1 mg,,,18.22,24.6,2
APC,9016,"Inj., triptorelin xr 3.75 mg",,,4256.67,7111.86,5
APC,9017,"Inj. byooviz, 0.1 mg",,,102.21,287.11,5
APC,9018,"Inj, rimabotulinumtoxinB",,,16.17,24.75,5
APC,9020,Argatroban nonesrd (accord),,,3.01,7.06,5
APC,9022,Argatroban nonesrd (auromed),,,1.85,3.02,5
APC,9024,Amphotericin b lipid complex,,,13.86,19.19,5
APC,9025,"Inj glucagon hcl, fresenius",,,135.63,277.57,5
APC,9026,"Inj, bortezomib, dr. reddy?s",,,8.13,9.15,2
APC,9026,"Inj, bortezomib, dr. reddyÆs",,,60.45,81.61,2
APC,9026,"Inj, bortezomib, dr. reddy’s",,,60.45,60.45,1
APC,9027,"Inj, bortezomib freseniuskab",,,20.55,30.73,5
APC,9028,Inj inotuzumab ozogam 0.1 mg,,,3260.96,5026.66,5
APC,9029,"Inj., guselkumab, 1 mg",,,92.73,141.54,5
APC,9032,Baclofen 10 MG injection,,,217.39,337.63,5
APC,9033,Cidofovir injection,,,657.46,1017.78,5
APC,9034,"Inj cuvitru, 100 mg",,,20.94,31.38,5
APC,9035,Axicabtagene ciloleucel car+,,,609464.69,993445.42,5
APC,9036,"Injection, renflexis",,,33.85,50.3,5
APC,9038,Inj estrogen conjugate,,,476.64,730.44,5
APC,9042,Glucagon hydrochloride,,,239.45,339.92,5
APC,9043,"Inj, afstyla, 1 i.u.",,,1.82,2.92,5
APC,9044,Ibutilide fumarate injection,,,284.99,405.8,5
APC,9045,Idursulfase injection,,,669.82,1040.44,5
APC,9046,"Inj., fibryga, 1 mg",,,1.38,2.28,5
APC,9048,"Inj, alymsys, 10 mg",,,62.55,95.58,5
APC,9050,"Leuprolide inj, camcevi, 1mg",,,68.48,147.03,5
APC,9051,"Inj, lanreotide, (cipla) 1mg",,,45.83,61.87,5
APC,9053,Fluorodopa f-18 diag per mci,,,620.88,1628.02,5
APC,9054,Lutetium lu 177 vipivotide,,,300.39,476.64,5
APC,9055,Gallium locametz 1 millicuri,,,630.2,1468.26,5
APC,9057,Inj nivol relatlimab 3mg/1mg,,,237.16,368.58,5
APC,9059,Vonvendi inj 1 iu vwf:rco,,,2.33,3.46,5
APC,9067,Lutetium lu 177 dotatat ther,,,368.89,590.58,5
APC,9068,Smallpox&monkeypox vac 0.5ml,,,0.01,0.02,5
APC,9070,Inj luxturna 1 billion vec g,,,3840.74,5594.03,5
APC,9071,Capsaicin 8% patch,,,4.14,6.38,5
APC,9073,Buprenorph xr 100 mg or less,,,2419.47,3756.73,5
APC,9075,"Inj, kovaltry, 1 i.u.",,,1.84,2.92,5
APC,9077,Epoetin beta non esrd,,,1.44,2.72,5
APC,9078,Testosterone undecanoate 1mg,,,2.42,3.85,5
APC,9079,"Genvisc 850, inj, 1mg",,,7.34,10.75,5
APC,9080,Fludarabine phosphate inj,,,112.8,225.51,5
APC,9088,Peng benzathine/procaine inj,,,24.31,36.37,5
APC,9094,Radiesse injection,,,415.17,621.18,5
APC,9095,"Inj, sculptra, 0.5mg",,,1.25,1.86,5
APC,9096,Inj retacrit esrd on dialysi,,,0.95,1.46,5
APC,9097,Inj retacrit non-esrd use,,,9.49,14.62,5
APC,9099,"Inj fosnetupitant, palonoset",,,846.12,1142.26,5
APC,9101,Vaccinia vrs vac 0.3 ml perq,,,0.01,0.02,5
APC,9102,"Inj, fulvestrant (teva)",,,26.4,86.09,5
APC,9103,"Inj, fulvestrant (fresenius)",,,44.28,89.09,5
APC,9104,Antithymocyte globuln rabbit,,,1191.32,1861.89,5
APC,9105,Inj pemetrexed (teva) 10mg,,,6.87,28.96,5
APC,9106,"Inj, bupivacaine (posimir)",,,0.63,0.95,5
APC,9107,"Inj, aponvie, 1 mg",,,2.32,3.56,5
APC,9108,Thyrotropin injection,,,2581.7,3942.86,5
APC,9109,"Inj, elahere, 1 mg",,,83.13,129.47,5
APC,9110,"Inj, tremelimumab-actl, 1 mg",,,168.66,262.5,5
APC,9111,Inj teclistamab cqyv 0.5 mg,,,39.82,62.55,5
APC,9112,Inj teplizumab mzwv 5 mcg,,,45.95,70.17,5
APC,9113,Inj olipudase alfa-rpcp 1mg,,,476.36,733.41,5
APC,9114,Inj eflapegrastim-xnst 0.1mg,,,28.33,38.89,5
APC,9115,"Inj, spesolimab-sbzo, 1 mg",,,76.49,122.45,5
APC,9116,"Chloroprocaine opht gel, 1mg",,,0.78,1.08,5
APC,9117,"Inj, cimerli, 0.1 mg",,,142.5,337.9,5
APC,9118,"Inj, fylnetra, 0.5 mg",,,228.2,312.98,5
APC,9119,Inj sodium thiosulfate 100mg,,,119.64,177.19,5
APC,9120,"Injection, Fulvestrant",,,9.35,12.62,5
APC,9122,Triptorelin pamoate,,,581.16,884.66,5
APC,9123,"Inj pemetrexed, hospira 10mg",,,0.77,6.61,5
APC,9125,"Risperidone, long acting",,,14.07,20.45,5
APC,9126,Natalizumab injection,,,30.08,44.71,5
APC,9127,Inj pemetrexed (accord) 10mg,,,12.02,18.14,5
APC,9129,"Inj, stimufend, 0.5 mg",,,305.85,513.81,5
APC,9131,"Inj, Ado-trastuzumab Emt 1mg",,,50.36,78.55,5
APC,9132,Prothrombin complex kcentra,,,2.79,3.99,5
APC,9133,"Rabies ig, im/sc",,,358.25,521.38,5
APC,9134,"Rabies ig, heat treated",,,574.47,806.41,5
APC,9135,"Varicella-zoster ig, im",,,2802.55,4400.24,5
APC,9136,Leuprolide depot cipla 7.5mg,,,320.89,1316.56,5
APC,9138,"Inj, hemgenix, per tx dose",,,4573451.01,6865911.76,5
APC,9139,"Rabies vaccine, im",,,435.99,588.59,5
APC,9140,"Rabies vaccine, id",,,329.31,492.72,5
APC,9141,Inj onase abepar-xioi treat,,,2974273.78,4574044.23,5
APC,9142,Fecal microbiota jslm 1 ml,,,78.82,118.93,3
APC,9142,Fecalámicrobiota jslm 1 ml,,,78.82,106.41,2
APC,9144,"Inj, panzyga, 500 mg",,,84.0,135.99,5
APC,9145,"Inj, invega hafyera/trinza",,,15.76,24.21,5
APC,9146,"Inj, ixinity, 1 i.u.",,,2.25,3.57,5
APC,9149,"Inj ublituximab-xiiy, 1 mg",,,86.46,131.82,5
APC,9150,"Inj mosunetuzumab-axgb, 1 mg",,,791.27,1219.63,5
APC,9154,"Inj, bendamustine, 1 mg",,,34.67,55.62,5
APC,9155,"Inj, lenacapavir, 1 mg",,,27.39,41.27,5
APC,9156,Inj pemetrexed ditromethamin,,,0.21,17.74,5
APC,9157,"Inj, lecanemab-irmb, 1 mg",,,1.66,2.46,5
APC,9158,"Inj, pegcetacoplan, 1mg",,,183.49,259.31,5
APC,9159,"Inj, vegzelma, 10 mg",,,66.11,95.52,5
APC,9166,"Inj, fosaprepitant (teva)",,,1.71,3.43,5
APC,9171,Factor ix idelvion inj,,,6.29,9.92,5
APC,9173,"Injection, fulphila",,,163.96,227.83,5
APC,9174,"Inj, durolane 1 mg",,,8.72,12.63,5
APC,9178,"Inj., meropenem, vaborbactam",,,2.61,4.07,5
APC,9179,"Inj., aristada initio, 1 mg",,,3.97,6.05,5
APC,9180,"Inj., patisiran, 0.1 mg",,,123.12,186.25,5
APC,9181,"Inj., perseris, 0.5 mg",,,15.18,22.63,5
APC,9182,"Inj mogamulizumab-kpkc, 1 mg",,,297.41,462.97,5
APC,9183,"Inj., plazomicin, 5 mg",,,4.47,6.53,5
APC,9186,"Inj., rituximab, 10 mg",,,96.27,140.15,5
APC,9187,"Injection, burosumab-twza 1m",,,584.71,901.99,5
APC,9188,Inj crotalidae im f(ab')2 eq,,,1295.14,1947.19,5
APC,9189,"Inj., ibalizumab-uiyk, 10 mg",,,95.96,147.67,5
APC,9193,Nivestym,,,0.34,0.56,5
APC,9194,Tisagenlecleucel car-pos t,,,658944.59,1102427.65,5
APC,9195,"Injection, udenyca 0.5 mg",,,175.88,241.02,5
APC,9196,"Inj, trivisc 1 mg",,,7.76,11.2,5
APC,9198,"Inj andexxa, 10 mg",,,164.36,244.76,5
APC,9200,"Inj, remdesivir, 1 mg",,,7.91,12.54,5
APC,9201,Rabies ig ht&sol human im/sc,,,330.6,446.31,5
APC,9203,Inj cyclophosphamd auromedic,,,1.05,1.95,5
APC,9204,"Inj tisotu vedotin-tftv, 1mg",,,226.12,351.68,5
APC,9205,Inj lon tesirin-lpyl 0.075mg,,,256.98,404.11,5
APC,9206,Inj plasminogen tvmh 1mg,,,40.53,61.05,5
APC,9208,Agalsidase beta injection,,,278.33,428.8,5
APC,9209,Laronidase injection,,,48.19,74.28,5
APC,9213,Inj. pemetrexed nos 10mg,,,5.21,8.11,5
APC,9214,Bevacizumab injection,,,90.53,136.38,5
APC,9215,Cetuximab injection,,,93.99,146.01,5
APC,9217,Leuprolide acetate suspnsion,,,219.79,328.74,5
APC,9219,Procainamide hcl injection,,,487.42,917.94,5
APC,9225,Fluocinolone acetonide implt,,,415.25,634.04,5
APC,9230,Abatacept injection,,,54.09,82.18,5
APC,9233,Ranibizumab injection,,,142.89,230.53,5
APC,9235,Panitumumab injection,,,198.39,322.38,5
APC,9237,"Inj, lanreotide acetate",,,56.31,84.0,5
APC,9239,Buprenorphine xr over 100 mg,,,2419.47,3756.73,5
APC,9240,"Injection, ixabepilone",,,166.93,259.36,5
APC,9241,Inj sirolimus prot part 1 mg,,,139.88,191.98,5
APC,9243,"Inj., treanda 1 mg",,,3.11,9.13,5
APC,9246,"Inj, abilify asimtufii, 1 mg",,,7.41,11.23,5
APC,9247,"Inj, amisulpride, 1 mg",,,11.28,17.91,5
APC,9250,Inj epcoritamab-bysp 0.16 mg,,,67.45,104.03,5
APC,9251,C1 esterase inhibitor inj,,,79.96,122.27,5
APC,9252,Plerixafor injection,,,41.9,84.84,5
APC,9253,Temozolomide injection,,,12.95,19.35,5
APC,9254,Flotufolastat f18 diag 1 mci,,,811.45,1250.53,5
APC,9255,"Inj, invega sustenna, 1 mg",,,18.38,28.16,5
APC,9256,Dexamethasone intra implant,,,256.04,381.2,5
APC,9257,"Inj., emicizumab-kxwh 0.5 mg",,,65.77,104.51,5
APC,9258,Telavancin injection,,,7.94,13.26,5
APC,9259,Pralatrexate injection,,,465.41,731.5,5
APC,9260,Ofatumumab injection,,,79.64,115.94,5
APC,9261,"Ustekinumab sub cu inj, 1 mg",,,199.12,278.35,5
APC,9262,Inj tofersen intrathec 1 mg,,,191.34,296.97,5
APC,9263,Ecallantide injection,,,704.56,1080.51,5
APC,9264,Tocilizumab injection,,,7.42,10.63,5
APC,9266,"Inj, uzedy, 1 mg",,,30.84,46.65,5
APC,9267,"Inj, rezafungin, 1 mg",,,12.6,19.8,5
APC,9269,"C-1 esterase, berinert",,,85.12,141.33,5
APC,9270,Gammaplex IVIG,,,72.13,118.65,5
APC,9271,Velaglucerase alfa,,,460.97,710.5,5
APC,9272,"Inj, denosumab",,,33.57,54.74,5
APC,9273,Sipuleucel-T auto CD54+,,,68504.3,102976.25,5
APC,9274,Crotalidae Poly Immune Fab,,,2194.45,3407.03,5
APC,9276,Cabazitaxel injection,,,269.53,423.43,5
APC,9277,Altuviiio per factor viii iu,,,5.84,8.69,5
APC,9278,Incobotulinumtoxin A,,,6.65,10.38,5
APC,9280,"Inj, retifanlimab-dlwr, 1 mg",,,36.36,56.93,5
APC,9281,"Injection, pegloticase",,,4335.94,6820.38,5
APC,9284,Ipilimumab injection,,,220.25,341.83,5
APC,9285,Inj allopurinol sodium 1 mg,,,6.23,8.79,5
APC,9286,Belatacept injection,,,4.75,7.24,5
APC,9287,Brentuximab vedotin inj,,,298.67,481.86,5
APC,9294,"Inj, taliglucerase alfa 10 u",,,53.02,76.59,5
APC,9295,"Injection, Carfilzomib, 1 mg",,,61.73,103.68,5
APC,9296,"Inj, ziv-aflibercept, 1mg",,,8.1,14.69,5
APC,9299,Inj. jivi 1 iu,,,3.04,4.93,5
APC,9300,Omalizumab injection,,,47.68,83.08,5
APC,9301,"Aminolevulinic acid, 10% gel",,,2.15,3.34,5
APC,9302,"Inj daunorubicin, cytarabine",,,301.95,477.11,5
APC,9304,"Inj., cemiplimab-rwlc, 1 mg",,,35.16,54.57,5
APC,9305,"Inj., lumoxiti, 0.01 mg",,,29.13,43.59,5
APC,9306,"Inj., tildrakizumab, 1 mg",,,169.25,237.45,5
APC,9309,Inj. tagraxofusp-erzs 10 mcg,,,422.16,664.99,5
APC,9310,"Inj., emapalumab-lzsg, 1 mg",,,470.72,717.0,5
APC,9311,"Inj., omadacycline, 1 mg",,,4.73,7.49,5
APC,9312,"Inj., ravulizumab-cwvz 10 mg",,,274.88,419.4,5
APC,9313,Inj. belrapzo/bendamustine,,,20.32,46.28,5
APC,9314,"Inj. herceptin hylecta, 10mg",,,79.43,114.46,5
APC,9319,Somatropin injection,,,60.91,91.14,5
APC,9320,Carbidopa levodopa ent 100ml,,,292.69,453.85,5
APC,9327,Inj. romosozumab-aqqg 1 mg,,,13.91,22.49,5
APC,9328,"Inj., yutiq, 0.01 mg",,,657.42,987.23,5
APC,9329,Inj mvasi 10 mg,,,33.1,51.92,5
APC,9330,"Inj., kanjinti, 10 mg",,,30.3,88.58,5
APC,9331,"Inj, polatuzumab vedotin 1mg",,,161.6,254.61,5
APC,9336,Inj truxima 10 mg,,,41.83,56.47,5
APC,9338,"Inj., triluron, 1 mg",,,12.9,19.14,5
APC,9340,"Inj, brolucizumab-dbll, 1 mg",,,414.11,644.82,5
APC,9341,Inj ogivri 10 mg,,,66.65,91.04,5
APC,9343,Inj givosiran 0.5 mg,,,139.63,218.64,5
APC,9345,Inj pegfilgrastim-bmez 0.5mg,,,50.16,582.9,5
APC,9346,Mometasone sinus sinuva,,,14.13,21.13,5
APC,9347,Inj luspatercept-aamt 0.25mg,,,50.57,78.21,5
APC,9348,"Inj., zirabev, 10 mg",,,29.37,48.01,5
APC,9349,Inj herzuma 10 mg,,,75.26,129.23,5
APC,9350,"Inj., trazimera, 10 mg",,,23.87,52.15,5
APC,9351,Inj bimatoprost itc imp 1mcg,,,261.32,398.4,5
APC,9353,Inj fam-trastu deru-nxki 1mg,,,34.63,55.85,5
APC,9354,Inj recombin esperoct per iu,,,2.7,4.14,5
APC,9355,Inj. teprotumumab-trbw 10 mg,,,428.2,669.2,5
APC,9357,Inj. eptinezumab-jjmr 1 mg,,,23.28,37.21,5
APC,9358,Inj xipere 1 mg,,,60.27,89.38,5
APC,9359,Inj crizanlizumab-tmca 5mg,,,160.05,241.24,5
APC,9361,Inj. cetirizine hcl 0.5mg,,,18.52,30.77,5
APC,9362,Inj imip 4 cilas 4 releb 2mg,,,3.13,4.85,5
APC,9364,Inj enfort vedo-ejfv 0.25mg,,,45.75,68.46,5
APC,9366,Fiasp for insulin pump use,,,9.23,15.38,5
APC,9367,"Inj ruxience, 10 mg",,,27.94,51.88,5
APC,9372,"Inj. xembify, 100 mg",,,17.8,27.66,5
APC,9374,Mitomycin instillation,,,382.7,593.45,5
APC,9375,"Inj., evomela, 1 mg",,,21.61,34.46,5
APC,9376,Sacituzumab govitecan-hziy,,,43.17,67.58,5
APC,9377,Inj. isatuximab-irfc 10 mg,,,97.19,152.59,5
APC,9378,"Daratumumab, hyaluronidase",,,64.02,103.53,5
APC,9381,"Inj. avsola, 10 mg",,,26.51,38.01,5
APC,9382,Inj ontruzant 10 mg,,,31.43,57.43,5
APC,9385,"Inj., tafasitamab-cxix",,,17.07,26.66,5
APC,9388,Inj. fe derisomaltose 10 mg,,,26.21,41.02,5
APC,9389,"Inj. lurbinectedin, 0.1 mg",,,253.53,385.89,5
APC,9390,"Pertuzu, trastuzu, 10 mg",,,80.41,115.69,5
APC,9391,Brexucabtagene car pos t,,,573446.93,911609.0,5
APC,9392,Inj. asceniv,,,611.89,925.46,5
APC,9394,"Inj. inebilizumab-cdon, 1 mg",,,603.17,923.23,5
APC,9396,"Afamelanotide implant, 1 mg",,,3577.83,5483.8,5
APC,9398,"Covid-19 Vaccine Admin Dose 2 of 2, Single Dose Product or Additional Dose",,,51.7,77.35,5
APC,9399,"Pneumococcal, Influenza, Hepatitis B, and/or Covid-19 Vaccine Home Administration",,,45.89,68.66,5
APC,9406,"Inj, nyvepria",,,120.22,244.36,5
APC,9407,"Inj. lumasiran, 0.5 mg",,,395.82,613.05,5
APC,9408,"Inj. naxitamab-gqgk, 1 mg",,,799.59,1278.07,5
APC,9409,Gallium ga-68 psma-11 ucsf,,,666.06,996.58,5
APC,9410,"Gallium ga-68 psma-11, ucla",,,463.42,693.38,5
APC,9411,"Inj. riabni, 10 mg",,,43.85,64.96,5
APC,9412,"Injection, casimersen, 10 mg",,,206.78,309.38,5
APC,9413,lisocabtagene car pos t,,,643421.11,1048048.32,5
APC,9414,"Inj, cabote rilpivir 2mg 3mg",,,28.52,44.06,5
APC,9415,"Injection, trilaciclib, 1mg",,,6.68,10.18,5
APC,9416,"Inj, evinacumab-dgnb, 5 mg",,,231.99,360.98,5
APC,9418,"Inj. margetuximab-cmkb, 5 mg",,,60.03,97.78,5
APC,9419,Inj fensolvi 0.25 mg,,,175.1,262.67,5
APC,9421,"Inj, granisetron, xr, 0.1 mg",,,7.09,9.59,5
APC,9422,Idecabtagene vicleucel car,,,655700.55,1038322.62,5
APC,9426,"Inj, cefiderocol, 10 mg",,,2.84,4.5,5
APC,9427,"Injection, oritavancin 10 mg",,,52.92,79.14,5
APC,9428,Inj romidepsin non-lyo 0.1mg,,,42.22,56.99,5
APC,9429,Inj romidepsin lyophil 0.1mg,,,37.19,57.33,5
APC,9430,"Piflu f-18, dia 1 millicurie",,,413.95,619.37,5
APC,9431,"Inj, dostarlimab-gxly, 10 mg",,,294.36,454.05,5
APC,9432,"Inj, amivantamab-vmjw",,,25.74,42.0,5
APC,9433,Inj aval alfa-nqpt 4mg,,,96.82,150.75,5
APC,9434,Inj anifrolumab-fnia 1mg,,,21.53,33.67,5
APC,9436,Inj pegfilgrast ex bio 0.5mg,,,38.78,166.46,5
APC,9437,"Inj, aspara, rylaze, 0.1 mg",,,65.73,103.35,5
APC,9438,"Injection, aducanumab-avwa, 2 mg",,,7.44,11.13,5
APC,9439,"Inj, susvimo 0.1 mg",,,98.47,147.06,5
APC,9440,"Instill, bupivac and meloxic",,,0.96,1.5,5
APC,9441,Inj ferric carboxymaltos 1mg,,,1.37,2.06,5
APC,9442,"Inj. pemetrexed, 10 mg",,,63.29,86.3,5
APC,9443,Gallium illuccix 1 millicure,,,846.12,1724.79,5
APC,9444,"Inj, sutimlimab-jome, 10 mg",,,22.57,35.14,5
APC,9445,"Injection, ruconest",,,43.24,68.5,5
APC,9446,"Inj, tebentafusp-tebn, 1 mcg",,,267.41,404.44,5
APC,9447,"Inj, releuko 1 mcg",,,0.59,0.79,5
APC,9448,"Oral netupitant, palonosetro",,,498.38,787.87,5
APC,9449,"Injection, blinatumomab",,,189.49,306.01,5
APC,9450,Fluocinol acet intravit imp,,,616.85,928.07,5
APC,9451,"Injection, peramivir",,,2.09,3.12,5
APC,9452,Inj ceftolozane tazobactam,,,10.25,16.9,5
APC,9453,"Injection, nivolumab",,,39.53,61.42,5
APC,9454,"Inj, pasireotide long acting",,,597.49,1067.47,5
APC,9455,"Injection, siltuximab",,,195.58,308.95,5
APC,9456,"Injection, isavuconazonium",,,1.22,1.88,5
APC,9460,"Injection, cangrelor",,,23.44,37.23,5
APC,9463,"Inj., aprepitant, 1 mg",,,2.2,3.06,5
APC,9466,"Inj., benralizumab, 1 mg",,,208.32,306.64,5
APC,9467,"Inj rituximab, hyaluronidase",,,46.0,68.36,5
APC,9468,Factor ix recomb gly rebinyn,,,5.68,8.31,5
APC,9469,Inj triamcinolone ace xr 1mg,,,22.1,34.09,5
APC,9470,Aripirazole lauroxil 1 mg,,,4.02,6.23,5
APC,9471,Hymovis injection 1 mg,,,21.73,32.83,5
APC,9472,Inj talimogene laherparepvec,,,87.61,137.74,5
APC,9473,"Injection, mepolizumab, 1mg",,,37.9,58.26,5
APC,9474,Inj irinotecan liposome 1 mg,,,80.64,122.95,5
APC,9475,"Injection, necitumumab, 1 mg",,,7.14,10.68,5
APC,9476,"Injection, daratumumab 10 mg",,,81.08,132.97,5
APC,9477,"Injection, elotuzumab, 1mg",,,9.44,14.69,5
APC,9478,Inj sebelipase alfa 1 mg,,,671.68,1005.9,5
APC,9480,Injection trabectedin 0.1mg,,,451.78,728.6,5
APC,9481,"Injection, reslizumab",,,12.84,20.4,5
APC,9482,Sotalol hydrochloride IV,,,28.42,46.67,5
APC,9483,"Inj, atezolizumab,10 mg",,,107.39,170.17,5
APC,9487,"Ustekinumab, iv inject,1 mg",,,16.15,24.21,5
APC,9489,"Inj, nusinersen, 0.1mg",,,1533.95,2385.19,5
APC,9490,"Inj, bezlotoxumab, 10 mg",,,49.64,74.19,5
APC,9491,"Injection, avelumab, 10 mg",,,118.51,186.46,5
APC,9492,"Inj., durvalumab, 10 mg",,,101.88,158.59,5
APC,9493,"Injection, edaravone, 1 mg",,,27.57,39.11,5
APC,9494,"Injection, ocrelizumab",,,74.46,110.69,5
APC,9495,Gemtuzumab ozogamicin inj,,,285.99,440.83,5
APC,9496,"Inj, faricimab-svoa, 0.1mg",,,42.64,63.11,5
APC,9498,Ciltacabtagene car-pos t,,,656367.77,1054253.75,5
APC,9500,"Platelets, irradiated",,,169.07,252.97,5
APC,9501,Platelet pheres leukoreduced,,,606.53,907.52,5
APC,9502,Platelet pheresis irradiated,,,731.73,1094.85,5
APC,9503,Fr frz plasma donor retested,,,60.93,91.16,5
APC,9504,RBC deglycerolized,,,814.03,1217.98,5
APC,9505,RBC irradiated,,,185.81,278.0,5
APC,9507,"Platelets, pheresis",,,494.5,739.89,5
APC,9508,Plasma 1 donor frz w/in 8 hr,,,104.96,157.04,5
APC,9509,"Frozen plasma, pooled, sd",,,77.59,116.09,5
APC,9510,Whole blood for transfusion,,,280.32,419.41,5
APC,9511,Cryoprecipitate each unit,,,79.16,118.43,5
APC,9512,RBC leukocytes reduced,,,226.62,339.09,5
APC,9513,"Plasma, frz between 8-24hour",,,88.52,132.46,5
APC,9514,"Plasma protein fract,5%,50ml",,,10.05,15.03,5
APC,9515,"Platelets, each unit",,,94.58,141.53,5
APC,9516,Plaelet rich plasma unit,,,693.97,1038.35,5
APC,9517,Red blood cells unit,,,179.71,268.88,5
APC,9518,Washed red blood cells unit,,,494.18,739.41,5
APC,9519,"Plasmaprotein fract,5%,250ml",,,91.8,137.34,5
APC,9520,Blood split unit,,,176.57,264.18,5
APC,9521,Platelets leukoreduced irrad,,,255.75,382.66,5
APC,9522,RBC leukoreduced irradiated,,,318.52,476.58,5
APC,9523,Cryoprecipitatereducedplasma,,,183.42,274.43,5
APC,9524,"Blood, l/r, cmv-neg",,,214.42,320.83,5
APC,9525,"Platelets, hla-m, l/r, unit",,,968.12,1448.54,5
APC,9526,Platelets leukocytes reduced,,,156.61,234.33,5
APC,9527,"Blood, l/r, froz/degly/wash",,,301.88,451.69,5
APC,9528,"Plt, aph/pher, l/r, cmv-neg",,,282.97,423.38,5
APC,9529,"Blood, l/r, irradiated",,,104.81,156.81,5
APC,9530,Plate pheres leukoredu irrad,,,841.32,1258.82,5
APC,9531,"Plt, pher, l/r cmv-neg, irr",,,571.83,855.59,5
APC,9532,"RBC, frz/deg/wsh, l/r, irrad",,,604.38,904.3,5
APC,9533,"RBC, l/r, cmv-neg, irrad",,,277.5,415.21,5
APC,9534,Pathogen reduced plasma pool,,,69.87,104.53,5
APC,9535,Pathogen reduced plasma sing,,,364.25,545.01,5
APC,9536,Platelets pheresis path redu,,,731.27,1094.15,5
APC,9537,Blood component/product noc,,,60.93,91.16,5
APC,9538,Plasma cryo redu path each,,,168.29,251.8,5
APC,9539,Cryo fib comp path redu each,,,390.7,584.58,5
APC,9540,Covid-19 convalescent plasma,,,529.98,792.97,5
APR-DRG,1,Liver Transplant,,,485809.05,485809.05,3
APR-DRG,1,Liver Transplant And/Or Intestinal Transplant,,,50490.44,50490.44,4
APR-DRG,1,Liver Transplant LO/DD- Inpatient Transplant Services from Admission to Discharge,,,50490.44,50490.44,1
APR-DRG,11,Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies,,,74625.74,74625.74,4
APR-DRG,110,"Ear, Nose, Mouth, Throat And Cranial/Facial Malignancies",,,6412.54,6412.54,4
APR-DRG,111,Vertigo And Other Labyrinth Disorders,,,4791.65,4791.65,4
APR-DRG,113,Infections Of Upper Respiratory Tract,,,2748.84,2748.84,4
APR-DRG,114,Dental Diseases And Disorders,,,3289.49,3289.49,4
APR-DRG,115,"Other Ear, Nose, Mouth, Throat And Cranial/Facial Diagnoses",,,3795.16,3795.16,4
APR-DRG,120,Major Respiratory And Chest Procedures,,,16008.57,16008.57,4
APR-DRG,121,Other Respiratory And Chest Procedures,,,11608.1,11608.1,4
APR-DRG,130,Respiratory System Diagnosis With Ventilator Support > 96 Hours,,,23436.69,23436.69,4
APR-DRG,131,Cystic Fibrosis - Pulmonary Disease,,,7099.49,7099.49,4
APR-DRG,132,Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period,,,3163.34,3163.34,4
APR-DRG,133,Respiratory Failure,,,4828.76,4828.76,4
APR-DRG,134,Pulmonary Embolism,,,4756.67,4756.67,4
APR-DRG,135,Major Chest And Respiratory Trauma,,,5145.73,5145.73,4
APR-DRG,136,Respiratory Malignancy,,,5539.02,5539.02,4
APR-DRG,137,Major Respiratory Infections And Inflammations,,,5081.06,5081.06,4
APR-DRG,138,Bronchiolitis And Rsv Pneumonia,,,2414.91,2414.91,4
APR-DRG,139,Other Pneumonia,,,4076.08,4076.08,4
APR-DRG,140,Chronic Obstructive Pulmonary Disease,,,4604.01,4604.01,4
APR-DRG,141,Asthma,,,3243.91,3243.91,4
APR-DRG,142,Interstitial And Alveolar Lung Diseases,,,5084.24,5084.24,4
APR-DRG,143,"Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses",,,4382.45,4382.45,4
APR-DRG,144,"Respiratory Signs, Symptoms And Miscellaneous Diagnoses",,,4182.09,4182.09,4
APR-DRG,145,Acute Bronchitis And Related Symptoms,,,3855.58,3855.58,4
APR-DRG,160,Major Cardiothoracic Repair Of Heart Anomaly,,,26478.12,26478.12,4
APR-DRG,161,Implantable Heart Assist Systems,,,109991.74,109991.74,4
APR-DRG,162,Cardiac Valve Procedures With Ami Or Complex Pdx,,,38042.75,38042.75,4
APR-DRG,163,Cardiac Valve Procedures Without Ami Or Complex Pdx,,,31937.63,31937.63,4
APR-DRG,165,Coronary Bypass With Ami Or Complex Pdx,,,35209.1,35209.1,4
APR-DRG,166,Coronary Bypass Without Ami Or Complex Pdx,,,29768.67,29768.67,4
APR-DRG,167,Other Cardiothoracic And Thoracic Vascular Procedures,,,19975.46,19975.46,4
APR-DRG,169,Major Abdominal Vascular Procedures,,,23588.29,23588.29,4
APR-DRG,170,"Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock",,,19611.85,19611.85,4
APR-DRG,171,"Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock",,,13213.09,13213.09,4
APR-DRG,174,Percutaneous Cardiac Intervention With Ami,,,16034.01,16034.01,4
APR-DRG,175,Percutaneous Cardiac Intervention Without Ami,,,16631.91,16631.91,4
APR-DRG,176,"Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices",,,12960.78,12960.78,4
APR-DRG,177,Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,,,9740.2,9740.2,4
APR-DRG,178,External Heart Assist Systems,,,39720.89,39720.89,4
APR-DRG,179,Defibrillator Implants,,,28107.49,28107.49,4
APR-DRG,180,Other Circulatory System Procedures,,,10439.86,10439.86,4
APR-DRG,181,Lower Extremity Arterial Procedures,,,14514.89,14514.89,4
APR-DRG,182,Other Peripheral Vascular And Related Procedures,,,12388.33,12388.33,4
APR-DRG,183,Percutaneous Structural Cardiac Procedures,,,31960.95,31960.95,4
APR-DRG,190,Acute Myocardial Infarction,,,6639.41,6639.41,4
APR-DRG,191,Cardiac Catheterization For Coronary Artery Disease,,,7807.64,7807.64,4
APR-DRG,192,Cardiac Catheterization For Other Non-Coronary Conditions,,,8493.52,8493.52,4
APR-DRG,193,Acute And Subacute Endocarditis,,,8140.51,8140.51,4
APR-DRG,194,Heart Failure,,,4436.52,4436.52,4
APR-DRG,196,Cardiac Arrest And Shock,,,3610.7,3610.7,4
APR-DRG,197,Peripheral And Other Vascular Disorders,,,4138.63,4138.63,4
APR-DRG,198,Angina Pectoris And Coronary Atherosclerosis,,,3984.92,3984.92,4
APR-DRG,199,Hypertension,,,4295.53,4295.53,4
APR-DRG,2,Heart And/Or Lung Transplant,,,77825.12,77825.12,4
APR-DRG,2,Heart Lung -inpatient Transplant Services from Admission to Discharge,,,77825.12,77825.12,1
APR-DRG,2,Heart Transplant,,,621838.12,621838.12,3
APR-DRG,2,Heart Transplant - Inpatient Transplant Services from Admission to Discharge,,,77825.12,77825.12,1
APR-DRG,2,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
APR-DRG,2,Lung Transplant (Single/Double)- Inpatient Transplant Services from Admission to Discharge,,,77825.12,77825.12,1
APR-DRG,20,Open Craniotomy For Trauma,,,15930.12,15930.12,4
APR-DRG,200,Cardiac Structural And Valvular Disorders,,,3867.24,3867.24,4
APR-DRG,201,Cardiac Arrhythmia And Conduction Disorders,,,3796.22,3796.22,4
APR-DRG,203,Chest Pain,,,4004.0,4004.0,4
APR-DRG,204,Syncope And Collapse,,,4687.76,4687.76,4
APR-DRG,205,Cardiomyopathy,,,4035.8,4035.8,4
APR-DRG,206,"Malfunction, Reaction, Complication Of Cardiac/Vascular Device Or Procedure",,,4777.87,4777.87,4
APR-DRG,207,Other Circulatory System Diagnoses,,,4289.16,4289.16,4
APR-DRG,21,Open Craniotomy Except Trauma,,,18262.34,18262.34,4
APR-DRG,22,Ventricular Shunt Procedures,,,11404.56,11404.56,4
APR-DRG,220,"Major Stomach, Esophageal And Duodenal Procedures",,,12005.63,12005.63,4
APR-DRG,222,"Other Stomach, Esophageal And Duodenal Procedures",,,6401.94,6401.94,4
APR-DRG,223,Other Small And Large Bowel Procedures,,,10021.13,10021.13,4
APR-DRG,224,Peritoneal Adhesiolysis,,,10979.46,10979.46,4
APR-DRG,226,Anal And Perineal Procedures,,,6668.03,6668.03,4
APR-DRG,227,"Hernia Procedures Except Inguinal, Femoral And Umbilical",,,9731.72,9731.72,4
APR-DRG,228,"Inguinal, Femoral And Umbilical Hernia Procedures",,,7754.63,7754.63,4
APR-DRG,229,Other Digestive System And Abdominal Procedures,,,9416.87,9416.87,4
APR-DRG,23,Spinal Procedures,,,13206.73,13206.73,4
APR-DRG,230,Major Small Bowel Procedures,,,10055.05,10055.05,4
APR-DRG,231,Major Large Bowel Procedures,,,12798.59,12798.59,4
APR-DRG,232,Gastric Fundoplication,,,9808.05,9808.05,4
APR-DRG,233,Appendectomy With Complex Principal Diagnosis,,,8727.8,8727.8,4
APR-DRG,234,Appendectomy Without Complex Principal Diagnosis,,,7065.57,7065.57,4
APR-DRG,24,Open Extracranial Vascular Procedures,,,8862.44,8862.44,4
APR-DRG,240,Digestive Malignancy,,,5584.61,5584.61,4
APR-DRG,241,Peptic Ulcer And Gastritis,,,5484.96,5484.96,4
APR-DRG,242,Major Esophageal Disorders,,,5211.45,5211.45,4
APR-DRG,243,Other Esophageal Disorders,,,4525.57,4525.57,4
APR-DRG,244,Diverticulitis And Diverticulosis,,,4359.13,4359.13,4
APR-DRG,245,Inflammatory Bowel Disease,,,4758.79,4758.79,4
APR-DRG,246,Gastrointestinal Vascular Insufficiency,,,5157.39,5157.39,4
APR-DRG,247,Intestinal Obstruction,,,3979.62,3979.62,4
APR-DRG,248,Major Gastrointestinal And Peritoneal Infections,,,4592.35,4592.35,4
APR-DRG,249,"Other Gastroenteritis, Nausa And Vomiting",,,3912.83,3912.83,4
APR-DRG,251,Abdominal Pain,,,3970.07,3970.07,4
APR-DRG,252,"Malfunction, Reaction And Complication Of Gi Device Or Procedure",,,4790.59,4790.59,4
APR-DRG,253,Other And Unspecified Gastrointestinal Hemorrhage,,,4941.13,4941.13,4
APR-DRG,254,Other Digestive System Diagnoses,,,4355.95,4355.95,4
APR-DRG,26,Other Nervous System And Related Procedures,,,10430.32,10430.32,4
APR-DRG,260,"Major Pancreas, Liver And Shunt Procedures",,,14425.84,14425.84,4
APR-DRG,261,Major Biliary Tract Procedures,,,12570.67,12570.67,4
APR-DRG,263,Cholecystectomy,,,9312.98,9312.98,4
APR-DRG,264,"Other Hepatobiliary, Pancreas And Abdominal Procedures",,,9903.45,9903.45,4
APR-DRG,27,Other Open Craniotomy,,,13857.63,13857.63,4
APR-DRG,279,Hepatic Coma And Other Major Acute Liver Disorders,,,4190.58,4190.58,4
APR-DRG,280,Alcoholic Liver Disease,,,4881.76,4881.76,4
APR-DRG,281,Malignancy Of Hepatobiliary System And Pancreas,,,5421.35,5421.35,4
APR-DRG,282,Disorders Of Pancreas Except Malignancy,,,4490.58,4490.58,4
APR-DRG,283,Other Disorders Of The Liver,,,4449.24,4449.24,4
APR-DRG,284,Disorders Of Gallbladder And Biliary Tract,,,5267.64,5267.64,4
APR-DRG,29,Other Percutaneous Intracranial Procedures,,,13756.92,13756.92,4
APR-DRG,30,Percutaneous Intra And Extracranial Vascular Procedures,,,13191.88,13191.88,4
APR-DRG,303,Dorsal And Lumbar Fusion Procedure For Curvature Of Back,,,32600.2,32600.2,4
APR-DRG,304,Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,,,21066.31,21066.31,4
APR-DRG,305,Amputation Of Lower Limb Except Toes,,,9407.33,9407.33,4
APR-DRG,308,Hip And Femur Fracture Repair,,,11701.38,11701.38,4
APR-DRG,309,Other Significant Hip And Femur Surgery,,,11924.0,11924.0,4
APR-DRG,310,Vertebral And Intervertebral Spinal Procedures Including Disc Procedures,,,9738.08,9738.08,4
APR-DRG,312,"Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses",,,9803.8,9803.8,4
APR-DRG,313,Knee And Lower Leg Procedures Except Foot,,,11387.59,11387.59,4
APR-DRG,314,Foot And Toe Procedures,,,8097.04,8097.04,4
APR-DRG,315,"Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement",,,9106.26,9106.26,4
APR-DRG,316,Hand And Wrist Procedures,,,7086.77,7086.77,4
APR-DRG,317,"Tendon, Muscle And Other Soft Tissue Procedures",,,8338.75,8338.75,4
APR-DRG,320,Other Musculoskeletal System And Connective Tissue Procedures,,,9117.92,9117.92,4
APR-DRG,321,Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures,,,13468.57,13468.57,4
APR-DRG,322,Shoulder And Elbow Joint Replacement,,,14982.39,14982.39,4
APR-DRG,323,Non-Elective Or Complex Hip Joint Replacement,,,14250.92,14250.92,4
APR-DRG,324,Elective Hip Joint Replacement,,,12305.64,12305.64,4
APR-DRG,325,Non-Elective Or Complex Knee Joint Replacement,,,17675.05,17675.05,4
APR-DRG,326,Elective Knee Joint Replacement,,,12205.99,12205.99,4
APR-DRG,340,Fracture Of Femur,,,4081.39,4081.39,4
APR-DRG,341,Fracture Of Pelvis Or Dislocation Of Hip,,,4419.56,4419.56,4
APR-DRG,342,"Fractures And Dislocations Except Femur, Pelvis And Back",,,4320.97,4320.97,4
APR-DRG,343,Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy,,,6602.3,6602.3,4
APR-DRG,344,"Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections",,,5518.88,5518.88,4
APR-DRG,346,Connective Tissue Disorders,,,5540.08,5540.08,4
APR-DRG,347,"Other Back And Neck Disorders, Fractures And Injuries",,,4993.07,4993.07,4
APR-DRG,349,"Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure",,,4600.83,4600.83,4
APR-DRG,351,Other Musculoskeletal System And Connective Tissue Diagnoses,,,4165.13,4165.13,4
APR-DRG,361,Skin Graft For Skin And Subcutaneous Tissue Diagnoses,,,11698.2,11698.2,4
APR-DRG,362,Mastectomy Procedures,,,11064.26,11064.26,4
APR-DRG,363,Breast Procedures Except Mastectomy,,,9470.93,9470.93,4
APR-DRG,364,"Other Skin, Subcutaneous Tissue And Related Procedures",,,6292.75,6292.75,4
APR-DRG,380,Skin Ulcers,,,4506.49,4506.49,4
APR-DRG,381,Major Skin Disorders,,,3258.75,3258.75,4
APR-DRG,382,Malignant Breast Disorders,,,4549.95,4549.95,4
APR-DRG,383,Cellulitis And Other Skin Infections,,,3744.27,3744.27,4
APR-DRG,384,"Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue",,,4735.47,4735.47,4
APR-DRG,385,"Other Skin, Subcutaneous Tissue And Breast Disorders",,,3734.73,3734.73,4
APR-DRG,4,Tracheostomy W Mv 96+ Hours With Extensive Procedure,,,43549.97,43549.97,4
APR-DRG,40,Spinal Disorders And Injuries,,,7326.35,7326.35,4
APR-DRG,401,Adrenal Procedures,,,10090.03,10090.03,4
APR-DRG,403,Procedures For Obesity,,,8756.43,8756.43,4
APR-DRG,404,"Thyroid, Parathyroid And Thyroglossal Procedures",,,8116.13,8116.13,4
APR-DRG,405,"Other Procedures For Endocrine, Nutritional And Metabolic Disorders",,,9904.51,9904.51,4
APR-DRG,41,Nervous System Malignancy,,,6200.52,6200.52,4
APR-DRG,42,Degenerative Nervous System Disorders Except Multiple Sclerosis,,,5906.88,5906.88,4
APR-DRG,420,Diabetes,,,4059.12,4059.12,4
APR-DRG,421,"Malnutrition, Failure To Thrive And Other Nutritional Disorders",,,3181.36,3181.36,4
APR-DRG,422,Hypovolemia And Related Electrolyte Disorders,,,3187.72,3187.72,4
APR-DRG,423,Inborn Errors Of Metabolism,,,4629.46,4629.46,4
APR-DRG,424,Other Endocrine Disorders,,,4158.77,4158.77,4
APR-DRG,425,Other Non-Hypovolemic Electrolyte Disorders,,,3870.43,3870.43,4
APR-DRG,426,Non-Hypovolemic Sodium Disorders,,,4002.94,4002.94,4
APR-DRG,427,Thyroid Disorders,,,3876.79,3876.79,4
APR-DRG,43,"Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies",,,7610.46,7610.46,4
APR-DRG,44,Intracranial Hemorrhage,,,5924.9,5924.9,4
APR-DRG,440,Kidney Pancreas (SPK) -Inpatient Transplant Services from Admission to Discharge,,,40365.43,40365.43,1
APR-DRG,440,Kidney Transplant,,,40365.43,228246.0,7
APR-DRG,440,Pancreas after Kidney (PAK)-inpatient Transplant Services from Admission to Discharge,,,40365.43,40365.43,1
APR-DRG,441,Major Bladder Procedures,,,17580.7,17580.7,4
APR-DRG,442,Kidney And Urinary Tract Procedures For Malignancy,,,11857.22,11857.22,4
APR-DRG,443,Kidney And Urinary Tract Procedures For Non-Malignancy,,,10144.1,10144.1,4
APR-DRG,444,Renal Dialysis Access Device Procedures,,,8999.19,8999.19,4
APR-DRG,445,Other Bladder Procedures,,,8570.91,8570.91,4
APR-DRG,446,Urethral And Transurethral Procedures,,,7246.84,7246.84,4
APR-DRG,447,"Other Kidney, Urinary Tract And Related Procedures",,,10503.47,10503.47,4
APR-DRG,45,Cva And Precerebral Occlusion With Infarct,,,6539.76,6539.76,4
APR-DRG,46,Nonspecific Cva And Precerebral Occlusion Without Infarct,,,5513.58,5513.58,4
APR-DRG,461,Kidney And Urinary Tract Malignancy,,,5120.28,5120.28,4
APR-DRG,462,Nephritis And Nephrosis,,,3762.29,3762.29,4
APR-DRG,463,Kidney And Urinary Tract Infections,,,4171.49,4171.49,4
APR-DRG,465,Urinary Stones And Acquired Upper Urinary Tract Obstruction,,,4725.93,4725.93,4
APR-DRG,466,"Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure",,,4428.04,4428.04,4
APR-DRG,468,"Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms",,,3948.87,3948.87,4
APR-DRG,469,Acute Kidney Injury,,,4013.54,4013.54,4
APR-DRG,47,Transient Ischemia,,,5542.2,5542.2,4
APR-DRG,470,Chronic Kidney Disease,,,3852.4,3852.4,4
APR-DRG,48,"Peripheral, Cranial And Autonomic Nerve Disorders",,,5101.2,5101.2,4
APR-DRG,482,Transurethral Prostatectomy,,,6152.82,6152.82,4
APR-DRG,483,"Penis, Testes And Scrotal Procedures",,,6974.4,6974.4,4
APR-DRG,484,Other Male Reproductive System And Related Procedures,,,9373.4,9373.4,4
APR-DRG,49,Bacterial And Tuberculous Infections Of Nervous System,,,8313.3,8313.3,4
APR-DRG,5,Tracheostomy W Mv 96+ Hours Without Extensive Procedure,,,25176.31,25176.31,4
APR-DRG,50,Non-Bacterial Infections Of Nervous System Except Viral Meningitis,,,6042.57,6042.57,4
APR-DRG,500,"Malignancy, Male Reproductive System",,,4498.0,4498.0,4
APR-DRG,501,Male Reproductive System Diagnoses Except Malignancy,,,3922.37,3922.37,4
APR-DRG,51,Viral Meningitis,,,5212.51,5212.51,4
APR-DRG,511,Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,,,11378.05,11378.05,4
APR-DRG,512,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy,,,11003.84,11003.84,4
APR-DRG,513,Uterine And Adnexa Procedures For Non-Malignancy Except Leiomyoma,,,8395.99,8395.99,4
APR-DRG,514,Female Reproductive System Reconstructive Procedures,,,7944.39,7944.39,4
APR-DRG,517,Dilation And Curettage For Non-Obstetric Diagnoses,,,6167.66,6167.66,4
APR-DRG,518,Other Female Reproductive System And Related Procedures,,,6999.84,6999.84,4
APR-DRG,519,Uterine And Adnexa Procedures For Leiomyoma,,,7824.6,7824.6,4
APR-DRG,52,Alteration In Consciousness,,,4892.36,4892.36,4
APR-DRG,53,Seizure,,,3911.77,3911.77,4
APR-DRG,530,Female Reproductive System Malignancy,,,4830.88,4830.88,4
APR-DRG,531,Female Reproductive System Infections,,,4150.29,4150.29,4
APR-DRG,532,Menstrual And Other Female Reproductive System Disorders,,,3524.83,3524.83,4
APR-DRG,539,Cesarean Section With Sterilization,,,5510.4,5510.4,4
APR-DRG,54,Migraine And Other Headaches,,,4932.65,4932.65,4
APR-DRG,540,Cesarean Section Without Sterilization,,,5389.55,5389.55,4
APR-DRG,541,Vaginal Delivery With Sterilization And/Or D&C,,,5614.29,5614.29,4
APR-DRG,542,Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,,,3733.67,3733.67,4
APR-DRG,543,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,4539.35,4539.35,4
APR-DRG,547,Antepartum With O.R. Procedure,,,4359.13,4359.13,4
APR-DRG,548,Postpartum & Post Abortion Diagnosis With O.R. Procedure,,,3377.48,3377.48,4
APR-DRG,55,Head Trauma With Coma > 1 Hour Or Hemorrhage,,,5098.02,5098.02,4
APR-DRG,56,"Brain Contusion/Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma",,,4859.5,4859.5,4
APR-DRG,560,Vaginal Delivery,,,3226.94,3226.94,4
APR-DRG,561,Postpartum & Post Abortion Diagnoses Wtihout Procedure,,,2269.67,2269.67,4
APR-DRG,564,"Abortion Without D&C, Aspiration Curettage Or Hysterotomy",,,2922.7,2922.7,4
APR-DRG,566,Antepartum Without O.R. Procedure,,,2267.55,2267.55,4
APR-DRG,57,"Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma",,,4449.24,4449.24,4
APR-DRG,58,Other Disorders Of Nervous System,,,5743.62,5743.62,4
APR-DRG,580,"Neonate, Transferred < 5 Days Old, Not Born Here",,,4247.82,4247.82,4
APR-DRG,581,"Neonate, Transferred < 5 Days Old, Born Here",,,1529.72,1529.72,4
APR-DRG,583,Neonate With Ecmo,,,264563.86,264563.86,4
APR-DRG,588,Neonate Birth Weight < 1500G With Major Procedure,,,217197.53,217197.53,4
APR-DRG,589,"Neonate Birth Weight < 500G, Or Birth Weight 500-999G And Gestational Age <24 Wks, Or Birth Weight 500-749G With Major Anomaly Or Without Life Sustaining Intervention",,,277806.63,277806.63,4
APR-DRG,59,Anoxic And Other Severe Brain Damage,,,4225.56,4225.56,4
APR-DRG,591,Neonate Birth Weight 500-749G Without Major Procedure,,,5791.33,5791.33,4
APR-DRG,593,Neonate Birth Weight 750-999G Without Major Procedure,,,87475.21,87475.21,4
APR-DRG,6,Kidney Pancreas (SPK) -Inpatient Transplant Services from Admission to Discharge,,,54005.73,54005.73,1
APR-DRG,6,Pancreas Transplant,,,54005.73,291486.71,7
APR-DRG,6,Pancreas Transplant- inpatient Transplant Services from Admission to Discharge,,,54005.73,54005.73,1
APR-DRG,6,Pancreas after Kidney (PAK)-inpatient Transplant Services from Admission to Discharge,,,54005.73,54005.73,1
APR-DRG,602,Neonate Birth Weight 1000-1249G With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,69334.78,69334.78,4
APR-DRG,603,Neonate Birth Weight 1000-1249G With Or Without Significant Condition,,,3963.71,3963.71,4
APR-DRG,607,Neonate Birth Weight 1250-1499G With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,51640.65,51640.65,4
APR-DRG,608,Neonate Birth Weight 1250-1499G With Or Without Significant Condition,,,22015.1,22015.1,4
APR-DRG,609,Neonate Birth Weight 1500-2499G With Major Procedure,,,58218.57,58218.57,4
APR-DRG,611,Neonate Birth Weight 1500-1999G With Major Anomaly,,,16224.83,16224.83,4
APR-DRG,612,Neonate Birth Weight 1500-1999G With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,32663.8,32663.8,4
APR-DRG,613,Neonate Birth Weight 1500-1999G With Congenital/Perinatal Infection,,,23313.72,23313.72,4
APR-DRG,614,Neonate Birth Weight 1500-1999G With Or Without Other Significant Condition,,,12200.69,12200.69,4
APR-DRG,621,Neonate Birth Weight 2000-2499G With Major Anomaly,,,4876.46,4876.46,4
APR-DRG,622,Neonate Birth Weight 2000-2499G With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,19002.29,19002.29,4
APR-DRG,623,Neonate Birth Weight 2000-2499G With Congenital/Perinatal Infection,,,12113.76,12113.76,4
APR-DRG,625,Neonate Birth Weight 2000-2499G With Other Significant Condition,,,12831.45,12831.45,4
APR-DRG,626,"Neonate Birth Weight 2000-2499G, Normal Newborn Or Neonate With Other Problem",,,1306.04,1306.04,4
APR-DRG,630,Neonate Birth Weight > 2499G With Major Cardiovascular Procedure,,,32441.18,32441.18,4
APR-DRG,631,Neonate Birth Weight > 2499G With Other Major Procedure,,,6189.92,6189.92,4
APR-DRG,633,Neonate Birth Weight > 2499G With Major Anomaly,,,2649.19,2649.19,4
APR-DRG,634,Neonate Birth Weight > 2499G With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,7782.19,7782.19,4
APR-DRG,636,Neonate Birth Weight > 2499G With Congenital/Perinatal Infection,,,7628.48,7628.48,4
APR-DRG,639,Neonate Birth Weight > 2499G With Other Significant Condition,,,3700.81,3700.81,4
APR-DRG,640,"Neonate Birth Weight > 2499G, Normal Newborn Or Neonate With Other Problem",,,980.59,980.59,4
APR-DRG,650,Splenic Procedures,,,12267.48,12267.48,4
APR-DRG,651,Other Procedures Of Blood And Blood-Forming Organs,,,9491.08,9491.08,4
APR-DRG,660,Major Hematologic/Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,,,4932.65,4932.65,4
APR-DRG,661,Coagulation And Platelet Disorders,,,6078.61,6078.61,4
APR-DRG,662,Sickle Cell Anemia Crisis,,,4505.43,4505.43,4
APR-DRG,663,Other Anemia And Disorders Of Blood And Blood-Forming Organs,,,4122.73,4122.73,4
APR-DRG,680,Major O.R. Procedures For Lymphatic/Hematopoietic/Other Neoplasms,,,12954.42,12954.42,4
APR-DRG,681,Other O.R. Procedures For Lymphatic/Hematopoietic/Other Neoplasms,,,10066.71,10066.71,4
APR-DRG,690,Acute Leukemia,,,8594.23,8594.23,4
APR-DRG,691,"Lymphoma, Myeloma And Non-Acute Leukemia",,,7200.2,7200.2,4
APR-DRG,692,Radiotherapy,,,5667.29,5667.29,4
APR-DRG,694,Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,,,4950.67,4950.67,4
APR-DRG,695,Chemotherapy For Acute Leukemia,,,5846.45,5846.45,4
APR-DRG,696,Other Chemotherapy,,,5259.16,5259.16,4
APR-DRG,7,Allogeneic Bone Marrow Transplant,,,55309.66,55309.66,4
APR-DRG,7,Bone Marrow/Stem Cell/Cord Blood Transplant- Outpatient Transplant Services,,,55309.66,55309.66,1
APR-DRG,7,Bone Marrow/Stem Cell/Cord Blood Transplant- inpatient Transplant Services from Admission to Discharge,,,55309.66,55309.66,1
APR-DRG,7,Inpatient Bone Marrow/ Stem Cell/ Cord Blood Acquisition and Related Donor Costs - Allogeneic Related or Autologous Donor Transplant Services,,,55309.66,55309.66,1
APR-DRG,710,Infections And Parasitic Diseases Including Hiv With O.R. Procedure,,,10057.17,10057.17,4
APR-DRG,711,"Post-Operative, Post-Trauma, Other Device Infections With O.R. Procedure",,,8668.44,8668.44,4
APR-DRG,720,Septicemia And Disseminated Infections,,,5186.01,5186.01,4
APR-DRG,721,"Post-Operative, Post-Traumatic, Other Device Infections",,,4827.7,4827.7,4
APR-DRG,722,Fever And Inflammatory Conditions,,,3387.02,3387.02,4
APR-DRG,723,Viral Illness,,,3118.81,3118.81,4
APR-DRG,724,Other Infectious And Parasitic Diseases,,,4178.91,4178.91,4
APR-DRG,73,Orbit And Eye Procedures,,,7339.07,7339.07,4
APR-DRG,740,Mental Illness Diagnosis With O.R. Procedure,,,6373.32,6373.32,4
APR-DRG,750,Schizophrenia,,,4355.95,4355.95,4
APR-DRG,751,Major Depressive Disorders And Other/Unspecified Psychoses,,,3040.37,3040.37,4
APR-DRG,752,Disorders Of Personality And Impulse Control,,,2817.75,2817.75,4
APR-DRG,753,Bipolar Disorders,,,3406.1,3406.1,4
APR-DRG,755,Adjustment Disorders And Neuroses Except Depressive Diagnoses,,,2180.63,2180.63,4
APR-DRG,756,Acute Anxiety And Delirium States,,,3331.89,3331.89,4
APR-DRG,757,Organic Mental Health Disturbances,,,3694.45,3694.45,4
APR-DRG,758,Behavioral Disorders,,,3371.12,3371.12,4
APR-DRG,759,Eating Disorders,,,6174.02,6174.02,4
APR-DRG,760,Other Mental Health Disorders,,,3205.74,3205.74,4
APR-DRG,770,"Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice",,,2155.18,2155.18,4
APR-DRG,772,Alcohol And Drug Dependence With Rehab Or Rehab/Detox Therapy,,,3856.64,3856.64,4
APR-DRG,773,Opioid Abuse And Dependence,,,2618.45,2618.45,4
APR-DRG,774,Cocaine Abuse And Dependence,,,2749.9,2749.9,4
APR-DRG,775,Alcohol Abuse And Dependence,,,3288.43,3288.43,4
APR-DRG,776,Other Drug Abuse And Dependence,,,2833.65,2833.65,4
APR-DRG,792,Extensive O.R. Procedures For Other Complications Of Treatment,,,12017.29,12017.29,4
APR-DRG,793,Moderately Extensive O.R. Procedures For Other Complications Of Treatment,,,8719.32,8719.32,4
APR-DRG,794,Non-Extensive O.R. Procedures For Other Complications Of Treatment,,,7065.57,7065.57,4
APR-DRG,8,Autologous Bone Marrow Transplant,,,29173.95,29173.95,4
APR-DRG,8,Bone Marrow/Stem Cell/Cord Blood Transplant- Outpatient Transplant Services,,,29173.95,29173.95,1
APR-DRG,8,Bone Marrow/Stem Cell/Cord Blood Transplant- inpatient Transplant Services from Admission to Discharge,,,29173.95,29173.95,1
APR-DRG,8,Inpatient Bone Marrow/ Stem Cell/ Cord Blood Acquisition and Related Donor Costs - Allogeneic Related or Autologous Donor Transplant Services,,,29173.95,29173.95,1
APR-DRG,810,Hemorrhage Or Hematoma Due To Complication,,,3945.69,3945.69,4
APR-DRG,811,Allergic Reactions,,,2829.41,2829.41,4
APR-DRG,812,Poisoning Of Medicinal Agents,,,3014.92,3014.92,4
APR-DRG,813,Other Complications Of Treatment,,,4495.88,4495.88,4
APR-DRG,815,"Other Injury, Poisoning And Toxic Effect Diagnoses",,,3184.54,3184.54,4
APR-DRG,816,Toxic Effects Of Non-Medicinal Substances,,,3432.6,3432.6,4
APR-DRG,817,Intentional Self-Harm And Attempted Suicide,,,3255.57,3255.57,4
APR-DRG,82,Eye Infections And Other Eye Disorders,,,4419.56,4419.56,4
APR-DRG,841,Extensive 3Rd Degree Burns With Skin Graft,,,15021.62,15021.62,4
APR-DRG,842,Burns With Skin Graft Except Extensive 3Rd Degree Burns,,,10311.59,10311.59,4
APR-DRG,843,Extensive 3Rd Degree Burns Without Skin Graft,,,4519.21,4519.21,4
APR-DRG,844,Partial Thickness Burns Without Skin Graft,,,3131.54,3131.54,4
APR-DRG,850,"Procedure With Diagnosis Of Rehab, Aftercare Or Other Contact With Health Services",,,10848.0,10848.0,4
APR-DRG,851,Gender Related Procedures,,,13340.3,13340.3,4
APR-DRG,860,Rehabilitation,,,8334.51,8334.51,4
APR-DRG,861,"Signs, Symptoms And Other Factors Influencing Health Status",,,3574.66,3574.66,4
APR-DRG,862,Other Aftercare And Convalescence,,,1776.73,1776.73,4
APR-DRG,863,Neonatal Aftercare,,,13855.51,13855.51,4
APR-DRG,89,Major Cranial/Facial Bone Procedures,,,12287.62,12287.62,4
APR-DRG,890,Hiv With Multiple Major Hiv Related Conditions,,,5917.48,5917.48,4
APR-DRG,892,Hiv With Major Hiv Related Condition,,,5316.4,5316.4,4
APR-DRG,893,Hiv With Multiple Significant Hiv Related Conditions,,,5667.29,5667.29,4
APR-DRG,894,Hiv With One Significant Hiv Condition Or Without Significant Related Conditions,,,4791.65,4791.65,4
APR-DRG,9,Extracorporeal Membrane Oxygenation (Ecmo),,,48887.57,48887.57,4
APR-DRG,91,Other Major Head And Neck Procedures,,,13410.27,13410.27,4
APR-DRG,910,Craniotomy For Multiple Significant Trauma,,,22594.97,22594.97,4
APR-DRG,911,Extensive Abdominal/Thoracic Procedures For Multiple Significant Trauma,,,15548.49,15548.49,4
APR-DRG,912,Musculoskeletal And Other Procedures For Multiple Significant Trauma,,,16415.65,16415.65,4
APR-DRG,92,Facial Bone Procedures Except Major Cranial/Facial Bone Procedures,,,11178.75,11178.75,4
APR-DRG,930,Multiple Significant Trauma Without O.R. Procedure,,,6462.37,6462.37,4
APR-DRG,95,Cleft Lip And Palate Repair,,,7198.08,7198.08,4
APR-DRG,950,Extensive Procedure Unrelated To Principal Diagnosis,,,12415.89,12415.89,4
APR-DRG,951,Moderately Extensive Procedure Unrelated To Principal Diagnosis,,,8980.11,8980.11,4
APR-DRG,952,Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,7565.93,7565.93,4
APR-DRG,97,Tonsil And Adenoid Procedures,,,4523.45,4523.45,4
APR-DRG,98,"Other Ear, Nose, Mouth And Throat Procedures",,,7013.62,7013.62,4
CDM,1200001,HB ROOM CHARGE 1:5 SEMI PRIV,12964.0,8426.6,13270.0,14761.0,8
CDM,1200002,HB ROOM CHG 1:5 OB PRIV DELX,12964.0,8426.6,13270.0,14761.0,2
CDM,1200005,HB ROOM CHG 1:5 OB DELX 3 ROOMS,12964.0,8426.6,13270.0,14761.0,2
CDM,1200006,HB ROOM CHARGE 1:5 SEMI PRIV NON-OB OVERFLOW,12964.0,8426.6,13270.0,14761.0,4
CDM,1270001,HB ROOM CHARGE 1:1 ONC,57311.0,37252.15,13270.0,14761.0,2
CDM,1270002,HB ROOM CHARGE 1:2 ONC,42235.0,27452.75,13270.0,14761.0,2
CDM,1270003,HB ROOM CHARGE 1:3 ONC,17726.0,11521.9,13270.0,14761.0,2
CDM,1270004,HB ROOM CHARGE 1:4 ONC,16015.0,10409.75,13270.0,14761.0,2
CDM,1290001,HB ROOM CHARGE TRAUMA 1:5 MED/SURG,18430.0,11979.5,13270.0,14761.0,2
CDM,1710001,HB ROOM CHARGE 1:8 NSY,5235.0,3402.75,13270.0,14761.0,2
CDM,1720001,HB ROOM CHARGE 1:4 NSY,6796.0,4417.4,13270.0,14761.0,2
CDM,1720003,HB ROOM CHARGE 1:4 NICU/PICU,26903.0,17486.95,13270.0,14761.0,4
CDM,1730002,HB ROOM CHARGE 1:3 NICU/PICU,32225.0,20946.25,13270.0,14761.0,4
CDM,1740001,HB ROOM CHARGE 2:1 NICU/PICU,73163.0,47555.95,13270.0,14761.0,4
CDM,1740002,HB ROOM CHARGE 1:1 NICU/PICU,56768.0,36899.2,13270.0,14761.0,4
CDM,1740003,HB ROOM CHARGE 1:2 NICU/PICU,46931.0,30505.15,13270.0,14761.0,4
CDM,2000001,HB ROOM CHARGE 2:1 ICU,65771.0,42751.15,13270.0,14761.0,2
CDM,2000002,HB ROOM CHARGE 1:1 ICU,52033.0,33821.45,13270.0,14761.0,2
CDM,2000003,HB ROOM CHARGE 1:2 ICU,38342.0,24922.3,13270.0,14761.0,4
CDM,2030001,HB ROOM CHARGE 1:3 STP DWN PED,15998.0,10398.7,13270.0,14761.0,2
CDM,2030002,HB ROOM CHARGE 1:4 STP DWN PED,14586.0,9480.9,13270.0,14761.0,2
CDM,2060001,HB ROOM CHARGE 1:3 STP DWN,15998.0,10398.7,13270.0,14761.0,4
CDM,2060003,HB ROOM CHARGE TRAUMA 1:3 & 1:4,38429.0,24978.85,13270.0,14761.0,2
CDM,2060006,HB ROOM CHARGE 1:4 STP DWN,14586.0,9480.9,13270.0,14761.0,4
CDM,2060008,HB ROOM CHARGE 1:4 STP DWN NON-OB OVERFLOW,14586.0,9480.9,13270.0,14761.0,2
CDM,2080001,HB ROOM CHARGE TRAUMA 2:1 TO 1:2,76644.0,49818.6,13270.0,14761.0,2
CDM,2500001,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,14761.0,104
CDM,2500001,Other Outpatient Services,926.425,602.175,,,0
CDM,2500018,HB SITZMARKER CAPSULE,2146.52,1395.24,,,0
CDM,2700005,HB CYTOTOXIC SPILL KIT,284.89,185.18,13270.0,14761.0,2
CDM,2700007,HB 24 HR PH PROBE,3608.68,2345.64,,,0
CDM,2700008,HB FEMSTOP,861.24,559.81,13270.0,14761.0,2
CDM,2700016,HB PEFR-EQUIPMENT,1032.06,670.84,13270.0,14761.0,2
CDM,2700018,HB PC AERO KIT,2111.07,1372.2,13270.0,14761.0,2
CDM,2700021,HB PC MICRO-SPIROMETER,12978.9,8436.28,13270.0,14761.0,2
CDM,2700022,HB PC O/P HHN EQUIPMENT,754.2,490.23,13270.0,14761.0,2
CDM,2700035,"HB NEEDLE, BIOPSY/ASP/LOC/INJ",484.54,314.95,13270.0,14761.0,2
CDM,2700044,HB METANEB RT DEVICE KIT,2615.19,1699.87,13270.0,14761.0,2
CDM,2700048,HB IB STIMULATOR,9610.49,6246.82,,,0
CDM,2710002,HB SPLINT FOREARM - SMALL,880.4,572.26,,,0
CDM,2710003,"HB SPLINT, SUGARTONG",880.4,572.26,13270.0,14761.0,2
CDM,2710006,"HB COLLAR, CERVICAL",771.86,501.71,13270.0,14761.0,2
CDM,2710009,"HB CAST, SHORT ARM CAST",880.4,572.26,,,0
CDM,2710012,HB PADS R2 EP STUDY,878.72,571.17,13270.0,14761.0,2
CDM,2710013,HB SPLINT FINGER 2 INCHES,880.4,572.26,13270.0,14761.0,2
CDM,2710014,HB MUCUS CLEARING DEVICE,410.2,266.63,13270.0,14761.0,2
CDM,2710019,HB FECAL INCONTINENCE COLLECTOR,880.4,572.26,13270.0,14761.0,2
CDM,2710022,HB PC PEP VALVE,464.43,301.88,13270.0,14761.0,2
CDM,2710023,HB SPLINT WRIST - LARGE,880.4,572.26,,,0
CDM,2710024,HB SPLINT WRIST - MEDIUM,880.4,572.26,,,0
CDM,2710027,HB PENTAMIDINE KIT,581.92,378.25,13270.0,14761.0,2
CDM,2710029,"HB SPLINT, WRIST",880.4,572.26,13270.0,14761.0,2
CDM,2710033,HB KNEE IMMOBILIZER,1550.81,1008.03,13270.0,14761.0,2
CDM,2710036,HB SPICA - THUMB OR FINGER,1876.57,1219.77,,,0
CDM,2710037,HB BI-VALVE OR DC CAST,880.4,572.26,,,0
CDM,2710038,"HB KIT, OSTOMY 5PK (1 PIECE)",1911.73,1242.62,13270.0,14761.0,2
CDM,2710039,"HB SPLINT, MOLDED",880.4,572.26,13270.0,14761.0,2
CDM,2710041,HB EAR LAVAGE,545.3,354.44,13270.0,14761.0,2
CDM,2710044,HB 02 CONNECTION TUBING MASK,548.48,356.51,,,0
CDM,2710047,HB SPLINT FOREARM - MEDIUM,880.4,572.26,,,0
CDM,2710054,HB TERM PC NITROGEN ADMIN. PER HOUR,880.4,572.26,13270.0,14761.0,2
CDM,2710056,HB UNIVALVE CAST OR SPLINT,880.4,572.26,,,0
CDM,2710057,HB PC H.H.N. KIT,491.79,319.66,13270.0,14761.0,4
CDM,2710058,HB SPLINT FOREARM - LARGE,880.4,572.26,,,0
CDM,2710059,"HB SPLINT,THUMB",880.4,572.26,13270.0,14761.0,2
CDM,2710060,HB PAG-HEART NEB EQUIP,882.08,573.35,13270.0,14761.0,4
CDM,2710061,HB PASSY MUIR SPEAKING VALVE,907.84,590.1,13270.0,14761.0,2
CDM,2710063,HB STOMAHESIVE WAFER,928.02,603.21,,,0
CDM,2710064,"HB SPLINT, ARM",880.4,572.26,13270.0,14761.0,2
CDM,2710073,"HB CAST, SHORT LEG WALKING",880.4,572.26,,,0
CDM,2710074,"HB CAST, CYLINDER THIGH TO ANKLE",880.4,572.26,,,0
CDM,2710078,"HB CAST, LONG LEG",880.4,572.26,,,0
CDM,2710080,"HB KIT, WOUND CLEASING",348.74,226.68,13270.0,14761.0,2
CDM,2710081,"HB SPLINT, SHORT/LONG LEG",880.4,572.26,13270.0,14761.0,2
CDM,2710083,HB PUMP DISCONNECT KIT,155.09,100.81,13270.0,14761.0,2
CDM,2710085,HB SPLINT WRIST - SMALL,880.4,572.26,,,0
CDM,2710089,HB CAST SHORT LEG,880.4,572.26,13270.0,14761.0,2
CDM,2710090,"HB CAST, LONG ARM",880.4,572.26,,,0
CDM,2710091,"HB CAST, LONG LEG WALKING",880.4,572.26,,,0
CDM,2710096,HB MISCELLANEOUS SUPPLY,880.4,572.26,,,0
CDM,2710101,"HB TERM SPLINT, IMMOBILIZER KNEE",880.4,572.26,13270.0,14761.0,2
CDM,2710104,"HB TERM SPLINT, IMMOBILIZER SHOULDER",880.4,572.26,13270.0,14761.0,2
CDM,2720001,HB BASKET GEMINI 3FR,2173.2,1412.58,13270.0,14761.0,2
CDM,2720008,HB MEDIA FOR IUI,255.4,166.01,,,0
CDM,2720009,"HB WIRE, MICRO EXCHANGE",2989.11,1942.92,13270.0,14761.0,2
CDM,2720016,HB LASER FIBER,4758.21,3092.84,13270.0,14761.0,2
CDM,2720017,HB NEUROPEN WITH NEUROENDOSCOPES,4977.77,3235.55,13270.0,14761.0,2
CDM,2720021,HB CATH DELIVERY SYSTEM,7621.03,4953.67,13270.0,14761.0,2
CDM,2720023,"HB LASER FIBER, 9",9819.88,6382.92,,,0
CDM,2720025,HB CATH INTRA-AORTC BALLOON,17954.1,11670.16,13270.0,14761.0,2
CDM,2720034,HB CLIP SURGICAL SPRING CLIP,245.01,159.26,13270.0,14761.0,2
CDM,2720035,"HB KIT, OSTOMY (2 PIECE)",1299.31,844.55,13270.0,14761.0,2
CDM,2720037,HB DRAIN 1,418.45,271.99,13270.0,14761.0,2
CDM,2720039,HB ENDOSCOPIC VERSATEP,1132.85,736.35,13270.0,14761.0,2
CDM,2720040,HB ENDO LLETZ BALL ELCTRODE,359.77,233.85,13270.0,14761.0,2
CDM,2720044,HB ENDOSCOPE SHEATH DISPOSABLE,660.48,429.31,13270.0,14761.0,2
CDM,2720045,HB COLOSTOMY BAG,661.63,430.06,13270.0,14761.0,2
CDM,2720047,"HB CATHETER, EPISTAXIS BALLOON",675.22,438.89,13270.0,14761.0,2
CDM,2720049,"HB SHEATH, PERITONEAL/AMPLATZ",685.31,445.45,13270.0,14761.0,2
CDM,2720050,HB PC NASAL MASKS BIPAP,1396.46,907.7,13270.0,14761.0,2
CDM,2720051,HB ENDO IRRIG ENDO-FLO 0037970,695.99,452.39,13270.0,14761.0,2
CDM,2720053,HB BIOPSY BRUSH COOK 040310,699.55,454.71,13270.0,14761.0,2
CDM,2720054,"HB NEEDLE, SCLEROSING",1429.92,929.45,13270.0,14761.0,2
CDM,2720055,HB CATH FOLEY W/THERMISTER,597.81,388.58,13270.0,14761.0,2
CDM,2720056,"HB CANNULA, CORONARY PERFUSION DL",702.37,456.54,13270.0,14761.0,2
CDM,2720064,HB CANNULA AVR CABG KIT,724.39,470.85,13270.0,14761.0,2
CDM,2720068,HB TRACH TUBE #14,1470.17,955.61,13270.0,14761.0,2
CDM,2720072,"HB CLAMP, DISPOSABLE",471.27,306.33,13270.0,14761.0,2
CDM,2720074,"HB PACING WIRE, TEMPORARY",936.2,608.53,13270.0,14761.0,2
CDM,2720075,"HB LEADWIRE, EKG",177.54,115.4,13270.0,14761.0,2
CDM,2720077,HB FRAZIER SUCTION TIPS,376.59,244.78,13270.0,14761.0,2
CDM,2720081,"HB TROCAR, ENDOSCOPIC 1",647.07,420.6,13270.0,14761.0,2
CDM,2720084,"HB NEEDLE, SPINAL/DISC",817.52,531.39,13270.0,14761.0,2
CDM,2720086,"HB KIT, PACEMAKER 1",823.16,535.05,13270.0,14761.0,2
CDM,2720089,"HB CATHETER, THORACIC MM",842.02,547.31,13270.0,14761.0,2
CDM,2720090,HB CATHETER PASSER,1087.89,707.13,13270.0,14761.0,2
CDM,2720093,"HB PIN, DISTRACTION",636.66,413.83,13270.0,14761.0,2
CDM,2720098,HB LACRIMAL INTUBATION SET,859.37,558.59,13270.0,14761.0,2
CDM,2720108,HB PIN SKULL PINS MAYFIELD- OMI,255.71,166.21,13270.0,14761.0,2
CDM,2720110,HB PREP DURA,239.1,155.41,13270.0,14761.0,2
CDM,2720111,"HB BLADE, TREPHINE",916.18,595.52,13270.0,14761.0,2
CDM,2720114,"HB TUBING, INSUFFLATION",496.18,322.52,13270.0,14761.0,2
CDM,2720123,"HB ADHESIVE, SKIN",442.0,287.3,13270.0,14761.0,2
CDM,2720124,HB 23G BIPOLAR TAPERED FINE POINT,557.51,362.38,13270.0,14761.0,2
CDM,2720125,"HB SYRINGE, ANGIOGRAPHIC",203.85,132.5,13270.0,14761.0,2
CDM,2720133,HB SONOHYSTOGRAM CATHETER,290.49,188.82,,,0
CDM,2720137,HB OSTENE BONE HEMOSTASIS 2.5GRMS,987.79,642.06,13270.0,14761.0,2
CDM,2720140,"HB FORCEPS, BIOPSY 1",606.6,394.29,13270.0,14761.0,2
CDM,2720144,"HB TUBE,TRACH DCT/DFEN W/DISP CAN",1747.84,1136.1,13270.0,14761.0,2
CDM,2720148,HB MEDTRONIC REFILL KIT,1749.55,1137.21,,,0
CDM,2720153,"HB TUNNELING ROD, CATH PASSER",1497.85,973.6,13270.0,14761.0,2
CDM,2720154,"HB TUBE, MIC (FEEDING)",2618.77,1702.2,13270.0,14761.0,2
CDM,2720159,"HB TOOL, DISSECTING 2",1739.97,1130.98,13270.0,14761.0,2
CDM,2720161,"HB KIT, TRANFIX/BIO-TENODESIS",1807.42,1174.82,13270.0,14761.0,2
CDM,2720162,"HB NEEDLE, ELECT/BEVEL/TROCAR",1857.14,1207.14,13270.0,14761.0,2
CDM,2720166,HB BAG DRAINAGE URINARY,304.92,198.2,13270.0,14761.0,2
CDM,2720169,HB PERF QUICK PRIME LINE,313.63,203.86,13270.0,14761.0,2
CDM,2720170,HB ENDO PROBE HANDPIECE,938.25,609.86,13270.0,14761.0,2
CDM,2720171,HB PC MICRO BRUSH,2282.39,1483.55,13270.0,14761.0,2
CDM,2720174,HB PLEUR-EVAC,2681.35,1742.88,13270.0,14761.0,2
CDM,2720175,HB SPENCER DEPTH ELECTRODES 8 CON,2785.4,1810.51,13270.0,14761.0,2
CDM,2720176,"HB NEEDLE, OSTYCUT",960.49,624.32,13270.0,14761.0,2
CDM,2720187,HB TWIST DRILL SURGICAL 1,1022.66,664.73,13270.0,14761.0,2
CDM,2720190,HB TRACH PERCUTANEOUS SET,831.36,540.38,13270.0,14761.0,2
CDM,2720191,HB ENDO SUCTION/IRRIG/PROBE,1036.88,673.97,,,0
CDM,2720193,"HB CATHETER, MULTI LUMEN",1038.89,675.28,13270.0,14761.0,2
CDM,2720195,"HB CANNULA, RETROGRADE CARDIOPLEG",1051.55,683.51,13270.0,14761.0,2
CDM,2720198,"HB CANNULA, RETROGRADE 1",1065.28,692.43,13270.0,14761.0,2
CDM,2720199,"HB IV PUMP SET, NITROGLYCERIN",845.3,549.44,13270.0,14761.0,2
CDM,2720201,HB ARTHRO WAND 1,2141.2,1391.78,13270.0,14761.0,2
CDM,2720208,"HB IRRIGATION SET, CYSTO",876.02,569.41,13270.0,14761.0,2
CDM,2720213,HB PERF RESERVOIR CARDIOTOMY,1114.96,724.72,13270.0,14761.0,2
CDM,2720215,"HB RESERVOIR, DRAIN 1",318.16,206.8,13270.0,14761.0,2
CDM,2720225,HB SHOULDER SUSPENSION KIT 2,1155.67,751.19,13270.0,14761.0,2
CDM,2720229,"HB TUBE, RECTAL",665.11,432.32,13270.0,14761.0,2
CDM,2720230,HB RADIAL ARTERY KIT,678.22,440.84,13270.0,14761.0,2
CDM,2720231,HB ENDO POLY LOOP,1560.87,1014.57,13270.0,14761.0,2
CDM,2720232,"HB TUBING, PCA",2334.97,1517.73,13270.0,14761.0,2
CDM,2720233,"HB TUBE, GASTROSTOMY 1",700.51,455.33,13270.0,14761.0,2
CDM,2720236,HB RESUSCITATION BAG,2334.97,1517.73,13270.0,14761.0,2
CDM,2720246,"HB NEEDLE SET, BX/ASPIR, ECHO TIP",759.87,493.92,,,0
CDM,2720247,"HB TROCAR, ENDOSCOPIC 2",1217.94,791.66,,,0
CDM,2720248,HB INFLATION DEVICE ENDO,1221.48,793.96,13270.0,14761.0,2
CDM,2720251,"HB BLADE, INCISOR/ABRADER",1228.58,798.58,,,0
CDM,2720253,HB INTRODUCER ACCUSTICK,784.76,510.09,13270.0,14761.0,2
CDM,2720257,"HB MARKER, SPOT TATOO",412.09,267.86,13270.0,14761.0,2
CDM,2720259,HB MICRO PUNCTURE SET,417.94,271.66,13270.0,14761.0,4
CDM,2720262,"HB CAPSULE, WIRELESS AGILE",1629.18,1058.97,13270.0,14761.0,2
CDM,2720263,"HB STAPLER, ENDOSCOPIC 5",3425.01,2226.26,13270.0,14761.0,2
CDM,2720264,"HB TAP, DISPOSABLE 1",1259.0,818.35,13270.0,14761.0,2
CDM,2720265,HB TUBING PENUMBRA STERILE,3554.17,2310.21,13270.0,14761.0,2
CDM,2720266,HB PC PNEUMOTHORAX SET,3843.86,2498.51,13270.0,14761.0,2
CDM,2720271,"HB ELECTRODE, ESU 1",1285.44,835.54,13270.0,14761.0,2
CDM,2720279,HB SECONDARY PIGGY BACK,2334.97,1517.73,13270.0,14761.0,2
CDM,2720280,HB UNIVER MICROINTRODUCER KIT 7FR,1084.75,705.09,13270.0,14761.0,2
CDM,2720283,HB ENDO SWITCH BLADE TIPS,624.49,405.92,13270.0,14761.0,2
CDM,2720285,"HB COLLAGEN, HEMOSTAT INSTAT 1",936.81,608.93,13270.0,14761.0,2
CDM,2720289,"HB CATHETER, VENTRICULAR 2",1391.32,904.36,13270.0,14761.0,2
CDM,2720290,"HB NEEDLE, KYPHON",1396.46,907.7,13270.0,14761.0,2
CDM,2720294,HB 8-CONTACT STRIP ELECTRODE,3478.33,2260.91,13270.0,14761.0,2
CDM,2720296,HB KYPHX SYRINGE A08A,1420.38,923.25,,,0
CDM,2720297,HB PC YAG LASER FIBER,7571.45,4921.44,13270.0,14761.0,2
CDM,2720303,HB TUBING SET,1460.24,949.16,13270.0,14761.0,2
CDM,2720308,"HB NEEDLE, FNA",2215.46,1440.05,13270.0,14761.0,2
CDM,2720311,HB ORAL APPLIANCE,2306.49,1499.22,,,0
CDM,2720315,HB CEMENT CART.SYS 540198000,1526.91,992.49,13270.0,14761.0,2
CDM,2720318,"HB CATHETER, THORACIC",326.78,212.41,13270.0,14761.0,2
CDM,2720321,"HB ENDO DISSECT, LONG/SHORT",3586.79,2331.41,13270.0,14761.0,2
CDM,2720325,HB TUBE HARVESTER WITH PINS,4357.96,2832.67,13270.0,14761.0,2
CDM,2720329,"HB CANNULA, HYDRODISSECTOR",173.61,112.85,13270.0,14761.0,2
CDM,2720334,HB APPLICATOR TIP 1,858.69,558.15,13270.0,14761.0,2
CDM,2720335,"HB BLADE, GENERAL 2",1575.29,1023.94,13270.0,14761.0,2
CDM,2720338,"HB NEEDLE, BIOPSY/ASP/LOC/INJ MRI",955.49,621.07,13270.0,14761.0,2
CDM,2720339,HB PERF RESEVOIR CARDIO 90300018,1587.28,1031.73,13270.0,14761.0,2
CDM,2720340,HB ELECTRODES,1588.95,1032.82,13270.0,14761.0,2
CDM,2720342,HB GASTROSTOMY GIAS-100,1594.04,1036.13,13270.0,14761.0,4
CDM,2720343,HB NEURO BECKER EDMS,1601.47,1040.96,13270.0,14761.0,2
CDM,2720356,HB INFLATION APPARATUS,1668.9,1084.79,13270.0,14761.0,2
CDM,2720357,"HB TWIST DRILL, SURGICAL 2",1668.9,1084.79,13270.0,14761.0,2
CDM,2720362,HB SEALANT HEMOSTATIC 1,2301.31,1495.85,13270.0,14761.0,2
CDM,2720363,HB PERF CDI 500 SHUNT SENSOR,1704.47,1107.91,13270.0,14761.0,2
CDM,2720368,"HB REAMER, MODULAR SHAFT 1",1735.16,1127.85,13270.0,14761.0,2
CDM,2720369,"HB CANNULA, CORONARY PERF",1739.68,1130.79,13270.0,14761.0,2
CDM,2720378,"HB PROBE, SOMN/ULTRSND/ARTHRO",1785.12,1160.33,13270.0,14761.0,2
CDM,2720379,HB NAV-X EP MAP ELECTRODE,10893.8,7080.97,13270.0,14761.0,2
CDM,2720380,"HB PROBE, ABLATION",14308.4,9300.46,,,0
CDM,2720381,"HB KIT, ENDO MUCOSAL RESECTION",2812.42,1828.07,13270.0,14761.0,2
CDM,2720382,"HB TUBE, GASTROSTOMY 2",1814.57,1179.47,13270.0,14761.0,2
CDM,2720384,HB BONE MILL BM200,1821.61,1184.05,13270.0,14761.0,2
CDM,2720389,HB IMPEDANCE PROBE,1874.88,1218.67,,,0
CDM,2720390,"HB CANNULA, ERCP BALL/CONTOUR",948.41,616.47,13270.0,14761.0,2
CDM,2720391,"HB RETRACTOR, FAN ENDOSCOPIC",1878.44,1220.99,13270.0,14761.0,2
CDM,2720392,"HB NEEDLE, ENTRY",1653.3799999999999,1074.695,13270.0,14761.0,4
CDM,2720395,HB SPHINCTERTOME DBL LUMEN,1732.98,1126.44,13270.0,14761.0,2
CDM,2720398,"HB BRUSH, FEMORAL/CYTO",372.87,242.37,13270.0,14761.0,2
CDM,2720400,HB IV BAG-O-JET,2334.97,1517.73,13270.0,14761.0,2
CDM,2720402,HB POSITION COLLAR CERVICAL SOFT,2334.97,1517.73,13270.0,14761.0,2
CDM,2720406,"HB NEEDLE, ENDO VERESS 1",394.16,256.2,13270.0,14761.0,2
CDM,2720407,"HB TUBING, PUMP",2334.97,1517.73,,,0
CDM,2720411,HB ENDO CLOSURE PROC/KIT CTI-512N,1608.05,1045.23,13270.0,14761.0,2
CDM,2720412,HB ENDO VERSASTEP NEEDLE 14G,404.79,263.11,13270.0,14761.0,2
CDM,2720415,"HB CLIP, HEMOLOK",415.47,270.06,13270.0,14761.0,2
CDM,2720420,HB DRAIN ABRAMSON TRIPLE LUMEN,422.54,274.65,13270.0,14761.0,2
CDM,2720423,"HB WIRE, TOUHY-BORST Y-VALVE CONN",429.51,279.18,13270.0,14761.0,4
CDM,2720425,"HB TUBING, IRRIGATION 1",717.36,466.28,13270.0,14761.0,2
CDM,2720426,HB COLOSTOMY CLAMP,430.94,280.11,13270.0,14761.0,2
CDM,2720428,HB PRESSURE TUBING,528.0,343.2,13270.0,14761.0,2
CDM,2720429,"HB TUBING, STACKHOUSE/EVACUATOR",440.31,286.2,13270.0,14761.0,2
CDM,2720432,"HB BALLOON, KYPHON",8821.77,5734.15,13270.0,14761.0,2
CDM,2720433,HB CANNULA 8.25MM X 7 CM AR 6530,443.89,288.53,13270.0,14761.0,2
CDM,2720435,HB BIOPSY KIT,444.28,288.78,13270.0,14761.0,2
CDM,2720438,"HB RETAINER, VISCERA SURGIFISH",451.93,293.75,13270.0,14761.0,2
CDM,2720442,"HB CANNULA, ARTHRO 1",458.04,297.73,13270.0,14761.0,2
CDM,2720446,"HB DRAIN, PENROSE",388.55,252.56,13270.0,14761.0,2
CDM,2720453,HB ENDO TIP COVER INTUI 400180-0,486.49,316.22,13270.0,14761.0,2
CDM,2720454,"HB CANNULA, VENOUS 2 STAGE OVAL",487.42,316.82,13270.0,14761.0,2
CDM,2720462,"HB SCALPEL, SURGICAL 2",2334.97,1517.73,13270.0,14761.0,2
CDM,2720465,HB SET MINI TRIFUSE,156.64,101.82,13270.0,14761.0,2
CDM,2720468,HB STATLOCK,352.42,229.07,13270.0,14761.0,2
CDM,2720469,"HB BLADE, SAW",556.82,361.93,13270.0,14761.0,2
CDM,2720472,"HB PROBE, FLOW PUMP",532.65,346.22,13270.0,14761.0,2
CDM,2720473,"HB SURGIFOAM, ABSORBABLE SPONGE 2",532.65,346.22,13270.0,14761.0,2
CDM,2720475,HB ENDO PROBE ELECTRODE,537.64,349.47,13270.0,14761.0,2
CDM,2720478,"HB CANNULA, OPS VALVE",551.31,358.35,13270.0,14761.0,2
CDM,2720483,"HB CANNULA, INNER DISP",560.54,364.35,,,0
CDM,2720484,"HB BLADE, AORTIC PUNCH",561.71,365.11,13270.0,14761.0,2
CDM,2720486,"HB NEEDLE, JAM/INF/CAR/MNS/DURA",568.15,369.3,13270.0,14761.0,2
CDM,2720493,HB INSEMI-CATHETER,197.09,128.11,,,0
CDM,2720496,HB ENDO IRRIGATOR HYDRO-SURG PLUS,911.64,592.57,13270.0,14761.0,2
CDM,2720501,"HB TUBE, GASTROSTOMY 2",1518.14,986.79,13270.0,14761.0,2
CDM,2720503,HB ABDOMINAL BINDER,1439.33,935.56,13270.0,14761.0,2
CDM,2720509,HB DILATOR,642.68,417.74,13270.0,14761.0,2
CDM,2720512,"HB SNARE, POLYPECTOMY",936.25,608.56,13270.0,14761.0,2
CDM,2720515,"HB CATHETER, CHOLANGIOGRAM",656.9,426.99,13270.0,14761.0,2
CDM,2720522,HB MONITORING TRANSDUCER VENOUS,1935.17,1257.86,13270.0,14761.0,2
CDM,2720523,HB MONITORING TRANSDUCER ARTERY,1707.02,1109.56,13270.0,14761.0,2
CDM,2720532,HB ENDO CLIP APPLIER 5MM,2009.85,1306.4,13270.0,14761.0,2
CDM,2720536,"HB PROBE, COAGULATING BEAM",1474.23,958.25,13270.0,14761.0,2
CDM,2720537,HB INJECTOR,1767.51,1148.88,13270.0,14761.0,2
CDM,2720538,"HB TUBE, BRONCHCATH, RT/LT",952.28,618.98,13270.0,14761.0,2
CDM,2720541,HB ANORECTAL CATHETER,1235.45,803.04,,,0
CDM,2720545,"HB TUBE, ET",435.37,282.99,13270.0,14761.0,2
CDM,2720549,HB INFUSION US LYSIS SYSTEM,12748.3,8286.4,13270.0,14761.0,2
CDM,2720556,"HB SHEATH, BANNANA PEEL",1692.98,1100.44,13270.0,14761.0,4
CDM,2720559,HB HEMOSTASIS PATCH,960.49,624.32,13270.0,14761.0,2
CDM,2720560,HB INFLATION DEVICE KYPHON,1123.39,730.2,,,0
CDM,2720562,"HB KIT, TIPS",4219.35,2742.58,13270.0,14761.0,2
CDM,2720563,HB 2 CONTACT STRIP ELECTRODE,1577.44,1025.34,13270.0,14761.0,2
CDM,2720567,"HB CATHETER, ARGON COAG PROBE",2078.99,1351.34,13270.0,14761.0,2
CDM,2720568,HB NASOGASTRIC TUBE IRRIGATION,643.96,418.57,13270.0,14761.0,2
CDM,2720575,"HB BLADE, PIVOTAL/FIXED HEAD",103.29,67.14,13270.0,14761.0,2
CDM,2720582,HB CANNULA SEAL,513.82,333.98,13270.0,14761.0,2
CDM,2720583,HB CANNULA AORTIC,1523.68,990.39,13270.0,14761.0,2
CDM,2720586,"HB CANNULA, ARTERIAL 2",2369.4,1540.11,13270.0,14761.0,2
CDM,2720588,"HB CANNULA, IMA",362.75,235.79,13270.0,14761.0,2
CDM,2720589,"HB CANNULA, OPHTHALMIC",578.77,376.2,13270.0,14761.0,2
CDM,2720591,"HB CANNULA, VENOUS 5",5180.81,3367.53,13270.0,14761.0,2
CDM,2720599,"HB CATHETER, VENTRICULAR 1",2334.97,1517.73,13270.0,14761.0,2
CDM,2720600,HB CLIP CORONARY ARTERY RETRACTON,2334.97,1517.73,13270.0,14761.0,2
CDM,2720601,HB CLIP OMNI CLIP GUN,873.5,567.77,13270.0,14761.0,2
CDM,2720602,HB CLIP SURGICLIP PREMIUM,2851.98,1853.79,13270.0,14761.0,2
CDM,2720604,"HB CUTTER, ENDOSCOPIC 4",3504.73,2278.07,13270.0,14761.0,2
CDM,2720606,"HB DISSECTOR, BLUNT CHERRY",436.76,283.89,13270.0,14761.0,2
CDM,2720609,HB ENDO ENDOPOUCH PRO RETRIEVAL,875.8,569.27,13270.0,14761.0,2
CDM,2720612,"HB SCISSORS, ENDOSCOPIC 1",1480.74,962.48,13270.0,14761.0,2
CDM,2720613,HB ENDO SURESEAL II,261.38,169.9,13270.0,14761.0,2
CDM,2720615,"HB HANDPIECE, ENDOSCOPIC 1",1156.96,752.02,13270.0,14761.0,2
CDM,2720619,"HB EXTRACTOR, STONE TIPLESS 2",2950.82,1918.03,13270.0,14761.0,2
CDM,2720621,"HB GELPORT, SEAL CAP",4481.23,2912.8,13270.0,14761.0,2
CDM,2720622,HB HEMOCLIP,478.26,310.87,13270.0,14761.0,2
CDM,2720624,"HB ISOLATOR, ENDO XCL / XCR",15472.3,10056.99,13270.0,14761.0,2
CDM,2720627,HB IV MICRODRIP SET,79.4,51.61,13270.0,14761.0,2
CDM,2720631,"HB KIT, WIRE STYLET",736.01,478.41,13270.0,14761.0,2
CDM,2720632,"HB KIT, NEEDLE EYE SNARE WRKSTN",6102.65,3966.72,13270.0,14761.0,2
CDM,2720633,"HB KIT, PROCEDURAL CARDIOVASCULAR",316.35,205.63,13270.0,14761.0,2
CDM,2720637,"HB LEAD EXTENDER, BULLDOG",1752.37,1139.04,13270.0,14761.0,2
CDM,2720638,HB MIDAS REX LUBRICANT/DIFFU,443.89,288.53,13270.0,14761.0,2
CDM,2720639,HB NEEDLE KEITH,117.17,76.16,13270.0,14761.0,2
CDM,2720645,"HB TUBE, GASTROSTOMY",643.96,418.57,13270.0,14761.0,2
CDM,2720649,HB PERFUSION HEMOCONCENTRATOR,1405.94,913.86,13270.0,14761.0,2
CDM,2720654,HB PERFUSION ASSIST PACK,3632.58,2361.18,13270.0,14761.0,2
CDM,2720655,HB RASP MICRO RECIPROCATING,899.68,584.79,13270.0,14761.0,2
CDM,2720656,"HB REAMER, CORING/HEAD",2428.83,1578.74,13270.0,14761.0,2
CDM,2720660,"HB SHUNT, CARDIOVASCULAR 1",1385.65,900.67,13270.0,14761.0,2
CDM,2720661,"HB KIT, CATHETER",645.23,419.4,13270.0,14761.0,2
CDM,2720662,HB ENDO TACKER SYSTEM 5MM,3067.99,1994.19,13270.0,14761.0,2
CDM,2720669,"HB T-TUBE, 1",372.87,242.37,13270.0,14761.0,2
CDM,2720671,HB TUBING LEVEL 1 IR 600,213.07,138.5,13270.0,14761.0,2
CDM,2720672,HB TUBING TUR 2 LEAD,323.25,210.11,13270.0,14761.0,2
CDM,2720673,"HB TUBING, TEFLON",2056.31,1336.6,13270.0,14761.0,2
CDM,2720681,"HB BIOGLUE, SKNCLSR SYRINGE 3",6148.34,3996.42,13270.0,14761.0,2
CDM,2720682,"HB BLADE, GENERAL 1",681.13,442.73,13270.0,14761.0,2
CDM,2720685,"HB CANNULA, ENDO/ERCP/IRRIG",613.35,398.68,13270.0,14761.0,2
CDM,2720692,"HB CATHETER, FOLEY 3WAY 5CC/30CC",757.97,492.68,13270.0,14761.0,2
CDM,2720693,"HB CATHETER, BAKRI TAMPONADE",2088.43,1357.48,13270.0,14761.0,2
CDM,2720695,"HB CATHETER, TEXAS EXTERNAL",193.36,125.68,13270.0,14761.0,2
CDM,2720697,"HB CATHETER, PENUMBRA DELIVERY 6F",4732.37,3076.04,13270.0,14761.0,2
CDM,2720702,"HB CANNULA, VENOUS 1",926.83,602.44,13270.0,14761.0,2
CDM,2720706,HB COOK NEEDLE,2334.97,1517.73,13270.0,14761.0,2
CDM,2720708,HB DRAIN PLEUR-EVAC ADULT/PEDS,614.31,399.3,13270.0,14761.0,2
CDM,2720716,HB INTRO BLUE-ON-BLUE 8FR 260-120,642.71,417.76,13270.0,14761.0,2
CDM,2720717,HB IV BLOOD PUMP Y-TYPE OR,206.39,134.15,13270.0,14761.0,2
CDM,2720721,HB LIGACLIP,304.83,198.14,13270.0,14761.0,2
CDM,2720723,HB BACKGROUND MATERIAL,230.79,150.01,13270.0,14761.0,2
CDM,2720726,HB NO COST SUPPLY,1.0,0.65,13270.0,14761.0,6
CDM,2720738,"HB BRUSH, CYTOLOGY RX",1655.25,1075.91,13270.0,14761.0,2
CDM,2720739,HB DEPT ELECTRODE PASSING NEEDLE,1188.74,772.68,13270.0,14761.0,2
CDM,2720745,"HB ELECTRODE, FETAL SCALP",519.41,337.62,13270.0,14761.0,2
CDM,2720748,HB EP MAP REFERENCE PATCH,8907.76,5790.04,13270.0,14761.0,2
CDM,2720750,"HB NEEDLE, GUN SEMI-AUTO DISP",781.22,507.79,13270.0,14761.0,2
CDM,2720754,HB INDEFLATOR PTCA,1149.45,747.14,13270.0,14761.0,2
CDM,2720760,HB CAST PLASTER SPLINT,1607.685,1044.995,13270.0,14761.0,4
CDM,2720763,HB ELC URINARY DRAIN BAG 154002,159.09,103.41,13270.0,14761.0,2
CDM,2720765,"HB TUBE, TRACHEOSOFT",1058.81,688.23,13270.0,14761.0,2
CDM,2720766,"HB CATHETER, FASTNER PERCU-STAY",164.07,106.65,13270.0,14761.0,2
CDM,2720767,HB FLOW CONTRL DEVICE 44-201,177.54,115.4,13270.0,14761.0,2
CDM,2720768,"HB DISSECTOR, SPONGE PEANUTS",119.54,77.7,13270.0,14761.0,2
CDM,2720769,"HB BLADE, BEAVER",184.0,119.6,13270.0,14761.0,2
CDM,2720770,HB PIN GUIDE,1122.09,729.36,13270.0,14761.0,2
CDM,2720771,HB IV PCA TUBING,2334.97,1517.73,13270.0,14761.0,2
CDM,2720772,"HB STAPLER, ENDOSCOPIC 1",1473.61,957.85,13270.0,14761.0,2
CDM,2720773,HB MERIT MEDICAL RESPONSE KIT,1595.31,1036.95,,,0
CDM,2720777,"HB CANNULA, BISHOP HARMON",140.51,91.33,13270.0,14761.0,2
CDM,2720778,"HB TUBE, REPLACMNT Y-PORT",245.46,159.55,13270.0,14761.0,2
CDM,2720781,"HB DILATOR, VESSEL",1653.3799999999999,1074.695,13270.0,14761.0,4
CDM,2720783,HB DECUBICARE PAD,329.24,214.01,13270.0,14761.0,2
CDM,2720784,HB ADAPTER TUOHY-BORST TBA-6,2334.97,1517.73,,,0
CDM,2720787,"HB TUNNELER, SURGICAL 1",616.58,400.78,13270.0,14761.0,2
CDM,2720789,HB TUBING HOTLINE,2334.97,1517.73,13270.0,14761.0,2
CDM,2720794,"HB MONITORING KIT, INTRAUTERINE PRESSURE CATHETER",1243.79,808.46,13270.0,14761.0,2
CDM,2720799,"HB ELECTRODE, ESU",1942.38,1262.55,13270.0,14761.0,2
CDM,2720800,"HB BLADE, OPTHALMOLOGIC 1",490.86,319.06,13270.0,14761.0,2
CDM,2720806,HB INTRODUCER SHEATH,281.2,182.78,13270.0,14761.0,2
CDM,2720807,"HB CLIP, DISPOSABLE 1",1183.62,769.35,13270.0,14761.0,2
CDM,2720808,HB ENDO ANTI FOG,197.29,128.24,13270.0,14761.0,2
CDM,2720813,HB ESU INSULATED COATED BLADE,147.29,95.74,13270.0,14761.0,2
CDM,2720814,HB SMOKE HOUSE FILTER,223.7,145.41,13270.0,14761.0,2
CDM,2720818,"HB BAG, DRAINAGE 600ML TRU-CLOSE",234.37,152.34,13270.0,14761.0,2
CDM,2720819,"HB NEEDLE, CHIBA",234.37,152.34,13270.0,14761.0,2
CDM,2720823,HB ADHESIVE REPAIR SUPPLY,242.16,157.4,13270.0,14761.0,2
CDM,2720825,"HB BUTTERFLY, IV INFUSION",2334.97,1517.73,13270.0,14761.0,2
CDM,2720835,HB TUBE STOMACH EVACUATOR 32FR,262.78,170.81,13270.0,14761.0,2
CDM,2720843,"HB CANNULA, INTRACARDIAC SUMP",298.58,194.08,13270.0,14761.0,2
CDM,2720845,"HB NEEDLE, LONG, AMNIO, ECHOTIP",519.42,337.62,,,0
CDM,2720847,"HB RELOAD, ENDOSTITCH 1",366.47,238.21,13270.0,14761.0,2
CDM,2720850,"HB TUBING, PRESSURE 1",301.81,196.18,13270.0,14761.0,2
CDM,2720854,HB TUBING SMOKE EVACUATOR,251.04,163.18,13270.0,14761.0,2
CDM,2720856,HB MISCELLANEOUS SUPPLY,5126.280000000001,3332.08,13270.0,14761.0,42
CDM,2720858,HB CLIP APPLIER LIGACLIP,1014.41,659.37,13270.0,14761.0,2
CDM,2720859,"HB SCALPEL, SURGICAL 1",44.58,28.98,13270.0,14761.0,2
CDM,2720860,HB MASTISOL LIQUID ADHESIVE,88.78,57.71,13270.0,14761.0,2
CDM,2720863,"HB SUCTION, RESEVOIR J-P",1129.17,733.96,13270.0,14761.0,2
CDM,2720864,"HB CATHETER, URINARY EXTERNAL",2334.97,1517.73,13270.0,14761.0,2
CDM,2720876,"HB BAG, DRAINAGE URINARY",125.46,81.55,13270.0,14761.0,2
CDM,2720880,"HB KIT, UROSTOMY",2334.97,1517.73,13270.0,14761.0,2
CDM,2720883,HB SNARE 1,306.68,199.34,13270.0,14761.0,2
CDM,2720884,"HB TIP,PULSEVAC FLEX / IRRIGATION",326.03,211.92,13270.0,14761.0,2
CDM,2720896,"HB CORD, DISPOSABLE 1",348.66,226.63,,,0
CDM,2720899,HB PERF PMP PCK MEMBRANE 62003-01,2066.68,1343.34,13270.0,14761.0,2
CDM,2720902,"HB CATHETER, RENAL DILATOR",2108.81,1370.73,,,0
CDM,2720904,HB TERM SPLINT 1,2334.97,1517.73,13270.0,14761.0,2
CDM,2720905,HB ENDOVASCULAR/RENAL DILATOR SET,2141.2,1391.78,13270.0,14761.0,2
CDM,2720913,"HB CANNULA, ARTERIAL FEMORAL 4",2197.3,1428.25,13270.0,14761.0,2
CDM,2720914,HB CATH ROBINSON,754.14,490.19,13270.0,14761.0,2
CDM,2720915,"HB BLADE, SAW 2",1195.59,777.13,13270.0,14761.0,2
CDM,2720916,"HB NEEDLE, BIOPSY",2247.42,1460.82,13270.0,14761.0,2
CDM,2720919,HB KYPHON BONE BIOSPY DEVICE,1619.24,1052.51,13270.0,14761.0,2
CDM,2720921,HB PC CYTOLOGY BRUSH,1631.9,1060.74,13270.0,14761.0,2
CDM,2720922,HB PC TOTAL FACE MASK,3079.59,2001.73,13270.0,14761.0,2
CDM,2720926,HB PC BRONCHOSCOPY FORCEPS,4009.19,2605.97,13270.0,14761.0,2
CDM,2720931,"HB EXTRACTOR, STONE",2324.12,1510.68,,,0
CDM,2720933,"HB CATHETER, SWAN-GANZ W/THROMBO",2358.86,1533.26,13270.0,14761.0,2
CDM,2720935,"HB FORCEPS, ENDOSCOPIC 3",2411.09,1567.21,,,0
CDM,2720936,HB ENDO CLIP,2451.92,1593.75,13270.0,14761.0,2
CDM,2720937,"HB TAP, DISPOSABLE 3",2475.92,1609.35,,,0
CDM,2720944,"HB KIT, CRANIAL ACCESS",2585.73,1680.72,13270.0,14761.0,2
CDM,2720950,HB CATH SIZING BALLOON,2730.87,1775.07,13270.0,14761.0,2
CDM,2720954,"HB TWIST DRILL, SURGICAL 3",2187.38,1421.8,13270.0,14761.0,2
CDM,2720957,"HB SNARE, GOOSE NECK",4502.53,2926.64,13270.0,14761.0,2
CDM,2720958,"HB CATHETER, DRAINAGE APDL",1406.19,914.02,13270.0,14761.0,2
CDM,2720962,"HB CATHETER, ACHALASIA DILATOR",3210.78,2087.01,13270.0,14761.0,2
CDM,2720968,"HB NEEDLE, SPINAL",362.22,235.44,13270.0,14761.0,2
CDM,2720969,HB PERF RESERVOIR OXGYENATOR,3108.65,2020.62,13270.0,14761.0,2
CDM,2720981,"HB TIP, CATHETER INTRODUCER",3147.39,2045.8,13270.0,14761.0,2
CDM,2720983,"HB FORCEPS, ENDOSCOPIC 4",3174.53,2063.44,13270.0,14761.0,2
CDM,2720987,"HB PIN, GUARD",430.42,279.77,13270.0,14761.0,2
CDM,2720992,HB ARTHRO WAND 2,3362.72,2185.77,13270.0,14761.0,2
CDM,2721000,"HB FORCEPS, SPYBITE BIOPSY",3621.06,2353.69,,,0
CDM,2721005,"HB LIGASURE, ESU 2",3838.21,2494.84,13270.0,14761.0,2
CDM,2721011,HB FORCEP BX PIRANHA 505-160,3980.58,2587.38,13270.0,14761.0,2
CDM,2721015,"HB TAP, DISPOSABLE 4",4122.27,2679.48,13270.0,14761.0,2
CDM,2721019,"HB TUBE, TRACHEOSTOMY 1",717.36,466.28,13270.0,14761.0,2
CDM,2721020,"HB TUBE, TRACHEOSTOMY 2",1872.28,1216.98,,,0
CDM,2721022,HB HEMORRHOID STAPLER,4200.7,2730.45,13270.0,14761.0,2
CDM,2721027,"HB CANNULA, VENOUS FEMORAL 2",4367.62,2838.95,13270.0,14761.0,2
CDM,2721047,HB BONE CEMENT REMOVAL SYSTEM,5019.72,3262.82,13270.0,14761.0,2
CDM,2721050,"HB NEEDLE, TRANSJUGULAR LIVER",5263.0,3420.95,13270.0,14761.0,4
CDM,2721056,HB NEURO MICROTARGETING DEVICE,5915.82,3845.28,13270.0,14761.0,2
CDM,2721067,"HB CATHETER, BICAP PROBE",7407.61,4814.95,13270.0,14761.0,4
CDM,2721073,"HB KIT, ENDOVESSEL HARVEST",7886.59,5126.28,13270.0,14761.0,2
CDM,2721080,HB 64-CONTACT STRIP ELECTRODE,8774.3,5703.3,13270.0,14761.0,2
CDM,2721081,"HB CATHETER, PENUMBRA REPERFUSION",8777.26,5705.22,13270.0,14761.0,2
CDM,2721092,HB MICROSYS CATHETER 2-TIP,3678.91,2391.29,13270.0,14761.0,2
CDM,2721105,HB BIOPTOME,4127.12,2682.63,13270.0,14761.0,2
CDM,2721107,"HB BLADE, SHAVER 1",1965.9,1277.84,13270.0,14761.0,2
CDM,2721109,HB BLOOD ADMIN SET Y TYPE,284.01,184.61,13270.0,14761.0,2
CDM,2721110,HB TERM BLOOD PUMP SET W/FILT 7',2334.97,1517.73,13270.0,14761.0,2
CDM,2721112,"HB CANISTER, V.A.C.",703.19,457.07,13270.0,14761.0,2
CDM,2721113,HB CATH FOLEY,1042.64,677.72,13270.0,14761.0,2
CDM,2721114,HB CATH ROBINSON 2-EYE 26FR,396.54,257.75,13270.0,14761.0,2
CDM,2721119,"HB CATHETER, DIAGNOSTIC",771.27,501.33,13270.0,14761.0,4
CDM,2721215,"HB NEEDLE, TRANSEPTAL",2504.12,1627.68,13270.0,14761.0,2
CDM,2721237,"HB K-WIRE, SUPPLY 2",1204.57,782.97,13270.0,14761.0,2
CDM,2721238,HB ENDOSCOPIC STRYKEFLOW II,759.16,493.45,13270.0,14761.0,2
CDM,2721239,"HB TOOL, DISSECTING 1",1139.1,740.41,13270.0,14761.0,2
CDM,2721241,"HB K-WIRE, SUPPLY 3",1847.19,1200.67,13270.0,14761.0,2
CDM,2721244,HB PERFUSION BIO PUMP 1,1959.57,1273.72,13270.0,14761.0,2
CDM,2721254,"HB K-WIRE, SUPPLY 1",467.32,303.76,13270.0,14761.0,2
CDM,2721255,"HB RELOAD, ENDOSCOPIC 2",1745.38,1134.5,13270.0,14761.0,2
CDM,2721256,"HB EXTENSION, SINUS GUIDE",950.52,617.84,13270.0,14761.0,2
CDM,2721258,HB ARTHRO FLOOR SUCTION MAT,548.18,356.32,13270.0,14761.0,2
CDM,2721259,"HB PRESSURIZER, FEMORAL CEMENT",845.88,549.82,13270.0,14761.0,2
CDM,2721298,"HB CATHETER,ANORECTAL MANOSHLD AR",688.15,447.3,,,0
CDM,2721300,"HB PINS, HEADLESS DISPOSABLE",1524.41,990.87,,,0
CDM,2721303,"HB CATHETER, CENTESIS",783.83,509.49,13270.0,14761.0,2
CDM,2721304,"HB KIT, BONOPTY BONE SYSTEM",907.54,589.9,13270.0,14761.0,2
CDM,2721305,"HB NEEDLE, TROCAR",416.0,270.4,13270.0,14761.0,2
CDM,2721307,"HB CATHETER, TROCAR",416.0,270.4,13270.0,14761.0,2
CDM,2721314,"HB PROBE, ABLATION VALLEY LAB",5070.24,3295.66,,,0
CDM,2721317,"HB NEEDLE, BONOPTY BIOPSY",1115.62,725.15,13270.0,14761.0,2
CDM,2721321,"HB NEEDLE, MAXI-CELL",485.75,315.74,13270.0,14761.0,2
CDM,2721322,HB DILATOR,252.47,164.11,13270.0,14761.0,2
CDM,2721323,"HB KIT, BARD BIOPSY SYSTEM",814.46,529.4,13270.0,14761.0,2
CDM,2721324,"HB KIT, EASY CORE BIOPSY SYSTEM",791.38,514.4,13270.0,14761.0,2
CDM,2721325,"HB PROBE, NIM 1",1090.98,709.14,13270.0,14761.0,2
CDM,2721327,"HB VACTHERAPY, CANISTER 300/500ML",708.36,460.43,13270.0,14761.0,2
CDM,2721328,"HB TUBE, VINYL CONNECTOR",416.0,270.4,13270.0,14761.0,2
CDM,2721330,"HB DILATOR, DISPOSABLE 1",1165.72,757.72,13270.0,14761.0,2
CDM,2721351,"HB TUBE, FEEDING 2",1760.5,1144.33,13270.0,14761.0,2
CDM,2721353,"HB PROBE, MONOPOLAR 3",8449.86,5492.41,13270.0,14761.0,2
CDM,2721354,"HB BLADE, REAMER 1",1915.96,1245.37,,,0
CDM,2721357,HB NEURO MONITORING KIT 4,6022.8,3914.82,13270.0,14761.0,2
CDM,2721360,"HB SPRAY SET, CSL/TSSL/BIOCUE",851.88,553.72,13270.0,14761.0,2
CDM,2721362,"HB SIZER, BREAST ALL SIZES",762.19,495.42,13270.0,14761.0,2
CDM,2721363,"HB PIN, PERCUTANEOUS",2328.43,1513.48,13270.0,14761.0,2
CDM,2721368,"HB TAP, DISPOSABLE 2",2083.31,1354.15,,,0
CDM,2721369,"HB CUTTER, ENDOSCOPIC 5",4106.87,2669.47,13270.0,14761.0,2
CDM,2721381,"HB TIP, RUMI",681.53,442.99,13270.0,14761.0,2
CDM,2721383,"HB TUBING, CUSA / MWA",2349.35,1527.08,13270.0,14761.0,2
CDM,2721385,"HB PERFUSION, PACK ADAPTER 1",1273.28,827.63,13270.0,14761.0,2
CDM,2721388,"HB KIT, INTERNAL TRAJECTORY GUIDE",8115.07,5274.8,13270.0,14761.0,2
CDM,2721395,"HB LASER FIBER, 4",5937.89,3859.63,13270.0,14761.0,2
CDM,2721396,"HB LASER FIBER, 1",1900.99,1235.64,,,0
CDM,2721399,"HB CANNULA, ARTERIAL 1",789.06,512.89,13270.0,14761.0,2
CDM,2721402,"HB NEEDLE, MICRODISSECTION",953.47,619.76,13270.0,14761.0,2
CDM,2721403,"HB CATHETER, SEEKING/EMBOL 1",567.91,369.14,13270.0,14761.0,2
CDM,2721405,"HB BLADE, SAW 5",5613.32,3648.66,13270.0,14761.0,2
CDM,2721408,"HB BALLOON, OCCLUSION NEURO",8954.99,5820.74,13270.0,14761.0,2
CDM,2721409,"HB IMMOBILIZER, ALUMI - HAND",496.18,322.52,13270.0,14761.0,2
CDM,2721410,"HB PUNCH, BIOPSY DISPOSABLE",74.75,48.59,,,0
CDM,2721416,"HB SPATULA, BRAIN SILICONE DISP",759.16,493.45,13270.0,14761.0,2
CDM,2721417,"HB LASER FIBER, 2",1145.75,744.74,13270.0,14761.0,2
CDM,2721418,"HB STRAP, FOOT/ANKLE DISTRACTOR",651.6,423.54,,,0
CDM,2721422,"HB RETRACTOR, WOUND 1",935.56,608.11,13270.0,14761.0,2
CDM,2721425,"HB PIN, GUIDE 2",1847.19,1200.67,13270.0,14761.0,2
CDM,2721454,"HB BLADE, SAW 3",2018.24,1311.86,,,0
CDM,2721458,"HB DRAIN, EXTERNAL 1",1424.33,925.81,13270.0,14761.0,2
CDM,2721465,HB TUBE NASO-ENTRO FED NG/J OR,3068.77,1994.7,13270.0,14761.0,2
CDM,2721467,"HB RETRACTOR LP/CHK, ADLT/CHLD",2334.97,1517.73,13270.0,14761.0,2
CDM,2721469,"HB PADS, ARCTIC SUN ADDL PAD",2441.46,1586.95,13270.0,14761.0,2
CDM,2721475,"HB STYLET, PACEMAKR ACCSS LEAD",759.16,493.45,13270.0,14761.0,2
CDM,2721479,"HB KIT, NAVIGATED PEDCLS ACCSS",5144.06,3343.64,,,0
CDM,2721487,"HB COLLAGEN,HEMOSTAT INSTAT MM",879.52,571.69,13270.0,14761.0,2
CDM,2721489,"HB KIT, PLATELET SEPARATION SYSTEM",4719.71,3067.81,,,0
CDM,2721490,HB T-TUBE 4,1889.38,1228.1,13270.0,14761.0,2
CDM,2721491,HB SMALL JOINT CANNULA SET,1151.72,748.62,13270.0,14761.0,2
CDM,2721497,"HB KIT, FRACTURE 5",21644.1,14068.66,13270.0,14761.0,2
CDM,2721498,HB GUIDEWIRE 4,2352.8,1529.32,13270.0,14761.0,2
CDM,2721507,"HB NEEDLE, ELECTRODE MICRO TIP",2334.97,1517.73,13270.0,14761.0,2
CDM,2721508,"HB TOOL, TUNNELING LONG",2396.68,1557.84,,,0
CDM,2721509,HB SPACE PASSING ELEVATOR,882.99,573.94,,,0
CDM,2721514,"HB PROBE, ENDOSCOPIC 2",2199.23,1429.5,13270.0,14761.0,2
CDM,2721515,HB ENDOSCOPIC STRYKEFLOW W/TIP,1549.34,1007.07,13270.0,14761.0,2
CDM,2721533,"HB MANIPULATOR, UTERINE",1124.3,730.79,13270.0,14761.0,2
CDM,2721536,HB ESU SEALER DISSECTING,7743.96,5033.57,13270.0,14761.0,2
CDM,2721539,"HB CATHETER, PACING BALLOON",1013.41,658.72,13270.0,14761.0,2
CDM,2721540,HB BIOPSY FORCEP 7F,1689.29,1098.04,13270.0,14761.0,2
CDM,2721543,"HB CATHETER, EXPORT ASPIRATION",4547.0,2955.55,13270.0,14761.0,2
CDM,2721547,"HB STAPLER, ENDOSCOPIC 2",1815.35,1179.98,13270.0,14761.0,2
CDM,2721548,"HB STAPLER, ENDOSCOPIC 3",2443.31,1588.15,13270.0,14761.0,2
CDM,2721551,"HB BLADE, TRUNCATED",4534.0,2947.1,13270.0,14761.0,2
CDM,2721555,HB PUNCH DISPOSABLE 1,649.92,422.45,13270.0,14761.0,2
CDM,2721557,"HB CATHETER, MULTI-TRACK",775.97,504.38,13270.0,14761.0,2
CDM,2721558,HB PERF CELL SAVER BRAT KIT,1689.18,1097.97,13270.0,14761.0,2
CDM,2721559,HB PERF UNIV 3 SPIKE,1587.74,1032.03,13270.0,14761.0,2
CDM,2721561,"HB CANNULA, VENOUS FEMORAL 1",2266.76,1473.39,13270.0,14761.0,2
CDM,2721563,"HB RETRACTOR, SCROTAL/TISSUE",2884.79,1875.11,13270.0,14761.0,2
CDM,2721564,"HB RETRACTOR, VAGINAL",1782.42,1158.57,13270.0,14761.0,2
CDM,2721566,HB MISC SUPPLY CATH LAB,2334.97,1517.73,13270.0,14761.0,2
CDM,2721570,"HB COLLAGEN, HEMOSTAT INSTAT 2",1920.21,1248.14,13270.0,14761.0,2
CDM,2721573,"HB NEEDLE, BIOPSY 1",745.87,484.82,13270.0,14761.0,2
CDM,2721576,"HB NEEDLE, ASPIRATION 1",1277.87,830.62,13270.0,14761.0,2
CDM,2721577,"HB CATHETER, ANORECTAL DISP.",847.65,550.97,,,0
CDM,2721580,HB SUCTION VALVE 1,345.52,224.59,13270.0,14761.0,2
CDM,2721582,HB CANNULA BLOWER MISTER,885.73,575.72,13270.0,14761.0,2
CDM,2721583,"HB KIT, TRI/QUAD LPRSCPC SYS",3674.55,2388.46,,,0
CDM,2721585,HB PERFUSION LINE SPIKE,2334.97,1517.73,13270.0,14761.0,2
CDM,2721586,HB ESU FILTER SMOKE EVACUATOR,1453.37,944.69,,,0
CDM,2721587,"HB PROBE, PRASS MONOPOLAR STIM",3146.82,2045.43,13270.0,14761.0,2
CDM,2721588,"HB PROBE, BALL TIP PEDICL STIM",3146.82,2045.43,13270.0,14761.0,2
CDM,2721590,"HB PACK, PERFUSION PUMP TABLE1",1428.68,928.64,13270.0,14761.0,2
CDM,2721592,"HB REAMER, MODULAR SHAFT 2",3496.29,2272.59,13270.0,14761.0,2
CDM,2721597,"HB KIT, PATIENT SPINAL CORD",1297.04,843.08,,,0
CDM,2721598,"HB ELECTRODE, ESU 2",1491.77,969.65,13270.0,14761.0,2
CDM,2721605,"HB CANNULA, VENOUS 4",3309.84,2151.4,13270.0,14761.0,2
CDM,2721607,"HB TUBE, ENDOTRACHEAL 3",2605.09,1693.31,13270.0,14761.0,2
CDM,2721611,"HB TUBING, PERFUSION 1",455.21,295.89,13270.0,14761.0,2
CDM,2721613,"HB PROBE, MONOPOLAR 1",1294.31,841.3,13270.0,14761.0,2
CDM,2721617,"HB STAPLER, ENDOSCOPIC 6",4105.05,2668.28,13270.0,14761.0,2
CDM,2721621,"HB CANNULA, ARTERIAL FEMORAL 5",2659.92,1728.95,13270.0,14761.0,2
CDM,2721624,"HB PROBE, MONOPOLAR 2",1886.63,1226.31,13270.0,14761.0,2
CDM,2721632,HB VAC THERAPY SYSTEM,792.51,515.13,13270.0,14761.0,2
CDM,2721637,"HB CLAMP, BULLDOG 1",235.83,153.29,13270.0,14761.0,2
CDM,2721638,"HB CANNULA, INTRODUCTION",877.52,570.39,13270.0,14761.0,2
CDM,2721640,"HB DILATOR,VSSL,PERI,HYDRO CTD",2334.97,1517.73,13270.0,14761.0,2
CDM,2721645,"HB SLEEVE, TRACTION ARM",1039.31,675.55,13270.0,14761.0,2
CDM,2721646,"HB FILTER, BLOOD 1",416.81,270.93,13270.0,14761.0,2
CDM,2721649,HB REAMER SWANSON 1,2334.97,1517.73,,,0
CDM,2721650,HB REAMER CRTCLSCRW RMVR DISP2,3918.58,2547.08,13270.0,14761.0,2
CDM,2721655,"HB NEEDLE, SPINAL",175.51,114.08,13270.0,14761.0,2
CDM,2721663,"HB ELECTRODE, ESU 4",2637.11,1714.12,13270.0,14761.0,2
CDM,2721666,HB BOLT EXTRACTION SCREW RMVL 1,1424.92,926.2,13270.0,14761.0,2
CDM,2721673,"HB CABLE, PACEMAKER ACCESSORY",1025.13,666.33,13270.0,14761.0,2
CDM,2721678,"HB SHEARS, HARMONIC 2",4082.56,2653.66,13270.0,14761.0,2
CDM,2721679,"HB PLEDGET, CARDIOVASCULAR 1",235.79,153.26,13270.0,14761.0,2
CDM,2721684,"HB CATHETER, GLIDECATH HYDRA 1",809.84,526.4,13270.0,14761.0,2
CDM,2721699,HB CANNULA LONG TERM SET 1,1563.3,1016.14,13270.0,14761.0,2
CDM,2721703,"HB CANNULA, CATH VENT SUMP 1",492.05,319.83,13270.0,14761.0,2
CDM,2721704,HB CANNULA AORTIC,479.22,311.49,13270.0,14761.0,2
CDM,2721706,HB ATRIAL CATH MONITORING SET,609.95,396.47,13270.0,14761.0,2
CDM,2721708,HB SUCTION COAGULATOR 1,269.08,174.9,13270.0,14761.0,2
CDM,2721710,"HB SEALANT, HEMOSTATIC",6704.26,4357.77,13270.0,14761.0,2
CDM,2721717,HB PERFUSION OXYGENATOR 6,8303.45,5397.24,13270.0,14761.0,2
CDM,2721718,HB PERFUSION OXYGENATOR 1,2929.26,1904.02,13270.0,14761.0,2
CDM,2721720,HB PERFUSION OXYGENATOR 3,4707.85,3060.1,13270.0,14761.0,2
CDM,2721724,HB PERF FILTER SET 1,1248.08,811.25,13270.0,14761.0,2
CDM,2721727,"HB CATHETER, CARDIOPLEGIA 1",1348.05,876.23,13270.0,14761.0,2
CDM,2721741,"HB RELOAD, ENDOSCOPIC 3",2334.95,1517.72,13270.0,14761.0,2
CDM,2721742,"HB RELOAD, ENDOSCOPIC 4",3008.71,1955.66,13270.0,14761.0,2
CDM,2721743,"HB TUBING, SUCTION",506.02,328.91,13270.0,14761.0,2
CDM,2721745,"HB CANNULA, VENOUS 3",2649.91,1722.44,13270.0,14761.0,2
CDM,2721747,"HB DRAIN, HEMOVAC 1",266.56,173.26,13270.0,14761.0,2
CDM,2721749,"HB BLADE, DERMACARRIER 1",571.5,371.48,13270.0,14761.0,2
CDM,2721751,HB PERFUSION EXTENTION LINE,627.89,408.13,13270.0,14761.0,2
CDM,2721755,"HB BLADE, SAW 4",3042.02,1977.31,13270.0,14761.0,2
CDM,2721773,HB SCREW POWER DRIVER,1230.15,799.6,13270.0,14761.0,2
CDM,2721774,"HB PLATE, TEMPLATE 1",730.41,474.77,13270.0,14761.0,2
CDM,2721777,HB SUCTION KAMVAC CVD MINI 1,553.6,359.84,13270.0,14761.0,2
CDM,2721778,"HB ADAPTER, LUER 1",89.68,58.29,13270.0,14761.0,2
CDM,2721779,"HB CANNULA, VENOUS 6",16342.9,10622.89,13270.0,14761.0,2
CDM,2721781,"HB RETRIEVER, ROTH NET 1",1330.08,864.55,13270.0,14761.0,2
CDM,2721782,HB REAMER CRTCLSCRW RMVR DISP1,2816.5,1830.73,,,0
CDM,2721786,"HB CATHETER, INTRVSC OCT LIGHT",8451.11,5493.22,13270.0,14761.0,2
CDM,2721787,HB AMBULATORY CARDIAC ZIO PATCH,2126.41,1382.17,13270.0,14761.0,2
CDM,2721789,"HB PROBE, ESU 1",4454.13,2895.18,,,0
CDM,2721791,HB SUCTION IRRIGATION SYSTEM 1,1952.86,1269.36,13270.0,14761.0,2
CDM,2721793,"HB DILATOR, DISPOSABLE 1",2278.31,1480.9,13270.0,14761.0,2
CDM,2721805,"HB CANNULA, RADIO FREQUENCY 1",592.01,384.81,13270.0,14761.0,2
CDM,2721806,"HB TUNNELER, SURGICAL 2",3862.14,2510.39,,,0
CDM,2721807,"HB KIT, PLASMA EXCH-SPECTRA/OPTIA",2659.94,1728.96,13270.0,14761.0,2
CDM,2721808,HB ANTICOAGULANT,146.94,95.51,,,0
CDM,2721809,"HB TUBING, BLOOD WARMER",254.49,165.42,13270.0,14761.0,2
CDM,2721810,"HB TUBING, EXTENSION PHERESIS",91.55,59.51,13270.0,14761.0,2
CDM,2721812,"HB KIT,RED BLOOD CELL EXCHANGE",2309.24,1501.01,13270.0,14761.0,2
CDM,2721813,HB TUBING LDL REDUCTION,884.43,574.88,13270.0,14761.0,2
CDM,2721814,HB LDL COLUMNS,9651.75,6273.64,13270.0,14761.0,2
CDM,2721815,HB LDL BLOOD CELL SEPARATOR,1522.58,989.68,13270.0,14761.0,2
CDM,2721816,"HB KIT, PHOTOPHERESIS",10815.3,7029.94,13270.0,14761.0,2
CDM,2721818,"HB KIT, STEM CELL COLLECTION",2093.95,1361.07,13270.0,14761.0,2
CDM,2721819,"HB KIT, WHITE CELL DEPLETION",2093.95,1361.07,13270.0,14761.0,2
CDM,2721823,"HB BASKET, RETRIEVAL III",5336.86,3468.96,13270.0,14761.0,2
CDM,2721825,"HB BASKET, LITHO MECHANICAL",6535.01,4247.76,13270.0,14761.0,2
CDM,2721826,"HB CATHETER, ERCP",1726.18,1122.02,13270.0,14761.0,2
CDM,2721827,"HB CANNULA, ERCP SWING TIP",2333.27,1516.63,13270.0,14761.0,2
CDM,2721828,HB SPHINCTERTOME/PAPILLOTOME I,2175.77,1414.25,13270.0,14761.0,2
CDM,2721829,HB SPHINCTERTOME/PAPILLOTOMEII,2843.1,1848.02,13270.0,14761.0,2
CDM,2721830,"HB BALLOON,RX EXTRACT/MULTI 3V",2007.98,1305.19,13270.0,14761.0,2
CDM,2721831,"HB STENT, RETRIEVER",1757.81,1142.58,13270.0,14761.0,2
CDM,2721834,"HB OVERTUBE, DOUBLE BALLOON I",2702.73,1756.77,13270.0,14761.0,2
CDM,2721836,"HB OVERTUBE, GASTRIC GARDIS",2136.21,1388.54,13270.0,14761.0,2
CDM,2721837,"HB TUBE, JEJUN GW(FEEDING)",3150.41,2047.77,13270.0,14761.0,2
CDM,2721838,"HB CAPSULE, WIRELESS PILLCAM",4671.59,3036.53,13270.0,14761.0,2
CDM,2721846,"HB FORCEPS, RESCUE",5897.57,3833.42,13270.0,14761.0,2
CDM,2721849,"HB BALLOON, ENDOSCOPY EXTRACTN",2585.37,1680.49,13270.0,14761.0,2
CDM,2721850,HB RAPID REFILL CONT. INJ SYS,558.52,363.04,13270.0,14761.0,2
CDM,2721852,"HB NEEDLE, HD U/S ACCESS",3950.15,2567.6,13270.0,14761.0,2
CDM,2721854,"HB SUCTION, ENDO BROVAC",3367.71,2189.01,13270.0,14761.0,2
CDM,2721855,HB OTSC SYSTEM SET 100.10,4141.39,2691.9,,,0
CDM,2721858,HB OTSC TWIN GRASPER 200.45,5257.34,3417.27,13270.0,14761.0,2
CDM,2721866,"HB ELECTRODE, ESU 5",4459.27,2898.53,13270.0,14761.0,2
CDM,2721867,"HB CAPSULE, ENDOSCOPE DEL SYS",1891.35,1229.38,13270.0,14761.0,2
CDM,2721868,"HB KIT, ENDO MUCUS RESECTION",2398.78,1559.21,,,0
CDM,2721872,"HB BLADE, TRUNCATED 1",5738.1,3729.77,13270.0,14761.0,2
CDM,2721873,HB ENDO CATCH 1,688.3,447.39,13270.0,14761.0,2
CDM,2721875,"HB COBLATOR, ENT 1",2498.72,1624.17,,,0
CDM,2721879,"HB SHEARS, HARMONIC 1",2355.2,1530.88,13270.0,14761.0,2
CDM,2721883,HB DRIVER AMPLATZER TORQUE 1,5366.46,3488.2,13270.0,14761.0,2
CDM,2721891,"HB KIT,TUBE GASTROSTOMY FEEDING",1484.29,964.79,13270.0,14761.0,2
CDM,2721892,HB OTSC SYSTEM SET 100.12,4606.75,2994.39,13270.0,14761.0,2
CDM,2721893,"HB KIT, TUBE JEJUNAL FEEDING",1806.9,1174.49,13270.0,14761.0,2
CDM,2721894,"HB NEEDLE,ECHOTIP CELIAC PLEXUS",2582.11,1678.37,13270.0,14761.0,2
CDM,2721900,"HB TUBE, NASAOGASTRIC",2456.03,1596.42,13270.0,14761.0,2
CDM,2721901,"HB KIT, COAXIAL TEMNO BX SYSTEM",973.78,632.96,,,0
CDM,2721905,HB OTSC SYSTEM SET 100.27,4839.08,3145.4,13270.0,14761.0,2
CDM,2721906,HB OTSC SYSTEM SET 100.14,5210.73,3386.97,,,0
CDM,2721909,"HB DISSECTOR, BALLOON ENDO 3",3995.41,2597.02,,,0
CDM,2721915,HB CONNECTOR SMARTSTITCH,1604.31,1042.8,,,0
CDM,2721917,"HB PROBE, RADIO FREQUENCY 1",4316.15,2805.5,13270.0,14761.0,2
CDM,2721919,HB DRAIN 2,2160.45,1404.29,13270.0,14761.0,2
CDM,2721921,"HB GUIDE, DRILL 2",2416.72,1570.87,,,0
CDM,2721925,"HB BLADE, OSTEOTOME 1",1837.51,1194.38,13270.0,14761.0,2
CDM,2721926,"HB BLADE, OSTEOTOME 2",2571.47,1671.46,13270.0,14761.0,2
CDM,2721930,"HB DRILL BIT, DISPOSABLE 1",845.73,549.72,13270.0,14761.0,2
CDM,2721931,"HB DRILL BIT, DISPOSABLE 2",1455.39,946.0,13270.0,14761.0,2
CDM,2721932,"HB DRILL BIT, DISPOSABLE 3",1894.34,1231.32,13270.0,14761.0,2
CDM,2721933,"HB DRILL BIT, DISPOSABLE 4",2424.42,1575.87,13270.0,14761.0,2
CDM,2721934,"HB DRILL BIT, DISPOSABLE 5",2872.9,1867.39,13270.0,14761.0,2
CDM,2721935,"HB DRILL BIT, DISPOSABLE 6",3394.55,2206.46,13270.0,14761.0,2
CDM,2721936,"HB DRILL BIT, DISPOSABLE 7",4236.3,2753.6,13270.0,14761.0,2
CDM,2721937,"HB DRILL BIT, DISPOSABLE 8",4915.44,3195.04,13270.0,14761.0,2
CDM,2721942,HB PREVALON BOOT,964.86,627.16,13270.0,14761.0,2
CDM,2721943,"HB CATH, CNTRL VENOUS, SINGLE",640.43,416.28,,,0
CDM,2721944,"HB KNIFE, BAYONET 1",2211.69,1437.6,13270.0,14761.0,2
CDM,2721946,HB NO COST ITEM SUPPLY-CL,1.0,0.65,13270.0,14761.0,2
CDM,2721948,"HB KNIFE, TRIANGLE TIP",5775.55,3754.11,,,0
CDM,2721953,"HB SCALPEL, SURGICAL 10 STER",2334.97,1517.73,,,0
CDM,2721973,"HB DRAIN, RESERVOIR",152.45,99.09,13270.0,14761.0,2
CDM,2721975,HB FLOSEAL HEMOSTAT 5ML,1902.77,1236.8,,,0
CDM,2721981,HB PRP INJECTION KIT,2063.8,1341.47,,,0
CDM,2721983,"HB KIT, SPINAL CORD STIM 2",13510.8,8782.02,,,0
CDM,2721984,HB BOLT EXTRACTION SCREW RMVL2,3123.34,2030.17,13270.0,14761.0,2
CDM,2721985,"HB NEEDLE, MAX FORCE INJECTOR",686.87,446.47,13270.0,14761.0,2
CDM,2721987,"HB GRASPER, MONOPOLAR HEMOST",2402.81,1561.83,13270.0,14761.0,2
CDM,2721990,HB ATTACHMENT DISTANT DISPOSBL,990.24,643.66,13270.0,14761.0,2
CDM,2721993,"HB HEARTMATE, CENTRIMAG PUMP",50747.0,32985.55,13270.0,14761.0,2
CDM,2722000,HB ATHERECTOMY DEVICE,25679.1,16691.42,13270.0,14761.0,2
CDM,2722001,"HB PROBE, MICROWAVE",11775.2,7653.88,13270.0,14761.0,2
CDM,2722009,"HB BALLOON, ULTRASOUND LIN/RAD",494.65,321.52,13270.0,14761.0,2
CDM,2722020,"HB TUBE, FEEDING 1",630.47,409.81,13270.0,14761.0,2
CDM,2722022,"HB PIN, STEINMAN 1",348.54,226.55,13270.0,14761.0,2
CDM,2722023,"HB PIN, STEINMAN 2",1309.62,851.25,13270.0,14761.0,2
CDM,2722026,HB FIBER LASER R-1,917.5,596.38,,,0
CDM,2722027,HB FIBER LASER R-2,1073.82,697.98,,,0
CDM,2722028,HB FIBER LASER R-3,1704.26,1107.77,,,0
CDM,2722031,"HB OCCLUDERS, COLPO-PNEUMO",1086.64,706.32,13270.0,14761.0,2
CDM,2722032,HB TROCAR SITE CLOSURE SYS,589.45,383.14,13270.0,14761.0,2
CDM,2722034,HB PERF ANTICOAGULANT LINE,448.48,291.51,13270.0,14761.0,2
CDM,2722035,HB INFINITY SAMPLING SYSTEM,2334.97,1517.73,13270.0,14761.0,2
CDM,2722037,HB INFLATION SYSTEM BIG60,756.8,491.92,13270.0,14761.0,2
CDM,2722038,HB CYSTOTOME,3647.99,2371.19,13270.0,14761.0,2
CDM,2722053,"HB NEEDLE, BIOPSY SYSTEM",589.52,383.19,,,0
CDM,2722056,HB MIC-KEY MEASURING STOMA,193.63,125.86,13270.0,14761.0,2
CDM,2722062,HB TISSUE HELIX,2042.54,1327.65,13270.0,14761.0,2
CDM,2722063,"HB CATHETER, RADIO ENDO",9718.53,6317.04,13270.0,14761.0,2
CDM,2722074,"HB SEALER, BIPOLAR 1",4610.45,2996.79,13270.0,14761.0,2
CDM,2722077,"HB LIGASURE, ESU 3",4558.68,2963.14,13270.0,14761.0,2
CDM,2722079,HB VAC THERAPY SYSTEM 2,1588.49,1032.52,13270.0,14761.0,2
CDM,2722080,"HB ROD, REAMING 1",1583.79,1029.46,13270.0,14761.0,2
CDM,2722082,"HB SEALANT, HEMOSTATIC",5609.95,3646.47,13270.0,14761.0,2
CDM,2722085,HB TUBING HTA PROCEDURE SET 1,9236.31,6003.6,,,0
CDM,2722088,"HB KIT, MENISCAL REPAIR",1307.46,849.85,,,0
CDM,2722090,HB TRACKER FUSION ENT,1765.76,1147.74,13270.0,14761.0,2
CDM,2722092,"HB REAMER, ORTHO 1",4641.24,3016.81,13270.0,14761.0,2
CDM,2722094,"HB CUP, VACCUUM EXTRACTION",651.56,423.51,13270.0,14761.0,2
CDM,2722095,HB SURGICEL,1041.54,677.0,13270.0,14761.0,2
CDM,2722097,"HB CATHETER, ENDO BIL DRAIN",1425.16,926.35,13270.0,14761.0,2
CDM,2722101,HB SURGICAL ELECTR KNIFE DISP,5375.88,3494.32,13270.0,14761.0,2
CDM,2722102,"HB TUBE, MIC-KEY JEJUNAL STOMA",3352.82,2179.33,13270.0,14761.0,2
CDM,2722104,"HB TOOL, ULTRA DISK DRIVE",4332.87,2816.37,13270.0,14761.0,2
CDM,2722105,HB INSERTION KIT ART/VEN,827.47,537.86,13270.0,14761.0,2
CDM,2722106,"HB FORCEPS, ENDOSCOPIC 1",432.2,280.93,13270.0,14761.0,2
CDM,2722109,HB EXTRACTION BALLOON 1,2007.98,1305.19,13270.0,14761.0,2
CDM,2722111,HB KNOT PUSHER 1,1785.27,1160.43,13270.0,14761.0,2
CDM,2722117,"HB CATHETER, FAST CLOSURE 1",6962.97,4525.93,,,0
CDM,2722127,"HB FORCEPS, ENDOSCOPIC 2",1670.16,1085.6,13270.0,14761.0,2
CDM,2722132,HB PREP CATHETER,1806.97,1174.53,,,0
CDM,2722134,HB SPECIMEN COLLECTION SYSTEM1,692.84,450.35,13270.0,14761.0,2
CDM,2722136,"HB DISSECTOR, ARTICULATING 1",9649.59,6272.23,13270.0,14761.0,2
CDM,2722137,HB PUSHER COIL NEURO,2074.78,1348.61,13270.0,14761.0,2
CDM,2722142,"HB PROBE, PEN 1",13433.0,8731.45,13270.0,14761.0,2
CDM,2722144,"HB PROBE, PEN 3",17798.4,11568.96,13270.0,14761.0,2
CDM,2722148,HB LUMBAR CATHETER 1,1796.14,1167.49,13270.0,14761.0,2
CDM,2722149,"HB TOOL, DISSECTING 3",3005.85,1953.8,13270.0,14761.0,2
CDM,2722153,HB DISPOSABLE INSTRUMENTS 1,6741.46,4381.95,,,0
CDM,2722157,"HB HANDPIECE, NEURO 1",17724.6,11520.99,13270.0,14761.0,2
CDM,2722158,HB HANDPIECE BENDING TOOL,692.84,450.35,13270.0,14761.0,2
CDM,2722160,HB DRAINAGE SYSTEM 1,718.9,467.29,13270.0,14761.0,2
CDM,2722162,"HB SCREW, STEREOTACTIC 1",1022.93,664.9,13270.0,14761.0,2
CDM,2722165,HB HAND DRILL DISPOSABLE 1,1077.24,700.21,13270.0,14761.0,2
CDM,2722167,"HB NEEDLE, BREAST VACUUM ATEC",3464.57,2251.97,,,0
CDM,2722169,"HB CATHETER, SINGLE LUMEN CAT895",3781.36,2457.88,,,0
CDM,2722170,"HB CATHETER, DUAL LUMEN CAT880",4609.88,2996.42,13270.0,14761.0,2
CDM,2722174,"HB TOOL, SIZING 1",1836.79,1193.91,,,0
CDM,2722185,HB FOREIGN BODY HOOD,2334.97,1517.73,13270.0,14761.0,2
CDM,2722189,HB NERVE STIMULATOR 2,3733.78,2426.96,13270.0,14761.0,2
CDM,2722192,HB ENDO ANTI-FOG 1,642.53,417.64,13270.0,14761.0,2
CDM,2722194,"HB PIN, STEINMAN 3",2349.25,1527.01,13270.0,14761.0,2
CDM,2722196,HB BOLT EXTRACTION SCREW RMVL 2,2999.81,1949.88,13270.0,14761.0,2
CDM,2722203,HB CANNULA AND STYLET 1,2256.92,1467.0,13270.0,14761.0,2
CDM,2722205,HB STINGRAY CTO BALLOON,9358.9,6083.28,13270.0,14761.0,2
CDM,2722207,HB DRY SEAL SHEATH,3375.71,2194.21,13270.0,14761.0,2
CDM,2722213,"HB BLADE, QUADCUT 1",1523.92,990.55,13270.0,14761.0,2
CDM,2722214,"HB BLADE, QUADCUT 2",2198.99,1429.34,13270.0,14761.0,2
CDM,2722217,HB LOCKING BIOPSY CAP,264.11,171.67,13270.0,14761.0,2
CDM,2722219,"HB CATHETER, SPRAY",2279.69,1481.8,13270.0,14761.0,2
CDM,2722222,"HB CANNULA, ARTERIAL 2",1907.64,1239.97,13270.0,14761.0,2
CDM,2722223,HB STERNAL CABLE SYSTEM,1332.08,865.85,13270.0,14761.0,2
CDM,2722224,HB SUCTION WATER SEAL,830.73,539.97,13270.0,14761.0,2
CDM,2722229,HB OBTURATOR 1,566.49,368.22,13270.0,14761.0,2
CDM,2722233,"HB BLADE, ROTATING 1",1514.87,984.67,13270.0,14761.0,2
CDM,2722234,HB ANES PRESSURE BAG DISP,628.02,408.21,13270.0,14761.0,2
CDM,2722235,"HB CATHETER, ENDOVASCULAR",17780.1,11557.06,13270.0,14761.0,2
CDM,2722247,HB INFLATION DEVICE,757.26,492.22,13270.0,14761.0,2
CDM,2722248,HB IMPELLA PURGE CASSETTE,2336.56,1518.76,13270.0,14761.0,2
CDM,2722255,"HB KNIFE, OPHTHALMIC 1",307.68,199.99,13270.0,14761.0,2
CDM,2722256,HB BONE CUTTER 1,743.86,483.51,13270.0,14761.0,2
CDM,2722257,"HB KIT, PORTAL ENTRY 1",2314.83,1504.64,,,0
CDM,2722259,HB TAMPONADE BALLOON KIT,2499.44,1624.64,13270.0,14761.0,2
CDM,2722260,"HB SHEARS, HARMONIC 4",5911.08,3842.2,13270.0,14761.0,2
CDM,2722267,HB WATCHMAN ACCESS SYSTEM,6865.88,4462.82,13270.0,14761.0,2
CDM,2722270,HB TRANSANAL ACCESS PLATFORM,5788.13,3762.28,13270.0,14761.0,2
CDM,2722273,HB CATHETER PH IMPEDANCE,1613.63,1048.86,,,0
CDM,2722276,"HB SPACER, TIBIAL/FEMORAL 2",8478.34,5510.92,13270.0,14761.0,2
CDM,2722277,"HB KIT, THERAPEUTIC DOUBLE PHLEBOTOMY",1128.1,733.26,13270.0,14761.0,2
CDM,2722279,"HB NEEDLE, BIOPSY",1355.19,880.87,13270.0,14761.0,2
CDM,2722280,"HB NEEDLE, BIOPSY 4",3350.53,2177.84,13270.0,14761.0,2
CDM,2722282,"HB NEEDLE, BIOPSY 6",5301.14,3445.74,13270.0,14761.0,2
CDM,2722285,HB BARRIER PROTECTIVE LIQUID,81.08,52.7,13270.0,14761.0,2
CDM,2722286,HB BARRIER RING,162.89,105.88,13270.0,14761.0,2
CDM,2722288,"HB BALLOON, ENDOSCOPY PULM BIOPSY",3791.16,2464.25,13270.0,14761.0,2
CDM,2722289,"HB ADAPTER, ENDOSCOPY BIOPSY",1114.01,724.11,13270.0,14761.0,2
CDM,2722290,"HB POSITIONER, DISPOSABLE 1",658.94,428.31,13270.0,14761.0,2
CDM,2722291,"HB POSITIONER, DISPOSABLE 2",1873.13,1217.53,13270.0,14761.0,2
CDM,2722295,HB DELIVERY SYSTEM EVOLUTR,17871.2,11616.28,13270.0,14761.0,2
CDM,2722296,HB LOADING SYSTEM EVOLUTR,3878.18,2520.82,13270.0,14761.0,2
CDM,2722299,HB EP CABLE UMBILICAL,6847.44,4450.84,13270.0,14761.0,2
CDM,2722300,"HB SENSOR, ANAL/EMG STIMULATION",1011.06,657.19,,,0
CDM,2722304,HB BREEZA DRINK /CAN,208.69,135.65,13270.0,14761.0,2
CDM,2722306,"HB KIT, COOLED RADIOFREQUENCY",6625.01,4306.26,,,0
CDM,2722308,"HB TERM PAD, GROUNDING",2334.97,1517.73,,,0
CDM,2722309,"HB KIT, COOLED RADIOFREQUENCY ACTIVE TIP",11395.7,7407.21,,,0
CDM,2722316,HB BRAINPATH SHEATH,8444.26,5488.77,13270.0,14761.0,2
CDM,2722317,HB BRAINPATH HOOKS,1269.44,825.14,13270.0,14761.0,2
CDM,2722318,"HB SCALPEL, BONE",3998.8,2599.22,13270.0,14761.0,2
CDM,2722319,"HB SCISSOR, ENDOSCOPIC",3146.49,2045.22,13270.0,14761.0,2
CDM,2722320,HB PERFUSION CANNULA BLUNT,3049.61,1982.25,13270.0,14761.0,2
CDM,2722323,HB PERFUSION SWITCH,702.87,456.87,13270.0,14761.0,2
CDM,2722324,HB DV FORCEPS BIPOLAR REPOSABLE,2855.85,1856.3,13270.0,14761.0,2
CDM,2722325,HB DV FORCEPS PROGRASP REPOSABLE,2497.81,1623.58,13270.0,14761.0,2
CDM,2722326,HB DV DRIVER NEEDLE REPOSABLE,2497.81,1623.58,13270.0,14761.0,2
CDM,2722327,HB DV SCISSORS MONO REPOSABLE,3301.84,2146.2,13270.0,14761.0,2
CDM,2722331,"HB PROBE, ABLATION",12305.1,7998.32,13270.0,14761.0,2
CDM,2722332,HB INFLOW TUBING SET,980.4,637.26,13270.0,14761.0,2
CDM,2722333,HB TISSUE REMOVAL STANDARD,6908.79,4490.71,,,0
CDM,2722334,HB TISSUE REMOVAL XL,7701.98,5006.29,13270.0,14761.0,2
CDM,2722335,HB TERM SEAL SCOPE SET,2334.97,1517.73,13270.0,14761.0,2
CDM,2722338,HB BALLOON APPLICATOR,11395.3,7406.94,,,0
CDM,2722339,"HB CLIP, LIGATING",679.87,441.92,13270.0,14761.0,2
CDM,2722342,HB KIT BMAC ANGEL,8332.57,5416.17,13270.0,14761.0,2
CDM,2722343,"HB SHEARS, HARMONIC",6892.36,4480.03,13270.0,14761.0,2
CDM,2722344,"HB KIT, ENDOMETRIAL ABLATION",7366.96,4788.52,,,0
CDM,2722345,HB PLEURX DRAINAGE,1000.31,650.2,13270.0,14761.0,2
CDM,2722348,HB MAX CANISTER,599.42,389.62,13270.0,14761.0,2
CDM,2722351,"HB CATHETER 6, STRAIGHT TIP",3103.78,2017.46,13270.0,14761.0,2
CDM,2722354,HB SEPARATOR 6,1773.59,1152.83,13270.0,14761.0,2
CDM,2722357,"HB CATHETER  SELECT NERUON BER, 5 FR",205.27,133.43,13270.0,14761.0,2
CDM,2722358,HB BLADELESS OBTURATOR,587.91,382.14,13270.0,14761.0,2
CDM,2722359,HB DV VESSEL SEALER,5540.52,3601.34,13270.0,14761.0,2
CDM,2722360,HB LITHOTRIPTOR CABLE,1727.61,1122.95,,,0
CDM,2722361,HB DV GRASPER REPOSABLE,2443.6,1588.34,13270.0,14761.0,2
CDM,2722363,"HB CATHETER, CORONARY DIAGNOSTIC",4842.77,3147.8,13270.0,14761.0,2
CDM,2722366,"HB NEEDLE, DEFLUX",1042.79,677.81,13270.0,14761.0,2
CDM,2722369,"HB KIT, VESSEL HARVESTING",8109.26,5271.02,13270.0,14761.0,2
CDM,2722373,HB DV SCISSORS REPOSABLE,2315.52,1505.09,13270.0,14761.0,2
CDM,2722393,HB AEROCHAMBER,168.88,109.77,13270.0,14761.0,2
CDM,2722481,HB SYSTEM VISIGI 3D SLEEVE GASTRE,2289.37,1488.09,13270.0,14761.0,2
CDM,2722497,HB DV CANNULA REDUCER,566.57,368.27,13270.0,14761.0,2
CDM,2722498,HB DV CLIP APPLIER REPOSABLE,438.46,285.0,13270.0,14761.0,2
CDM,2722503,HB GELPORT PLATFORM,2944.47,1913.91,13270.0,14761.0,2
CDM,2722504,HB ARTHRO WAND,5007.1,3254.62,,,0
CDM,2722507,HB CATHETER SPYGLASS,16934.5,11007.43,13270.0,14761.0,2
CDM,2722509,"HB FORCEP, ENDOSCOPIC",4498.02,2923.71,13270.0,14761.0,2
CDM,2722511,HB POWERPICK,1532.18,995.92,13270.0,14761.0,2
CDM,2722514,HB PERFUSION CARDIOPLEGIA SET,645.4,419.51,13270.0,14761.0,2
CDM,2722516,HB NAIL INSERTION SLEEVE,1982.15,1288.4,13270.0,14761.0,2
CDM,2722517,"HB KIT, DRILL AND WRENCH",4542.36,2952.53,13270.0,14761.0,2
CDM,2722519,HB TRUFREEZE ACTIVE VENTING SPRAY KIT,12531.7,8145.61,13270.0,14761.0,2
CDM,2722520,HB CARPAL TUNNEL RELEASE SYSTEM,6619.76,4302.84,13270.0,14761.0,2
CDM,2722521,HB BALLOON RUMI,1257.94,817.66,13270.0,14761.0,2
CDM,2722522,HB PERFUSION PIGTAIL LINE,338.31,219.9,13270.0,14761.0,2
CDM,2722523,HB CARDIOHELP HLS SET,33093.8,21510.97,13270.0,14761.0,2
CDM,2722525,HB TITANIUM FASTENERS,6476.87,4209.97,13270.0,14761.0,2
CDM,2722527,HB TISSUE REMOVAL REACH,7692.46,5000.1,13270.0,14761.0,2
CDM,2722528,HB TISSUE REMOVAL LITE,5140.12,3341.08,,,0
CDM,2722538,"HB INTRODUCER, OSTEO TOOL",3154.35,2050.33,13270.0,14761.0,2
CDM,2722539,HB PULMONARY BALLOON DILATOR,3104.09,2017.66,13270.0,14761.0,2
CDM,2722540,HB DV REPOSABLE DISSECTOR,2900.1,1885.07,13270.0,14761.0,2
CDM,2722542,HB BONE GRAFTING KIT,7639.02,4965.36,13270.0,14761.0,2
CDM,2722543,"HB HANDPIECE, NEURO",15320.9,9958.59,13270.0,14761.0,2
CDM,2722544,"HB HANDPIECE, NEURO",16637.9,10814.64,13270.0,14761.0,2
CDM,2722545,HB ENDOSCOPIC SEAL,249.81,162.38,13270.0,14761.0,2
CDM,2722546,HB OBTURATOR PORT,1328.84,863.75,13270.0,14761.0,2
CDM,2722547,HB FILTERED TUBE SET,1361.37,884.89,13270.0,14761.0,2
CDM,2722548,"HB BLADE, SHAVER",2100.44,1365.29,13270.0,14761.0,2
CDM,2722549,HB CUSA STANDARD TIP,4858.65,3158.12,13270.0,14761.0,2
CDM,2722550,HB DV REPOSABLE HOOKS,1683.59,1094.33,13270.0,14761.0,2
CDM,2722551,HB DV REPOSABLE RETRACTOR,3104.09,2017.66,13270.0,14761.0,2
CDM,2722552,HB PROTECTION SLEEVE,1033.21,671.59,13270.0,14761.0,2
CDM,2722554,"HB SLEEVE, OUTER PROTECTION",1565.35,1017.48,13270.0,14761.0,2
CDM,2722555,HB PROBE EXTENSION CABLE,1380.59,897.38,13270.0,14761.0,2
CDM,2722557,"HB PROBE, BIPOLAR",5469.11,3554.92,,,0
CDM,2722561,HB CARTRIDGE CRRT,2159.17,1403.46,13270.0,14761.0,2
CDM,2722566,"HB KIT, DISPOSABLE INSTRUMENTS",2129.99,1384.49,13270.0,14761.0,2
CDM,2722567,"HB STAPLER, ENDOSCOPIC",5114.36,3324.33,13270.0,14761.0,2
CDM,2722569,"HB PROBE, DOPPLER",3297.75,2143.54,13270.0,14761.0,2
CDM,2722574,HB PROLACT +8 40ML,2737.17,1779.16,13270.0,14761.0,2
CDM,2722575,HB PROLACT +10 50ML,3243.95,2108.57,13270.0,14761.0,2
CDM,2722581,"HB PROBE, ABLATION",15020.8,9763.52,13270.0,14761.0,2
CDM,2722582,HB CAROTID SHUNT,5916.99,3846.04,13270.0,14761.0,2
CDM,2722604,HB TERM CABLE OR 1MM X 16 61CM IN EXTENSION,2334.97,1517.73,,,0
CDM,2722605,"HB DRIVER, DISPOSABLE",919.25,597.51,13270.0,14761.0,2
CDM,2722608,HB AIMING GUIDES,377.27,245.23,13270.0,14761.0,2
CDM,2722619,"HB TIP, ASPIRATION",4749.27,3087.03,13270.0,14761.0,2
CDM,2722620,"HB KIT, CEMENT MIXING",1846.21,1200.04,13270.0,14761.0,2
CDM,2722621,HB THREAD LOCKING SLEEVE,2931.15,1905.25,13270.0,14761.0,2
CDM,2722622,"HB MANIPULATOR, UTERINE",1723.5,1120.28,13270.0,14761.0,2
CDM,2722623,"HB BLADE, DERMATOME",752.38,489.05,13270.0,14761.0,2
CDM,2722624,"HB KIT, AUTOMATED MANIFOLD",2016.18,1310.52,,,0
CDM,2722628,HB ADJUSTABLE ENDOSCOPIC VALVE,755.32,490.96,13270.0,14761.0,2
CDM,2722630,HB SPINAL CORD CABLE,51.72,33.62,,,0
CDM,2722632,"HB BAG, TISSUE RETRIEVAL",1259.38,818.6,13270.0,14761.0,2
CDM,2722633,HB DV BLADELESS OBTURATOR,595.68,387.19,13270.0,14761.0,2
CDM,2722634,HB BALLOON DILATOR,1927.49,1252.87,13270.0,14761.0,2
CDM,2722637,HB ERCP SAMPLING SYSTEM,1521.01,988.66,13270.0,14761.0,2
CDM,2722638,HB INJECTABLE SUBMUCOSAL COMPOSITION,1278.59,831.08,13270.0,14761.0,2
CDM,2722639,HB PROTEK DUO KIT,41061.2,26689.78,13270.0,14761.0,2
CDM,2722649,"HB BINDER, PELVIC",2170.28,1410.68,13270.0,14761.0,2
CDM,2722660,"HB DETACHER, AZUR",2064.77,1342.1,13270.0,14761.0,2
CDM,2722665,"HB TUBING, ASPIRATION",3630.97,2360.13,13270.0,14761.0,2
CDM,2722666,HB MAX CANISTER 1,3630.97,2360.13,13270.0,14761.0,2
CDM,2722668,"HB VALVE, ROTATING HEMOSTATIC",389.98,253.49,13270.0,14761.0,2
CDM,2722676,"HB REAMER, METATARSALPHALANGEAL",3241.56,2107.01,,,0
CDM,2722677,HB SUCTION TOOL REMOVABLE SHEATH,2334.97,1517.73,13270.0,14761.0,2
CDM,2722679,"HB CORD, BIPOLAR HIGH FREQUENCY",2577.89,1675.63,,,0
CDM,2722680,HB COMPRESSION APPARATUS,665.17,432.36,13270.0,14761.0,2
CDM,2722681,"HB CANNULA, EXTRACTION",943.05,612.98,13270.0,14761.0,2
CDM,2722682,HB UNIVERSAL FILL KIT,301.53,195.99,13270.0,14761.0,2
CDM,2722683,"HB HANDPIECE, SURGICAL GUIDE",2739.0,1780.35,,,0
CDM,2722687,HB TISSUE HARVESTING SYSTEM,4548.24,2956.36,13270.0,14761.0,2
CDM,2722688,HB SAFETY PEG KIT,1389.45,903.14,13270.0,14761.0,2
CDM,2722689,"HB PROBE, PNEUMATIC",2570.48,1670.81,13270.0,14761.0,2
CDM,2722690,HB TRACTION ROPE,2334.97,1517.73,13270.0,14761.0,2
CDM,2722691,HB SEALANT HEMOSTATIC,1521.01,988.66,13270.0,14761.0,2
CDM,2722698,HB TITANIUM FASTENERS,3550.48,2307.81,13270.0,14761.0,2
CDM,2722699,HB DV REPOSABLE RETRACTOR,2657.71,1727.51,13270.0,14761.0,2
CDM,2722700,HB DV SCISSORS REPOSABLE,5101.06,3315.69,13270.0,14761.0,2
CDM,2722701,"HB PROBE, ULTRASOUND",4984.29,3239.79,13270.0,14761.0,2
CDM,2722702,HB CARTRIDGE NEEDLE INJECTOR,2505.44,1628.54,,,0
CDM,2722704,HB ENDOSCOPY BRAVO CAPSULE,2722.74,1769.78,13270.0,14761.0,2
CDM,2722707,"HB CAP, DISTAL ATTACHMENT",429.37,279.09,13270.0,14761.0,2
CDM,2722708,HB DV CAUTERY SPATULA,2331.24,1515.31,13270.0,14761.0,2
CDM,2722709,HB PRECISION INFLATION INJECTOR,1601.95,1041.27,13270.0,14761.0,2
CDM,2722710,HB SPINE BALLOON,16633.1,10811.51,13270.0,14761.0,2
CDM,2722711,HB BONEWAX,153.45,99.74,13270.0,14761.0,2
CDM,2722713,HB FIDUCIAL ECHO TIP NEEDLE,4880.67,3172.44,13270.0,14761.0,2
CDM,2722715,HB VOCAL INFUSION NEEDLE,2331.24,1515.31,,,0
CDM,2722717,HB ABLATION CATHETER,17040.8,11076.52,13270.0,14761.0,2
CDM,2722726,HB CHEST TUBE SILICONE CATHETER,2334.97,1517.73,13270.0,14761.0,2
CDM,2722727,HB SILICONE BREAST DELIVERY SLEEVE,1287.96,837.17,13270.0,14761.0,2
CDM,2722728,"HB RELOAD, ENDOSCOPIC",4617.96,3001.67,13270.0,14761.0,2
CDM,2722731,HB BOOT LINER DISPOSABLE,366.16,238.0,13270.0,14761.0,2
CDM,2722734,HB PENILE ASSEMBLY SYSTEM,3791.08,2464.2,,,0
CDM,2722740,HB MANIFOLD FOUR PORT,429.37,279.09,13270.0,14761.0,2
CDM,2722745,HB EXTERNAL NEUROSTIMULATOR,3952.98,2569.44,,,0
CDM,2722746,HB WIRE GUIDE LOCKING TOOL,280.15,182.1,13270.0,14761.0,2
CDM,2722749,HB TISSUE EXTACTION SYSTEM,1925.81,1251.78,13270.0,14761.0,2
CDM,2722754,"HB KIT, ANGEL SYSTEM PRP",3344.82,2174.13,13270.0,14761.0,2
CDM,2722756,HB PERFUSION OXYGENATOR,5417.05,3521.08,13270.0,14761.0,2
CDM,2722759,"HB NEEDLE, INJECTION",882.67,573.74,13270.0,14761.0,2
CDM,2722761,HB ILLUMINATOR,2939.39,1910.6,13270.0,14761.0,2
CDM,2722764,"HB KIT, HAND CONTROLLER",537.77,349.55,13270.0,14761.0,2
CDM,2722765,HB ZEPHYR DELIVERY CATHETER,4764.32,3096.81,13270.0,14761.0,2
CDM,2722766,HB CHARTIS CATHETER,8102.8,5266.82,13270.0,14761.0,2
CDM,2722769,HB FORCEP BIPOLAR TIPS,4740.0,3081.0,13270.0,14761.0,2
CDM,2722772,HB LEAD EXTENDER,2866.89,1863.48,13270.0,14761.0,2
CDM,2722774,HB INTRODUCER SHEATH PERITONEAL,2046.55,1330.26,13270.0,14761.0,2
CDM,2722775,"HB SEALANT, HEMOSTATIC",2938.18,1909.82,13270.0,14761.0,2
CDM,2722779,"HB ADAPTER, CARIOPLEGIA CANNULAE",543.57,353.32,13270.0,14761.0,2
CDM,2722780,"HB CATHETER, PERITONEAL",4882.66,3173.73,13270.0,14761.0,2
CDM,2722781,"HB CANNULA, TRANSSEPTAL TANDEMHEART",27230.2,17699.63,13270.0,14761.0,2
CDM,2722783,"HB TUBING, ASPIRATION",2045.27,1329.43,13270.0,14761.0,2
CDM,2722784,"HB KNIFE, ELECTROSURGICAL",4903.42,3187.22,13270.0,14761.0,2
CDM,2722785,"HB SHEARS, THERMAL LIGATING",3750.74,2437.98,13270.0,14761.0,2
CDM,2722787,"HB TOOL, DISSECTING",3888.59,2527.58,13270.0,14761.0,2
CDM,2722788,"HB CATHETER, VENTRICULAR",4391.33,2854.36,13270.0,14761.0,2
CDM,2722790,"HB PROBE, ENDOSCOPIC",4672.2,3036.93,13270.0,14761.0,2
CDM,2722791,HB DRILL PIN HEADLESS,3344.49,2173.92,13270.0,14761.0,2
CDM,2722793,"HB RELOAD, ENDOSCOPIC",6248.09,4061.26,13270.0,14761.0,2
CDM,2722794,"HB CABLES, ELECTRODE STERILE",4167.52,2708.89,13270.0,14761.0,2
CDM,2722797,"HB TUBE, TRACHEAL LASER",818.62,532.1,,,0
CDM,2722800,HB BARDY CARNATION PATCH 7-DAY,2331.72,1515.62,13270.0,14761.0,2
CDM,2722802,HB DISPOSABLE TISSUE RESECTOR,4753.28,3089.63,,,0
CDM,2722804,"HB KIT, ARM SUPPORT",1198.85,779.25,13270.0,14761.0,2
CDM,2722805,HB CATHETER ERCP,726.59,472.28,13270.0,14761.0,2
CDM,2722806,"HB CABLE, MULTILEAD",3950.52,2567.84,13270.0,14761.0,2
CDM,2722807,HB PROSTATE TEMPLATE,1332.86,866.36,13270.0,14761.0,2
CDM,2722809,HB TUBING SET,3344.48,2173.91,13270.0,14761.0,2
CDM,2722811,HB VIRTUAL SURGICAL PLANNING SPLINT,2334.97,1517.73,13270.0,14761.0,2
CDM,2722812,"HB TUBING, IRRIGATION",2620.48,1703.31,13270.0,14761.0,2
CDM,2722813,HB STONE CATCHER,1293.29,840.64,13270.0,14761.0,2
CDM,2722816,HB WOUND RETRACTION SYSTEM MEDIUM,3910.0,2541.5,13270.0,14761.0,2
CDM,2722818,HB ADAPTER DRAPE SLEEVE,1720.64,1118.42,13270.0,14761.0,2
CDM,2722819,HB EXTENSION CABLE,3347.88,2176.12,13270.0,14761.0,2
CDM,2722821,"HB CARTRIDGE, PUMP",1605.21,1043.39,13270.0,14761.0,2
CDM,2722822,HB COLLECTION SYSTEM FMS,1524.03,990.62,13270.0,14761.0,2
CDM,2722824,"HB KNIFE, COLD WAVEFORM",1963.36,1276.18,,,0
CDM,2722826,"HB NEEDLE, ASPIRATION",2799.1,1819.41,13270.0,14761.0,2
CDM,2722827,"HB DISSECTOR, ARTICULATING",11970.3,7780.69,13270.0,14761.0,2
CDM,2722830,"HB RETRACTOR, WOUND",2288.26,1487.37,13270.0,14761.0,2
CDM,2722833,HB CATHETER BILIARY DILATION,1032.91,671.39,,,0
CDM,2722841,HB PROLACT RTF28 CALORIES,2667.74,1734.03,13270.0,14761.0,2
CDM,2722843,HB TUBE MEDULLARY,1064.83,692.14,13270.0,14761.0,2
CDM,2722845,"HB PIN, FIXATION",1639.57,1065.72,13270.0,14761.0,2
CDM,2722846,HB KNEE TRACKING SYSTEM,3950.52,2567.84,13270.0,14761.0,2
CDM,2722852,HB ANGIOVAC COMPLETE KIT,32938.9,21410.29,13270.0,14761.0,2
CDM,2722853,HB LASER FIBER,10745.8,6984.77,13270.0,14761.0,2
CDM,2722855,HB TRAPPER EXCHANGE DEVICE,2734.23,1777.25,13270.0,14761.0,2
CDM,2722859,HB COAGULATION GUIDED DEVICE,32313.2,21003.58,13270.0,14761.0,2
CDM,2722860,HB BONE PLANER,2142.29,1392.49,,,0
CDM,2722861,HB DV SUCTION IRRIGATOR,2855.85,1856.3,13270.0,14761.0,2
CDM,2722862,HB PULMONARY EMBOLISM REMOVAL SYSTEM,29473.3,19157.65,13270.0,14761.0,2
CDM,2722863,HB SCALPEL BONE,5334.99,3467.74,13270.0,14761.0,2
CDM,2722865,HB FAT TRANSFER SYSTEM,4420.83,2873.54,13270.0,14761.0,2
CDM,2722866,HB CAUTERY PENCIL,2334.97,1517.73,13270.0,14761.0,2
CDM,2722868,HB ACCESS DISPOSABLE INSTRUMENTS,13136.6,8538.79,,,0
CDM,2722870,HB 4 CONTACT STRIP ELECTRODES,4542.46,2952.6,13270.0,14761.0,2
CDM,2722882,HB NEUROPROTECTION TRANSCAROTID SYSTEM,22175.0,14413.75,13270.0,14761.0,2
CDM,2722886,HB FLUID CONTROL SYSTEM,3545.09,2304.31,13270.0,14761.0,2
CDM,2722887,"HB PROBE, BIPOLAR",4185.68,2720.69,13270.0,14761.0,2
CDM,2722891,"HB CATHETER, SHOCKWAVE PERIPHERAL",19556.8,12711.92,13270.0,14761.0,4
CDM,2722892,HB DESTINO TWIST GUIDING SHEATH,4864.86,3162.16,13270.0,14761.0,2
CDM,2722899,"HB KIT, IMAGING DRUG PACK",3539.7,2300.8,13270.0,14761.0,2
CDM,2722901,HB PERFUSION OXYGENATOR,9730.17,6324.61,13270.0,14761.0,2
CDM,2722902,HB DRILL TROCAR PIN,560.68,364.44,13270.0,14761.0,2
CDM,2722903,"HB KIT, REMOTE MONITOR",18979.6,12336.74,13270.0,14761.0,2
CDM,2722904,HB BONE SCREW REMOVER,1809.94,1176.46,,,0
CDM,2722906,HB INDIGO SEPARATOR 12,13990.2,9093.63,13270.0,14761.0,2
CDM,2722907,"HB SIZING KIT, AIRWAY W/ BALLOON CATH",3140.45,2041.29,13270.0,14761.0,2
CDM,2722908,"HB CATHETER, DEPLOYMENT AND LOADER",8475.53,5509.09,13270.0,14761.0,2
CDM,2722909,HB VERSA CROSS TRNSPTL KIT,8376.54,5444.75,13270.0,14761.0,2
CDM,2722911,HB AZUR DETACHMENT CONTROLLER,7264.14,4721.69,13270.0,14761.0,2
CDM,2722912,HB EBUS PROBE,544.46,353.9,13270.0,14761.0,2
CDM,2722913,HB RAT TOOTH ALLIGATOR FORCEPS,4108.64,2670.62,13270.0,14761.0,2
CDM,2722916,HB PAIN PUMP PCA SYSTEM,3205.61,2083.65,13270.0,14761.0,2
CDM,2722917,HB PAIN PUMP PCA SYSTEM,1112.36,723.03,13270.0,14761.0,2
CDM,2722918,HB SUBMUCOSAL LIFTING AGENT,1454.06,945.14,13270.0,14761.0,2
CDM,2722919,HB BLADE AND TUBING SET,5172.15,3361.9,13270.0,14761.0,2
CDM,2722920,HB REAMER HEAD,6173.78,4012.96,13270.0,14761.0,2
CDM,2722921,"HB KIT, BONE HARVESTING",19096.3,12412.59,13270.0,14761.0,2
CDM,2722922,HB TUBING SET W/TIP,6864.67,4462.04,13270.0,14761.0,2
CDM,2722923,HB NEEDLE MODULE EMG,5505.53,3578.59,13270.0,14761.0,2
CDM,2722924,HB DV CAMERA SHEATH SP,1007.37,654.79,13270.0,14761.0,2
CDM,2722925,HB HEADED SCREW,1160.52,754.34,13270.0,14761.0,2
CDM,2722926,HB OLIVE WIRE,1428.52,928.54,13270.0,14761.0,2
CDM,2722927,HB MORCELLATOR LAPAROSCOPIC,6344.55,4123.96,13270.0,14761.0,2
CDM,2722928,HB DV STAPLER CANNULA,10080.3,6552.19,13270.0,14761.0,2
CDM,2722929,"HB DV KIT, ENTRY GUIDE",2166.9,1408.49,13270.0,14761.0,2
CDM,2722930,HB SUCTION IRRIGATION SYSTEM,1753.13,1139.53,13270.0,14761.0,2
CDM,2722931,"HB HANDPIECE, ENDOSCOPIC",5943.59,3863.33,,,0
CDM,2722932,HB RETRACTOR ATTACHMENT,3546.1,2304.97,13270.0,14761.0,2
CDM,2722933,"HB KIT, HIGH INTENSITY FOCUSED ULTRASOUND",13144.0,8543.6,,,0
CDM,2722934,HB DIRECT CURRENT CUTTER SET,3943.62,2563.35,13270.0,14761.0,2
CDM,2722935,HB BLUEPRINT GUIDE,6148.5,3996.53,,,0
CDM,2722936,"HB CATHETER, SEROMA 14G X 3.5IN",803.17,522.06,,,0
CDM,2722937,HB BRONCHIAL BALLOON,1616.19,1050.52,13270.0,14761.0,2
CDM,2722938,"HB FULLY ARTICULATING CATHETER,IF1000",8475.53,5509.09,13270.0,14761.0,2
CDM,2722939,"HB PERIPHERAL VISION PROBE,IF1000",3789.48,2463.16,13270.0,14761.0,2
CDM,2722940,HB CATHETER GUIDE,752.12,488.88,13270.0,14761.0,2
CDM,2722942,"HB BIOPSY NEEDLE,23G,IF1000,5-PACK",2734.8,1777.62,13270.0,14761.0,2
CDM,2722945,HB SWIVEL CONNECTOR,1761.25,1144.81,13270.0,14761.0,2
CDM,2722946,"HB ASSEMBLY,VISION PROBE ADAPTER AND SUCTIO",879.74,571.83,13270.0,14761.0,2
CDM,2722947,"HB VISION PROBE BAG,IF1000",522.39,339.55,13270.0,14761.0,2
CDM,2722953,HB ELECTROMAGNETIC PATIENT TRACKER,2248.03,1461.22,13270.0,14761.0,2
CDM,2722954,"HB APPLICATOR, ULTRAMIST",879.78,571.86,13270.0,14761.0,2
CDM,2722955,HB MINIONE FEED SET W/ ADAPTER,292.53,190.14,,,0
CDM,2722956,HB PLATE HOLDING PIN,299.21,194.49,13270.0,14761.0,2
CDM,2722963,HB DV CAUTERY SPATULA,1326.44,862.19,13270.0,14761.0,2
CDM,2722964,HB DV FORCEPS REPOSABLE,1923.52,1250.29,13270.0,14761.0,2
CDM,2722965,HB KIT SMARTHCATH,1007.37,654.79,13270.0,14761.0,2
CDM,2722966,HB DV DISPOSABLE INSTRUMENT SHEATH,624.51,405.93,13270.0,14761.0,2
CDM,2722968,"HB GUIDE WIRE, ROTAWIRE",2787.13,1811.63,13270.0,14761.0,2
CDM,2722969,HB CONTROLLER MAGNET,1262.61,820.7,,,0
CDM,2722970,HB PERFUSION CARDIOPLEGIA SET,1899.17,1234.46,13270.0,14761.0,2
CDM,2722975,HB G-TUBE,1537.66,999.48,,,0
CDM,2722977,HB HARMONY DELIVERY SYSTEM,15897.7,10333.51,,,0
CDM,2722987,"HB ELECTRODES, STAR RF",12853.2,8354.58,,,0
CDM,2722990,HB CLOTRIEVER SHEATH 13F/16F,11393.1,7405.52,13270.0,14761.0,2
CDM,2722992,HB PORTICO FLEXNAV DELIVERY SYS,11393.1,7405.52,13270.0,14761.0,2
CDM,2722993,HB PORTICO FLEXNAV LOADING SYS,4762.3,3095.5,13270.0,14761.0,2
CDM,2722996,"HB KIT, FRACTURE",23997.4,15598.31,13270.0,14761.0,2
CDM,2723001,HB ANGIOVAC CIRCUIT STAND ALONE,11393.1,7405.52,13270.0,14761.0,2
CDM,2723004,HB NEEDLE COUP EPIMED RX 4.5,2166.88,1408.47,,,0
CDM,2723010,HB FLEXIBLE DIGITAL CYSTOSCOPE SINGLE USE,1923.56,1250.31,13270.0,14761.0,2
CDM,2723011,HB OPTICHAMBER DIAMOND RECLOSABLE BAG,173.87,113.02,13270.0,14761.0,2
CDM,2723013,"HB KIT, SURGICAL SKIN CLOSURE",1836.38,1193.65,13270.0,14761.0,2
CDM,2723014,"HB RETRACTOR, CORDLESS SU",2531.86,1645.71,13270.0,14761.0,2
CDM,2723015,"HB CANNULA, FENESTRATED",2734.63,1777.51,13270.0,14761.0,2
CDM,2723016,"HB INTRODUCER/SHEATH, PERITONEAL",781.51,507.98,13270.0,14761.0,2
CDM,2723017,HB DUAL KNIFE,6788.38,4412.45,13270.0,14761.0,2
CDM,2723018,"HB CAP, FULL THICKNESS RESECTION",828.73,538.67,,,0
CDM,2723019,HB FULL THICKNESS RESECTION SYSTEM,10931.8,7105.67,,,0
CDM,2723020,"HB KIT, UROLOGY MONITOR",1883.01,1223.96,13270.0,14761.0,2
CDM,2723021,HB DISTAL UNLOCK BUTTON,2734.63,1777.51,13270.0,14761.0,2
CDM,2723022,HB RETRIEVAL NET,1390.38,903.75,13270.0,14761.0,2
CDM,2723026,"HB CATHETER, TRNSLUMN INTRVSC LITHO, CORO",30084.9,19555.19,,,0
CDM,2723045,HB BRONCHOSCOPE FLEXIBLE DISPOSABLE,3130.81,2035.03,,,0
CDM,2723065,HB HST (HOME SLEEP TEST) DEVICE,1071.26,696.32,,,0
CDM,2723066,HB VALVE DEPLOYMENT CATHETER,8473.09,5507.51,13270.0,14761.0,2
CDM,2723067,HB TACKING SYSTEM,5504.46,3577.9,13270.0,14761.0,2
CDM,2723068,HB PRESSURE GRADIENT MEASUREMENT SYSTEM,14108.8,9170.72,,,0
CDM,2723069,"HB RASP,CUTTING HELIOCOIDAL",355.65,231.17,13270.0,14761.0,2
CDM,2723071,HB BLADE AND TUBING SET,6656.12,4326.48,13270.0,14761.0,2
CDM,2723072,"HB KIT, SPINE DISPOSABLE",4762.3,3095.5,13270.0,14761.0,2
CDM,2723073,HB TACK PLATE,828.73,538.67,,,0
CDM,2723074,HB ABLATOR MULTIPORT,1883.01,1223.96,13270.0,14761.0,2
CDM,2723076,HB KNIFE ELECTROSURGICAL,8213.32,5338.66,13270.0,14761.0,2
CDM,2723077,"HB FORCEPS, PULMONARY",4782.46,3108.6,13270.0,14761.0,2
CDM,2723079,"HB CATHETER, DELIVERY AVEIR VR",12757.5,8292.38,13270.0,14761.0,2
CDM,2723080,"HB KIT, INTRODUCER 50CM AVEIR",5095.16,3311.85,13270.0,14761.0,2
CDM,2723081,"HB KIT, INTRODUCER 30CM AVEIR",5095.16,3311.85,13270.0,14761.0,2
CDM,2723082,"HB CATHETER, TRI LOOP RETRIEVER AVEIR",20003.3,13002.15,13270.0,14761.0,2
CDM,2723085,"HB INTRAUTERINE LOOP, JADA SYSTEM",9610.49,6246.82,13270.0,14761.0,2
CDM,2723086,"HB RETRACTOR, TRAXI PANNICULUS",1006.63,654.31,13270.0,14761.0,2
CDM,2723088,HB AZUR DETACHMENT CONTROLLER,2636.32,1713.61,13270.0,14761.0,2
CDM,2723098,"HB BLADE, SAW",4143.52,2693.29,13270.0,14761.0,2
CDM,2723335,"HB SHEATH, EP VIZIGO 3 CURVE SM MD LG",8285.83,5385.79,13270.0,14761.0,2
CDM,2723337,"HB KIT, MANOMETER W/STOPCOCK",137.73,89.52,13270.0,14761.0,2
CDM,2723338,"HB KIT, MICROINTRODUCER MINI-STICK",426.98,277.54,13270.0,14761.0,2
CDM,2723339,HB KIT SPRINT EXTENSA PNS SYSTEM,25438.6,16535.09,,,0
CDM,2723414,HB TYRX ABSORBABLE ENVELOPE,12137.8,7889.57,13270.0,14761.0,2
CDM,2723416,"HB PROBE, CRYO FLEXIBLE",3171.34,2061.37,13270.0,14761.0,2
CDM,2723418,"HB KIT, VESSEL HARVESTING",9709.79,6311.36,13270.0,14761.0,2
CDM,2723420,HB BLADE AND TUBING SET,8836.49,5743.72,13270.0,14761.0,2
CDM,2723421,HB CUTTING LOOP,3555.75,2311.24,13270.0,14761.0,2
CDM,2723422,HB ACCESSORY TEMPLATE DISPOSABLE,7692.04,4999.83,13270.0,14761.0,2
CDM,2723423,"HB INTRODUCER, FLUID COOLED RADIOFREQUENCY",1287.98,837.19,,,0
CDM,2723424,"HB KIT, PROBE COOLED RADIOFREQUENCY",6615.79,4300.26,,,0
CDM,2723425,"HB KIT, MULTI COOLED RADIOFREQUENCY",9756.62,6341.8,,,0
CDM,2723426,"HB PROBE, COOLED RADIOFREQUENCY",3365.89,2187.83,,,0
CDM,2723429,HB TAP PLATE,3163.24,2056.11,13270.0,14761.0,2
CDM,2723430,HB DV CANNULA,5502.43,3576.58,13270.0,14761.0,2
CDM,2723432,HB EXTRACTOR STONE,3933.33,2556.66,,,0
CDM,2723433,"HB HMIII TOOL, CORING",4314.34,2804.32,13270.0,14761.0,2
CDM,2723434,HB REAMER HEAD,6170.44,4010.79,13270.0,14761.0,2
CDM,2723435,HB TISSUE STABILIZER,10819.7,7032.81,13270.0,14761.0,2
CDM,2723436,"HB PIN, DRILL",701.05,455.68,13270.0,14761.0,2
CDM,2723437,"HB SET, KNEE ARRAY",3511.81,2282.68,13270.0,14761.0,2
CDM,2723439,"HB TOOL, DISSECTING",3663.4,2381.21,13270.0,14761.0,2
CDM,2723440,HB CUTTING GUIDES,10662.0,6930.3,13270.0,14761.0,2
CDM,2723441,"HB SYSTEM, WATER VAPOR",10510.1,6831.57,,,0
CDM,2723442,"HB CHARGER, NEUROSTIMULATOR",8471.38,5506.4,,,0
CDM,2723443,HB LIGASURE ESU,2895.25,1881.91,13270.0,14761.0,2
CDM,2723444,HB BONE FIDUCIALS,1039.17,675.46,13270.0,14761.0,2
CDM,2723448,"HB LEAD, NERVE STIMULATOR",1102.97,716.93,,,0
CDM,2723449,HB SYTLET KIT W/ CAP,1716.26,1115.57,,,0
CDM,2723454,"HB TERM MAT, TRANSFER SINGE USE",2334.97,1517.73,13270.0,14761.0,2
CDM,2723455,"HB NEEDLE, ASPIRATION",2158.05,1402.73,13270.0,14761.0,2
CDM,2723456,"HB PORT, ACCESS L/P",1286.57,836.27,13270.0,14761.0,2
CDM,2723458,HB DV PORT ACCESS,4557.52,2962.39,,,0
CDM,2723464,HB DETACHMENT CONTROLLER,2368.8,1539.72,13270.0,14761.0,2
CDM,2723469,"HB KIT, MRI FOCUSED US ABLATION",50329.4,32714.11,,,0
CDM,2723475,"HB TIP, SOFT TISSUE",7555.98,4911.39,13270.0,14761.0,2
CDM,2723476,"HB BLADE, ARTHROSCOPIC",4797.29,3118.24,,,0
CDM,2723477,"HB KIT, DIAGNOSTIC SHEATH",1639.24,1065.51,,,0
CDM,2723478,"HB NEEDLE, ARTHROSCOPIC",4945.74,3214.73,,,0
CDM,2723479,"HB GRASPER, ENDOSCOPIC",2855.19,1855.87,,,0
CDM,2723480,HB SCREWDRIVER MIDFACE,2295.87,1492.32,13270.0,14761.0,2
CDM,2723481,"HB CANNULA, STEREOTACTIC",2782.24,1808.46,13270.0,14761.0,2
CDM,2723482,HB BATTERY PACK,2983.28,1939.13,13270.0,14761.0,2
CDM,2723483,HB TISSUE COLLECTOR,3827.95,2488.17,,,0
CDM,2723485,HB INJECTOR DISPOSABLE,602.17,391.41,13270.0,14761.0,2
CDM,2723486,HB CUTTING GUIDES,29650.3,19272.69,13270.0,14761.0,2
CDM,2723487,"HB TOOL, SOFT TISSUE RELEASE",2328.28,1513.38,13270.0,14761.0,2
CDM,2723488,"HB NEEDLE, BLUNT NIM",1701.09,1105.71,13270.0,14761.0,2
CDM,2723489,"HB TOOL, TUNNELING",2652.54,1724.15,,,0
CDM,2723490,HB DV CAUTERY MONOPOLAR TOOL,2425.55,1576.61,13270.0,14761.0,2
CDM,2723502,"HB ADAPTOR, BIOPSY VALVE",1090.59,708.88,13270.0,14761.0,2
CDM,2723503,HB SKULL CUSTOM MODEL,8578.58,5576.08,13270.0,14761.0,2
CDM,2723504,HB MODEL SUPPLEMENT,8757.86,5692.61,13270.0,14761.0,2
CDM,2723505,HB CUTTING GUIDES,13752.9,8939.39,13270.0,14761.0,2
CDM,2723506,HB CUTTING GUIDES,21567.1,14018.61,13270.0,14761.0,2
CDM,2723508,HB MAXILLOFACIAL RECON BUNDLE,29226.9,18997.49,13270.0,14761.0,2
CDM,2723510,HB SUCTION IRRIGATION,4373.19,2842.57,13270.0,14761.0,2
CDM,2723511,HB TISSUE ABLATION APPLICATOR,14312.9,9303.39,13270.0,14761.0,2
CDM,2723512,HB BONE CUTTING KNIFE,8512.33,5533.01,,,0
CDM,2723514,"HB SEALER, BIPOLAR",5873.55,3817.81,13270.0,14761.0,2
CDM,2723528,HB ISOLATOR CLAMP,34174.0,22213.1,13270.0,14761.0,2
CDM,2723529,"HB PRESSURIZER, FEMORAL CANAL",2334.97,1517.73,13270.0,14761.0,2
CDM,2723530,HB VENTILATOR CIRCUIT,1415.57,920.12,13270.0,14761.0,2
CDM,2723535,HB DV SEALER,6170.44,4010.79,13270.0,14761.0,2
CDM,2723537,"HB STYLET, ELECTROMAGNETIC",4719.65,3067.77,13270.0,14761.0,2
CDM,2723538,"HB KIT, INSTRUMENT DUAL PORT",14312.9,9303.39,13270.0,14761.0,2
CDM,2723539,HB MAT CALCIUM ABSORBABLE,6207.55,4034.91,13270.0,14761.0,2
CDM,2723540,HB BONE PLANER,2141.83,1392.19,,,0
CDM,2723542,"HB NEEDLE, BLUNT",1701.09,1105.71,13270.0,14761.0,2
CDM,2723543,"HB NEEDLE, TROCAR",4908.64,3190.62,13270.0,14761.0,2
CDM,2723544,HB TENDON STRIPPER,2125.62,1381.65,,,0
CDM,2723547,HB NEEDLE FLEXI,866.92,563.5,13270.0,14761.0,2
CDM,2723556,HB TRAPEZOIDAL MEDICAL INSERT,4251.67,2763.59,13270.0,14761.0,2
CDM,2723558,HB FULL THICKNESS RESECTION SYSTEM,10545.1,6854.32,,,0
CDM,2723559,HB TUBE FEEDING JEJUNAL TRANSGASTRIC,4916.06,3195.44,,,0
CDM,2723565,HB DISPOSABLE INSTRUMENTS,3098.38,2013.95,,,0
CDM,2723566,HB BONE AND IMPLANT MODEL,8369.76,5440.34,,,0
CDM,2723575,HB REAMER KIT R.I.A.,15714.9,10214.68,13270.0,14761.0,2
CDM,2723579,HB ILLUMINATION SYSTEM,12832.1,8340.86,13270.0,14761.0,2
CDM,2723580,HB CUTTING GUIDES,23840.8,15496.52,13270.0,14761.0,2
CDM,2723581,HB PROBE DRIVER ROBOTIC,20136.9,13088.99,13270.0,14761.0,2
CDM,2723582,HB LASER PROBE,26742.5,17382.63,13270.0,14761.0,2
CDM,2723584,HB HIFU FOCALPAK,31837.4,20694.31,,,0
CDM,2723598,"HB PIN, DRILL",2247.21,1460.69,,,0
CDM,2723599,HB ENDOSCOPE OVERTUBE,6615.79,4300.26,,,0
CDM,2723603,"HB SPLINT, NASAL",2334.97,1517.73,13270.0,14761.0,2
CDM,2723605,HB CANNULA ELECTRODE KIT,8535.64,5548.17,13270.0,14761.0,2
CDM,2723611,"HB KIT, GYNECOLOGICAL TEMPLATE DISPOSABLE",12781.8,8308.17,,,0
CDM,2723617,"HB MANOMETER, CSF",779.59,506.73,13270.0,14761.0,2
CDM,2723619,HB CABLE TESTING LEAD,1795.05,1166.78,,,0
CDM,2723623,HB LINER PROTECTIVE CAST,2334.97,1517.73,,,0
CDM,2723624,"HB KIT, ACCESSORY",3651.59,2373.53,13270.0,14761.0,2
CDM,2723649,"HB KIT, ACCESSORY",3844.85,2499.15,13270.0,14761.0,2
CDM,2740002,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,239.0,155.35,13270.0,14761.0,8
CDM,2750018,HB MISCELLANEOUS PACEMAKER,116392.5,75655.13,13270.0,14761.0,2
CDM,2780009,"HB IMPLANT, CARDIAC PLEDGET",84.89,55.18,13270.0,14761.0,2
CDM,2780013,HB ANCHOR BOLTS,364.27,236.78,13270.0,14761.0,2
CDM,2780014,HB ORTHO CEMENTRALIZER,394.38,256.35,13270.0,14761.0,2
CDM,2780017,"HB KIT, VARICEAL BANDING",1914.39,1244.35,13270.0,14761.0,2
CDM,2780025,"HB CONNECTOR, CEREBRAL 1",696.96,453.02,13270.0,14761.0,2
CDM,2780033,"HB FELT, SURGICAL 1",845.12,549.33,13270.0,14761.0,2
CDM,2780037,HB EMBOLIC LIQUID SYSTEM GLUE,28770.0,18700.5,13270.0,14761.0,2
CDM,2780055,HB LAP BAND SYSTEM 3,38031.9,24720.74,,,0
CDM,2780065,HB CARDIAC VALVE HUMAN TISSUE 4,54890.1,35678.57,13270.0,14761.0,2
CDM,2780075,HB CARDIAC BAND,13521.9,8789.24,13270.0,14761.0,2
CDM,2780078,"HB SPACER, SPINE 14",40114.9,26074.69,13270.0,14761.0,2
CDM,2780084,"HB CAGE, SPINE 26",62452.4,40594.06,13270.0,14761.0,2
CDM,2780086,HB CARDIAC VALVE HUMAN TISSUE 3,48373.7,31442.9,13270.0,14761.0,2
CDM,2780090,HB CARDIAC VALVE HUMAN TISSUE 7,56341.2,36621.78,13270.0,14761.0,2
CDM,2780099,HB SUPPORT BAR PECTUS,9589.27,6233.03,13270.0,14761.0,2
CDM,2780107,HB GRAFT 2,10130.1,6584.57,13270.0,14761.0,2
CDM,2780117,HB BONE GRAFT 2,10952.7,7119.26,13270.0,14761.0,2
CDM,2780121,"HB COIL, EMBOLIZATION 1",18032.3,11721.0,13270.0,14761.0,2
CDM,2780138,HB CARDIAC RING ANNULOPLASTY 2,15065.7,9792.7,13270.0,14761.0,2
CDM,2780140,"HB COIL, EMBOLIZATION 2",14341.4,9321.91,13270.0,14761.0,2
CDM,2780154,"HB SPACER, SPINE 8",22085.7,14355.71,,,0
CDM,2780161,HB VALVE 3,25058.7,16288.16,13270.0,14761.0,2
CDM,2780164,HB EMBOLIC SPHERES,2089.46,1358.15,13270.0,14761.0,2
CDM,2780172,"HB CROSSLINK, SPINE 1",3591.19,2334.27,13270.0,14761.0,2
CDM,2780173,HB SHUNT 4,9228.7,5998.66,13270.0,14761.0,2
CDM,2780175,HB VALVE 2,9782.55,6358.66,13270.0,14761.0,2
CDM,2780183,"HB LINER, ORTHO 5",24790.1,16113.57,13270.0,14761.0,2
CDM,2780189,HB SEALANT 3,4996.65,3247.82,13270.0,14761.0,2
CDM,2780193,"HB GRAFT, DURAGEN 3",5359.74,3483.83,13270.0,14761.0,2
CDM,2780205,HB BONE FILLER 2,7047.37,4580.79,,,0
CDM,2780224,"HB CONNECTOR, SPINE 5",9125.94,5931.86,13270.0,14761.0,2
CDM,2780231,"HB IMPLANT, PENILE DEACTIVATION",2235.03,1452.77,,,0
CDM,2780234,HB PLATE 1,1137.07,739.1,13270.0,14761.0,2
CDM,2780235,HB SHUNT 1,1171.86,761.71,13270.0,14761.0,2
CDM,2780241,HB CEMENT RESTRICTOR,1408.55,915.56,13270.0,14761.0,2
CDM,2780242,HB PLUG,2342.03,1522.32,13270.0,14761.0,2
CDM,2780249,"HB RESERVOIR, NEURO 1",1577.56,1025.41,13270.0,14761.0,2
CDM,2780254,HB SEAMGUARD BIOAB,1836.72,1193.87,13270.0,14761.0,2
CDM,2780263,"HB CONNECTOR, SPINE 2",2449.14,1591.94,13270.0,14761.0,2
CDM,2780265,HB GASTROSTOMY G-J TUBE,2895.13,1881.83,13270.0,14761.0,2
CDM,2780270,HB ORTHO CABLE 2,3399.2,2209.48,13270.0,14761.0,2
CDM,2780273,HB BONE FILLER 1,3606.64,2344.32,,,0
CDM,2780278,"HB SHEET, MEDPOR 2",4146.32,2695.11,13270.0,14761.0,2
CDM,2780282,HB PATCH 1,4163.65,2706.37,13270.0,14761.0,2
CDM,2780287,"HB CONNECTOR, SPINE 3",4443.07,2888.0,13270.0,14761.0,2
CDM,2780293,HB NEURO CATH KIT,4448.69,2891.65,13270.0,14761.0,2
CDM,2780294,HB NO COST IMPLANT,1.0,0.65,13270.0,14761.0,2
CDM,2780310,HB SPACER 3,1771.96,1151.77,13270.0,14761.0,2
CDM,2780318,HB MISCELLANEOUS IMPLANT,19592.1,12734.86,13270.0,14761.0,68
CDM,2780322,HB AUDITORY IMPLANT 2,3231.18,2100.27,,,0
CDM,2780330,HB PROSTHESIS ENT,3324.13,2160.68,13270.0,14761.0,2
CDM,2780339,"HB SPACER, SPINE 12",29871.1,19416.22,13270.0,14761.0,2
CDM,2780357,"HB CONNECTOR, SPINE 1",247.9,161.14,13270.0,14761.0,2
CDM,2780359,"HB CLIP, ANEURYSM 1",2724.53,1770.94,13270.0,14761.0,2
CDM,2780363,"HB SPACER, SPINE 5",10130.1,6584.57,13270.0,14761.0,2
CDM,2780366,HB SPINE PEEK 4,30424.2,19775.73,13270.0,14761.0,2
CDM,2780372,"HB SHEET, MEDPOR 1",3262.86,2120.86,,,0
CDM,2780381,"HB CEMENT, BONE KYPHON",2548.61,1656.6,13270.0,14761.0,2
CDM,2780391,"HB TUBE,EAR PRESSURE EQUALIZING 1",125.57,81.62,13270.0,14761.0,2
CDM,2780400,HB ROD 1,1202.75,781.79,13270.0,14761.0,2
CDM,2780402,"HB CONNECTOR, SPINE 4",6550.58,4257.88,13270.0,14761.0,2
CDM,2780404,"HB COVER, BUR HOLE 1",1194.46,776.4,13270.0,14761.0,2
CDM,2780415,"HB GRAFT, DURAGEN 1",1480.52,962.34,13270.0,14761.0,2
CDM,2780416,"HB GRAFT, DURAGEN 2",2949.57,1917.22,13270.0,14761.0,2
CDM,2780417,"HB GRAFT, DURAGEN 4",9548.8,6206.72,13270.0,14761.0,2
CDM,2780498,"HB COIL, NESTOR",1749.98,1137.49,13270.0,14761.0,2
CDM,2780523,HB BONE CEMENT 4,5882.03,3823.32,13270.0,14761.0,2
CDM,2780525,HB ROD 3,5960.9,3874.59,13270.0,14761.0,2
CDM,2780603,HB BONE CEMENT 6,10914.1,7094.17,13270.0,14761.0,2
CDM,2780687,HB BONE CEMENT 10,27324.8,17761.12,13270.0,14761.0,2
CDM,2780813,HB CARDIAC VALVE HUMAN TISSUE 6,50861.5,33059.97,13270.0,14761.0,2
CDM,2780825,"HB CATHETER, IMPELLA",255664.0,166181.6,13270.0,14761.0,2
CDM,2780848,"HB STENT, GRAFT BIFURCATED 25",97533.4,63396.71,13270.0,14761.0,2
CDM,2780852,"HB EXTNSN, AORTIC/ILIAC/THORACIC3",44945.6,29214.64,13270.0,14761.0,2
CDM,2780858,"HB EXTNSN, AORTIC/ILIAC/THORACIC1",32894.2,21381.23,13270.0,14761.0,2
CDM,2780861,"HB EXTNSN, AORTIC/ILIAC/THORACIC4",48007.9,31205.14,13270.0,14761.0,2
CDM,2780900,"HB COIL, MICRO DETACHABLE",3664.85,2382.15,13270.0,14761.0,2
CDM,2780902,HB BONE CEMENT 1,976.04,634.43,13270.0,14761.0,2
CDM,2780911,HB CARDIAC VALVE HUMAN TISSUE 19,101235.0,65802.75,13270.0,14761.0,2
CDM,2780925,HB CARDIAC VALVE HUMAN TISSUE 9,55284.3,35934.8,13270.0,14761.0,2
CDM,2780935,"HB SHEET, MEDPOR 3",5275.83,3429.29,13270.0,14761.0,2
CDM,2780940,HB EYE SPHERE W/CONFORMER,701.14,455.74,,,0
CDM,2780941,"HB VALVE, ENDOBRONCHIAL",27895.7,18132.21,13270.0,14761.0,2
CDM,2780943,"HB COVER, BUR HOLE 2",3550.38,2307.75,13270.0,14761.0,2
CDM,2780945,HB COUPLER 1,2028.78,1318.71,13270.0,14761.0,2
CDM,2780995,HB MISC IMPLANT CATH LAB,19799.1,12869.41,13270.0,14761.0,2
CDM,2780996,HB CARDIAC RING ANNULOPLASTY 3,16901.5,10985.98,13270.0,14761.0,2
CDM,2781005,HB BONE CEMENT 3,3629.94,2359.46,,,0
CDM,2781006,HB BONE CEMENT 5,9221.5,5993.98,13270.0,14761.0,2
CDM,2781025,HB ORBITAL IMPLANT,19799.1,12869.41,,,0
CDM,2781028,HB CARDIAC VALVE HUMAN TISSUE 1,38288.3,24887.4,13270.0,14761.0,2
CDM,2781031,"HB SPACER, SPINE 2",6016.75,3910.89,13270.0,14761.0,2
CDM,2781033,"HB SHEET, SILASTIC 1",283.43,184.23,13270.0,14761.0,2
CDM,2781034,"HB SHEET, SILASTIC 2",1290.39,838.75,13270.0,14761.0,2
CDM,2781036,"HB STENT, SELF RETAINING",721.01,468.66,13270.0,14761.0,2
CDM,2781051,HB PROSTHESIS EYELID,5441.76,3537.14,,,0
CDM,2781066,"HB CROSSLINK, SPINE 2",5111.93,3322.75,13270.0,14761.0,2
CDM,2781095,HB SEALANT 5,8873.84,5768.0,13270.0,14761.0,2
CDM,2781106,"HB FELT, SURGICAL",1154.82,750.63,13270.0,14761.0,2
CDM,2781110,"HB SPACER, SPINE 19",52978.1,34435.76,13270.0,14761.0,2
CDM,2781135,HB SPACER 1,685.47,445.56,,,0
CDM,2781136,"HB SPACER, SPINE 4",7156.7,4651.86,13270.0,14761.0,2
CDM,2781144,HB SPINE PEEK 5,30671.5,19936.48,13270.0,14761.0,2
CDM,2781148,"HB PLUG, VASCULAR 2",8179.08,5316.4,13270.0,14761.0,2
CDM,2781150,"HB CAGE, SPINE 1",3271.65,2126.57,13270.0,14761.0,2
CDM,2781151,"HB CAGE, SPINE 3",8476.51,5509.73,13270.0,14761.0,2
CDM,2781155,"HB CAGE, SPINE 7",17810.4,11576.76,13270.0,14761.0,2
CDM,2781156,"HB CAGE, SPINE 8",20038.7,13025.16,13270.0,14761.0,2
CDM,2781161,"HB CAGE, SPINE 15",30671.5,19936.48,13270.0,14761.0,2
CDM,2781162,"HB CAGE, SPINE 16",33606.2,21844.03,13270.0,14761.0,2
CDM,2781164,"HB CAGE, SPINE 18",36682.7,23843.75,13270.0,14761.0,2
CDM,2781165,"HB CAGE, SPINE 21",42050.2,27332.63,13270.0,14761.0,2
CDM,2781166,"HB CAGE, SPINE 22",47029.7,30569.31,13270.0,14761.0,2
CDM,2781168,"HB CAGE, SPINE 24",62977.6,40935.44,13270.0,14761.0,2
CDM,2781169,"HB CAGE, SPINE 25",65223.9,42395.54,13270.0,14761.0,2
CDM,2781174,"HB SPACER/CAGE, SPINE",95006.7,61754.36,13270.0,14761.0,2
CDM,2781176,"HB KIT, PENILE PROSTHESIS 1",4579.82,2976.88,13270.0,14761.0,2
CDM,2781195,HB SEALANT 1,2300.37,1495.24,13270.0,14761.0,2
CDM,2781196,HB SEALANT 2,3517.92,2286.65,13270.0,14761.0,2
CDM,2781224,"HB CLIP, ANEURYSM 2",3773.52,2452.79,13270.0,14761.0,2
CDM,2781228,"HB RESERVOIR, NEURO 2",2811.56,1827.51,13270.0,14761.0,2
CDM,2781236,"HB SPACER, SPINE 10",22778.2,14805.83,13270.0,14761.0,2
CDM,2781251,HB TESTICULAR PROSTHESIS,26998.7,17549.16,13270.0,14761.0,2
CDM,2781264,"HB KIT, CAGE INTERLOCK 1",25550.3,16607.69,13270.0,14761.0,2
CDM,2781265,"HB KIT, CAGE INTERLOCK 2",38829.7,25239.31,13270.0,14761.0,2
CDM,2781266,"HB KIT, CAGE INTERLOCK 3",52111.3,33872.35,13270.0,14761.0,2
CDM,2781267,"HB KIT, CAGE INTERLOCK 4",65390.7,42503.96,,,0
CDM,2781275,"HB SPACER, SPINE",60591.2,39384.28,,,0
CDM,2781277,"HB PROSTHESIS, PENILE INFLATABLE 3",15038.3,9774.9,13270.0,14761.0,2
CDM,2781285,HB CARDIAC VALVE HUMAN TISSUE 5,47131.9,30635.74,13270.0,14761.0,2
CDM,2781319,"HB STENT, GRAFT BIFURCATED 11",43460.6,28249.39,13270.0,14761.0,2
CDM,2781320,"HB STENT, GRAFT BIFURCATED 12",48082.3,31253.5,13270.0,14761.0,2
CDM,2781329,"HB STENT, GRAFT BIFURCATED 24",96880.1,62972.07,13270.0,14761.0,2
CDM,2781338,"HB CAGE, SPINE 2",6901.13,4485.73,13270.0,14761.0,2
CDM,2781352,HB VASCULAR PLUG AMPLATZ,8179.08,5316.4,13270.0,14761.0,2
CDM,2781353,HB SAPIEN AORTIC VALVE 23/26MM,332270.0,215975.5,13270.0,14761.0,2
CDM,2781403,"HB CATHETER, IMPELLA 5.0",263766.0,171447.9,13270.0,14761.0,2
CDM,2781404,HB FLOSEAL MM,1659.48,1078.66,13270.0,14761.0,2
CDM,2781407,"HB CLIP, HEMOSTASIS",1647.07,1070.6,13270.0,14761.0,2
CDM,2781429,"HB SPACER, SPINE 9",24537.2,15949.18,13270.0,14761.0,2
CDM,2781433,"HB COIL, EMBOLIZATION",1666.65,1083.32,13270.0,14761.0,2
CDM,2781439,"HB CAGE, SPINE 10",21503.1,13977.01,13270.0,14761.0,2
CDM,2781443,"HB KIT, XLIF 1",32941.4,21411.91,13270.0,14761.0,2
CDM,2781451,HB CARDIAC RING ANNULOPLASTY 5,27237.3,17704.24,13270.0,14761.0,2
CDM,2781467,"HB CLIP, ENDO CLOSURE DEVICE",4904.77,3188.1,13270.0,14761.0,2
CDM,2781470,HB MITRAL CLIP IMPLANT,313266.0,203622.9,13270.0,14761.0,2
CDM,2781498,HB VALVE 3,11273.4,7327.71,13270.0,14761.0,2
CDM,2781499,HB BONE CEMENT 2,2427.23,1577.7,13270.0,14761.0,2
CDM,2781503,HB BONE FILLER 3,12492.3,8119.99,13270.0,14761.0,2
CDM,2781524,HB BONE FILLER 4,28383.7,18449.41,13270.0,14761.0,2
CDM,2781531,HB TESTICULAR PROSTHESIS 3,18933.4,12306.71,13270.0,14761.0,2
CDM,2781565,HB LAMINARIA,117.47,76.36,,,0
CDM,2781566,HB DILAPAN (AQUACRYL),203.19,132.07,,,0
CDM,2781575,HB VALVE AORTIC EVOLUTR,313266.0,203622.9,13270.0,14761.0,2
CDM,2781610,"HB SPACER, SPINE",29266.6,19023.29,13270.0,14761.0,2
CDM,2781612,HB CARDIAC VALVE HUMAN TISSUE,48655.6,31626.14,13270.0,14761.0,2
CDM,2781621,"HB SPACER, SPINE",50754.1,32990.17,13270.0,14761.0,2
CDM,2781628,"HB SPACER, SPINE",53450.4,34742.76,13270.0,14761.0,2
CDM,2781631,"HB CATHETER, VENTRICULAR",1646.76,1070.39,13270.0,14761.0,2
CDM,2781684,HB KIT BRIGADE ANTERIOR LUMBAR 1 LEVEL,60850.0,39552.5,13270.0,14761.0,2
CDM,2781690,HB AAA EXCLUDER ENDOPROSTHESIS,124263.0,80770.95,13270.0,14761.0,2
CDM,2781704,HB EXCLUDER ENDOPROSTHESIS,50736.0,32978.4,13270.0,14761.0,2
CDM,2781707,"HB VALVE, NEURO",38867.9,25264.14,13270.0,14761.0,2
CDM,2781708,"HB VALVE, NEURO",40225.5,26146.58,13270.0,14761.0,2
CDM,2781746,HB ENDOPROSTHESIS EXCLUDER,123779.0,80456.35,13270.0,14761.0,2
CDM,2781752,"HB STENT, ESOPHAGEAL",27440.2,17836.13,13270.0,14761.0,2
CDM,2781754,HB EMBOLIZATION COIL,15738.7,10230.16,13270.0,14761.0,2
CDM,2781761,"HB CATHETER, ICY",9538.58,6200.08,13270.0,14761.0,2
CDM,2781768,"HB COIL, EMBOLIZATION 6",12073.7,7847.91,13270.0,14761.0,2
CDM,2781769,"HB COIL, EMBOLIZATION 7",15732.4,10226.06,13270.0,14761.0,2
CDM,2781779,"HB CAGE, SPINE",12064.2,7841.73,13270.0,14761.0,2
CDM,2781784,"HB KIT, URINARY SPHINCTER ACCESSORY",11719.9,7617.94,13270.0,14761.0,2
CDM,2781790,"HB CATHETER, IMPELLA RP",251824.0,163685.6,13270.0,14761.0,2
CDM,2781805,HB BONE FILLER,16911.8,10992.67,13270.0,14761.0,2
CDM,2781814,HB PROSTHESIS ENT,7626.26,4957.07,13270.0,14761.0,2
CDM,2781836,HB REFLUX MANAGEMENT SYSTEM,67111.1,43622.22,,,0
CDM,2781852,HB VALVE PROGRAMMABLE,49857.2,32407.18,13270.0,14761.0,2
CDM,2781855,HB BONE FILLER,24404.0,15862.6,13270.0,14761.0,2
CDM,2781856,"HB KIT, XLIF 2 LEVEL",61307.6,39849.94,13270.0,14761.0,2
CDM,2781857,HB CARDIAC VALVE HUMAN TISSUE,87831.5,57090.47,13270.0,14761.0,2
CDM,2781861,HB HEARTMATE III MINI APICAL CUFF,6893.63,4480.86,13270.0,14761.0,2
CDM,2781862,HB HEARTMATE III IMPLANT KIT,835976.0,543384.4,13270.0,14761.0,2
CDM,2781864,"HB SPACER, SPINE",51913.2,33743.58,13270.0,14761.0,2
CDM,2781879,"HB KIT, XLIF 3 LEVEL",89684.8,58295.12,13270.0,14761.0,2
CDM,2781883,"HB CLIP, OCCLUSION",45757.6,29742.44,13270.0,14761.0,2
CDM,2781892,HB VASCULAR PATCH,2367.2,1538.68,13270.0,14761.0,2
CDM,2781895,"HB CAGE, SPINE",21654.8,14075.62,13270.0,14761.0,2
CDM,2781896,HB ANCHOR / SCREW,60993.8,39645.97,13270.0,14761.0,2
CDM,2781899,"HB COVER, BURR HOLE",9760.41,6344.27,13270.0,14761.0,2
CDM,2781901,"HB CATHETER, PERITONEAL",6294.84,4091.65,13270.0,14761.0,2
CDM,2781909,HB BONE GRAFT MATRIX,14640.6,9516.39,13270.0,14761.0,2
CDM,2781911,HB GRAFT VASCULAR,215027.0,139767.55,13270.0,14761.0,2
CDM,2781912,"HB CLIP, OCCLUSION",67102.8,43616.82,13270.0,14761.0,2
CDM,2781913,"HB STENT, GRAFT BIFURCATED",74362.1,48335.37,13270.0,14761.0,2
CDM,2781919,"HB CATHETER, IMPELLA",351275.0,228328.75,13270.0,14761.0,2
CDM,2781928,"HB SHEET, MEDPOR",11479.2,7461.48,,,0
CDM,2781931,"HB VALVE, ENDOBRONCHIAL",42091.8,27359.67,13270.0,14761.0,2
CDM,2781937,"HB STENT, ATLAS NEUROVASCULAR",90869.4,59065.11,13270.0,14761.0,2
CDM,2781946,HB ENDOBRONCHIAL VALVE,26850.9,17453.09,13270.0,14761.0,2
CDM,2781947,HB ENDOBRONCHIAL VALVE - SPIRATION,31732.9,20626.39,13270.0,14761.0,2
CDM,2781951,HB CARDIAC VALVE HUMAN TISSUE,186218.0,121041.7,13270.0,14761.0,2
CDM,2781968,"HB SPACER/CAGE, SPINE",48819.8,31732.87,13270.0,14761.0,2
CDM,2781970,HB EXCLUDER ENDOPROSTHESIS,35394.4,23006.36,13270.0,14761.0,2
CDM,2781972,HB CARDIAC VALVE HUMAN TISSUE,52798.7,34319.15,13270.0,14761.0,2
CDM,2781976,HB KIT BRIGADE ANTERIOR LUMBAR LEVEL 2,87875.7,57119.21,13270.0,14761.0,2
CDM,2781981,"HB KIT, XLIF LEVEL 1",51260.8,33319.52,13270.0,14761.0,2
CDM,2781982,"HB KIT, TLIF",59560.2,38714.13,13270.0,14761.0,2
CDM,2781983,HB CARDIAC VALVE HUMAN TISSUE,161413.0,104918.45,13270.0,14761.0,2
CDM,2781986,"HB SPACER/CAGE, SPINE",77623.5,50455.28,13270.0,14761.0,2
CDM,2781987,"HB SPACER/CAGE, SPINE",105207.0,68384.55,13270.0,14761.0,2
CDM,2781988,"HB SPACER/CAGE, SPINE",124783.0,81108.95,13270.0,14761.0,2
CDM,2781992,HB STENT CLIP,7310.78,4752.01,13270.0,14761.0,2
CDM,2781995,HB COUPLER,12143.9,7893.53,13270.0,14761.0,2
CDM,2781996,HB OCCLUSION CLIP,22579.2,14676.48,13270.0,14761.0,2
CDM,2781997,"HB KIT, XLIF LEVEL 4",117155.0,76150.75,13270.0,14761.0,2
CDM,2781999,"HB STENT, GRAFT BIFURCATED",53915.4,35045.01,13270.0,14761.0,2
CDM,2782008,HB BONE FILLER,29059.4,18888.61,13270.0,14761.0,2
CDM,2782015,HB HARMONY TPV 25 PULMONARY VALVE,336071.0,218446.15,,,0
CDM,2782026,HB PORTICO AORTIC VALVE,276926.0,180001.9,13270.0,14761.0,2
CDM,2782042,"HB PULMONARY VALVE, SAPIEN 3",400535.0,260347.75,13270.0,14761.0,2
CDM,2782073,HB PUTTY BONE SYNTHETIC,21349.8,13877.37,13270.0,14761.0,2
CDM,2782074,HB PUTTY BONE SYNTHETIC,9027.91,5868.14,13270.0,14761.0,2
CDM,2782075,HB PUTTY BONE SYNTHETIC,31097.5,20213.38,13270.0,14761.0,2
CDM,2782076,"HB SPACER/CAGE, SPINE",146176.0,95014.4,13270.0,14761.0,2
CDM,2782077,"HB KIT, TLIF",64415.3,41869.94,13270.0,14761.0,2
CDM,2782345,"HB VALVE, AORTIC RESILIA",346252.0,225063.8,13270.0,14761.0,2
CDM,2782346,"HB VALVE, PASCAL MITRAL CLASP",320215.0,208139.75,13270.0,14761.0,2
CDM,2782358,"HB STENT, TRACHEOBRONCHIAL SIZING DEVICE",2134.78,1387.61,13270.0,14761.0,2
CDM,2782363,HB CARDIAC VALVE HUMAN TISSUE,168495.0,109521.75,13270.0,14761.0,2
CDM,2782387,"HB CLIP, ENDOSCOPIC CLOSURE",3958.5,2573.03,,,0
CDM,2782388,"HB KIT, ALIF",64043.5,41628.28,13270.0,14761.0,2
CDM,2782401,"HB EXTENSION, AORTIC/ILIAC/THORACIC",86626.4,56307.16,13270.0,14761.0,2
CDM,2782428,HB STENT GRAFT AORTIC,353910.0,230041.5,13270.0,14761.0,2
CDM,2782429,"HB KIT, TLIF",39402.0,25611.3,13270.0,14761.0,2
CDM,2782433,"HB COIL, EMBOLIZATION",14028.6,9118.59,13270.0,14761.0,2
CDM,2782434,"HB COIL, EMBOLIZATION",18956.9,12321.99,13270.0,14761.0,2
CDM,2782435,"HB COIL, EMBOLIZATION",9149.07,5946.9,,,0
CDM,2782451,HB TESTICULAR PROSTHESIS,22555.5,14661.08,13270.0,14761.0,2
CDM,2782464,"HB COIL, EMBOLIZATION",31192.2,20274.93,13270.0,14761.0,2
CDM,2782487,HB INTRAUTERINE TANDEM,1366.26,888.07,13270.0,14761.0,2
CDM,3091068,CSMC IP,713.495,463.77,,,0
CDM,3091068,HB MISC LAB SPECIAL TEST,161.12,106.39,66.53,14761.0,616
CDM,3600002,HB OR LEVEL 5 - EA ADDL MINUTE,177.95,115.67,13270.0,14761.0,2
CDM,3600003,HB OR LEVEL 4 - EA ADDL MINUTE,221.08,143.7,13270.0,14761.0,2
CDM,3600004,HB OR LEVEL 3 - EA ADDL MINUTE,288.39,187.45,13270.0,14761.0,2
CDM,3600005,HB OR LEVEL 2 - EA ADDL MINUTE,380.08,247.05,13270.0,14761.0,2
CDM,3600006,HB OR LEVEL 1 - EA ADDL MINUTE,475.75,309.24,13270.0,14761.0,2
CDM,3600007,HB BEDSIDE PROCEDURE - MINOR,7534.9,4897.68,13270.0,14761.0,2
CDM,3600008,HB OR LEVEL 1 - 1ST HOUR,49409.0,32115.85,13270.0,14761.0,2
CDM,3600010,HB BEDSIDE PROCEDURE - MAJOR,18255.1,11865.81,13270.0,14761.0,2
CDM,3600011,HB OR LEVEL 4 - 1ST HOUR,26364.5,17136.92,13270.0,14761.0,2
CDM,3600012,HB OR LEVEL 3 - 1ST HOUR,35772.4,23252.06,13270.0,14761.0,2
CDM,3600013,HB OR LEVEL 2 - 1ST HOUR,41974.7,27283.56,13270.0,14761.0,2
CDM,3600014,HB OR LEVEL 5 - 1ST HOUR,13930.0,9054.5,13270.0,14761.0,2
CDM,3600016,HB OR LEVEL 1 - 1ST HOUR CANCELED,13649.9,8872.43,13270.0,14761.0,2
CDM,3600017,HB OR LEVEL 2 - 1ST HOUR CANCELED,11602.0,7541.3,13270.0,14761.0,2
CDM,3600018,HB OR LEVEL 3 - 1ST HOUR CANCELED,9827.56,6387.91,13270.0,14761.0,2
CDM,3600019,HB OR LEVEL 4 - 1ST HOUR CANCELED,7019.59,4562.73,13270.0,14761.0,2
CDM,3600020,HB OR LEVEL 5 - 1ST HOUR CANCELED,3732.9,2426.39,13270.0,14761.0,2
CDM,3610536,HB MISCELLANEOUS PROCEDURE,7788.35,5062.43,1108.58,14761.0,22
CDM,3700001,HB ANES-CAT 2-BASIC+A LINE-1ST HR,17128.1,11133.26,13270.0,14761.0,2
CDM,3700002,HB ANES-CAT 2 - EA ADDL MIN,168.64,109.62,13270.0,14761.0,2
CDM,3700003,HB ANES-CAT 1-BASIC - 1ST HOUR,12286.0,7985.9,13270.0,14761.0,2
CDM,3700004,HB ANES-CAT 2+ALINE OUTLYING AREA,13052.8,8484.32,13270.0,14761.0,2
CDM,3700005,HB ANES-CAT 3 - EA ADDL MIN,260.85,169.55,13270.0,14761.0,2
CDM,3700006,HB ANES-CAT 1-BASIC OUTLYING AREA,7443.08,4838.0,13270.0,14761.0,2
CDM,3700007,HB ANES-CAT 1 - EA ADDL MIN,126.45,82.19,13270.0,14761.0,2
CDM,3700008,"HB ANES-CAT 3+CVP,SWAN-1ST HOUR",27005.9,17553.84,13270.0,14761.0,2
CDM,3700018,HB ANES-CAT 3+ALINE OUTLYING AREA,20545.3,13354.44,13270.0,14761.0,2
CDM,4200002,HB M CAL PT EXRCSE EA ADDL 15M,609.9749999999999,396.485,13270.0,14761.0,2
CDM,4200003,HB M CAL PT EVALUATION,2598.83,1689.2399999999998,13270.0,14761.0,2
CDM,4200004,HB M CAL PT EXRCSE 1ST 30M,1218.27,791.875,13270.0,14761.0,2
CDM,4200005,HB M CAL PT MOD/EXER 1ST 30M,1218.27,791.875,13270.0,14761.0,2
CDM,4200008,HB M CAL PT MOD/EXER EA ADDL 15M,609.9749999999999,396.485,13270.0,14761.0,2
CDM,4200055,"HB M CAL PT SNGL MODAL, INIT 30M",1334.36,867.33,13270.0,14761.0,2
CDM,4200086,HB M-CAL PT EVAL ADDL 15 MIN,1129.73,734.32,,,0
CDM,4200090,"HB M CAL PT SNGL MODAL, EA ADDL 15M",688.67,447.64,13270.0,14761.0,2
CDM,4300003,HB M CAL OT TRTMNT EA ADDL 15M,670.61,435.9,13270.0,14761.0,2
CDM,4300004,HB M CAL OT TRTMNT INIT 30 MIN,1341.22,871.7950000000001,13270.0,14761.0,2
CDM,4340001,HB M CAL OT EVAL ADD'L 15M,591.925,384.75,13270.0,14761.0,4
CDM,4340002,HB M CAL OT EVAL INIT 30 MIN,1180.515,767.335,13270.0,14761.0,4
CDM,4340018,HB M CAL OT EVAL EA ADDL 15M,514.86,334.66,,,0
CDM,4400002,HB M CAL SLP IND TX 30 MIN,1399.0949999999998,909.415,13270.0,14761.0,2
CDM,4400003,HB M CAL SWALLOW EVAL 60 MIN,2598.83,1689.2399999999998,13270.0,14761.0,2
CDM,4400004,HB M CAL VIDEO SWALLOW,2921.89,1899.23,13270.0,14761.0,2
CDM,4400005,HB M CAL SLP IND TX 60 MIN,3478.74,2261.18,13270.0,14761.0,2
CDM,4400007,HB M CAL SPEECH EVAL,2938.25,1909.86,13270.0,14761.0,2
CDM,4400010,HB M CAL LANG SWALL IND TX 60 MIN,2675.93,1739.35,,,0
CDM,4440003,HB M CAL LANG COG EVAL 60 MIN,2259.41,1468.62,,,0
CDM,4440004,HB M CAL SPEECH VOICE EVALUATION,2259.41,1468.62,,,0
CDM,4500244,"HB TRAUMA, NO PRE-NOTIFICATION HIGH LEVEL RESP",50660.71,32929.465,13270.0,14761.0,2
CDM,4500245,"HB TRAUMA, NO PRE-NOTIFICATION MID LEVEL RESP",39402.785,25611.809999999998,13270.0,14761.0,4
CDM,4500246,"HB TRAUMA, NO PRE-NOTIFICATION LOW LEVEL RESP",16888.595,10977.585,13270.0,14761.0,4
CDM,6240114,"HB VALVE, SAPIEN M3 SYS ENCIRCLE (G170152)",315650.0,205172.5,13270.0,14761.0,2
CDM,6240118,HB CLASP MVR GUIDE SHEATH (G170166),1.0,0.65,13270.0,14761.0,2
CDM,6240123,HB TRILUMINATE STEERABLE GUIDE CATH (G170118),1.0,0.65,13270.0,14761.0,2
CDM,6240127,HB GORE TAG THORACIC BRANCH ENDOPROSTHESIS (TBE) (G130120/S026),1.0,0.65,13270.0,14761.0,2
CDM,6240131,"HB VALVE, APOLLO MVR (G160020)",380650.0,247422.5,13270.0,14761.0,2
CDM,6240132,"HB VALVE, CENTERA STUDY (G180045)",296350.0,192627.5,13270.0,14761.0,2
CDM,6240133,HB JENA VALVE (G150035),296350.0,192627.5,13270.0,14761.0,4
CDM,6240136,HB ACURATE NEO2 (G190051) VALVE-S,265700.0,172705.0,13270.0,14761.0,2
CDM,6240137,HB ACURATE NEO2 (G190051) VALVE-M,265700.0,172705.0,13270.0,14761.0,2
CDM,6240138,HB ACURATE NEO2 (G190051) VALVE-L,265700.0,172705.0,13270.0,14761.0,2
CDM,6240140,HB SAFARI2 WIRE SMALL CURVE (G190051),1.0,0.65,13270.0,14761.0,2
CDM,6240150,HB PORTICO NG VALVE (G120263),231450.0,150442.5,13270.0,14761.0,2
CDM,6240152,HB TRI-CLIP TVR SYS (G170118),279400.0,181610.0,13270.0,14761.0,2
CDM,6240161,HB INTREPID TRICUSPID VALVE (G200119),1.0,0.65,13270.0,14761.0,2
CDM,6240163,HB INTREPID DELIVERY SYS (G200119),1.0,0.65,13270.0,14761.0,2
CDM,6240165,HB SAPIEN AORTIC VALVE (G210075),279400.0,181610.0,13270.0,14761.0,2
CDM,6240166,HB TRISCEND II TRICUSPID VALVE (G190289),333640.0,216866.0,13270.0,14761.0,2
CDM,6240167,HB CEPHEA MITRAL VALVE (G210284),1.0,0.65,13270.0,14761.0,2
CDM,6240168,HB RENATA MINIMA STENT (G210256),1.0,0.65,13270.0,14761.0,2
CDM,6240169,HB HANCOCK JAFFE SAVVE VALVE (G210069),1.0,0.65,13270.0,14761.0,2
CDM,6240172,"HB VALVE, SAPIEN 4 (G210327)",281500.0,182975.0,13270.0,14761.0,2
CDM,6240193,HB ACURATE NEO2 VALVE-XL (G190051),229060.0,148889.0,13270.0,14761.0,2
CDM,6240194,HB ACURATE NEO2 DEL SYS-XL (G190051),24227.6,15747.94,13270.0,14761.0,2
CDM,6240196,HB DA VINCI SURGICAL SYSTEM (G210237) IRB#1891,1.0,0.65,13270.0,14761.0,2
CDM,7100005,HB HOURLY EXT RECOVERY,540.0,351.0,13270.0,14761.0,2
CDM,7100050,HB PHASE I PACU 1ST HOUR,7105.64,4618.67,13270.0,14761.0,2
CDM,7100051,HB PHASE I PACU EA ADDL MIN,113.83,73.99,13270.0,14761.0,2
CDM,7100052,HB PHASE II PACU 1ST HOUR,2777.42,1805.32,13270.0,14761.0,2
CDM,7100053,HB PHASE II PACU EA ADDL MIN,28.47,18.51,13270.0,14761.0,2
CDM,7100054,HB RECOVERY LABOR & DELIVERY,5915.97,3845.38,13270.0,14761.0,2
CDM,7200001,HB VAGINAL DELVRY-W/VBAC SUCCESS,25124.1,16330.66,13270.0,14761.0,2
CDM,7200002,HB C-SECTION W/FAILED VBAC,25279.5,16431.67,13270.0,14761.0,2
CDM,7200003,HB C-SECTION W/TUBAL LIGATION,24932.2,16205.93,13270.0,14761.0,2
CDM,7200005,HB L & D MINOR PROCEDURE,6815.67,4430.19,13270.0,14761.0,2
CDM,7200008,HB C-SECTION MULTIPLE BIRTHS,25617.6,16651.44,13270.0,14761.0,2
CDM,7200009,HB C-SECTION,24594.0,15986.1,13270.0,14761.0,2
CDM,7200010,HB VAGINAL MULTIPLE BIRTHS,25462.3,16550.49,13270.0,14761.0,2
CDM,7200011,HB ADDL PROC OR RETURN TO THE OR/MINOR,12103.3,7867.14,13270.0,14761.0,2
CDM,7200012,HB C-SECTION W/HYSTERECTOMY,27418.1,17821.76,13270.0,14761.0,2
CDM,7200013,HB ADDL PROC OR RETURN TO THE OR/MAJOR,16081.5,10452.98,13270.0,14761.0,2
CDM,7200020,HB C-SEC-MULT BRTHS/W HYSTRCTMY,37197.2,24178.18,13270.0,14761.0,2
CDM,7200021,HB C-SEC MULT BRTHS W/TBL LIG,36191.8,23524.67,13270.0,14761.0,2
CDM,7500004,HB GI PROCEDURE-EACH ADDL MINUTE,86.15,56.0,13270.0,14761.0,2
CDM,7500015,HB GI BEDSIDE PROC - MAJOR,8665.38,5632.5,13270.0,14761.0,2
CDM,7500020,HB GI PROC LEVEL I- 1ST HR,11197.2,7278.18,13270.0,14761.0,2
CDM,7500021,HB GI PROC LEVEL II - 1ST HR,29756.9,19341.99,13270.0,14761.0,2
CDM,7500025,HB CANCELED PROC GI LEVEL 1,3247.2,2110.68,13270.0,14761.0,2
CDM,7500026,HB CANCELED PROC GI LEVEL 2,7503.89,4877.53,13270.0,14761.0,2
CDM,7500028,HB GI BEDSIDE PROC - MINOR,4332.69,2816.25,13270.0,14761.0,2
CDM,7610005,HB CHRONIC PAIN CNTR PROCEDURES 1,1953.82,1269.98,367.57,14761.0,10
CDM,7610006,HB CHRONIC PAIN CNTR PROCEDURES 2,6955.71,4521.21,,,0
CDM,7610008,HB CHRONIC PAIN CNTR PROCEDURES 4,19643.1,12768.01,13270.0,14761.0,2
CDM,7610009,HB CHRONIC PAIN CNTR PROCEDURES 5,29297.3,19043.24,,,0
CDM,7610010,HB CHRONIC PAIN CNTR PROCEDURES 3,8829.34,5739.07,13270.0,14761.0,2
CDM,7610011,HB CANCELED PROCEDURE PAIN CENTER,1730.52,1124.84,13270.0,14761.0,2
CDM,7610012,HB CHRONIC PAIN CNTR PROCEDURES 6,47167.7,30659.0,,,0
CDM,80000045,HB FOLLOW-UP-NO CHARGE VISIT,,,13270.0,14761.0,2
CDM,80000059,HB PC PATIENT NOT AVAIL,,,13270.0,14761.0,2
CDM,80000069,HB PC VENT. CIRCUIT CHANGE,,,13270.0,14761.0,2
CDM,80000093,HB STATISTIC GI LAB,,,13270.0,14761.0,2
CDM,80000102,HB STATISTIC CT RECON MPR,,,13270.0,14761.0,2
CDM,80000115,HB STATISTIC UOS,,,13270.0,14761.0,2
CDM,80000126,HB STATISTIC NM EXTRA VIEWS,,,13270.0,14761.0,2
CDM,80000248,HB PROF CONS XMATCH IRREG AB,,,13270.0,14761.0,2
CDM,80000316,HB PROF CONSULT DIRECTED DONOR,,,13270.0,14761.0,2
CDM,80000340,HB LAB STAT ONLY-CS AUTO,,,13270.0,14761.0,2
CDM,80000360,HB PROF CSF OLIGOCLONAL BANDS,,,13270.0,14761.0,2
CDM,80000395,HB LAB AGAR MIC (NO CHARGE) #,,,13270.0,14761.0,2
CDM,80002832,HB DIABETES EDUCATION INIT 1 HR,,,13270.0,14761.0,2
CDM,80002833,HB DIABETES EDUCATION ADDL 30 MIN,,,13270.0,14761.0,2
CDM,80016021,HB PB SM W/G REFERRED INTERP,,,13270.0,14761.0,2
CDM,80016104,HB PROF LIMITED CA,,,13270.0,14761.0,2
CDM,80016283,HB THAW PLAS STATISTICAL CHG,,,13270.0,14761.0,2
CDM,80016284,HB IRRADIATION STATISTICAL CHG,,,13270.0,14761.0,2
CDM,80016350,HB CATH LAB CANCELED PROC,,,13270.0,14761.0,2
CDM,80016359,HB STATISTIC MR SPECTROSCOPY,,,13270.0,14761.0,2
CDM,80016373,HB PC TRANSPORT 20 MINUTES,,,13270.0,14761.0,2
CDM,80016390,HB STATISTIC XR LINE PLCMT,,,13270.0,14761.0,2
CDM,80016394,HB STATISTIC MR EXTRA SEQUENCE,,,13270.0,14761.0,2
CDM,80016397,HB PROF BB REFERRED TEST,,,13270.0,14761.0,2
CDM,80016423,HB PROF MOL TCRB INTERP & RPT,,,13270.0,14761.0,2
CDM,80016455,HB CLOSE ENCOUNTER E & M STAT,,,13270.0,14761.0,2
CDM,80016457,HB PROF MP MD I & R CHRM CONST,,,13270.0,14761.0,2
CDM,80016462,HB STATISTIC XR NO CHARGE,,,13270.0,14761.0,2
CDM,80016464,HB MITRAL CLIP--ADDITIONAL CLIP,,,13270.0,14761.0,2
CDM,80016467,HB HOSPICE SEASONS - GIP,,,13270.0,14761.0,2
CDM,80016483,HB LEFT W/O BEING SEEN,,,13270.0,14761.0,2
CDM,80016485,HB STAT XR FLUOROSCOPY 1HR/LESS,,,13270.0,14761.0,2
CDM,80016486,HB STAT XR FLUOROSCOPY 1HR/MORE,,,13270.0,14761.0,2
CDM,80016488,HB STATISTIC NUC MED PREP,,,13270.0,14761.0,2
CDM,80016537,HB STATISTIC POCUS,,,13270.0,14761.0,2
CDM,80016542,HB STATISTIC NTAP STROKE ANALYSIS,,,13270.0,14761.0,2
CDM,8110002,HB ORGAN ACQ KIDNEY LIVE DONOR,458384.0,297949.6,13270.0,14761.0,2
CDM,8120002,HB ORGAN ACQ LIVER DEC DONOR,519083.0,337403.95,13270.0,14761.0,4
CDM,8120003,HB ORGAN ACQ HEART DEC DONOR,664314.0,431804.1,13270.0,14761.0,4
CDM,8120004,HB ORGAN ACQ LUNG BILA DEC DNR,806820.0,524433.0,13270.0,14761.0,4
CDM,8120005,HB ORGAN ACQ SNGL LUNG DEC DNR,806820.0,524433.0,13270.0,14761.0,2
CDM,8120006,HB ORGAN ACQ KIDNEY DEC DONOR,458384.0,297949.6,13270.0,14761.0,4
CDM,8120007,HB ORGAN ACQ PANCREAS,366942.0,238512.3,13270.0,14761.0,2
CDM,8190005,HB NMDP IDM TESTING AT CT,1841.85,1197.2,13270.0,14761.0,2
CDM,8190006,HB NMDP CUSTMZD(HR)HLA TS DNR,21160.1,13754.06,,,0
CDM,9900052,HB ROOM PRIVATE DELUXE,3161.0,2054.65,13270.0,14761.0,2
CDM,9900053,HB ROOM OB DELUXE 1 RM,5643.0,3667.95,13270.0,14761.0,2
CDM,9900054,HB ROOM OB DELUXE 2 RM,6580.0,4277.0,13270.0,14761.0,2
CDM,9900055,HB ROOM OB DELUXE 3 RM,7987.0,5191.55,13270.0,14761.0,2
CDM,9900500,HB A LA CARTE TRAY,,,13270.0,14761.0,2
CDM,9900503,HB ADD-ON FOR DELUXE ROOM 8-NE,3161.0,2054.65,13270.0,14761.0,2
CDM,9900505,HB ADD-ON FOR DELUXE ROOM 8-SE,3161.0,2054.65,,,0
CDM,9900506,HB ADD-ON FOR DELUXE ROOM 8-SW,3161.0,2054.65,13270.0,14761.0,2
CDM,HC1757,"HB CATHETER, THROMBECTOMY/EMBOLECTOMY",2334.97,1517.73,13270.0,14761.0,2
CDT,D0416,Laboratory Services,,,159.05,159.07,2
CDT,D0431,Laboratory Services,,,148.61,148.63,2
CDT,D0475,Laboratory Services,,,260.68,260.71,2
CDT,D0476,Laboratory Services,,,252.89,252.91,2
CDT,D0477,Laboratory Services,,,346.72,346.75,2
CDT,D0478,Laboratory Services,,,318.04,318.07,2
CDT,D0479,Laboratory Services,,,484.89,484.94,2
CDT,D0481,Laboratory Services,,,1118.39,1118.5,2
CDT,D0482,Laboratory Services,,,372.82,372.86,2
CDT,D0483,Laboratory Services,,,372.82,372.86,2
CPT,0001A,HB TERM ADM SARSCOV2 30MCG/0.3ML 1ST,396.14,257.49,,,0
CPT,0001U,"RED BLOOD CELL ANTIGEN TYPING,DNA,HUMAN ERYTHROCYTE ANTIGEN GENE ANALYSIS OF 35 ANTIGENS FROM 11 BLOOD GROUPS,UTILIZING",,,3801.45,6054.19,2
CPT,0001U,"Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported",,,1768.08,1768.08,2
CPT,00028,Spine Surgery,,,72263.82,72263.82,4
CPT,00029,Spine Surgery,,,72263.82,72263.82,4
CPT,0002M,"LIVER DISEASE, TEN BIOCHEMICAL ASSAYS UTILIZING SERUM, REPORTED AS QUANTITATIVE SCORES FOR FIBROSIS, STEATOSIS & ALCO(AS",,,2657.83,4232.86,2
CPT,0002M,Laboratory Services,,,2691.05,2691.32,2
CPT,0002M,"Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo",,,1236.41,1236.41,2
CPT,0002U,"ONCOLOGY (COLORECTAL),QUANTITATIVE ASSESSMENT OF THREE URINEMETABOLITES(ASCORBIC ACID,SUCCINIC ACID/CARNITINE)BY LIQUID",,,131.99,210.22,2
CPT,0002U,"Oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine) by liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple ",,,61.57,61.57,2
CPT,00030,Spine Surgery,,,72263.82,72263.82,4
CPT,00035,CSMC IP,30.43,19.78,,,0
CPT,0003M,"LIVER DISEASE, TEN BIOCHEMICAL ASSAYS UTILIZING SERUM, REPORTED AS QUANTITATIVE SCORES FOR FIBROSIS, STEATOSIS & NONALCO",,,2657.83,4232.86,2
CPT,0003M,Laboratory Services,,,2691.05,2691.32,2
CPT,0003M,"Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo",,,1236.41,1236.41,2
CPT,0003U,"ONCOLOGY (OVARIAN)BIOCHEMICAL ASSAYS OF FIVE PROTEINS(APOLIPOPROTEIN A-1,CA 125 II,FOLLICLE STIMULATING HORMONE, HUMAN",,,5015.8,7988.17,2
CPT,0003U,"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1, CA 125 II, follicle stimulating hormone, human epididymis protein 4, transferrin), utilizing serum, algorithm reported as a ",,,2332.2,2332.2,2
CPT,0004M,Laboratory Services,,,422.31,422.36,2
CPT,0004M,"SCOLIOSIS,DNA ANALYSIS OF 53 SINGLE NUCLEOTIDE POLYMORPHISMS(SNPS),USING SALIVA,PROGNOSTIC,ALGO REPORTED AS A RISK SCORE",,,417.09,664.26,2
CPT,0004M,"Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score",,,193.87,193.87,2
CPT,0005U,Laboratory Services,,,4062.76,4063.17,2
CPT,0005U,"ONCOLOGY (PROSTATE) GENE EXPRESSION PROFILE BY REAL-TIME RT-PCR OF 3 GENES (ERG, PCA3, AND SPDEF), URINE, ALGORITHM",,,4012.64,6390.54,2
CPT,0005U,"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score",,,1866.26,1866.26,2
CPT,0006M,Laboratory Services,,,801.86,801.94,2
CPT,0006M,"ONCOLOGY (HEPATIC), MRNA EXPRESSION LEVELS OF 161 GENES, UTILIZING FRESH HEPATOCELLULAR CARCINOMA TUMOR TISSUE, WITH ALP",,,791.97,1261.29,2
CPT,0006M,"Oncology (hepatic), mRNA expression levels of 161 genes, utilizing fresh hepatocellular carcinoma tumor tissue, with alpha-fetoprotein level, algorithm reported as a risk classifier",,,368.6,368.6,2
CPT,00077,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,0007M,Laboratory Services,,,2004.65,2004.85,2
CPT,0007M,"ONCOLOGY REAL-TIME PCR EXPRESSION ANALYSIS OF 51 GENES, UTILIZING WHOLE PERIPHERAL BLOOD, ALGORITHM REPORTED AS A NOMOGR",,,1979.92,3153.23,2
CPT,0007M,"Oncology (gastrointestinal neuroendocrine tumors), real-time PCR expression analysis of 51 genes, utilizing whole peripheral blood, algorithm reported as a nomogram of tumor disease index",,,921.07,921.07,2
CPT,0007U,"DRUG TEST(S), PRESUMPTIVE, WITH DEFINITIVE CONFIRMATION OF POSITIVE RESULTS, ANY NUMBER OF DRUG CLASSES, URINE, INCLUDE",,,604.18,962.21,2
CPT,0007U,"Drug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine, includes specimen verification including DNA authentication in comparison to buccal DNA,",,,281.23,281.23,2
CPT,0007U,Laboratory Services,,,611.74,611.8,2
CPT,0008U,"HELICOBACTER PYLORI DETECTION AND ANTIBIOTIC RESISTANCE, DNA, 16S AND 23S RRNA, GYRA, PBP1, RDXA ANDRPOB, NEXT-GENERATION SEQUENCING, FORMALIN-FIXED PARAFFIN-EMBEDDED OR FRESH TISSUE OR FECAL SAMPLE,",,,3156.82,5027.56,2
CPT,0008U,"Helicobacter pylori detection and antibiotic resistance, DNA, 16S and 23S rRNA, gyrA, pbp1, rdxA and rpoB, next generation sequencing, formalin-fixed paraffin embedded or fresh tissue, predictive, rep",,,1467.72,1467.72,2
CPT,0008U,Laboratory Services,,,3196.25,3196.57,2
CPT,0009U,Laboratory Services,,,571.99,572.05,2
CPT,0009U,"ONCOLOGY (BREAST CANCER), ERBB2 (HER2) COPY NUMBER BY FISH, TUMOR CELLS FROM FORMALIN FIXED PARAFFIN EMBEDDED TISSUE ISO",,,564.96,899.76,2
CPT,0009U,"Oncology (breast cancer), ERBB2 (HER2) copy number by FISH, tumor cells from formalin-fixed paraffin-embedded tissue isolated using image-based dielectrophoresis (DEP) sorting, reported as ERBB2 gene ",,,262.93,262.93,2
CPT,0010U,"INFECTIOUS DISEASE (BACTERIAL), STRAIN TYPING BY WHOLE GENOME SEQUENCING, PHYLOGENETIC-BASED REPORT OF STRAIN RELATEDNES",,,2255.85,3592.66,2
CPT,0010U,"Infectious disease (bacterial), strain typing by whole genome sequencing, phylogenetic-based report of strain relatedness, per submitted isolate",,,1049.2,1049.2,2
CPT,0010U,Laboratory Services,,,2284.02,2284.24,2
CPT,0011M,Laboratory Services,,,4062.76,4063.17,2
CPT,0011M,"ONCOLOGY,PROSTATE CANCER,MRNA EXPRESSION ASSAY OF 12 GENES(10 CONTENT/2 HOUSEKEEPING) RT-PCR TEST UTILIZING BLOOD PLASM",,,4012.64,6390.54,2
CPT,0011M,"Oncology, prostate cancer, mRNA expression assay of 12 genes (10 content and 2 housekeeping), RT-PCR test utilizing blood plasma and urine, algorithms to predict high-grade prostate cancer risk",,,1866.26,1866.26,2
CPT,0011U,Laboratory Services,,,611.74,611.8,2
CPT,0011U,"PRESCRIPTION DRUG MONITORING, EVALUATION OF DRUGS PRESENT BYLC-MS/MS, USING ORAL FLUID, REPORTED AS A COMPARISON TO AN",,,604.18,962.21,2
CPT,0011U,"Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds a",,,281.23,281.23,2
CPT,0012M,Drug assay caffeine,,,3950.08,6290.91,2
CPT,0012M,Laboratory Services,,,4062.76,4063.17,2
CPT,0012M,"Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 [CDK1], IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo",,,1866.26,1866.26,2
CPT,0013M,Assay carbamazepine free,,,3950.08,6290.91,2
CPT,0013M,Laboratory Services,,,4062.76,4063.17,2
CPT,0013M,"Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 [CDK1], IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo",,,1866.26,1866.26,2
CPT,0014M,"Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, ",,,432.66,432.66,2
CPT,0015M,"ADRENAL CORTICAL TUMOR, BIOCHEMICAL ASSAY OF 25 STEROID MARKERS, UTILIZING 24-HOUR URINE SPECIMEN AND CLINICAL PARAMETER",,,6892.07,10976.32,2
CPT,0015M,"Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical ster",,,3205.01,3205.01,2
CPT,0016M,"ONCOLOGY (BLADDER), MRNA, MICROARRAY GENE EXPRESSION PROFILING OF 219 GENES, UTILIZING FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE, ALGORITHM REPORTED AS MOLECULAR SUBTYPE (LUMINAL, LUMINAL INFILTRATED,",,,18424.53,29342.93,2
CPT,0016M,"Oncology (bladder), mRNA, microarray gene expression profiling of 209 genes, utilizing formalin fixed paraffin-embedded tissue, algorithm reported as molecular subtype (luminal, luminal infiltrated, b",,,8568.34,8568.34,2
CPT,0016U,Laboratory Services,,,1082.1,1082.21,2
CPT,0016U,"ONCOLOGY (HEMATOLYMPHOID NEOPLASIA), RNA, BCR/ABL1 MAJOR AND MINOR BREAKPOINT FUSION TRANSCRIPTS, QUANTITATIVE PCR AMPLI",,,865.7,1378.71,2
CPT,0016U,"Oncology (hematolymphoid neoplasia), RNA, BCR/ABL1 major and minor breakpoint fusion transcripts, quantitative PCR amplification, blood or bone marrow, report of fusion not detected or detected with q",,,402.7,402.7,2
CPT,0017M,Laboratory Services,,,13418.95,13420.29,2
CPT,0017M,"Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of",,,6163.74,6163.74,2
CPT,0017U,Laboratory Services,,,604.95,605.01,2
CPT,0017U,"ONCOLOGY (HEMATOLYMPHOID NEOPLASIA), JAK2 MUTATION, DNA, PCR AMPLIFICATION OF EXONS 12-14 AND SEQUENCE ANALYSIS, BLOOD",,,483.94,770.73,2
CPT,0017U,"Oncology (hematolymphoid neoplasia), JAK2 mutation, DNA, PCR amplification of exons 12-14 and sequence analysis, blood or bone marrow, report of JAK2 mutation not detected or detected",,,224.65,224.65,2
CPT,0018M,"TRANSPLANTATION MEDICINE (ALLOGRAFT REJECTION, RENAL), MEASUREMENT OF DONOR AND THIRD-PARTY-INDUCED CD154+T-CYTOTOXIC",,,3382.95,5387.69,2
CPT,0018M,"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection ",,,1573.38,1573.38,2
CPT,0018U,"ONCOLOGY(THYROID)MICRORNA PROFILING BY RT-PCR OF 10 MICRORNA SEQUENCES,UTILIZING FINE NEEDLE ASPIRATE, ALGORITHM REPORT",,,15850.43,25243.41,2
CPT,0018U,"Oncology (thyroid), microRNA profiling by RT-PCR of 10 microRNA sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy",,,7371.04,7371.04,2
CPT,0019U,"ONCOLOGY,RNA,GENE EXPRESSION BY WHOLE TRANSCRIPTOME SEQUENING, FORMALIN-FIXED PARAFFIN EMBEDDED TISSUE OR FRESH,FROZEN",,,19403.23,30901.61,2
CPT,0019U,"Oncology, RNA, gene expression by whole transcriptome sequencing, formalin-fixed paraffin-embedded tissue or fresh frozen tissue, predictive algorithm reported as potential targets for therapeutic age",,,9023.47,9023.47,2
CPT,0021U,"ONCOLOGY(PROSTATE)DETECTION OF 8 AUTOANTIBODIES (ARF 6,NKX3-1, 5'-UTR-BMI1, CEP 164,3'-UTR-ROPPORIN,DESMOCOLLIN,AURKAIP",,,4012.64,6390.54,2
CPT,0021U,"Oncology (prostate), detection of 8 autoantibodies (ARF 6, NKX3-1, 5SQUOTE-UTR-BMI1, CEP 164, 3SQUOTE-UTR-Ropporin, Desmocollin, AURKAIP-1, CSNK2A2), multiplexed immunoassay and flow cytometry serum, ",,,1866.26,1866.26,2
CPT,0022U,"Targeted genomic sequence analysis panel, non-small cell lung neoplasia, DNA and RNA analysis, 23 genes, interrogation for sequence variants and rearrangements, reported as presence/absence of variant",,,79.44,79.44,2
CPT,0023U,"ONCOLOGY (ACUTE MYELOGENOUS LEUKEMIA)DNA,GENOTYPING OF INTERNAL TANDEM DUPLICATION,P.D835,P.I836,USING MONONUCLEAR CELLS",,,1312.07,2089.6,2
CPT,0023U,"Oncology (acute myelogenous leukemia), DNA, genotyping of internal tandem duplication, p.D835, p.I836, using mononuclear cells, reported as detection or non-detection of FLT3 mutation and indication f",,,609.88,609.88,2
CPT,0024U,"Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative",,,84.04,149.63,4
CPT,0024U,Laboratory Services,,,65.16,65.16,2
CPT,0025U,Laboratory Services,,,509.48,509.53,2
CPT,0025U,"Tenofovir, by liquid chromatography with tandem mass spectrometry (LC-MS/MS), urine, quantitative",,,210.5,1071.49,4
CPT,0026U,Laboratory Services,,,19244.67,19246.6,2
CPT,0026U,"Oncology (thyroid), DNA and mRNA of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule, algorithmic analysis reported as a categorical result (Positive, high probability of ",,,8838.75,33709.32,4
CPT,0027U,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15",,,299.54,7924.22,4
CPT,0027U,Laboratory Services,,,804.63,804.71,2
CPT,0029U,"Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823)",,,1822.17,7924.22,4
CPT,0029U,Laboratory Services,,,3967.99,3968.39,2
CPT,0030U,"Drug metabolism (warfarin drug response), targeted sequence analysis (ie, CYP2C9, CYP4F2, VKORC1, rs12777823)",,,329.49,6547.47,4
CPT,0030U,Laboratory Services,,,717.02,717.09,2
CPT,0031U,"CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F, *1K, *6, *7)",,,429.33,429.33,2
CPT,0031U,"CYP1A2 (cytochrome P450 family 1, subfamily A, member 2)(eg, drug metabolism) gene analysis, common variants (ie, *1F, *1K, *6, *7)",,,2651.13,4222.19,2
CPT,0031U,Laboratory Services,,,934.5,934.59,2
CPT,0032U,"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis, c.472G>A (rs4680) variant",,,1027.8,1636.87,2
CPT,0032U,"COMT (catechol-O-methyltransferase)(eg, drug metabolism) gene analysis, c.472G>A (rs4680) variant",,,429.33,429.33,2
CPT,0032U,Laboratory Services,,,934.5,934.59,2
CPT,0033U,"HTR2A (5-hydroxytryptamine receptor 2A), HTR2C (5-hydroxytryptamine receptor 2C) (eg, citalopram metabolism) gene analysis, common variants (ie, HTR2A rs7997012 [c.614-2211T>C], HTR2C rs3813929 [c.-75",,,858.67,6547.47,4
CPT,0033U,Laboratory Services,,,1869.0,1869.18,2
CPT,0034U,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,0034U,Laboratory Services,,,2492.0,2492.25,2
CPT,0034U,"TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15)(eg, thiopurine metabolism) gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5)",,,1144.88,1144.88,2
CPT,0034U,"TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15)(eg, thiopurine metabolism), gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5)",,,4111.18,6547.47,2
CPT,0035U,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,0035U,Laboratory Services,,,2891.98,2892.27,2
CPT,0035U,"NEUROLOGY (PRION DISEASE), CEREBROSPINAL FLUID, DETECTION OFPRION PROTEIN BY QUAKING-INDUCED CONFORMATIONAL CONVERSION,",,,2856.32,4548.98,2
CPT,0035U,"Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative",,,1327.93,1327.93,2
CPT,0036U,Assay of phenytoin free,,,24843.94,39566.5,2
CPT,0036U,"Exome (ie, somatic mutations), paired formalin-fixed paraffin-embedded tumor tissue and normal specimen, sequence analyses",,,11736.74,11736.74,2
CPT,0036U,Laboratory Services,,,25552.65,25555.21,2
CPT,0037U,Assay of primidone,,,18191.17,28971.29,2
CPT,0037U,Laboratory Services,,,18710.1,18711.98,2
CPT,0037U,"Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instabili",,,8593.3,8593.3,2
CPT,0038U,Assay of procainamide,,,170.92,272.2,2
CPT,0038U,Laboratory Services,,,175.84,175.86,2
CPT,0038U,"Vitamin D, 25 hydroxy D2 and D3, by LC-MS/MS, serum microsample, quantitative",,,72.39,72.39,2
CPT,0039U,Assay of procainamide,,,79.37,126.41,2
CPT,0039U,"Deoxyribonucleic acid (DNA) antibody; double stranded, high avidity",,,34.12,34.12,2
CPT,0039U,Laboratory Services,,,81.63,81.64,2
CPT,0040U,Assay of quinidine,,,2367.2,3770.01,2
CPT,0040U,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis, major breakpoint, quantitative",,,1006.76,1006.76,2
CPT,0040U,Laboratory Services,,,2434.7,2434.95,2
CPT,0041U,"BORRELIA BURGDORFERI, ANTIBODY DETECTION OF 5 RECOMBINANT PROTEIN GROUPS, BY IMMUNOBLOT, IGM",,,90.84,144.67,2
CPT,0041U,"Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM",,,42.43,42.43,2
CPT,0041U,Laboratory Services,,,92.01,92.02,2
CPT,0042T,CAT Scan,6006.14,3903.99,2808.07,2839.65,2
CPT,0042T,CEREBRAL PERFUSION ANALYSIS USING COMPUTED TOMOGRAPHY W/CONTADMIN INCL POST PROC OF PARAMETRIC MAPS W/DETER OF CEREBRAL,6006.14,3903.99,,,0
CPT,0042T,HB CT PERFUSION BRAIN,6907.0599999999995,4489.59,13270.0,14761.0,2
CPT,0042U,"BORRELIA BURGDORFERI, ANTIBODY DETECTION OF 12 RECOMBINANT PROTEIN GROUPS, BY IMMUNOBLOT, IGG",,,90.84,144.67,2
CPT,0042U,"Borrelia burgdorferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG",,,42.43,42.43,2
CPT,0042U,Laboratory Services,,,92.01,92.02,2
CPT,0043U,Laboratory Services,,,79.43,79.44,2
CPT,0043U,"TICK-BORNE RELAPSING FEVER BORRELIA GROUP, ANTIBODY DETECTION TO 4 RECOMBINANT PROTEIN GROUPS, BY IMMUNOBLOT,IGM",,,78.43,124.91,2
CPT,0043U,"Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM",,,36.61,36.61,2
CPT,0044U,Laboratory Services,,,79.43,79.44,2
CPT,0044U,"TICK-BORNE RELAPSING FEVER BORRELIA GROUP, ANTIBODY DETECTION TO 4 RECOMBINANT PROTEIN GROUPS,BY IMMMUNOBLOT,IGG",,,78.43,124.91,2
CPT,0044U,"Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG",,,36.61,36.61,2
CPT,00453,Spine Surgery,,,72263.82,72263.82,4
CPT,00454,Spine Surgery,,,72263.82,72263.82,4
CPT,00455,Spine Surgery,,,72263.82,72263.82,4
CPT,00456,Spine Surgery,,,72263.82,72263.82,4
CPT,00457,Spine Surgery,,,72263.82,72263.82,4
CPT,00458,Spine Surgery,,,72263.82,72263.82,4
CPT,00459,Spine Surgery,,,72263.82,72263.82,4
CPT,0045U,Assay of tobramycin,,,20129.82,32058.78,2
CPT,0045U,"Oncology (breast ductal carcinoma in situ), mRNA, gene expression profiling by realtime RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm ",,,9509.37,9509.37,2
CPT,00460,Spine Surgery,,,72263.82,72263.82,4
CPT,0046U,Assay of topiramate,,,860.23,1370.0,2
CPT,0046U,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia) internal tandem duplication (ITD) variants, quantitative",,,1000.11,1000.11,2
CPT,00471,Spine Surgery,,,72263.82,72263.82,4
CPT,00472,Spine Surgery,,,72263.82,72263.82,4
CPT,00473,Spine Surgery,,,72263.82,72263.82,4
CPT,0047U,Assay of vancomycin,,,20129.82,32058.78,2
CPT,0047U,"Oncology (prostate), mRNA, gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a risk sc",,,9509.37,9509.37,2
CPT,0048U,"ONCOLOGY (SOLID ORGAN NEOPLASIA), DNA, TARGETED SEQUENCING OF PROTEIN-CODING EXONS OF 468 CANCER-ASSOCIATED GENES, INCL",,,15414.87,24549.75,2
CPT,0048U,"Oncology (solid organ neoplasia), DNA, targeted sequencing of protein-coding exons of 468 cancer-associated genes, including interrogation for somatic mutations and microsatellite instability, matched",,,7168.85,7168.85,2
CPT,0049U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,0049U,Quantitative assay drug,,,1281.26,2040.54,2
CPT,0049U,"U NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative",,,1000.11,1000.11,2
CPT,0050U,"TARGETED GENOMIC SEQUENCE ANALYSIS PANEL, ACUTE MYELOGENOUS LEUKEMIA, DNA ANALYSIS, 194 GENES, INTERROGATION FOR SEQUEN",,,15399.06,24524.56,2
CPT,0050U,"Targeted genomic sequence analysis panel, acute myelogenous leukemia, DNA analysis, 194 genes, interrogation for sequence variants, copy number variants or rearrangements",,,7161.36,7161.36,2
CPT,00518,Spine Surgery,,,72263.82,72263.82,4
CPT,00519,Spine Surgery,,,72263.82,72263.82,4
CPT,0051A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR 1,455.565,296.115,13270.0,14761.0,2
CPT,0051U,Drug test prsmv dir opt obs,,,1068.78,1702.13,2
CPT,0051U,"Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, urine, 31 drug panel, reported as quantitative results, detected or not detected, per date of service",,,475.93,475.93,2
CPT,00520,Spine Surgery,,,72263.82,72263.82,4
CPT,0052A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR 2,514.99,334.74,13270.0,14761.0,2
CPT,0052U,Drug test prsmv instrmnt,,,175.97,280.26,2
CPT,0052U,"Lipoprotein, blood, high resolution fractionation and quantitation of lipoproteins, including all five major lipoprotein classes and subclasses of HDL, LDL, and VLDL by vertical auto profile ultracent",,,83.2,83.2,2
CPT,0053A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR 3,514.99,334.74,13270.0,14761.0,2
CPT,0053U,"ONCOLOGY (PROSTATE CANCER), FISH ANALYSIS OF 4 GENES (ASAP1,HDAC9, CHD1 AND PTEN), NEEDLE BIOPSY SPECIMEN, ALGORITHM REP",,,10717.98,17069.46,2
CPT,0053U,"Oncology (prostate cancer), FISH analysis of 4 genes (ASAP1, HDAC9, CHD1 and PTEN), needle biopsy specimen, algorithm reported as probability of higher tumor grade",,,4983.92,4983.92,2
CPT,0054A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR B,455.565,296.115,13270.0,14761.0,2
CPT,0054T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0054U,Acth stimulation panel,,,860.29,1370.1,2
CPT,0054U,"Prescription drug monitoring, 14 or more classes of drugs and substances, definitive tandem mass spectrometry with chromatography, capillary blood, quantitative report with therapeutic and toxic range",,,366.1,366.1,2
CPT,0055T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0055T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0055U,"CARDIOLOGY (HEART TRANSPLANT), CELL-FREE DNA, PCR ASSAY OF 96 DNA TARGET SEQUENCES (94 SINGLE NUCLEOTIDE POLYMORPHISM",,,17106.52,27243.87,2
CPT,0055U,"Cardiology (heart transplant), cell-free DNA, PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets), plasma",,,7955.12,7955.12,2
CPT,0058T,Other tests - other,,,2975.03,4738.03,2
CPT,0058U,Calcitonin stimul panel,,,1865.09,2970.35,2
CPT,0058U,"Oncology (Merkel cell carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative",,,792.93,792.93,2
CPT,0059U,Crh stimulation panel,,,1865.09,2970.35,2
CPT,0059U,"Oncology (Merkel cell carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative",,,792.93,792.93,2
CPT,0060U,Testosterone response,,,3945.14,6283.04,2
CPT,0060U,"Twin zygosity, genomic targeted sequence analysis of chromosome 2, using circulating cell-free fetal DNA in maternal blood",,,1863.76,1863.76,2
CPT,0061U,Estradiol response panel,,,144.75,230.53,2
CPT,0061U,"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2], oxyhemoglobin [ctHbO2], deoxyhemoglobin [ctHbR], papillary and reticular dermal hemoglobin concentrations [ctHb1 and ctHb2]), ",,,61.57,61.57,2
CPT,0062U,"AUTOIMMUNE (SYSTEMIC LUPUS ERYTHEMATOSUS), IGG AND IGM ANALYSIS OF 80 BIOMARKERS, UTILIZING SERUM, ALGORITHM REPORTED WI",,,2010.14,3201.36,2
CPT,0062U,"Autoimmune (systemic lupus erythematosus), IgG and IgM analysis of 80 biomarkers, utilizing serum, algorithm reported with a risk score",,,934.38,934.38,2
CPT,0063U,"NEUROLOGY (AUTISM), 32 AMINES BY LC-MS/MS, USING PLASMA, ALGORITHM REPORTED AS METABOLIC SIGNATURE ASSOCIATED WITH AUTIS",,,3959.84,6306.45,2
CPT,0063U,"Neurology (autism), 32 amines by LC-MS/MS, using plasma, algorithm reported as metabolic signature associated with autism spectrum disorder",,,1841.3,1841.3,2
CPT,0064U,"ANTIBODY, TREPONEMA PALLIDUM, TOTAL AND RAPID PLASMA REAGIN (RPR), IMMUNOASSAY, QUALITATIVE",,,165.39,263.4,2
CPT,0064U,"Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative",,,76.55,76.55,2
CPT,0065U,"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY, IMMUNOASSAY, QUALITATIVE (RPR)",,,95.48,152.07,2
CPT,0065U,"Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR)",,,44.1,44.1,2
CPT,0066U,"PLACENTAL ALPHA-MICRO GLOBULIN-1 (PAMG-1), IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION, CERVICO-VAGINAL FLUID, EACH SPEC",,,80.73,128.56,2
CPT,0066U,"Placental alpha-micro globulin-1 (PAMG-1), immunoassay with direct optical observation, cervico-vaginal fluid, each specimen",,,37.44,37.44,2
CPT,0067U,"ONCOLOGY (BREAST), IMMUNOHISTOCHEMISTRY, PROTEIN EXPRESSION PROFILING OF 4 BIOMARKERS (MATRIX METALLOPROTEINASE-1 (MMP-1",,,10015.79,15951.16,2
CPT,0067U,"Oncology (breast), immunohistochemistry, protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1], carcinoembryonic antigen-related cell adhesion molecule 6 [CEACAM6], hyaluron",,,4657.75,4657.75,2
CPT,0068U,"CANDIDA SPECIES PANEL (C. ALBICANS, C. GLABRATA, C. PARAPSILOSIS, C. KRUSEII, C TROPICALIS, AND C. AURIS), AMPLIFIED PRO",,,753.05,1199.3,2
CPT,0068U,"Candida species panel (C. albicans, C. glabrata, C. parapsilosis, C. kruseii, C. tropicalis, and C. auris), amplified probe technique with qualitative report of the presence or absence of each species",,,350.29,350.29,2
CPT,0069U,"ONCOLOGY (COLORECTAL), MICRORNA, RT-PCR EXPRESSION PROFILING OF MIR-31-3P, FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE, ALGO",,,2006.32,3195.27,2
CPT,0069U,"Oncology (colorectal), microRNA, RT-PCR expression profiling of miR-31-3p, formalin-fixed paraffin-embedded tissue, algorithm reported as an expression score",,,932.71,932.71,2
CPT,0070U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) (EG, DRUG METABOLISM) GENE ANALYSIS, COMMON AND SELECT RA",,,3571.09,5687.32,2
CPT,0070U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, common and select rare variants (ie, *2, *3, *4, *4N, *5, *6, *7, *8, *9, *10, *11, *12, *13, *14A, ",,,1660.75,1660.75,2
CPT,0071T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0071U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, FULL GENE SEQUENCE",,,3167.87,5045.16,2
CPT,0071U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, full gene sequence (List separately in addition to code for primary procedure)",,,1473.54,1473.54,2
CPT,0072T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0072T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0072U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS (IE,CYP2D6-2D7",,,2380.73,3791.55,2
CPT,0072U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D6-2D7 hybrid gene) (List separately in addition to code for pri",,,1107.44,1107.44,2
CPT,0073U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS (IE, CYP2D7-2D6",,,2380.73,3791.55,2
CPT,0073U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D7-2D6 hybrid gene) (List separately in addition to code for pri",,,1107.44,1107.44,2
CPT,0074U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS (IE, NON-DUPLIC",,,2380.73,3791.55,2
CPT,0074U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, non-duplicated gene when duplication/multiplication is trans) (List ",,,1107.44,1107.44,2
CPT,0075T,HB PERQ STENT/CHEST VERT ART,28996.18,18847.52,13270.0,14761.0,2
CPT,0075T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0075T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0075U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS (IE, 5' GENE DU",,,2380.73,3791.55,2
CPT,0075U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 5SQUOTE gene duplication/multiplication) (List separately in additio",,,1107.44,1107.44,2
CPT,0076T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0076T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0076U,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS (IE, 3' GENE DU",,,2380.73,3791.55,2
CPT,0076U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 3SQUOTE gene duplication/ multiplication) (List separately in additi",,,1107.44,1107.44,2
CPT,0077U,HB MISC LAB SPECIAL TEST,449.47999999999996,292.15999999999997,13270.0,14761.0,2
CPT,0077U,"IMMUNOGLOBULIN PARAPROTEIN (M-PROTEIN), QUALITATIVE, IMMUNOPRECIPITATION AND MASS SPECTROMETRY, BLOOD OR URINE, INCLUDIN",,,229.3,365.18,2
CPT,0077U,"Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype",,,106.5,106.5,2
CPT,0078U,"PAIN MANAGEMENT (OPIOID-USE DISORDER) GENOTYPING PANEL, 16 COMMON VARIANTS (IE, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2",,,2380.73,3791.55,2
CPT,0078U,"Pain management (opioid-use disorder) genotyping panel, 16 common variants (ie, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2, DRD4, GABA, GAL, HTR2A, HTTLPR, MTHFR, MUOR, OPRK1, OPRM1), buccal swab or othe",,,1107.44,1107.44,2
CPT,008.7,CSMC IP,1396.56,907.76,,,0
CPT,0080U,Laboratory Services,,,18817.01,18818.9,2
CPT,0080U,"ONCOLOGY (LUNG), MASS SPECTROMETRIC ANALYSIS OF GALECTIN-3-BINDING PROTEIN AND SCAVENGER RECEPTOR CYSTEINE-RICH TYPE 1",,,18584.86,29598.28,2
CPT,0080U,"Oncology (lung), mass spectrometric analysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein M130, with five clinical risk factors (age, smoking status, nodule diamet",,,8642.39,8642.39,2
CPT,0082U,"DRUG TEST(S), DEFINITIVE, 90 OR MORE DRUGS OR SUBSTANCES, DEFINITIVE CHROMATOGRAPHY WITH MASS SPECTROMETRY, AND PRESUMPT",,,1303.66,2076.21,2
CPT,0082U,"Drug test(s), definitive, 90 or more drugs or substances, definitive chromatography with mass spectrometry, and presumptive, any number of drug classes, by instrument chemistry analyzer (utilizing imm",,,606.56,606.56,2
CPT,0082U,Laboratory Services,,,1319.96,1320.09,2
CPT,0083A,HB TERM ADM PED 6M-4YR SARSCV2 3MCG TRS-SUCR 3,514.99,334.74,13270.0,14761.0,2
CPT,0083U,Laboratory Services,,,894.63,894.72,2
CPT,0083U,"ONCOLOGY, RESPONSE TO CHEMOTHERAPY DRUGS USING MOTILITY CONTRAST TOMOGRAPHY, FRESH OR FROZEN TISSUE, REPORTED AS LIKELIH",,,883.57,1407.18,2
CPT,0083U,"Oncology, response to chemotherapy drugs using motility contrast tomography, fresh or frozen tissue, reported as likelihood of sensitivity or resistance to drugs or drug combinations",,,411.02,411.02,2
CPT,0084U,"RED BLOOD CELL ANTIGEN TYPING, DNA, GENOTYPING OF 10 BLOOD GROUPS WITH PHENOTYPE PREDICTION OF 37 RED BLOOD CELL ANTIGEN",300.0,195.0,3801.45,6054.19,2
CPT,0084U,"Red blood cell antigen typing, DNA, genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens",300.0,195.0,1768.08,1768.08,2
CPT,0086U,"INFECTIOUS DISEASE (BACTERIAL AND FUNGAL), ORGANISM IDENTIFICATION, BLOOD CULTURE, USING RRNA FISH, 6 OR MORE ORGANISM T",,,1055.96,1681.72,2
CPT,0086U,"Infectious disease (bacterial and fungal), organism identification, blood culture, using rRNA FISH, 6 or more organism targets, reported as positive or negative with phenotypic minimum inhibitory conc",,,490.9,490.9,2
CPT,0087U,"CARDIOLOGY (HEART TRANSPLANT), MRNA GENE EXPRESSION PROFILING BY MICROARRAY OF 1283 GENES, TRANSPLANT BIOPSY TISSUE, ALL",,,16681.08,26566.32,2
CPT,0087U,"Cardiology (heart transplant), mRNA gene expression profiling by microarray of 1283 genes, transplant biopsy tissue, allograft rejection and injury algorithm reported as a probability score",,,7757.1,7757.1,2
CPT,0088U,"TRANSPLANTATION MEDICINE (KIDNEY ALLOGRAFT REJECTION), MICROARRAY GENE EXPRESSION PROFILING OF 1494 GENES, UTILIZING TRA",,,16681.08,26566.32,2
CPT,0088U,"Transplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing transplant biopsy tissue, algorithm reported as a probability score for rejection",,,7757.1,7757.1,2
CPT,0089U,"ONCOLOGY (MELANOMA), GENE EXPRESSION PROFILING BY RTQPCR, PRAME AND LINC00518, SUPERFICIAL COLLECTION USING ADHESIVE PAT",,,4012.64,6390.54,2
CPT,0089U,"Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)",,,1866.26,1866.26,2
CPT,0090U,"ONCOLOGY (CUTANEOUS MELANOMA), MRNA GENE EXPRESSION PROFILING BY RT-PCR OF 23 GENES (14 CONTENT AND 9 HOUSEKEEPING), UTILIZING FORMALIN-FIXED PARAFFIN-EMBEDDED (FFPE) TISSUE, ALGORITHM REPORTED A",,,9266.03,14757.1,2
CPT,0090U,"Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a categori",,,4309.13,4309.13,2
CPT,0092U,"ONCOLOGY (LUNG), THREE PROTEIN BIOMARKERS, IMMUNOASSAY USINGMAGNETIC NANOSENSOR TECHNOLOGY, PLASMA, ALGORITHM REPORTED A",,,13136.1,20920.57,2
CPT,0092U,"Oncology (lung), three protein biomarkers, immunoassay using magnetic nanosensor technology, plasma, algorithm reported as risk score for likelihood of malignancy",,,6108.84,6108.84,2
CPT,0093U,"PRESCRIPTION DRUG MONITORING, EVALUATION OF 65 COMMON DRUGS BY LC-MS/MS, URINE, EACH DRUG REPORTED DETECTED OR NOT DETEC",,,328.08,522.49,2
CPT,0093U,"Prescription drug monitoring, evaluation of 65 common drugs by LC-MS/MS, urine, each drug reported detected or not detected",,,152.26,152.26,2
CPT,0094U,"GENOME (EG, UNEXPLAINED CONSTITUTIONAL OR HERITABLE DISORDEROR SYNDROME), RAPID SEQUENCE ANALYSIS",,,40032.46,63755.75,2
CPT,0094U,"Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis",,,18616.88,18616.88,2
CPT,0095T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0095U,"INFLAMMATION (EOSINOPHILIC ESOPHAGITIS), ELISA ANALYSIS OF EOTAXIN-3 (CCL26 (C-C MOTIF CHEMOKINE LIGAND 26) AND MAJOR",,,4075.9,6491.29,2
CPT,0095U,"Inflammation (eosinophilic esophagitis), ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2, pro eosinophil major basic protein]), specim",,,1895.38,1895.38,2
CPT,0096U,"HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES (IE, 16, 18, 31,33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), MALE URINE",,,185.26,295.05,2
CPT,0096U,"Human papillomavirus (HPV), high-risk types (ie, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), male urine",,,86.54,86.54,2
CPT,0097U,Test for detection of gastrointestinal disease-causing organism using amplified,,,1075.77,1713.28,2
CPT,0098T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0100T,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,0100T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0100T,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,0101T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0101T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0101U,"HEREDITARY COLON CANCER DISORDERS , GENOMIC SEQUENCE ANALYSIS PANEL UTILIZING A COMBINATION OF NGS, SANGER, MLPA, & ARRA",,,9207.71,14664.21,2
CPT,0101U,"Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel utilizing a combination of NGS, Sange",,,4281.67,4281.67,2
CPT,0102T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0102T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0102U,"HEREDITARY BREAST CANCER-RELATED DISORDERS , GENOMIC SEQUENCE ANALYSIS PANEL UTILIZING A COMBINATION OF NGS, SANGER, MLP",,,6884.6,10964.42,2
CPT,0102U,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, San",,,3201.69,3201.69,2
CPT,0103U,"HEREDITARY OVARIAN CANCER, GENOMIC SEQUENCE ANALYSIS PANEL UTILIZING A COMBINATION OF NGS, SANGER, MLPA, AND ARRAY CGH,",,,9207.71,14664.21,2
CPT,0103U,"Hereditary ovarian cancer (eg, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, Sanger, MLPA, and array CGH, with MRNA analyti",,,4281.67,4281.67,2
CPT,0105U,"NEPHROLOGY (CHRONIC KIDNEY DISEASE), MULTIPLEX ELECTROCHEMILUMINESCENT IMMUNOASSAY (ECLIA) OF TUMOR NECROSIS FACTOR RECE",,,5015.8,7988.17,2
CPT,0105U,"Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KI",,,2332.2,2332.2,2
CPT,0106T,"QUANTITATIVE SENSORY TESTING (QST), TESTING AND INTERPRETATION PER EXTREMITY; USING TOUCH PRESSURE STIMULI TO ASSESS LAR",,,223.01,355.17,2
CPT,0106U,"GASTRIC EMPTYING, SERIAL COLLECTION OF 7 TIMED BREATH SPECIMENS, NON-RADIOISOTOPE CARBON-13 (13C) SPIRULINA SUBSTRATE, A",8342.7,5422.76,4617.11,7353.22,2
CPT,0106U,"Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rat",8342.7,5422.76,2147.49,2147.49,2
CPT,0107T,"QUANTITATIVE SENSORY TESTING (QST), TESTING AND INTERPRETATION PER EXTREMITY; USING VIBRATION STIMULI TO ASSESS LARGE DI",,,382.76,609.58,2
CPT,0107U,"CLOSTRIDIUM DIFFICILE TOXIN(S) ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, STOOL, QUALITATIVE, MULTIPLE-STEP METHOD",,,84.49,134.56,2
CPT,0107U,"Clostridium difficile toxin(s) antigen detection by immunoassay technique, stool, qualitative, multiple-step method",,,39.11,39.11,2
CPT,0108T,"QUANTITATIVE SENSORY TESTING (QST), TESTING AND INTERPRETATION PER EXTREMITY; USING COOLING STIMULI TO ASSESS SMALL NERV",,,382.76,609.58,2
CPT,0108U,"GASTROENTEROLOGY (BARRETT'S ESOPHAGUS), WHOLE SLIDE-DIGITAL IMAGING, INCLUDING MORPHOMETRIC ANALYSIS, COMPUTER-ASSISTED",,,26134.97,41622.58,2
CPT,0108U,"Gastroenterology (BarrettSQUOTEs esophagus), whole slideûdigital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68",,,12153.6,12153.6,2
CPT,0109T,"QUANTITATIVE SENSORY TESTING (QST), TESTING AND INTERPRETATION PER EXTREMITY; USING HEAT-PAIN STIMULI TO ASSESS SMALL NE",,,175.09,278.85,2
CPT,0109U,"INFECTIOUS DISEASE (ASPERGILLUS SPECIES), REAL-TIME PCR FOR DETECTION OF DNA FROM 4 SPECIES (A. FUMIGATUS, A. TERREUS, A",,,753.05,1199.3,2
CPT,0109U,"Infectious disease (Aspergillus species), real-time PCR for detection of DNA from 4 species (A. fumigatus, A. terreus, A. niger, and A. flavus), blood, lavage fluid, or tissue, qualitative reporting o",,,350.29,350.29,2
CPT,0110T,"QUANTITATIVE SENSORY TESTING (QST), TESTING AND INTERPRETATION PER EXTREMITY; USING OTHER STIMULI TO ASSESS SENSATION ï",,,123.59,196.82,2
CPT,0110U,"PRESCRIPTION DRUG MONITORING, ONE OR MORE ORAL ONCOLOGY DRUG(S) AND SUBSTANCES, DEFINITIVE TANDEM MASS SPECTROMETRY WITH",,,143.11,227.91,2
CPT,0110U,"Prescription drug monitoring, one or more oral oncology drug(s) and substances, definitive tandem mass spectrometry with chromatography, serum or plasma from capillary blood or venous blood, quantitat",,,66.56,66.56,2
CPT,0111U,"ONCOLOGY (COLON CANCER), TARGETED KRAS (CODONS 12, 13, AND 61) AND NRAS (CODONS 12, 13, AND 61) GENE ANALYSIS UTILIZING",,,3602.37,5737.14,2
CPT,0111U,"Oncology (colon cancer), targeted KRAS (codons 12, 13, and 61) and NRAS (codons 12, 13, and 61) gene analysis utilizing formalin-fixed paraffin-embedded tissue",,,1674.89,1674.89,2
CPT,0112U,"INFECTIOUS AGENT DETECTION AND IDENTIFICATION, TARGETED SEQUENCE ANALYSIS (16S AND 18S RRNA GENES) WITH DRUG-RESISTANCE",,,1880.26,2994.51,2
CPT,0112U,"Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene",,,874.48,874.48,2
CPT,0113U,"ONCOLOGY (PROSTATE), MEASUREMENT OF PCA3 AND TMPRSS2-ERG IN URINE AND PSA IN SERUM FOLLOWING PROSTATIC MASSAGE, BY RNA",,,4012.64,6390.54,2
CPT,0113U,"Oncology (prostate), measurement of PCA3 and TMPRSS2-ERG in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence-based detection, algorithm reported as risk score",,,1866.26,1866.26,2
CPT,0114U,"GASTROENTEROLOGY (BARRETT?S ESOPHAGUS), VIM AND CCNA1 METHYLATION ANALYSIS, ESOPHAGEAL CELLS, ALGORITHM REPORTED AS LIKE",,,10232.27,16295.93,2
CPT,0114U,"Gastroenterology (BarrettSQUOTEs esophagus), VIM and CCNA1 methylation analysis, esophageal cells, algorithm reported as likelihood for BarrettSQUOTEs esophagus",,,4758.43,4758.43,2
CPT,0115U,"RESPIRATORY INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA AND RNA), 18 VIRAL TYPES AND SUBTYPES AND 2 BACTERIAL TARGET",,,1453.77,2315.27,2
CPT,0115U,"Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral types and subtypes and 2 bacterial targets, amplified probe technique, including multiplex reverse transcription for RNA ",,,676.45,676.45,2
CPT,0116U,"PRESCRIPTION DRUG MONITORING, ENZYME IMMUNOASSAY OF 35 OR MORE DRUGS CONFIRMED WITH LC-MS/MS, ORAL FLUID, ALGORITHM RESU",,,1303.66,2076.21,2
CPT,0116U,"Prescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with LC-MS/MS, oral fluid, algorithm results reported as a patient-compliance measurement with risk of drug to drug inter",,,606.56,606.56,2
CPT,0117U,"PAIN MANAGEMENT, ANALYSIS OF 11 ENDOGENOUS ANALYTES (METHYLMALONIC ACID, XANTHURENIC ACID,HOMOCYSTEINE, PYROGLUTAMIC ACI",,,4438.43,7068.66,2
CPT,0117U,"Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmal",,,2064.29,2064.29,2
CPT,0118U,"TRANSPLANTATION MEDICINE, QUANTIFICATION OF DONOR-DERIVED CELL-FREE DNA USING WHOLE GENOME NEXT-GENERATION SEQUENCING, P",,,14536.59,23151.0,2
CPT,0118U,"Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA in the total cell-f",,,6760.31,6760.31,2
CPT,0119U,"CARDIOLOGY, CERAMIDES BY LIQUID CHROMATOGRAPHY TANDEM MASS SPECTROMETRY, PLASMA, QUANTITATIVE REPORT WITH RISK SCORE FOR",,,442.26,704.34,2
CPT,0119U,"Cardiology, ceramides by liquid chromatographyûtandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events",,,205.51,205.51,2
CPT,0119U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,0120U,"ONCOLOGY (B-CELL LYMPHOMA CLASSIFICATION), MRNA, GENE EXPRESSION PROFILING BY FLUORESCENT PROBE HYBRIDIZATION OF 58 GENE",,,13253.39,21107.37,2
CPT,0120U,"Oncology (B-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissu",,,6163.74,6163.74,2
CPT,0121U,"SICKLE CELL DISEASE, MICROFLUIDIC FLOW ADHESION (VCAM-1), WHOLE BLOOD",,,2688.46,4281.65,2
CPT,0121U,"Sickle cell disease, microfluidic flow adhesion (VCAM-1), whole blood",,,1250.56,1250.56,2
CPT,0122U,"SICKLE CELL DISEASE, MICROFLUIDIC FLOW ADHESION (P-SELECTIN), WHOLE BLOOD",,,2778.36,4424.82,2
CPT,0122U,"Sickle cell disease, microfluidic flow adhesion (P-Selectin), whole blood",,,1292.16,1292.16,2
CPT,0123U,"MECHANICAL FRAGILITY, RBC, SHEAR STRESS AND SPECTRAL ANALYSIS PROFILING",,,1888.2,3007.15,2
CPT,0123U,"Mechanical fragility, RBC, shear stress and spectral analysis profiling",,,877.8,877.8,2
CPT,0124A,HB TERM ADM SARSCOV2 30MCG/0.3 ML BIVALENT BST,455.565,296.115,13270.0,14761.0,2
CPT,0129U,"HEREDITARY BREAST CANCER RELATED DISORDERS (EG, HEREDITARY BREAST CANCER), GENOMIC SEQUENCE ANALYSIS AND DELETION/DUPLIC",,,6884.6,10964.42,2
CPT,0129U,"Hereditary breast cancerûrelated disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and deletion/duplication analysis panel ",,,3201.69,3201.69,2
CPT,0130U,"HEREDITARY COLON CANCER DISORDERS (EG, LYNCH SYNDROME), TARGETED MRNA SEQUENCE ANALYSIS PANEL (APC, CDH1, CHEK2, MLH1, M",,,3088.15,4918.19,2
CPT,0130U,"Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), targeted mRNA sequence analysis panel (APC, CDH1, CHEK2, MLH1, MSH2, ",,,1436.1,1436.1,2
CPT,0131U,"HEREDITARY BREAST CANCER RELATED DISORDERS (EG, HEREDITARY BREAST CANCER), TARGETED MRNA SEQUENCE ANALYSIS PANEL (13 GEN",,,3748.65,5970.11,2
CPT,0131U,"Hereditary breast cancerûrelated disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (13 genes) (List separately ",,,1743.12,1743.12,2
CPT,0132U,"HEREDITARY OVARIAN CANCER RELATED DISORDERS (EG, HEREDITARY BREAST CANCER), TARGETED MRNA SEQUENCE ANALYSIS PANEL (17 GE",,,3915.69,6236.13,2
CPT,0132U,"Hereditary ovarian cancerûrelated disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (17 genes) (List separately",,,1821.33,1821.33,2
CPT,0133U,"HEREDITARY PROSTATE CANCER RELATED DISORDERS, TARGETED MRNA SEQUENCE ANALYSIS PANEL (11 GENES) (LIST SEPARATELY IN ADDIT",,,3644.58,5804.37,2
CPT,0133U,"Hereditary prostate cancerûrelated disorders, targeted mRNA sequence analysis panel (11 genes) (List separately in addition to code for primary procedure)",,,1694.86,1694.86,2
CPT,0134U,"HEREDITARY PAN CANCER(EG,HEREDITARY BREAST AND OVARIAN CANCER)TARGETED MRNA SEQUENCE ANALYSIS PANEL (18 GENES)",,,3951.32,6292.87,2
CPT,0134U,"Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (18 genes) (List separately in addi",,,1837.14,1837.14,2
CPT,0135U,"HEREDITARY GYNECOLOGICAL CANCER (EG, HEREDITARY BREAST AND OVARIAN CANCER), TARGETED MRNA SEQUENCE ANALYSIS PANEL (12 GE",,,3698.79,5890.7,2
CPT,0135U,"Hereditary gynecological cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (12 genes) (List separate",,,1719.82,1719.82,2
CPT,0136U,"ATM (ATAXIA TELANGIECTASIA MUTATED) (EG, ATAXIA TELANGIECTASIA) MRNA SEQUENCE ANALYSIS (LIST SEPARATELY IN ADDITION TO C",,,2151.13,3425.9,2
CPT,0136U,"ATM (ataxia telangiectasia mutated) (eg, ataxia telangiectasia) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,1000.11,1000.11,2
CPT,0137U,"PALB2 (PARTNER AND LOCALIZER OF BRCA2) (EG, BREAST AND PANCREATIC CANCER) MRNA SEQUENCE ANALYSIS (LIST SEPARATELY IN ADD",,,1493.57,2378.66,2
CPT,0137U,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,694.75,694.75,2
CPT,0138U,"BRCA1 (BRCA1, DNA REPAIR ASSOCIATED), BRCA2 (BRCA2,DNA REPAIR ASSOCIATED) (EG, HEREDITARY BREAST & OVARIAN CANCER) MRNA",,,2472.68,3938.0,2
CPT,0138U,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,1149.88,1149.88,2
CPT,0139U,"Neurology (autism spectrum disorder [ASD]), quantitative measurements of 6 central carbon metabolites (ie, ?-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, and succinate), LC-MS/MS, plasma,",,,1977.04,3148.64,2
CPT,0140U,"Infectious disease (fungi), fungal pathogen identification, DNA (15 fungal targets), blood culture, amplified probe technique, each target reported as detected or not detected",,,385.24,1335.54,4
CPT,0140U,Laboratory Services,,,837.96,838.04,2
CPT,0141U,"Infectious disease (bacteria and fungi), gram-positive organism identification and drug resistance element detection, DNA (20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative b",,,78.08,385.24,4
CPT,0141U,Laboratory Services,,,837.96,838.04,2
CPT,0142U,"Infectious disease (bacteria and fungi), gram-negative bacterial identification and drug resistance element detection, DNA (21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive ",,,78.08,385.24,4
CPT,0142U,Laboratory Services,,,837.96,838.04,2
CPT,0143U,"Drug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,281.23,2312.08,4
CPT,0144U,"Drug assay, definitive, 160 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,281.23,2312.08,4
CPT,0145U,"Drug assay, definitive, 65 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,281.23,2312.08,4
CPT,0146U,"Drug assay, definitive, 80 or more drugs or metabolites, urine, by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or me",,,281.23,2312.08,4
CPT,0147U,"Drug assay, definitive, 85 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,281.23,2312.08,4
CPT,0148U,"Drug assay, definitive, 100 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,281.23,2312.08,4
CPT,0149U,"Drug assay, definitive, 60 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,281.23,2312.08,4
CPT,0150U,"Drug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,281.23,2312.08,4
CPT,0151U,"Infectious disease (bacterial or viral respiratory tract infection), pathogen specific nucleic acid (DNA or RNA), 33 targets, real-time semi-quantitative PCR, bronchoalveolar lavage, sputum, or endotr",,,78.08,124.35,2
CPT,0152U,HB MISC LAB SPECIAL TEST,1800.0,1170.0,13270.0,14761.0,8
CPT,0152U,"Infectious disease (bacteria, fungi, parasites, and DNA viruses), DNA, PCR and next-generation sequencing, plasma, detection of >1,000 potential microbial organisms for significant positive pathogens",1800.0,1170.0,78.08,124.35,2
CPT,0152U,"Infectious disease (bacteria, fungi, parasites, and DNA viruses), microbial cell-free DNA, plasma, untargeted next-generation sequencing, report for significant positive pathogens",1800.0,1170.0,5220.22,5220.22,2
CPT,0152U,Laboratory Services,1800.0,1170.0,11366.12,11367.26,2
CPT,0153U,Laboratory Services,,,16889.46,16891.16,2
CPT,0153U,"Oncology (breast), mRNA, gene expression profiling by next-generation sequencing of 101 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a triple negative breast cancer ",,,7757.1,23504.85,4
CPT,0154U,"FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie, p.R248C [c.742C>T], p.S249C [c.746C>G], p.G370C [c.1108G>T], p.Y373C [c.1118A>G], FGFR3-TACC3v1, and FGFR3-TACC3v3)",,,1615.86,2573.43,2
CPT,0154U,Laboratory Services,,,1108.2,1108.32,2
CPT,0154U,"Oncology (urothelial cancer), RNA, analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie, p.R248C [c.742C>T], p.S249C [c.746C>G], p.G370C [c.1108G>T], p.Y37",,,1183.99,1183.99,2
CPT,0155U,Laboratory Services,,,1469.2,1469.35,2
CPT,0155U,"Oncology (breast cancer), DNA, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha) (eg, breast cancer) gene analysis (ie, p.C420R, p.E542K, p.E545A, p.E545D [g.1635G>T onl",,,674.79,674.79,2
CPT,0155U,"PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha) (eg, breast cancer) gene analysis (ie, p.C420R, p.E542K, p.E545A, p.E545D [g.1635G>T only], p.E545G, p.E545K, p.Q546E, ",,,1615.86,2573.43,2
CPT,0156U,"Copy number (eg, intellectual disability, dysmorphology), sequence analysis",,,4272.53,8558.42,4
CPT,0156U,Laboratory Services,,,9301.59,9302.53,2
CPT,0157U,"APC (APC regulator of WNT signaling pathway) (eg, familial adenomatosis polyposis [FAP]) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,694.75,694.75,2
CPT,0157U,Apc mrna seq alys,,,3438.92,5476.83,2
CPT,0157U,Laboratory Services,,,1512.22,1512.37,2
CPT,0158U,Laboratory Services,,,1512.22,1512.37,2
CPT,0158U,"MLH1 (mutL homolog 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,694.75,694.75,2
CPT,0158U,Mlh1 mrna seq alys,,,3438.92,5476.83,2
CPT,0159U,Laboratory Services,,,1512.22,1512.37,2
CPT,0159U,"MSH2 (mutS homolog 2) (eg, hereditary colon cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,694.75,694.75,2
CPT,0159U,Msh2 mrna seq alys,,,3438.92,5476.83,2
CPT,015SU,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,0160U,Laboratory Services,,,1512.22,1512.37,2
CPT,0160U,"MSH6 (mutS homolog 6) (eg, hereditary colon cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,694.75,694.75,2
CPT,0160U,Msh6 mrna seq alys,,,3438.92,5476.83,2
CPT,0161U,Laboratory Services,,,1512.22,1512.37,2
CPT,0161U,"PMS2 (PMS1 homolog 2, mismatch repair system component) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedu",,,694.75,694.75,2
CPT,0161U,Pms2 mrna seq alys,,,3438.92,5476.83,2
CPT,0162U,Hered colon ca trgt mrna pnl,,,3438.92,5476.83,2
CPT,0162U,"Hereditary colon cancer (Lynch syndrome), targeted mRNA sequence analysis panel (MLH1, MSH2, MSH6, PMS2) (List separately in addition to code for primary procedure)",,,1194.81,1194.81,2
CPT,0162U,Laboratory Services,,,2600.92,2601.18,2
CPT,0163T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0163U,Laboratory Services,,,2088.86,2089.07,2
CPT,0163U,"ONCOLOGY (COLORECTAL) SCREENING, BIOCHEMICAL ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) OF 3 PLASMA OR SERUM PROTEINS (TE",,,2063.06,3285.63,2
CPT,0163U,"Oncology (colorectal) screening, biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1, Cripto-1], carcinoembryonic antig",,,959.35,959.35,2
CPT,0164T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0164T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0164T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0164U,"GASTROENTEROLOGY (IRRITABLE BOWEL SYNDROME (IBS)), IMMUNOASSAY FOR ANTI-CDTB AND ANTI-VINCULIN ANTIBODIES, UTILIZING PLA",,,591.42,941.89,2
CPT,0164U,"Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results",,,275.4,275.4,2
CPT,0164U,Laboratory Services,,,598.85,598.91,2
CPT,0165T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0165T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0165T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0165U,Laboratory Services,,,2479.17,2479.42,2
CPT,0165U,"PEANUT ALLERGEN-SPECIFIC IGE AND QUANTITATIVE ASSESSMENT OF 64 EPITOPES USING ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA),",,,2448.58,3899.61,2
CPT,0165U,"Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (ELISA), blood, individual epitope results and probability of peanut allergy",,,1139.06,1139.06,2
CPT,0166U,Laboratory Services,,,2691.05,2691.32,2
CPT,0166U,"Liver disease, 10 biochemical assays (?2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT, ALT, AST, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utili",,,1236.41,2375.66,4
CPT,0167U,"Gonadotropin, chorionic (hCG), immunoassay with direct optical observation, blood",,,18.31,35.49,4
CPT,0167U,Laboratory Services,,,40.19,40.19,2
CPT,0168U,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff, algorithm reported as a risk score for each trisomy",,,2249.26,3582.18,2
CPT,0169U,Laboratory Services,,,2492.0,2492.25,2
CPT,0169U,"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) (eg, drug metabolism) gene analysis, common variants",,,1144.88,2200.0,4
CPT,0170U,Laboratory Services,,,9381.78,9382.72,2
CPT,0170U,"Neurology (autism spectrum disorder [ASD]), RNA, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of ASD diagnosis",,,4309.13,8282.38,4
CPT,0171U,Laboratory Services,,,8120.5,8121.31,2
CPT,0171U,"TARGETED GENOMIC SEQUENCE ANALYSIS PANEL, ACUTE MYELOID LEUKEMIA, MYELODYSPLASTIC SYNDROME, AND MYELOPROLIFERATIVE NEOPL",,,8020.34,12773.21,2
CPT,0171U,"Targeted genomic sequence analysis panel, acute myeloid leukemia, myelodysplastic syndrome, and myeloproliferative neoplasms, DNA analysis, 23 genes, interrogation for sequence variants, rearrangement",,,3730.04,3730.04,2
CPT,0172U,Laboratory Services,,,16197.6,16199.23,2
CPT,0172U,"Oncology (solid tumor as indicated by the label), somatic mutation analysis of BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) and analysis of homologous recombination defic",,,7439.27,14299.49,4
CPT,0173U,Laboratory Services,,,2492.0,2492.25,2
CPT,0173U,"PSYCHIATRY (IE, DEPRESSION, ANXIETY), GENOMIC ANALYSIS PANEL, INCLUDES VARIANT ANALYSIS OF 14 GENE",,,2461.28,3919.83,2
CPT,0173U,"Psychiatry (ie, depression, anxiety), genomic analysis panel, includes variant analysis of 14 genes",,,1144.88,1144.88,2
CPT,0174U,Laboratory Services,,,6978.14,6978.84,2
CPT,0174U,"ONCOLOGY (SOLID TUMOR), MASS SPECTROMETRIC 30 PROTEIN TARGETS, FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE, PROGNOSTIC AND P",,,6892.07,10976.32,2
CPT,0174U,"Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 che",,,3205.01,3205.01,2
CPT,0175U,Laboratory Services,,,7142.41,7143.13,2
CPT,0175U,"PSYCHIATRY (EG, DEPRESSION, ANXIETY), GENOMIC ANALYSIS PANEL, VARIANT ANALYSIS OF 15 GENES",,,7054.28,11234.66,2
CPT,0175U,"Psychiatry (eg, depression, anxiety), genomic analysis panel, variant analysis of 15 genes",,,3280.73,3280.73,2
CPT,0176U,"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie, ELISA)",,,157.25,302.92,4
CPT,0176U,Laboratory Services,,,343.13,343.17,2
CPT,0177U,Laboratory Services,,,1317.82,1317.95,2
CPT,0177U,"Oncology (breast cancer), DNA, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) gene analysis of 11 gene variants utilizing plasma, reported as PIK3CA gene mutation stat",,,674.79,1296.97,4
CPT,0178U,Laboratory Services,,,2458.29,2458.53,2
CPT,0178U,"PEANUT ALLERGEN-SPECIFIC QUANTITATIVE ASSESSMENT OF MULTIPLEEPITOPES USING ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA), BL",,,2427.94,3866.74,2
CPT,0178U,"Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (ELISA), blood, report of minimum eliciting exposure for a clinical reaction",,,1129.07,1129.07,2
CPT,0179U,Laboratory Services,,,10387.91,10388.95,2
CPT,0179U,"ONCOLOGY (NON-SMALL CELL LUNG CANCER), CELL-FREE DNA, TARGETED SEQUENCE ANALYSIS OF 23 GENES (SINGLE NUCLEOTIDE VARIATIO",,,10259.73,16339.66,2
CPT,0179U,"Oncology (non-small cell lung cancer), cell-free DNA, targeted sequence analysis of 23 genes (single nucleotide variations, insertions and deletions, fusions without prior knowledge of partner/breakpo",,,4770.91,4770.91,2
CPT,0180U,Laboratory Services,500.0,325.0,1469.2,1469.35,2
CPT,0180U,"RED CELL ANTIGEN (ABO BLOOD GROUP) GENOTYPING (ABO), GENE ANALYSIS SANGER/CHAIN TERMINATION/CONVENTIONAL SEQUENCING, ABO",500.0,325.0,1451.06,2310.96,2
CPT,0180U,"Red cell antigen (ABO blood group) genotyping (ABO), gene analysis Sanger/chain termination/conventional sequencing, ABO (ABO, alpha 1-3-N-acetylgalactosaminyltransferase and alpha 1-3-galactosyltrans",500.0,325.0,674.79,674.79,2
CPT,0181U,Laboratory Services,,,990.03,990.13,2
CPT,0181U,"Red cell antigen (Colton blood group) genotyping (CO), gene analysis, AQP1 (aquaporin 1 [Colton blood group]) exon 1",,,455.13,874.01,4
CPT,0182U,Laboratory Services,,,1610.96,1611.12,2
CPT,0182U,"Red cell antigen (Cromer blood group) genotyping (CROM), gene analysis, CD55 (CD55 molecule [Cromer blood group]) exons 1-10",,,739.68,1422.16,4
CPT,0183U,Laboratory Services,,,990.03,990.13,2
CPT,0183U,"Red cell antigen (Diego blood group) genotyping (DI), gene analysis, SLC4A1 (solute carrier family 4 member 1 [Diego blood group]) exon 19",,,455.13,874.01,4
CPT,0184T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0184T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0184U,Laboratory Services,,,990.03,990.13,2
CPT,0184U,"Red cell antigen (Dombrock blood group) genotyping (DO), gene analysis, ART4 (ADP-ribosyltransferase 4 [Dombrock blood group]) exon 2",,,455.13,874.01,4
CPT,0185U,Laboratory Services,,,990.03,990.13,2
CPT,0185U,"Red cell antigen (H blood group) genotyping (FUT1), gene analysis, FUT1 (fucosyltransferase 1 [H blood group]) exon 4",,,455.13,874.01,4
CPT,0186U,Laboratory Services,,,990.03,990.13,2
CPT,0186U,"Red cell antigen (H blood group) genotyping (FUT2), gene analysis, FUT2 (fucosyltransferase 2) exon 2",,,455.13,874.01,4
CPT,0187U,Laboratory Services,,,1469.2,1469.35,2
CPT,0187U,"Red cell antigen (Duffy blood group) genotyping (FY), gene analysis, ACKR1 (atypical chemokine receptor 1 [Duffy blood group]) exons 1-2",,,674.79,1296.97,4
CPT,0188U,Laboratory Services,,,1469.2,1469.35,2
CPT,0188U,"Red cell antigen (Gerbich blood group) genotyping (GE), gene analysis, GYPC (glycophorin C [Gerbich blood group]) exons 1-4",,,674.79,1296.97,4
CPT,0189U,Laboratory Services,,,1469.2,1469.35,2
CPT,0189U,"Red cell antigen (MNS blood group) genotyping (GYPA), gene analysis, GYPA (glycophorin A [MNS blood group]) introns 1, 5, exon 2",,,674.79,1296.97,4
CPT,0190U,Laboratory Services,,,1469.2,1469.35,2
CPT,0190U,"Red cell antigen (MNS blood group) genotyping (GYPB), gene analysis, GYPB (glycophorin B [MNS blood group]) introns 1, 5, pseudoexon 3",,,674.79,1296.97,4
CPT,0191T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0191U,Laboratory Services,,,1469.2,1469.35,2
CPT,0191U,"Red cell antigen (Indian blood group) genotyping (IN), gene analysis, CD44 (CD44 molecule [Indian blood group]) exons 2, 3, 6",,,674.79,1296.97,4
CPT,0192U,Laboratory Services,,,1469.2,1469.35,2
CPT,0192U,"Red cell antigen (Kidd blood group) genotyping (JK), gene analysis, SLC14A1 (solute carrier family 14 member 1 [Kidd blood group]) gene promoter, exon 9",,,674.79,1296.97,4
CPT,0193U,Laboratory Services,,,1512.22,1512.37,2
CPT,0193U,"Red cell antigen (JR blood group) genotyping (JR), gene analysis, ABCG2 (ATP binding cassette subfamily G member 2 [Junior blood group]) exons 2-26",,,694.75,1334.98,4
CPT,0194U,Laboratory Services,,,990.03,990.13,2
CPT,0194U,"Red cell antigen (Kell blood group) genotyping (KEL), gene analysis, KEL (Kell metallo-endopeptidase [Kell blood group]) exon 8",,,455.13,874.01,4
CPT,0195U,"KLF1 (Kruppel-like factor 1), targeted sequencing (ie, exon 13)",,,921.07,1770.96,4
CPT,0195U,Laboratory Services,,,2005.97,2006.18,2
CPT,0196U,Laboratory Services,,,990.03,990.13,2
CPT,0196U,"Red cell antigen (Lutheran blood group) genotyping (LU), gene analysis, BCAM (basal cell adhesion molecule [Lutheran blood group]) exon 3",,,455.13,874.01,4
CPT,0197U,Laboratory Services,,,990.03,990.13,2
CPT,0197U,"Red cell antigen (Landsteiner-Wiener blood group) genotyping (LW), gene analysis, ICAM4 (intercellular adhesion molecule 4 [Landsteiner-Wiener blood group]) exon 1",,,455.13,874.01,4
CPT,0198U,Laboratory Services,350.0,227.5,1512.22,1512.37,2
CPT,0198U,"Red cell antigen (RH blood group) genotyping (RHD and RHCE), gene analysis Sanger/chain termination/conventional sequencing, RHD (Rh blood group D antigen) exons 1-10 and RHCE (Rh blood group CcEe ant",350.0,227.5,694.75,1334.98,4
CPT,0199U,Laboratory Services,,,1469.2,1469.35,2
CPT,0199U,"Red cell antigen (Scianna blood group) genotyping (SC), gene analysis, ERMAP (erythroblast membrane associated protein [Scianna blood group]) exons 4, 12",,,674.79,1296.97,4
CPT,0200T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0200T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0200T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0200U,Laboratory Services,,,1469.2,1469.35,2
CPT,0200U,"Red cell antigen (Kx blood group) genotyping (XK), gene analysis, XK (X-linked Kx blood group) exons 1-3",,,674.79,1296.97,4
CPT,0201T,Outpatient Grouper - 4,38758.7,25193.15,19724.25,21397.98,24
CPT,0201T,Outpatient Surgery Group 4 Global Rate,38758.7,25193.15,26623.0,28144.0,2
CPT,0201T,Outpatient Surgical Group 1,38758.7,25193.15,9088.3,13492.72,50
CPT,0201U,Laboratory Services,,,990.03,990.13,2
CPT,0201U,"Red cell antigen (Yt blood group) genotyping (YT), gene analysis, ACHE (acetylcholinesterase [Cartwright blood group]) exon 2",,,455.13,874.01,4
CPT,0202T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0202T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0202U,HB VIRAL RESPIRATORY PANEL WITH COVID19 - 22 TARGETS,535.86,348.31,13270.0,14761.0,2
CPT,0202U,"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua",,,1235.05,1966.94,2
CPT,0203U,"Autoimmune (inflammatory bowel disease), mRNA, gene expression profiling by quantitative RT-PCR, 17 genes (15 target and 2 reference genes), whole blood, reported as a continuous risk score and classi",,,1866.26,3586.67,4
CPT,0204U,"Oncology (thyroid), mRNA, gene expression analysis of 593 genes (including BRAF, RAS, RET, PAX8, and NTRK) for sequence variants and rearrangements, utilizing fine needle aspirate, reported as detecte",,,7168.85,13778.5,4
CPT,0205U,"Ophthalmology (age-related macular degeneration), analysis of 3 gene variants (2 CFH gene, 1 ARMS2 gene), using PCR and MALDI-TOF, buccal swab, reported as positive or negative for neovascular age-rel",,,115.65,221.83,4
CPT,0206U,NEUROLOGY (ALZHEIMER DISEASE); CELL AGGREGATION USING MORPHOMETRIC IMAGING AND PROTEIN KINASE C-EPSILON (PKCE) CONCENTRA,,,11696.85,18628.43,2
CPT,0206U,"Neurology (Alzheimer disease); cell aggregation using morphometric imaging and protein kinase C-epsilon (PKCe) concentration in response to amylospheroid treatment by ELISA, cultured skin fibroblasts,",,,5439.87,5439.87,2
CPT,0207T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0207T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0207U,NEUROLOGY (ALZHEIMER DISEASE); QUANTITATIVE IMAGING OF PHOSPHORYLATED ERK1 AND ERK2 IN RESPONSE TO BRADYKININ TREATMENT,,,2699.04,4298.5,2
CPT,0207U,"Neurology (Alzheimer disease); quantitative imaging of phosphorylated ERK1 and ERK2 in response to bradykinin treatment by in situ immunofluorescence, using cultured skin fibroblasts, reported as a pr",,,1255.55,1255.55,2
CPT,0209U,"CYTOGENOMIC CONSTITUTIONAL (GENOME-WIDE) ANALYSIS, INTERROGATION OF GENOMIC REGIONS FOR COPY NUMBER, STRUCTURAL CHANGES",,,4155.98,6618.82,2
CPT,0209U,"Cytogenomic constitutional (genome-wide) analysis, interrogation of genomic regions for copy number, structural changes and areas of homozygosity for chromosomal abnormalities",,,1932.82,1932.82,2
CPT,0210U,"Syphilis test, non-treponemal antibody, immunoassay, quantitative (RPR)",,,45.76,87.93,4
CPT,0211U,"Oncology (pan-tumor), DNA and RNA by next-generation sequencing, utilizing formalin-fixed paraffin-embedded tissue, interpretative report for single nucleotide variants, copy number alterations, tumor",,,20759.38,39901.72,4
CPT,0212U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), IDENTIFICATION AND CATEGORIZATION OF GENETIC VARYSIANTS, PROBAND",,,28907.91,46038.78,2
CPT,0212U,"Rare diseases (constitutional/heritable disorders), whole genome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions",,,13443.26,13443.26,2
CPT,0213T,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,0213T,Outpatient Surgical Group 0,6874.78,4468.61,2806.68,4166.87,50
CPT,0213U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), IDENTIFICATION AND CATEGORIZATION OF GENETIC VAR EIANTS, EACH COMPAR",,,14308.0,22786.94,2
CPT,0213U,"Rare diseases (constitutional/heritable disorders), whole genome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions",,,6653.81,6653.81,2
CPT,0214T,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,0214T,Outpatient Surgical Group 0,3870.35,2515.73,2806.68,4166.87,50
CPT,0214U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), WHOLE EXOME AND MITOCHONDRIAL DNA SEQUENCE ANALYSIS, PROBAND",,,27584.79,43931.58,2
CPT,0214U,"Rare diseases (constitutional/heritable disorders), whole exome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions,",,,12828.38,12828.38,2
CPT,0215T,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,0215T,Outpatient Surgical Group 0,3870.35,2515.73,2806.68,4166.87,50
CPT,0215U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), WHOLE EXOME AND MITOCHONDRIAL INCLUDING SMALL SEQUENCE CHANGES, EACH",,,13593.64,21649.25,2
CPT,0215U,"Rare diseases (constitutional/heritable disorders), whole exome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions,",,,6321.84,6321.84,2
CPT,0216T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0216T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0216U,"NEUROLOGY (INHERITED ATAXIAS), GENOMIC DNA SEQUENCE ANALYSISOF 12 COMMON GENES INCLUDING SMALL SEQUENCE CHANGES, DELETIO",,,8115.12,12924.15,2
CPT,0216U,"Neurology (inherited ataxias), genomic DNA sequence analysis of 12 common genes including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniq",,,3774.13,3774.13,2
CPT,0217T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0217T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0217U,"NEUROLOGY (INHERITED ATAXIAS), GENOMIC DNA SEQUENCE ANALYSISOF 51 GENES INCLUDING SMALL SEQUENCE CHANGES, DELETIONS, DUP",,,11606.84,18485.07,2
CPT,0217U,"Neurology (inherited ataxias), genomic DNA sequence analysis of 51 genes including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely ma",,,5397.44,5397.44,2
CPT,0218T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0218T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0218U,"Neurology (muscular dystrophy), DMD gene sequence analysis, including small sequence changes, deletions, duplications, and variants in non-uniquely mappable regions, blood or saliva, identification an",,,5595.47,10755.33,4
CPT,0219T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0219T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0219T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0219U,"INFECTIOUS AGENT (HUMAN IMMUNODEFICIENCY VIRUS), TARGETED VIRAL NEXT-GENERATION SEQUENCE ANALYSIS (IE, PROTEASE(PR),RE",,,3827.85,6096.24,2
CPT,0219U,"Infectious agent (human immunodeficiency virus), targeted viral next-generation sequence analysis (ie, protease [PR], reverse transcriptase [RT], integrase [INT]), algorithm reported as prediction of ",,,1779.73,1779.73,2
CPT,0220T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0220T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0220T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0220U,"ONCOLOGY (BREAST CANCER), IMAGE ANALYSIS WITH ARTIFICIAL INTELLIGENCE ASSESSMENT OF 12 HISTOLOGIC AND IMMUNOHISTOCHEMICA",,,3728.84,5938.55,2
CPT,0220U,"Oncology (breast cancer), image analysis with artificial intelligence assessment of 12 histologic and immunohistochemical features, reported as a recurrence score",,,1733.97,1733.97,2
CPT,0221T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0221T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0221T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0221U,"RED CELL ANTIGEN (ABO BLOOD GROUP) GENOTYPING (ABO), GENE ANALYSIS, NEXT-GENERATION SEQUENCING, ABO (ABO, ALPHA 1-3-N-",,,1451.06,2310.96,2
CPT,0221U,"Red cell antigen (ABO blood group) genotyping (ABO), gene analysis, next-generation sequencing, ABO (ABO, alpha 1-3-N-acetylgalactosaminyltransferase and alpha 1-3-galactosyltransferase) gene",,,674.79,674.79,2
CPT,0222T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0222T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0222U,"RED CELL ANTIGEN (RH BLOOD GROUP) GENOTYPING (RHD AND RHCE),GENE ANALYSIS, NEXT-GENERATION SEQUENCING, RH PROXIMAL PROMO",1800.0,1170.0,1493.57,2378.66,2
CPT,0222U,"Red cell antigen (RH blood group) genotyping (RHD and RHCE), gene analysis, next-generation sequencing, RH proximal promoter, exons 1-10, portions of introns 2-3",1800.0,1170.0,694.75,694.75,2
CPT,0223U,"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua",,,3400.41,5415.5,2
CPT,0224U,"Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed",,,295.5,470.62,2
CPT,0225U,"INFECTIOUS DISEASE (BACTERIAL OR VIRAL RESPIRATORY TRACT INFECTION) PATHOGEN-SPECIFIC DNA AND RNA, 21 TARGETS, INCLUDING",,,2200.52,3504.55,2
CPT,0226U,"INFECTIOUS DISEASE (BACTERIAL OR VIRAL RESPIRATORY TRACT INFECTION) PATHOGEN-SPECIFIC DNA AND RNA, 21 TARGETS, INCLUDING",,,195.02,310.59,2
CPT,0227U,"Drug assay, presumptive, 30 or more drugs or metabolites, urine, liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite DESCri",,,187.67,298.89,2
CPT,0227U,"Drug assay, presumptive, 30 or more drugs or metabolites, urine, liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite descri",,,152.26,152.26,2
CPT,0227U,Laboratory Services,,,332.19,332.22,2
CPT,0228U,Laboratory Services,,,925.0,925.09,2
CPT,0228U,"Oncology (prostate), multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning, utilizing first morning voided urine, algorith",,,425.17,2846.56,4
CPT,0229U,"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg, colorectal cancer) promoter methylation analysis",,,196.79,942.7,4
CPT,0229U,Laboratory Services,,,1026.38,1026.49,2
CPT,0230U,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation), full sequence analysis, including small sequence changes in exonic and intronic regions, de",,,708.71,1128.7,4
CPT,0230U,Laboratory Services,,,1610.96,1611.12,2
CPT,0231U,"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg, spinocerebellar ataxia), full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, sho",,,1990.27,3169.71,4
CPT,0231U,Laboratory Services,,,4523.94,4524.4,2
CPT,0232T,HB INJ PLATELET PLASMA & IMG,739.73,480.82,496.88,571.41,8
CPT,0232T,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,0232U,"CSTB (cystatin B) (eg, progressive myoclonic epilepsy type 1A, Unverricht-Lundborg disease), full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplication",,,646.33,1029.35,4
CPT,0232U,Laboratory Services,,,1469.2,1469.35,2
CPT,0233U,"FXN (frataxin) (eg, Friedreich ataxia), gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, short tandem repeat (STR) expansions, mobile element in",,,646.33,1029.35,4
CPT,0233U,Laboratory Services,,,1469.2,1469.35,2
CPT,0234T,Outpatient Grouper - 7,72732.9,47276.38,32948.13,35744.6,24
CPT,0234T,Outpatient Surgery Group 4 Global Rate,72732.9,47276.38,26623.0,28144.0,2
CPT,0234T,Outpatient Surgical Group 7,72732.9,47276.38,27131.25,40279.73,50
CPT,0234U,Laboratory Services,,,2821.86,2822.14,2
CPT,0234U,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome), full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, mobile element insertions, and v",,,1241.46,1977.15,4
CPT,0235T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0235T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0235T,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,0235U,Laboratory Services,,,3207.45,3207.77,2
CPT,0235U,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome), full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications",,,1411.08,2247.29,4
CPT,0236T,Outpatient Grouper - 7,72732.9,47276.38,32948.13,35744.6,24
CPT,0236T,Outpatient Surgery Group 4 Global Rate,72732.9,47276.38,26623.0,28144.0,2
CPT,0236T,Outpatient Surgical Group 7,72732.9,47276.38,27131.25,40279.73,50
CPT,0236U,Laboratory Services,,,3221.91,3222.23,2
CPT,0236U,"SMN1 (survival of motor neuron 1, telomeric) and SMN2 (survival of motor neuron 2, centromeric) (eg, spinal muscular atrophy) full gene analysis, including small sequence changes in exonic and introni",,,708.71,1480.2,4
CPT,0237T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0237T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0237T,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,0237U,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia), genomic sequence analysis panel including ANK2, CASQ2, C",,,1436.1,2704.61,4
CPT,0237U,Laboratory Services,,,3126.76,3127.07,2
CPT,0238T,"HB ATHERECTOMY ILIAC,EA VESSEL",114605.0,74493.25,22359.49,25713.42,8
CPT,0238T,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,0238T,Outpatient Surgery Group 4 Global Rate,114605.0,74493.25,26623.0,28144.0,2
CPT,0238T,Outpatient Surgical Group 7,114605.0,74493.25,27131.25,40279.73,50
CPT,0238U,Laboratory Services,,,3126.76,3127.07,2
CPT,0238U,"Oncology (Lynch syndrome), genomic DNA sequence analysis of MLH1, MSH2, MSH6, PMS2, and EPCAM, including small sequence changes in exonic and intronic regions, deletions, duplications, mobile element ",,,1436.1,2704.61,4
CPT,0239U,Laboratory Services,,,18710.1,18711.98,2
CPT,0239U,"Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free DNA, analysis of 311 or more genes, interrogation for sequence variants, including substitutions, insertions, deletions, selec",,,8593.3,18615.04,4
CPT,0240U,"Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 3 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B), upper respiratory spe",,,413.86,659.11,2
CPT,0241U,HB COVID SEASONAL INFLUENZA PCR PANEL RESP (COVID-19),1132.545,736.15,13270.0,14761.0,2
CPT,0241U,"Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 4 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B, respiratory syncytial ",,,413.86,659.11,2
CPT,0242U,"Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearra",,,12276.73,26592.91,4
CPT,0243U,"Obstetrics (preeclampsia), biochemical assay of placental-growth factor, time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia",,,158.08,158.08,2
CPT,0244U,"Oncology (solid organ), DNA, comprehensive genomic profiling, 257 genes, interrogation for single-nucleotide variants, insertions/deletions, copy number alterations, gene rearrangements, tumor-mutatio",,,8593.3,8593.3,2
CPT,0245U,"Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of maligna",,,1705.15,1705.15,2
CPT,0246U,"Red blood cell antigen typing, DNA, genotyping of at least 16 blood groups with phenotype prediction of at least 51 red blood cell antigens",,,1768.08,1768.08,2
CPT,0247U,"Obstetrics (preterm birth), insulin-like growth factor-binding protein 4 (IBP4), sex hormone-binding globulin (SHBG), quantitative measurement by LC-MS/MS, utilizing maternal serum, combined with clin",,,1841.3,1841.3,2
CPT,0248U,"ONCOLOGY (BRAIN), SPHEROID CELL CULTURE IN A 3D MICROENVIRONMENT,12 DRUG PANEL, TUMOR-RESPONSE PREDICTION FOR EACH DRUG",,,16018.17,25510.56,2
CPT,0248U,"Oncology (brain), spheroid cell culture in a 3D microenvironment, 12 drug panel, tumor-response prediction for each drug",,,7449.24,7449.24,2
CPT,0249U,"ONCOLOGY (BREAST), SEMIQUANTITATIVE ANALYSIS OF 32 PHOSPHOPROTEINS AND PROTEIN ANALYTES, INCLUDES LASER CAPTURE MICRODIS",,,11716.55,18659.79,2
CPT,0249U,"Oncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, includes laser capture microdissection, with algorithmic analysis and interpretative report",,,5449.03,5449.03,2
CPT,0250U,"ONCOLOGY (SOLID ORGAN NEOPLASM), TARGETED GENOMIC SEQUENCE DNA ANALYSIS OF 505 GENES, INTERROGATION FOR SOMATIC ALTERATI",,,15414.87,24549.75,2
CPT,0250U,"Oncology (solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for somatic alterations (SNVs [single nucleotide variant], small insertions and deletions, one ampli",,,7168.85,7168.85,2
CPT,0251U,"HEPCIDIN-25, ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA), SERUM OR PLASMA",,,91.19,145.23,2
CPT,0251U,"Hepcidin-25, enzyme-linked immunosorbent assay (ELISA), serum or plasma",,,42.43,42.43,2
CPT,0252U,"FETAL ANEUPLOIDY SHORT TANDEM REPEAT COMPARATIVE ANALYSIS, FETAL DNA FROM PRODUCTS OF CONCEPTION, REPORTED AS NORMAL",,,4007.64,6382.58,2
CPT,0252U,"Fetal aneuploidy short tandem-repeat comparative analysis, fetal DNA from products of conception, reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism, and segm",,,1863.76,1863.76,2
CPT,0253T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0253T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0253U,"REPRODUCTIVE MEDICINE (ENDOMETRIAL RECEPTIVITY ANALYSIS), RNA GENE EXPRESSION PROFILE, 238 GENES BY NEXT-GENERATION",,,16681.08,26566.32,2
CPT,0253U,"Reproductive medicine (endometrial receptivity analysis), RNA gene expression profile, 238 genes by next-generation sequencing, endometrial tissue, predictive algorithm reported as endometrial window ",,,7757.1,7757.1,2
CPT,0254U,"REPRODUCTIVE MEDICINE (PREIMPLANTATION GENETIC ASSESSMENT), ANALYSIS OF 24 CHROMOSOMES USING EMBRYONIC DNA GENOMIC",,,4007.64,6382.58,2
CPT,0254U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, r",,,1863.76,1863.76,2
CPT,0255U,"ANDROLOGY (INFERTILITY), SPERM-CAPACITATION ASSESSMENT OF GANGLIOSIDE GM1 DISTRIBUTION PATTERNS, FLUORESCENCE MICROSCOP",,,166.86,265.74,2
CPT,0255U,"Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and prob",,,77.38,77.38,2
CPT,0256U,"TRIMETHYLAMINE/TRIMETHYLAMINE N-OXIDE (TMA/TMAO) PROFILE, TANDEM MASS SPECTROMETRY (MS/MS), URINE, WITH ALGORITHMIC",,,844.53,1345.0,2
CPT,0256U,"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile, tandem mass spectrometry (MS/MS), urine, with algorithmic analysis and interpretive report",,,392.73,392.73,2
CPT,0257U,"VERY LONG CHAIN ACYL-COENZYME A (COA) DEHYDROGENASE (VLCAD), LEUKOCYTE ENZYME ACTIVITY, WHOLE BLOOD",,,3761.7,5990.9,2
CPT,0257U,"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD), leukocyte enzyme activity, whole blood",,,1748.94,1748.94,2
CPT,0258U,"AUTOIMMUNE (PSORIASIS), MRNA, NEXT-GENERATION SEQUENCING, GENE EXPRESSION PROFILING OF 50-100 GENES,SKIN-SURFACE COLLE",,,19403.23,30901.61,2
CPT,0258U,"Autoimmune (psoriasis), mRNA, next-generation sequencing, gene expression profiling of 50-100 genes, skin-surface collection using adhesive patch, algorithm reported as likelihood of response to psori",,,9023.47,9023.47,2
CPT,0259U,"NEPHROLOGY (CHRONIC KIDNEY DISEASE), NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY MEASUREMENT OF MYO-INOSITOL, VALINE, AND",,,278.28,443.18,2
CPT,0259U,"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin C (by immunoassay) and demograp",,,129.8,129.8,2
CPT,0260U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), IDENTIFICATION OF COPY NUMBER VARIATIONS, INVERSIONS, INSERTIONS,",,,6671.17,10624.52,2
CPT,0260U,"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping",,,3102.67,3102.67,2
CPT,0261U,"ONCOLOGY (COLORECTAL CANCER), IMAGE ANALYSIS WITH ARTIFICIAL INTELLIGENCE ASSESSMENT OF 4 HISTOLOGIC AND IMMUNOHISTOCHE",,,26134.97,41622.58,2
CPT,0261U,"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border and tumor core), tissue, r",,,12153.6,12153.6,2
CPT,0262U,"ONCOLOGY (SOLID TUMOR), GENE EXPRESSION PROFILING BY REAL-TIME RT-PCR OF 7 GENE PATHWAYS (ER, AR, PI3K, MAPK, HH, TGFB,",,,16895.33,26907.53,2
CPT,0262U,"Oncology (solid tumor), gene expression profiling by real-time RT-PCR of 7 gene pathways (ER, AR, PI3K, MAPK, HH, TGFB, Notch), formalin-fixed paraffin-embedded (FFPE), algorithm reported as gene path",,,7856.94,7856.94,2
CPT,0263T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0263T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0263T,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,0263U,"NEUROLOGY (AUTISM SPECTRUM DISORDER (ASD)), QUANTITATIVE MEASUREMENTS OF 16 CENTRAL CARBON METABOLITES (IE, A-KETOGLUTA",,,3959.84,6306.45,2
CPT,0263U,"Neurology (autism spectrum disorder [ASD]), quantitative measurements of 16 central carbon metabolites (ie, ?-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, f",,,1841.3,1841.3,2
CPT,0264T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0264T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0264T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0264U,"RARE DISEASES (CONSTITUTIONAL/HERITABLE DISORDERS), IDENTIFICATION OF COPY NUMBER VARIATIONS, INVERSIONS, INSERTIONS",,,6671.17,10624.52,2
CPT,0264U,"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping",,,3102.67,3102.67,2
CPT,0265T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0265T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0265T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0265U,"RARE CONSTITUTIONAL AND OTHER HERITABLE DISORDERS, WHOLE GENOME AND MITOCHONDRIAL DNA SEQUENCE ANALYSIS, BLOOD, FROZEN",,,28911.09,46043.84,2
CPT,0265U,"Rare constitutional and other heritable disorders, whole genome and mitochondrial DNA sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (FFPE) tissue, saliva, buccal swabs or cell ",,,13444.92,13444.92,2
CPT,0266T,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,0266T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0266T,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,0266U,"UNEXPLAINED CONSTITUTIONAL OR OTHER HERITABLE DISORDERS OR SYNDROMES, TISSUE-SPECIFIC GENE EXPRESSION BY WHOLE-TRANSCRI",,,16895.33,26907.53,2
CPT,0266U,"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (FF",,,7856.94,7856.94,2
CPT,0267T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0267T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0267T,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,0267U,"RARE CONSTITUTIONAL AND OTHER HERITABLE DISORDERS,IDENTIFICATION OF COPY NUMBER VARIATIONS, INVERSIONS, INSERTIONS,",,,35582.26,56668.36,2
CPT,0267U,"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole g",,,16547.59,16547.59,2
CPT,0268T,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,0268T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0268T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0268U,"HEMATOLOGY (ATYPICAL HEMOLYTIC UREMIC SYNDROME {AHUS}), GENOMIC SEQUENCE ANALYSIS OF 15 GENES, BLOOD, BUCCAL SWAB, OR",,,3211.03,5113.89,2
CPT,0268U,"Hematology (atypical hemolytic uremic syndrome [aHUS]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0269T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0269T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0269T,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,0269U,"HEMATOLOGY (AUTOSOMAL DOMINANT CONGENITAL THROMBOCYTOPENIA), GENOMIC SEQUENCE ANALYSIS OF 14 GENES, BLOOD, BUCCAL SWAB,",,,3211.03,5113.89,2
CPT,0269U,"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0270T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0270T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0270T,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,0270U,"HEMATOLOGY (CONGENITAL COAGULATION DISORDERS), GENOMIC SEQUENCE ANALYSIS OF 20 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTIC",,,3211.03,5113.89,2
CPT,0270U,"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0271T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0271T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0271T,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,0271U,"HEMATOLOGY (CONGENITAL NEUTROPENIA), GENOMIC SEQUENCE ANALYSIS OF 23 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTIC FLUID",,,3211.03,5113.89,2
CPT,0271U,"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0272T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0272U,"HEMATOLOGY (GENETIC BLEEDING DISORDERS), GENOMIC SEQUENCE ANALYSIS OF 51 GENES, BLOOD, BUCCAL SWAB, COMPREHENSIVE",,,3211.03,5113.89,2
CPT,0272U,"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive",,,1493.51,1493.51,2
CPT,0273T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0273U,"HEMATOLOGY (GENETIC HYPERFIBRINOLYSIS, DELAYED BLEEDING), GENOMIC SEQUENCE ANALYSIS OF 8 GENES (F13A1, F13B, FGA, FGB",,,3211.03,5113.89,2
CPT,0273U,"Hematology (genetic hyperfibrinolysis, delayed bleeding), analysis of 9 genes (F13A1, F13B, FGA, FGB, FGG, SERPINA1, SERPINE1, SERPINF2 by next-generation sequencing and PLAU by array comparative geno",,,1493.51,1493.51,2
CPT,0274T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0274T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0274T,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,0274U,"HEMATOLOGY (GENETIC PLATELET DISORDERS), GENOMIC SEQUENCE ANALYSIS OF 43 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTIC FLUID",,,3211.03,5113.89,2
CPT,0274U,"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0275T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0275T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0275T,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,0275U,"HEMATOLOGY (HEPARIN-INDUCED THROMBOCYTOPENIA), PLATELET ANTIBODY REACTIVITY BY FLOW CYTOMETRY, SERUM",,,97.01,154.5,2
CPT,0275U,"Hematology (heparin-induced thrombocytopenia), platelet antibody reactivity by flow cytometry, serum",,,44.93,44.93,2
CPT,0276U,"HEMATOLOGY (INHERITED THROMBOCYTOPENIA), GENOMIC SEQUENCE ANALYSIS OF 23 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTIC FLUID",,,12927.9,20589.0,2
CPT,0276U,"Hematology (inherited thrombocytopenia), genomic sequence analysis of 42 genes, blood, buccal swab, or amniotic fluid",,,6012.31,6012.31,2
CPT,0277U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,0277U,"HEMATOLOGY (GENETIC PLATELET FUNCTION DISORDER), GENOMIC SEQUENCE ANALYSIS OF 31 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTI",,,3211.03,5113.89,2
CPT,0277U,"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0278T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0278T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0278U,"HEMATOLOGY (GENETIC THROMBOSIS), GENOMIC SEQUENCE ANALYSIS OF 12 GENES, BLOOD, BUCCAL SWAB, OR AMNIOTIC FLUID",,,3211.03,5113.89,2
CPT,0278U,"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid",,,1493.51,1493.51,2
CPT,0279U,"HEMATOLOGY (VON WILLEBRAND DISEASE {VWD}), VON WILLEBRAND FACTOR (VWF) AND COLLAGEN III BINDING BY ENZYME-LINKED IMMUN",,,60.85,96.91,2
CPT,0279U,"Hematology (von Willebrand disease [VWD]), von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA), plasma, report of collagen III binding",,,28.29,28.29,2
CPT,0280U,"HEMATOLOGY (VON WILLEBRAND DISEASE {VWD}), VON WILLEBRAND FACTOR (VWF) AND COLLAGEN IV, PLASMA, REPORT OF COLLAGEN IV",,,91.19,145.23,2
CPT,0280U,"Hematology (von Willebrand disease [VWD]), von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA), plasma, report of collagen IV binding",,,42.43,42.43,2
CPT,0281U,"HEMATOLOGY (VON WILLEBRAND DISEASE {VWD}), VON WILLEBRAND PROPEPTIDE, VON WILLEBRAND FACTOR (VWF) PROPEPTIDE ANTIGEN LE",,,91.19,145.23,2
CPT,0281U,"Hematology (von Willebrand disease [VWD]), von Willebrand propeptide, enzyme-linked immunosorbent assays (ELISA), plasma, diagnostic report of von Willebrand factor (VWF) propeptide antigen level",,,42.43,42.43,2
CPT,0282U,"RED BLOOD CELL ANTIGEN TYPING, DNA, GENOTYPING OF 12 BLOOD GROUP SYSTEM GENES TO PREDICT 44 RED BLOOD CELL ANTIGEN",,,3801.45,6054.19,2
CPT,0282U,"Red blood cell antigen typing, DNA, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes",,,1768.08,1768.08,2
CPT,0283U,"VON WILLEBRAND FACTOR (VWF), TYPE 2B, PLATELET-BINDING EVALUATION, RADIOIMMUNOASSAY, PLASMA",,,97.13,154.69,2
CPT,0283U,"von Willebrand factor (VWF), type 2B, platelet-binding evaluation, radioimmunoassay, plasma",,,44.93,44.93,2
CPT,0284U,"VON WILLEBRAND FACTOR (VWF), TYPE 2N, FACTOR VIII AND VWF BINDING EVALUATION, ENZYME-LINKED IMMUNOSORBENT",,,91.19,145.23,2
CPT,0284U,"von Willebrand factor (VWF), type 2N, factor VIII and VWF binding evaluation, enzyme-linked immunosorbent assays (ELISA), plasma",,,42.43,42.43,2
CPT,0285U,"Oncology, response to radiation, cell-free DNA, quantitative branched chain DNA amplification, plasma, reported as a radiation toxicity score",,,66.61,106.09,2
CPT,0286U,"CEP72 (centrosomal protein, 72-KDa), NUDT15 (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) (eg, drug metabolism) gene analysis, common variants",,,329.49,2618.84,4
CPT,0287U,"Oncology (thyroid), DNA and mRNA, next-generation sequencing analysis of 112 genes, fine needle aspirate or formalin-fixed paraffin-embedded (FFPE) tissue, algorithmic prediction of cancer recurrence,",,,8466.48,13483.73,4
CPT,0288U,"Oncology (lung), mRNA, quantitative PCR analysis of 11 genes (BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR, WNT3A) and 3 reference genes (ESD, TBP, YAP1), formalin-fixed paraffin-e",,,6752.02,10753.27,4
CPT,0289U,"Neurology (Alzheimer disease), mRNA, gene expression profiling by RNA sequencing of 24 genes, whole blood, algorithm reported as predictive risk score",,,988.52,1866.26,4
CPT,0290T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0290U,"Pain management, mRNA, gene expression profiling by RNA sequencing of 36 genes, whole blood, algorithm reported as predictive risk score",,,1866.26,7924.22,4
CPT,0291U,"Psychiatry (mood disorders), mRNA, gene expression profiling by RNA sequencing of 144 genes, whole blood, algorithm reported as predictive risk score",,,2487.85,3962.16,2
CPT,0292U,"Psychiatry (stress disorders), mRNA, gene expression profiling by RNA sequencing of 72 genes, whole blood, algorithm reported as predictive risk score",,,2487.85,3962.16,2
CPT,0293U,"Psychiatry (suicidal ideation), mRNA, gene expression profiling by RNA sequencing of 54 genes, whole blood, algorithm reported as predictive risk score",,,1866.26,3962.16,4
CPT,0294U,"Longevity and mortality risk, mRNA, gene expression profiling by RNA sequencing of 18 genes, whole blood, algorithm reported as predictive risk score",,,1866.26,11670.92,4
CPT,0295U,"Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicopathologic factors (size, age, ",,,4657.75,14506.24,4
CPT,0296U,"Oncology (oral and/or oropharyngeal cancer), gene expression profiling by RNA sequencing at least 20 molecular features (eg, human and/or microbial mRNA), saliva, algorithm reported as positive or neg",,,8466.48,13483.73,2
CPT,0296U,"Oncology (oral and/or oropharyngeal cancer), gene expression profiling by RNA sequencing of at least 20 molecular features (eg, human and/or microbial mRNA), saliva, algorithm reported as positive or ",,,4309.13,4309.13,2
CPT,0297U,"Oncology (pan tumor), whole genome sequencing of paired malignant and normal DNA specimens, fresh or formalin-fixed paraffin-embedded (FFPE) tissue, blood or bone marrow, comparative sequence analyses",,,1222.94,1947.65,2
CPT,0298U,"Oncology (pan tumor), whole transcriptome sequencing of paired malignant and normal RNA specimens, fresh or formalin-fixed paraffin-embedded (FFPE) tissue, blood or bone marrow, comparative sequence a",,,1222.94,7168.85,4
CPT,0299U,"Oncology (pan tumor), whole genome optical genome mapping of paired malignant and normal DNA specimens, fresh frozen tissue, blood, or bone marrow, comparative structural variant identification",,,1222.94,1947.65,2
CPT,0300U,"Oncology (pan tumor), whole genome sequencing and optical genome mapping of paired malignant and normal DNA specimens, fresh tissue, blood, or bone marrow, comparative sequence analyses and variant id",,,1222.94,1947.65,2
CPT,0301U,"Infectious agent detection by nucleic acid (DNA or RNA), Bartonella henselae and Bartonella quintana, droplet digital PCR (ddPCR);",,,1210.12,1927.24,2
CPT,0302U,"Infectious agent detection by nucleic acid (DNA or RNA), Bartonella henselae and Bartonella quintana, droplet digital PCR (ddPCR); following liquid enhancement",,,1210.12,1927.24,2
CPT,0303U,"Hematology, red blood cell (RBC) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood, with algorithmic analysis and result reported as an RBC adhesion index; ",,,72.55,115.55,2
CPT,0304U,"Hematology, red blood cell (RBC) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood, with algorithmic analysis and result reported as an RBC adhesion index; ",,,72.55,115.55,2
CPT,0305U,"Hematology, red blood cell (RBC) functionality and deformity as a function of shear stress, whole blood, reported as a maximum elongation index",,,72.55,115.55,2
CPT,0308T,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,0308T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0308T,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,0308U,"CARDIOLOGY (CORONARY ARTERY DISEASE (CAD)), ANALYSIS OF 3 PROTEINS (HIGH SENSITIVITY (HS) TROPONIN, ADIPONECTIN, AND KID",,,2063.06,3285.63,2
CPT,0308U,"Cardiology (coronary artery disease [CAD]), analysis of 3 proteins (high sensitivity [hs] troponin, adiponectin, and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported as a risk score for o",,,959.35,959.35,2
CPT,0309U,"CARDIOLOGY (CARDIOVASCULAR DISEASE), ANALYSIS OF 4 PROTEINS (NT-PROBNP, OSTEOPONTIN, TISSUE INHIBITOR OF METALLOPROTEIN",,,2063.06,3285.63,2
CPT,0309U,"Cardiology (cardiovascular disease), analysis of 4 proteins (NT-proBNP, osteopontin, tissue inhibitor of metalloproteinase-1 [TIMP-1], and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported",,,959.35,959.35,2
CPT,0310U,"PEDIATRICS (VASCULITIS, KAWASAKI DISEASE (KD)), ANALYSIS OF 3 BIOMARKERS (NT-PROBNP, C-REACTIVE PROTEIN, AND T-UPTAKE),",,,2063.06,3285.63,2
CPT,0310U,"Pediatrics (vasculitis, Kawasaki disease [KD]), analysis of 3 biomarkers (NT-proBNP, C-reactive protein, and T-uptake), plasma, algorithm reported as a risk score for KD",,,959.35,959.35,2
CPT,0311U,"INFECTIOUS DISEASE (BACTERIAL), QUANTITATIVE ANTIMICROBIAL SUSCEPTIBILITY REPORTED AS PHENOTYPIC MINIMUM INHIBITORY CONC",,,42.69,67.98,2
CPT,0311U,"Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)ûbased antimicrobial susceptibility for each organism identified",,,19.97,19.97,2
CPT,0312T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0312U,"AUTOIMMUNE DISEASES (EG, SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)), ANALYSIS OF 8 IGG AUTOANTIBODIES AND 2 CELL-BOUND COMPLEM",,,4438.43,7068.66,2
CPT,0312U,"Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), fl",,,2064.29,2064.29,2
CPT,0313T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0313U,"ONCOLOGY (PANCREAS), DNA AND MRNA NEXT-GENERATION SEQUENCINGANALYSIS OF 74 GENES AND ANALYSIS OF CEA (CEACAM5) GENE",,,19007.25,30270.97,2
CPT,0313U,"Oncology (pancreas), DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression, pancreatic cyst fluid, algorithm reported as a categorical result (ie, ",,,8838.75,8838.75,2
CPT,0314T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0315T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0316T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0316U,"BORRELIA BURGDORFERI (LYME DISEASE), OSPA PROTEIN EVALUATION, URINE",,,98.54,156.94,2
CPT,0316U,"Borrelia burgdorferi (Lyme disease), OspA protein evaluation, urine",,,45.76,45.76,2
CPT,0317T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0317U,"ONCOLOGY (LUNG CANCER), FOUR-PROBE FISH (3Q29, 3P22.1, 10Q22.3, 10CEN) ASSAY, WHOLE BLOOD, PREDICTIVE ALGORITHM-GENERATE",,,10717.98,17069.46,2
CPT,0317U,"Oncology (lung cancer), four-probe FISH (3q29, 3p22.1, 10q22.3, 10cen) assay, whole blood, predictive algorithm-generated evaluation reported as decreased or increased risk for lung cancer",,,4983.92,4983.92,2
CPT,0321U,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), GENITOURINARY PATHOGENS, IDENTIFICATION OF 20 BACTERIAL AND FUN",,,3351.84,5338.15,2
CPT,0321U,"Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms and identification of 16 associated antibiotic-resistance genes, m",,,1558.41,1558.41,2
CPT,0322U,"NEUROLOGY (AUTISM SPECTRUM DISORDER (ASD)), QUANTITATIVE MEASUREMENTS OF 14 ACYL CARNIINES AND MICROBIOME-DERIVED METAB",,,3959.84,6306.45,2
CPT,0322U,"Neurology (autism spectrum disorder [ASD]), quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites, liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma, ",,,1841.3,1841.3,2
CPT,0323U,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA AND RNA), CENTRAL NERVOUS SYSTEM PATHOGEN, METAGENOMIC NEXT-GENERATION",,,11225.91,17878.39,2
CPT,0323U,"Infectious agent detection by nucleic acid (DNA and RNA), central nervous system pathogen, metagenomic next-generation sequencing, cerebrospinal fluid (CSF), identification of pathogenic bacteria, vir",,,5220.22,5220.22,2
CPT,0324U,"ONCOLOGY (OVARIAN), SPHEROID CELL CULTURE, 4-DRUG PANEL (CARBOPLATIN, DOXORUBICIN, GEMCITABINE, PACLITAXEL), TUMOR CHEM",,,5871.86,9351.53,2
CPT,0325U,"ONCOLOGY (OVARIAN), SPHEROID CELL CULTURE, POLY (ADP-RIBOSE)POLYMERASE (PARP) INHIBITORS (NIRAPARIB, OLAPARIB, RUCAP",,,5871.86,9351.53,2
CPT,0327U,"FETAL ANEUPLOIDY (TRISOMY 13, 18, AND 21), DNA SEQUENCE ANALYSIS OF SELECTED REGIONS USING MATERNAL PLASMA, ALGORITHM",,,4197.43,6684.84,2
CPT,0327U,"Fetal aneuploidy (trisomy 13, 18, and 21), DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy, includes sex reporting, if performed",,,1951.97,1951.97,2
CPT,0328U,"DRUG ASSAY, DEFINITIVE, 120 OR MORE DRUGS AND METABOLITES, URINE, QUANTITATIVE LIQUID CHROMATOGRAPHY WITH TANDEM MASS",,,604.18,962.21,2
CPT,0328U,"Drug assay, definitive, 120 or more drugs and metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS), includes specimen validity and algorithmic analysis descr",,,281.23,281.23,2
CPT,0330U,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), VAGINAL PATHOGEN PANEL, IDENTIFICATION OF 27 ORGANISMS, AMPLIF",,,2200.52,3504.55,2
CPT,0330U,"Infectious agent detection by nucleic acid (DNA or RNA), vaginal pathogen panel, identification of 27 organisms, amplified probe technique, vaginal swab",,,1023.41,1023.41,2
CPT,0331T,Outpatient Surgical Group 0,10096.7,6562.86,2806.68,4166.87,50
CPT,0332T,Outpatient Surgical Group 0,10096.7,6562.86,2806.68,4166.87,50
CPT,0334U,Onc sld orgn tgsa dna 84/+,,,15414.87,24549.75,2
CPT,0334U,"Oncology (solid organ), targeted genomic sequence analysis, formalin-fixed paraffin-embedded (FFPE) tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number ",,,7168.85,7168.85,2
CPT,0335T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0335T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0335T,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,0335U,"Rare diseases (constitutional/heritable disorders), whole genome sequence analysis, including small sequence changes, copy number variants, deletions, duplications, mobile element insertions, uniparen",,,12828.38,12828.38,2
CPT,0335U,Rare ds whl gen seq feta,,,27584.79,43931.58,2
CPT,0336U,"Rare diseases (constitutional/heritable disorders), whole genome sequence analysis, including small sequence changes, copy number variants, deletions, duplications, mobile element insertions, uniparen",,,6321.84,6321.84,2
CPT,0336U,Rare ds whl gen seq bld/slv,,,13593.64,21649.25,2
CPT,0338T,Outpatient Grouper - 4,45399.9,29509.94,19724.25,21397.98,24
CPT,0338T,Outpatient Surgery Group 3 Global Rate,45399.9,29509.94,22055.0,22787.0,2
CPT,0338T,Outpatient Surgical Group 1,45399.9,29509.94,9088.3,13492.72,50
CPT,0339T,Outpatient Grouper - 4,47896.9,31132.99,19724.25,21397.98,24
CPT,0339T,Outpatient Surgery Group 3 Global Rate,47896.9,31132.99,22055.0,22787.0,2
CPT,0339T,Outpatient Surgical Group 1,47896.9,31132.99,9088.3,13492.72,50
CPT,0339U,Onc prst8 mrna hoxc6 & dlx1,,,4012.64,6390.54,2
CPT,0339U,"Oncology (prostate), mRNA expression profiling of HOXC6 and DLX1, reverse transcription polymerase chain reaction (RT-PCR), first-void urine following digital rectal examination, algorithm reported as",,,1866.26,1866.26,2
CPT,0340U,DNA assays for detection of minimal residual disease in cancer,,,20696.78,32961.72,2
CPT,0340U,"Oncology (pan-cancer), analysis of minimal residual disease (MRD) from plasma, with assays personalized to each patient based on prior next-generation sequencing of the patient's tumor and germline DN",,,9625.03,9625.03,2
CPT,0342T,INFUSION THERAPY,19737.5,12829.38,2148.0,2209.0,2
CPT,0342T,Outpatient Grouper - 5,19737.5,12829.38,25486.19,27649.53,24
CPT,0342T,Outpatient Surgical Group 4,19737.5,12829.38,17187.58,25517.11,50
CPT,0342U,Onc pncrtc ca mult ia eclia,,,4736.0,7542.55,2
CPT,0342U,"Oncology (pancreatic cancer), multiplex immunoassay of C5, C4, cystatin C, factor B, osteoprotegerin (OPG), gelsolin, IGFBP3, CA125 and multiplex electrochemiluminescent immunoassay (ECLIA) for CA19-9",,,2202.41,2202.41,2
CPT,0343U,Onc prst8 xom aly 442 sncrna,,,4012.64,6390.54,2
CPT,0343U,"Oncology (prostate), exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR), urine, reported as molecular evidence of no",,,1866.26,1866.26,2
CPT,0345T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0345T,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,0345T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0345U,Psyc genom alys pnl 15 gen,,,7054.28,11234.66,2
CPT,0345U,"Psychiatry (eg, depression, anxiety, attention deficit hyperactivity disorder [ADHD]), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6",,,3280.73,3280.73,2
CPT,0346U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,0347T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0347U,"Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes",,,3280.73,3280.73,2
CPT,0347U,Rx metab/pcx dna 16 gen alys,,,7054.28,11234.66,2
CPT,0348T,"Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow, and wrist, when performed)",,,260.92,260.92,2
CPT,0348U,"Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes",,,1822.17,1822.17,2
CPT,0348U,Rx metab/pcx dna 25 gen alys,,,3919.04,6241.47,2
CPT,0349T,"Radiologic examination, radiostereometric analysis (RSA); spine, (includes, cervical, thoracic and lumbosacral, when performed)",,,260.92,260.92,2
CPT,0349U,"Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interacti",,,1822.17,1822.17,2
CPT,0349U,Rx metab/pcx dna 27gen rx ia,,,3919.04,6241.47,2
CPT,0350T,"Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed)",,,212.09,212.09,2
CPT,0350U,"Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis and reported phenotypes",,,3280.73,3280.73,2
CPT,0350U,Rx metab/pcx dna 27 gen alys,,,7054.28,11234.66,2
CPT,0351U,"Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum",,,639.83,639.83,2
CPT,0351U,Nfct ds bct/viral trail ip10,,,1375.39,2190.45,2
CPT,0352U,"Infectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosisûassociated bacteria (BVAB-2, Atopobium vaginae, and Megasphera type 1",,,350.29,350.29,2
CPT,0352U,Nfct ds bv&vaginitis amp prb,,,753.05,1199.3,2
CPT,0353U,Iadna chlmyd&gonorr amp prb,,,370.53,590.1,2
CPT,0353U,"Infectious agent detection by nucleic acid (DNA), Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique, urine, vaginal, pharyngeal, or rectal, each pathogen reported as",,,172.24,172.24,2
CPT,0354U,Hpv hi rsk qual mrna e6/e7,,,185.26,295.05,2
CPT,0354U,"Human papilloma virus (HPV), high-risk types (ie, 16, 18, 31, 33, 45, 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)",,,86.54,86.54,2
CPT,0361U,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,0376T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0378T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0379T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0394T,HB HDR ELCTRNC SKN SURF BRCHYTX,3386.14,2200.99,327.46,376.58,8
CPT,0394T,"High dose rate electronic brachytherapy, skin surface application, per fraction, includes basic dosimetry, when performed",3386.14,2200.99,641.87,641.87,2
CPT,0394T,Outpatient Surgical Group 9,3386.14,2200.99,36513.58,54208.97,50
CPT,0394T,RADIATION THERAPY SERVICES,3386.14,2200.99,,,0
CPT,0395T,HB HDR ELCTR NTRST/NTRCV BRCHTX,20280.0,13182.0,863.92,993.51,8
CPT,0395T,"High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed",20280.0,13182.0,1761.88,1761.88,2
CPT,0395T,"High dose rate electronic brachytherapy, interstitial or intracavity treatment, per fraction, includes basic dosimetry, when performed",20280.0,13182.0,,,0
CPT,0395T,Outpatient Surgical Group 9,20280.0,13182.0,36513.58,54208.97,50
CPT,0395T,RADIATION THERAPY SERVICES,20280.0,13182.0,,,0
CPT,0397T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0397T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0398T,HB MRGFUS STEREOTACTIC ABLAT LES INTRCRNL,6099.75,3964.84,,,0
CPT,0398T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0402T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0402T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0408T,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,194.82,224.05,8
CPT,0408T,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,0408T,Outpatient Surgery Group 3 Global Rate,261951.0,170268.15,22055.0,22787.0,2
CPT,0408T,Outpatient Surgical Group 1,261951.0,170268.15,9088.3,13492.72,50
CPT,0409T,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,0409T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0409T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0410T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0410T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0410T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0411T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0411T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0411T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0412T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0412T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0412T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0413T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0413T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0413T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0414T,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,0414T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0414T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0415T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0415T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0415T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0416T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0416T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0416T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0419T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0419T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0419T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0420T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0420T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0420T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0421T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0421T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0421T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0424T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0427T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0431T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0437T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0440T,Outpatient Grouper - 5,13722.6,8919.69,25486.19,27649.53,24
CPT,0440T,Outpatient Surgical Group 3,13722.6,8919.69,13899.75,20635.92,50
CPT,0441T,"HB ABLTN, PERQ CRYO PERP NRV LOWER EXT",13722.6,8919.69,2431.57,2796.3,8
CPT,0441T,Outpatient Grouper - 5,13722.6,8919.69,25486.19,27649.53,24
CPT,0441T,Outpatient Surgical Group 3,13722.6,8919.69,13899.75,20635.92,50
CPT,0442T,Outpatient Grouper - 5,25520.1,16588.06,25486.19,27649.53,24
CPT,0442T,Outpatient Surgical Group 3,25520.1,16588.06,13899.75,20635.92,50
CPT,0443T,Laboratory Services,,,274.96,274.99,2
CPT,0443T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0443T,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,0444T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0445T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0446T,Outpatient Grouper - 0,7948.54,5166.55,9059.94,9827.82,24
CPT,0446T,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,0447T,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,0448T,HB RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE,7948.54,5166.55,2277.74,2619.4,8
CPT,0448T,Outpatient Grouper - 0,7948.54,5166.55,9059.94,9827.82,24
CPT,0448T,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,0449T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0449T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0449T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0450T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0450T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0450T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0451T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0452T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0453T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0454T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0455T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0456T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0457T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0458T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0459T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0460T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0461T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0465T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0467T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0468T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0474T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0474T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0474T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0479T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0479T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0480T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0480T,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,0481T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0481T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0481T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0483T,HB TMVI PERCUTANEOUS APPROACH,75161.77,48855.15,13270.0,14761.0,2
CPT,0483T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0483T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0483T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0484T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0484T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0484T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0485T,"Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral",,,608.18,968.58,2
CPT,0486T,"Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral",,,1216.35,1937.16,2
CPT,0487T,"Biomechanical mapping, transvaginal, with report",,,901.44,1435.64,2
CPT,0489T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0489T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0489T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0490T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0490T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0490T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0493T,"Near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin measurement)",,,1131.33,1801.76,2
CPT,0494T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0494T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0494T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0495T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0496T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0497T,"External patient-activated, physician- or other qualified health care professional-prescribed, electrocardiographic rhythm derived event recording without 24 hour attended monitoring; in-office connec",,,4986.64,7941.73,2
CPT,0498T,"External patient-activated, physician- or other qualified health care professional-prescribed, electrocardiographic rhythm derived event recording without 24 hour attended monitoring; review and inter",,,163.21,259.94,2
CPT,0499T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0500T,"Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) (i",,,254.76,405.73,2
CPT,0500T,Laboratory Services,,,161.0,161.02,2
CPT,0501T,CT SCAN,,,568.98,574.55,2
CPT,0501T,Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of fun,,,584.66,931.13,2
CPT,0502T,CT SCAN,,,142.24,143.64,2
CPT,0502T,HB TERM COR FFR DATA PREP & TRANS,1657.105,1077.12,13270.0,14761.0,2
CPT,0502T,Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of fun,,,146.16,232.78,2
CPT,0503T,CT SCAN,,,142.24,143.64,2
CPT,0503T,HB TERM COR FFR CTA DATA ALYS & GNRJ,1657.105,1077.12,13270.0,14761.0,2
CPT,0503T,Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of fun,,,146.16,232.78,2
CPT,0504T,Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of fun,,,584.66,931.13,2
CPT,0505T,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,0505T,Outpatient Surgery Group 5 Global Rate,102328.0,66513.2,32992.0,34883.0,2
CPT,0505T,Outpatient Surgical Group 0,102328.0,66513.2,2806.68,4166.87,50
CPT,0506T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0507T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0508T,"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density, tibia",,,22.92,22.92,2
CPT,0510T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0510T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0510T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0511T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0511T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0511T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0512T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0512T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0512T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0513T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0513T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0515T,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,0515T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0515T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0516T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0516T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0516T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0517T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0517T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0517T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0518T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0518T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0518T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0519T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0519T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0519T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0520T,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,0520T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0520T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0521T,Interrog dev eval wcs ip,,,154.34,245.8,2
CPT,0522T,Prgrmg dev eval wcs ip,,,154.34,245.8,2
CPT,0523T,Ntrapx c ffr w/3d funcjl map,24591.5,15984.48,584.66,931.13,2
CPT,0523T,Outpatient Grouper - 0,24591.5,15984.48,9059.94,9827.82,24
CPT,0524T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0524T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0524T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0525T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0525T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0525T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0526T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0526T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0526T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0527T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0527T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0527T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0528T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0528T,Prgrmg dev eval iims ip,,,149.52,238.12,2
CPT,0529T,Interrog dev eval iims ip,,,154.34,245.8,2
CPT,0529T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0530T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0530T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0530T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0531T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0531T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0531T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0532T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0532T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0532T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0533T,Cont rec mvmt do 6-10 days,,,1368.57,2179.59,2
CPT,0534T,Cont rec mvmt do setup&train,,,479.0,762.86,2
CPT,0535T,Cont rec mvmt do reprt cnfig,,,479.0,762.86,2
CPT,0536T,Cont rec mvmt do dl w/i&r,,,410.57,653.87,2
CPT,0537T,HB LYMPHS CAR-T CELL HARVEST,8187.66,5321.98,13270.0,14761.0,4
CPT,0537T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0538T,HB LYMPHS PREP/TRNSPRT,4420.69,2873.45,13270.0,14761.0,2
CPT,0538T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0539T,HB CAR-T CELL PREP/ADMINISTRATION,3793.25,2465.61,13270.0,14761.0,4
CPT,0539T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0540T,CAR-T Cell Therapy,2434.68,1582.54,,,0
CPT,0540T,Cellular Immunotherapy Hospital Services,2434.68,1582.54,150960.0,185700.0,3
CPT,0540T,"HB CAR-T CELL ADMINISTRATION, AUTOLOGUS",2434.68,1582.54,13270.0,14761.0,4
CPT,0540T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0540T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0541T,Myocardial imaging mcg,,,1426.07,2271.17,2
CPT,0542T,Myocardial imaging mcg i&r,,,1426.07,2271.17,2
CPT,0543T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0543T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0543T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0544T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0544T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0544T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0545T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0545T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0545T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0548T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0549T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0553T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0553T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0553T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0555T,"Bone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; retrieval and transmission of the scan data",,,61.59,61.59,2
CPT,0556T,"Bone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; assessment of bone strength and fracture ris",,,573.69,573.69,2
CPT,0558T,CAT Scan,,,2808.07,2839.65,2
CPT,0558T,Computed tomography scan taken for the purpose of biomechanical computed tomography analysis,,,201.67,201.67,2
CPT,0563T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0563T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0564T,Laboratory Services,,,212.57,212.59,2
CPT,0564T,"Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on percent of cytotoxicity observed",,,1.24,2170.32,4
CPT,0565T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0565T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0565T,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,0566T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0566T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0566T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0567T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0567T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0567T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0568T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0569T,HB TRANSCATH TRI PERQ APPR INITIAL PROSTH,75161.77,48855.15,13270.0,14761.0,2
CPT,0569T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0569T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0569T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0570T,HB TRANSCATH TRI PERQ APPR EACH ADDL PROSTH,75161.77,48855.15,13270.0,14761.0,2
CPT,0570T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0570T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0570T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0571T,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,0571T,Outpatient Surgery Group 5 Global Rate,261951.0,170268.15,32992.0,34883.0,2
CPT,0571T,Outpatient Surgical Group 0,261951.0,170268.15,2806.68,4166.87,50
CPT,0572T,Outpatient Grouper - 7,44676.8,29039.92,32948.13,35744.6,24
CPT,0572T,Outpatient Surgery Group 4 Global Rate,44676.8,29039.92,26623.0,28144.0,2
CPT,0572T,Outpatient Surgical Group 0,44676.8,29039.92,2806.68,4166.87,50
CPT,0573T,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,0573T,Outpatient Surgery Group 4 Global Rate,14406.5,9364.23,26623.0,28144.0,2
CPT,0573T,Outpatient Surgical Group 0,14406.5,9364.23,2806.68,4166.87,50
CPT,0574T,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,0574T,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,0574T,Outpatient Surgical Group 0,14406.5,9364.23,2806.68,4166.87,50
CPT,0575T,Outpatient Surgical Group 0,1440.95,936.62,2806.68,4166.87,50
CPT,0576T,Outpatient Surgical Group 0,1440.95,936.62,2806.68,4166.87,50
CPT,0577T,Outpatient Surgical Group 0,6469.03,4204.87,2806.68,4166.87,50
CPT,0578T,Outpatient Surgical Group 0,1461.44,949.94,2806.68,4166.87,50
CPT,0579T,Outpatient Surgical Group 0,1440.95,936.62,2806.68,4166.87,50
CPT,0580T,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,0580T,Outpatient Surgery Group 4 Global Rate,14406.5,9364.23,26623.0,28144.0,2
CPT,0580T,Outpatient Surgical Group 0,14406.5,9364.23,2806.68,4166.87,50
CPT,0581T,Outpatient Grouper - 3,19893.2,12930.58,14341.63,15558.59,24
CPT,0581T,Outpatient Surgery Group 3 Global Rate,19893.2,12930.58,22055.0,22787.0,2
CPT,0581T,Outpatient Surgical Group 0,19893.2,12930.58,2806.68,4166.87,50
CPT,0582T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0582T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0582T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0583T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0583T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0584T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0584T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0584T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0585T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0585T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0585T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0586T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0586T,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,0586T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0587T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0587T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0587T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0588T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0588T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0588T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0594T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0594T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0594T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0596T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0596T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0597T,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,0597T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0600T,Outpatient Grouper - 6,23086.6,15006.29,28632.25,34209.93,24
CPT,0600T,Outpatient Surgery Group 4 Global Rate,23086.6,15006.29,26623.0,28144.0,2
CPT,0600T,Outpatient Surgical Group 0,23086.6,15006.29,2806.68,4166.87,50
CPT,0601T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0601T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0601T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0609T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); acquisition of single voxel data, per disc, on biomarkers (ie, lactic acid, carbohyd",,,570.08,570.08,2
CPT,0611T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); postprocessing for algorithmic analysis of biomarker data for determination of relat",,,570.08,570.08,2
CPT,0613T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0613T,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,0613T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0614T,Outpatient Grouper - 10,234423.0,152374.95,43941.81,47671.53,24
CPT,0614T,Outpatient Surgery Group 9 Global Rate,234423.0,152374.95,36365.0,36365.0,1
CPT,0614T,Outpatient Surgical Group 0,234423.0,152374.95,2806.68,4166.87,50
CPT,0616T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0616T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0616T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0617T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0617T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0617T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0618T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0618T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0618T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0619T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0619T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0619T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0620T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0620T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0620T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0621T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0621T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0621T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0622T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0622T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0627T,Outpatient Grouper - 6,98487.4,64016.81,28632.25,34209.93,24
CPT,0627T,Outpatient Surgery Group 3 Global Rate,98487.4,64016.81,22055.0,22787.0,2
CPT,0627T,Outpatient Surgical Group 0,98487.4,64016.81,2806.68,4166.87,50
CPT,0628T,Outpatient Grouper - 0,54802.6,35621.69,9059.94,9827.82,24
CPT,0628T,Outpatient Surgery Group 3 Global Rate,54802.6,35621.69,22055.0,22787.0,2
CPT,0628T,Outpatient Surgical Group 0,54802.6,35621.69,2806.68,4166.87,50
CPT,0629T,Outpatient Grouper - 6,98487.4,64016.81,28632.25,34209.93,24
CPT,0629T,Outpatient Surgery Group 3 Global Rate,98487.4,64016.81,22055.0,22787.0,2
CPT,0629T,Outpatient Surgical Group 0,98487.4,64016.81,2806.68,4166.87,50
CPT,0630T,Outpatient Grouper - 0,54802.6,35621.69,9059.94,9827.82,24
CPT,0630T,Outpatient Surgery Group 3 Global Rate,54802.6,35621.69,22055.0,22787.0,2
CPT,0630T,Outpatient Surgical Group 0,54802.6,35621.69,2806.68,4166.87,50
CPT,0631T,"Transcutaneous visible light hyperspectral imaging measurement of oxyhemoglobin, deoxyhemoglobin, and tissue oxygenation, with interpretation and report, per extremity",,,2014.43,3208.19,2
CPT,0632T,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,0632T,Outpatient Surgery Group 3 Global Rate,114605.0,74493.25,22055.0,22787.0,2
CPT,0632T,Outpatient Surgical Group 0,114605.0,74493.25,2806.68,4166.87,50
CPT,0633T,CAT Scan,,,2808.07,2839.65,2
CPT,0633T,CT SCAN,,,1316.87,1329.78,2
CPT,0633T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material",,,311.73,2155.06,4
CPT,0634T,CAT Scan,,,2808.07,2839.65,2
CPT,0634T,CT SCAN,,,1551.24,1566.45,2
CPT,0634T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s)",,,336.7,2538.59,4
CPT,0635T,CAT Scan,,,2808.07,2839.65,2
CPT,0635T,CT SCAN,,,1869.77,1888.1,2
CPT,0635T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast material(s)",,,351.67,3059.87,4
CPT,0636T,CAT Scan,,,2808.07,2839.65,2
CPT,0636T,CT SCAN,,,1807.06,1824.78,2
CPT,0636T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s)",,,311.73,2957.24,4
CPT,0637T,CAT Scan,,,2808.07,2839.65,2
CPT,0637T,CT SCAN,,,2158.61,2179.77,2
CPT,0637T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)",,,336.7,3532.55,4
CPT,0638T,CAT Scan,,,2808.07,2839.65,2
CPT,0638T,CT SCAN,,,2636.38,2662.23,2
CPT,0638T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s)",,,351.67,4314.42,4
CPT,0641T,"Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition only, each flap or wou",,,82.9,82.9,2
CPT,0643T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0643T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0644T,HB TCAT REMOVAL HEART MASS W SUCTION DEV,47896.9,31132.99,13270.0,14761.0,4
CPT,0644T,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,0644T,Outpatient Surgical Group 0,47896.9,31132.99,2806.68,4166.87,50
CPT,0645T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0645T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0646T,HB TTVI/RPLCMT W/ PROSTHETIC VALVE PERQ,58420.96,37973.62,13270.0,14761.0,2
CPT,0646T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0646T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0647T,HB INSERT PERC GASTROSTOMY TUBE W US DOC & RPT,10320.01,6708.01,13270.0,14761.0,2
CPT,0647T,Outpatient Grouper - 2,7938.47,5160.01,13036.88,14143.2,24
CPT,0647T,Outpatient Surgical Group 0,7938.47,5160.01,2806.68,4166.87,50
CPT,0648T,HB QUANT MR ANALYSIS TISSUE W/O MRI EXAM,3428.63,2228.61,1183.55,1361.08,8
CPT,0648T,MRI,3428.63,2228.61,,,0
CPT,0648T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",3428.63,2228.61,2320.39,2320.39,2
CPT,0649T,HB QUANT MR ANALYSIS TISSUE W/ MRI EXAM,5419.065,3522.395,1183.55,14761.0,10
CPT,0649T,MRI,4712.23,3062.95,,,0
CPT,0649T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",4712.23,3062.95,2320.39,2320.39,2
CPT,0651T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0651T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0652T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0652T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0653T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0653T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0654T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0654T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0655T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0655T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0656T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0656T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0657T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0657T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0659T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0659T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,0660T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0660T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0661T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0661T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0662T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0663T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0664T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0664T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0665T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0665T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0666T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0666T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0667T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0667T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0668T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0668T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0669T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0669T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0670T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0670T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0671T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0671T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0671T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0672T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0672T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0672T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0673T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0673T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0673T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0674T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0674T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0674T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0675T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0675T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0675T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0676T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0676T,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,0676T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0677T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0677T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0677T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0678T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0678T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0678T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0679T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0679T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0679T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0680T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0680T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0680T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0681T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0681T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0681T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0682T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0682T,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,0682T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0683T,"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,236.77,377.08,2
CPT,0684T,"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualif",,,75.79,120.7,2
CPT,0685T,"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient e",,,236.77,377.08,2
CPT,0686T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0689T,"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tiss",,,212.09,212.09,2
CPT,0690T,"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue,",,,711.36,1132.91,2
CPT,0691T,"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report",,,313.2,498.8,2
CPT,0692T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0693T,Comprehensive full body computer-based markerless 3D kinematic and kinetic motion analysis and report,,,491.64,782.99,2
CPT,0694T,"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time",,,329.55,524.84,2
CPT,0696T,"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, d",,,344.24,548.24,2
CPT,0697T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",,,570.08,570.08,2
CPT,0699T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0699T,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,0699T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0700T,Molecular fluorescent imaging of suspicious nevus; first lesion,,,602.0,958.75,2
CPT,0701T,Molecular fluorescent imaging of suspicious nevus; each additional lesion (List separately in addition to code for primary procedure),,,556.02,885.53,2
CPT,0707T,Outpatient Grouper - 4,16289.4,10588.11,19724.25,21397.98,24
CPT,0707T,Outpatient Surgical Group 0,16289.4,10588.11,2806.68,4166.87,50
CPT,0708T,Outpatient Grouper - Unlisted,1314.18,854.22,13030.5,14136.81,24
CPT,0708T,Outpatient Surgical Group 0,1314.18,854.22,2806.68,4166.87,50
CPT,0709T,Outpatient Grouper - Unlisted,394.25,256.26,13030.5,14136.81,24
CPT,0709T,Outpatient Surgical Group 0,394.25,256.26,2806.68,4166.87,50
CPT,0710T,CT SCAN,,,2193.91,2215.42,2
CPT,0710T,"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structu",,,2254.38,3590.32,2
CPT,0711T,CT SCAN,,,2193.91,2215.42,2
CPT,0711T,Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission,,,2254.38,3590.32,2
CPT,0712T,CT SCAN,,,126.91,128.15,2
CPT,0712T,Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and ass,,,130.41,212.09,4
CPT,0713T,CT SCAN,,,2193.91,2215.42,2
CPT,0713T,"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report",,,2254.38,3590.32,2
CPT,0714T,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,0714T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0715T,HB PERC TRANSLUMINAL CORONARY LITHOTRIPSY,45170.755000000005,29360.989999999998,13270.0,14761.0,2
CPT,0715T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0716T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0716T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0717T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0717T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0718T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0718T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0719T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0719T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0720T,HB PERQ ELEC NRV STIM CRANIAL WO IMPLT,3969.24,2580.01,1266.84,1456.87,8
CPT,0720T,Outpatient Grouper - 2,3969.24,2580.01,13036.88,14143.2,24
CPT,0720T,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,50
CPT,0721T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0721T,"Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnos",,,1588.02,1588.02,2
CPT,0722T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0722T,"Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diag",,,1588.02,1588.02,2
CPT,0723T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0723T,"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (MRI) ex",,,2320.39,2320.39,2
CPT,0724T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0724T,"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) exami",,,2320.39,2320.39,2
CPT,0725T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0725T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0726T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0726T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0727T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0727T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0728T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0729T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0730T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0730T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0731T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0732T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0732T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0735T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0735T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0736T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0736T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0737T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0737T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0738T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0739T,"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature ",,,6103.86,9721.02,2
CPT,0739T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0739T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0740T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0741T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0742T,Outpatient Surgical Group 0,3158.22,2052.84,2806.68,4166.87,50
CPT,0743T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0744T,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,0744T,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,0744T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0745T,"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and Maping of arrhythmia site (nidus), derived from anatomical image data (eg, CT, MRI, or myocar",10318.6,6707.09,1049.78,1717.96,2
CPT,0745T,Outpatient Grouper - Unlisted,10318.6,6707.09,13030.5,14136.81,24
CPT,0745T,Outpatient Surgical Group 0,10318.6,6707.09,2806.68,4166.87,50
CPT,0746T,Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and Maping of arrhythmia site (nidus) into a multidimensional radiation treatment plan,10318.6,6707.09,844.53,1345.0,2
CPT,0746T,Outpatient Grouper - Unlisted,10318.6,6707.09,13030.5,14136.81,24
CPT,0746T,Outpatient Surgical Group 0,10318.6,6707.09,2806.68,4166.87,50
CPT,0747T,"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia",3530.57,2294.87,696.9,1109.88,2
CPT,0747T,Outpatient Grouper - Unlisted,3530.57,2294.87,13030.5,14136.81,24
CPT,0747T,Outpatient Surgical Group 0,3530.57,2294.87,2806.68,4166.87,50
CPT,0748T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0748T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0749T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0750T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0751T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0752T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0753T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0754T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0755T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0756T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0757T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0758T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0759T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0760T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0761T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0762T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0763T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0764T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0765T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0766T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0767T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0770T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0771T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0772T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0773T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0774T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0775T,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,0776T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0778T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0779T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0780T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0780T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0781T,Outpatient Grouper - Unlisted,25399.1,16509.42,13030.5,14136.81,24
CPT,0781T,Outpatient Surgery Group 6 Global Rate,25399.1,16509.42,34526.0,35549.0,2
CPT,0781T,Outpatient Surgical Group 0,25399.1,16509.42,2806.68,4166.87,50
CPT,0782T,Outpatient Grouper - Unlisted,17938.0,11659.7,13030.5,14136.81,24
CPT,0782T,Outpatient Surgery Group 6 Global Rate,17938.0,11659.7,34526.0,35549.0,2
CPT,0782T,Outpatient Surgical Group 0,17938.0,11659.7,2806.68,4166.87,50
CPT,0783T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0784T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0784T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0785T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0785T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0786T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0786T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0787T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0787T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0788T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0789T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0790T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0790T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0791T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0792T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0793T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0793T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0794T,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,0794T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0795T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0795T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0796T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0796T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0797T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0797T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0798T,Outpatient Grouper - 4,14485.5,9415.58,19724.25,21397.98,24
CPT,0798T,Outpatient Surgical Group 0,14485.5,9415.58,2806.68,4166.87,50
CPT,0799T,Outpatient Grouper - 4,14485.5,9415.58,19724.25,21397.98,24
CPT,0799T,Outpatient Surgical Group 0,14485.5,9415.58,2806.68,4166.87,50
CPT,0800T,Outpatient Grouper - 4,14485.5,9415.58,19724.25,21397.98,24
CPT,0800T,Outpatient Surgical Group 0,14485.5,9415.58,2806.68,4166.87,50
CPT,0801T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0801T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0802T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0802T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0803T,Outpatient Grouper - 7,111346.0,72374.9,32948.13,35744.6,24
CPT,0803T,Outpatient Surgical Group 0,111346.0,72374.9,2806.68,4166.87,50
CPT,0804T,Outpatient Surgical Group 0,1399.99,909.99,2806.68,4166.87,50
CPT,0805T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0805T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0806T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0806T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0807T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0808T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0810T,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,0810T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0811T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0812T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0813T,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,0813T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0814T,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,0814T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0816T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0816T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0817T,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,0817T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0818T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0818T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0819T,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,0819T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0823T,Outpatient Grouper - 7,75602.9,49141.88,32948.13,35744.6,24
CPT,0823T,Outpatient Surgical Group 0,75602.9,49141.88,2806.68,4166.87,50
CPT,0824T,Outpatient Grouper - 4,14485.5,9415.58,19724.25,21397.98,24
CPT,0824T,Outpatient Surgical Group 0,14485.5,9415.58,2806.68,4166.87,50
CPT,0825T,Outpatient Grouper - 7,75602.9,49141.88,32948.13,35744.6,24
CPT,0825T,Outpatient Surgical Group 0,75602.9,49141.88,2806.68,4166.87,50
CPT,0826T,Outpatient Surgical Group 0,1399.99,909.99,2806.68,4166.87,50
CPT,0858T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,0861T,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,0861T,Outpatient Surgical Group 0,14406.5,9364.23,2806.68,4166.87,50
CPT,0862T,Outpatient Grouper - 2,7722.51,5019.63,13036.88,14143.2,24
CPT,0862T,Outpatient Surgical Group 0,7722.51,5019.63,2806.68,4166.87,50
CPT,0863T,Outpatient Grouper - 2,7722.51,5019.63,13036.88,14143.2,24
CPT,0863T,Outpatient Surgical Group 0,7722.51,5019.63,2806.68,4166.87,50
CPT,0864T,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,10004,OUTPATIENT SURGERY CPT GROUP 1,1513.56,983.81,6417.0,7038.0,2
CPT,10004,Outpatient Grouper - 0,1513.56,983.81,9059.94,9827.82,24
CPT,10005,HB FINE NEEDLE ASP W/ US GUID FIRST LESION,6845.335,4449.47,876.1,14761.0,10
CPT,10005,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10005,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10005,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,10006,HB FINE NEEDLE ASP W/ US GUID EA ADDL LESION,4601.56,2991.0150000000003,13270.0,14761.0,2
CPT,10006,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,10006,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,10007,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10007,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10007,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,10008,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,10008,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,10009,HB FINE NEEDLE ASP W/ CT GUID FIRST LESION,6845.335,4449.47,876.1,14761.0,10
CPT,10009,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10009,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10009,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,10010,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,10010,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,10011,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10011,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10011,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,10012,OUTPATIENT SURGERY CPT GROUP 1,4088.56,2657.56,6417.0,7038.0,2
CPT,10012,Outpatient Grouper - 0,4088.56,2657.56,9059.94,9827.82,24
CPT,10021,HB FINE NEEDLE ASP W/O IMG GUID FIRST LESION,2063.43,1341.23,497.49,572.11,8
CPT,10021,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,10021,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,10021,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,10030,HB DRAINAGE SUBQ SFT TISS W IMG,6845.335,4449.47,876.1,14761.0,10
CPT,10030,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10030,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10030,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,10035,HB PLACEMENT LOC DEV W IMG 1ST LESION,7738.2,5029.83,13270.0,14761.0,2
CPT,10035,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,10035,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,10035,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,10036,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,10036,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,10040,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,10040,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,10040,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,10060,"HB INCISION & DRAINAGE, ABSCESS",1797.2150000000001,1168.19,247.42,14761.0,18
CPT,10060,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,10060,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,10060,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,10061,HB I & D ABSCESS COMPL/MULTI,2372.935,1542.4099999999999,497.49,14761.0,18
CPT,10061,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,10061,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,10061,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,10080,HB I&D PILONIDAL CYST,2144.78,1394.11,876.1,1007.52,8
CPT,10080,OUTPATIENT SURGERY CPT GROUP 1,2144.78,1394.11,6417.0,7038.0,2
CPT,10080,Outpatient Grouper - 1,2144.78,1394.11,10495.38,11385.92,24
CPT,10080,Outpatient Surgical Group 0,2144.78,1394.11,2806.68,4166.87,50
CPT,10081,HB PILONIDAL CYST COMPLEX,5419.28,3522.53,876.1,1007.52,8
CPT,10081,Outpatient Grouper - 1,5419.28,3522.53,10495.38,11385.92,24
CPT,10081,Outpatient Surgery Group 2 Global Rate,5419.28,3522.53,14322.0,15354.0,2
CPT,10081,Outpatient Surgical Group 1,5419.28,3522.53,9088.3,13492.72,50
CPT,10120,HB REMOVAL FB SQ SIMPLE,2063.43,1341.23,497.49,572.11,16
CPT,10120,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,10120,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,10120,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,10121,HB INC & REM FB SQ; COMPL,11474.0,7458.1,2017.5,2320.13,8
CPT,10121,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,10121,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,10121,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,10140,HB I&D HEMATOMA,13195.1,8576.815,2017.5,14761.0,18
CPT,10140,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,10140,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,10140,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,10160,HB PUNCTURE ASPIRATION CYST,2372.935,1542.4099999999999,497.49,14761.0,20
CPT,10160,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,10160,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,10160,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,10180,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,10180,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,10180,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,11000,OUTPATIENT SURGERY CPT GROUP 1,4035.97,2623.38,6417.0,7038.0,2
CPT,11000,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,11000,Outpatient Surgical Group 0,4035.97,2623.38,2806.68,4166.87,50
CPT,11001,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11001,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11001,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11004,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11004,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,11004,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11005,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11005,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,11005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11006,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,11006,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11006,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11008,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11008,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,11008,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11010,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,11010,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11010,Outpatient Surgical Group 2,5952.47,3869.11,12162.28,18056.43,50
CPT,11011,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11011,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11011,Outpatient Surgical Group 2,5952.47,3869.11,12162.28,18056.43,50
CPT,11012,Outpatient Grouper - 1,12510.8,8132.02,10495.38,11385.92,24
CPT,11012,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,11012,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,11042,HB DEBRIDEMENT SQ TISSUE,2372.935,1542.4099999999999,497.49,14761.0,18
CPT,11042,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11042,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,11042,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,11043,HB DEBRIDEMENT MUSCLE/FASCIA,4641.349999999999,3016.875,762.22,14761.0,14
CPT,11043,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,11043,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,11043,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,11044,HB DEB BONE 20 SQ CM/<,13195.1,8576.815,2017.5,14761.0,10
CPT,11044,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,11044,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11044,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,11045,OUTPATIENT SURGERY CPT GROUP 1,622.66,404.73,6417.0,7038.0,2
CPT,11045,Outpatient Grouper - 0,622.66,404.73,9059.94,9827.82,24
CPT,11046,HB DEBRIDE MUSC/FASCIA ADD-ON,2073.64,1347.87,13270.0,14761.0,2
CPT,11046,OUTPATIENT SURGERY CPT GROUP 1,1595.09,1036.81,6417.0,7038.0,2
CPT,11046,Outpatient Grouper - 0,1595.09,1036.81,9059.94,9827.82,24
CPT,11047,OUTPATIENT SURGERY CPT GROUP 1,1083.15,704.05,6417.0,7038.0,2
CPT,11047,Outpatient Grouper - 0,1083.15,704.05,9059.94,9827.82,24
CPT,11055,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11055,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11056,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11056,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11057,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11057,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11102,HB BX SKIN TANGENTIAL SIMP CLS SNGL LESION,1562.8,1015.82,247.42,284.53,8
CPT,11102,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11102,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11102,Outpatient Surgical Group 2,1562.8,1015.82,12162.28,18056.43,50
CPT,11103,HB BX SKIN TANGENTIAL SIMP CLS ADDL LESION,442.33,287.51,,,0
CPT,11103,OUTPATIENT SURGERY CPT GROUP 1,442.33,287.51,6417.0,7038.0,2
CPT,11103,Outpatient Grouper - 0,442.33,287.51,9059.94,9827.82,24
CPT,11104,HB BX SKIN PUNCH SIMP CLS SNGL LESION,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,11104,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,11104,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11104,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,11105,HB BX SKIN PUNCH SIMP CLS ADDL LESION,508.29499999999996,330.39,13270.0,14761.0,2
CPT,11105,OUTPATIENT SURGERY CPT GROUP 1,442.33,287.51,6417.0,7038.0,2
CPT,11105,Outpatient Grouper - 0,442.33,287.51,9059.94,9827.82,24
CPT,11106,HB BX SKIN INCISIONAL SIMP CLS SNGL LESION,4641.349999999999,3016.875,762.22,14761.0,10
CPT,11106,OUTPATIENT SURGERY CPT GROUP 1,4035.97,2623.38,6417.0,7038.0,2
CPT,11106,Outpatient Grouper - 1,4035.97,2623.38,10495.38,11385.92,24
CPT,11106,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,11107,HB BX SKIN INCISIONAL SIMP CLS ADDL LESION,442.33,287.51,,,0
CPT,11107,OUTPATIENT SURGERY CPT GROUP 1,442.33,287.51,6417.0,7038.0,2
CPT,11107,Outpatient Grouper - 0,442.33,287.51,9059.94,9827.82,24
CPT,11200,HB RMVL SKIN TAGS UP TO 15,1562.8,1015.82,247.42,284.53,8
CPT,11200,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11200,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11200,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11201,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11201,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11201,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11300,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,11300,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11300,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,11301,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11301,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11301,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11302,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11302,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11302,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11303,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11303,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11303,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11305,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11305,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11305,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11306,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11306,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11306,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11307,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11307,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11307,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11308,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11308,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11308,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11310,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11310,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11310,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11311,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11311,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11311,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11312,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11312,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11312,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11313,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11313,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11313,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11400,"HB EXC, BENIGN DIA 0.5 CM- LESS",5952.47,3869.11,876.1,1007.52,8
CPT,11400,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11400,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11400,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11401,"HB EXC,BENIGN DIA 0.6 TO 1.0",2063.43,1341.23,497.49,572.11,8
CPT,11401,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11401,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,11401,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,11402,"HB EXC, BENIGN DIA 1.1-2.0 CM",5952.47,3869.11,876.1,1007.52,8
CPT,11402,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11402,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11402,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11403,HB EXCISION 2.1 TO 3.0 CM,5952.47,3869.11,876.1,1007.52,8
CPT,11403,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11403,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11403,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11404,"HB EXC,BEN LES,T/A/L;3.1-4.0CM",11474.0,7458.1,2017.5,2320.13,8
CPT,11404,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,11404,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11404,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,11406,HB EXC BEN LESS T/A/L; >4.0CM,11474.0,7458.1,2017.5,2320.13,8
CPT,11406,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,11406,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11406,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,11420,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,11420,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11420,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,11421,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11421,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11421,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11422,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,11422,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11422,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,11423,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,11423,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11423,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11424,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,11424,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11424,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11426,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,11426,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,11426,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,11440,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11440,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11440,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11441,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11441,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11441,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11442,Outpatient Grouper - 1,5636.8,3663.92,10495.38,11385.92,24
CPT,11442,Outpatient Surgery Group 2 Global Rate,5636.8,3663.92,14322.0,15354.0,2
CPT,11442,Outpatient Surgical Group 1,5636.8,3663.92,9088.3,13492.72,50
CPT,11443,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11443,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11443,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11444,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11444,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11444,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11446,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11446,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11446,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11450,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11450,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11450,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11451,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11451,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11451,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11462,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11462,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11462,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11463,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11463,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11463,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11470,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11470,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11470,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11471,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11471,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11471,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11600,HB EXC TR-EXT MAL+MARG 0.5 < CM,5952.47,3869.11,876.1,1007.52,8
CPT,11600,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11600,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11600,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11601,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11601,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11601,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11602,HB EXC MLES T/A/L; 1.1-2.0CM,2063.43,1341.23,497.49,572.11,8
CPT,11602,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,11602,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11602,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,11603,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11603,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11603,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11604,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11604,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11604,Outpatient Surgical Group 2,5952.47,3869.11,12162.28,18056.43,50
CPT,11606,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,11606,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11606,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,11620,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,11620,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11620,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,11621,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11621,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11621,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11622,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11622,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11622,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11623,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,11623,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,11623,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,11624,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,11624,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11624,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11626,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11626,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11626,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11640,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11640,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11640,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11641,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11641,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11641,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11642,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11642,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,11642,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11643,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11643,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11643,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11644,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,11644,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11644,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11646,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,11646,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,11646,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,11719,HB TRIM NONDYSTROPHIC NAILS,1348.33,876.41,13270.0,14761.0,2
CPT,11719,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,11719,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,11720,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11720,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11720,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11721,OUTPATIENT SURGERY CPT GROUP 1,1037.19,674.17,6417.0,7038.0,2
CPT,11721,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,11721,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,11730,HB AVULSION NAIL PLATE; SGL,1797.225,1168.195,247.42,14761.0,18
CPT,11730,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11730,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11730,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11732,OUTPATIENT SURGERY CPT GROUP 1,964.2,626.73,6417.0,7038.0,2
CPT,11732,Outpatient Grouper - 0,964.2,626.73,9059.94,9827.82,24
CPT,11732,Outpatient Surgical Group 1,964.2,626.73,9088.3,13492.72,50
CPT,11740,HB SUBUNGUAL HEMATOMA EVAC,1074.29,698.29,160.5,184.58,8
CPT,11740,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,11740,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,11740,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,11750,HB REMOVAL OF NAIL BED,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,11750,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,11750,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11750,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,11755,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11755,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11755,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11760,HB REPAIR NAIL BED,4641.349999999999,3016.875,762.22,14761.0,10
CPT,11760,OUTPATIENT SURGERY CPT GROUP 1,4035.97,2623.38,6417.0,7038.0,2
CPT,11760,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,11760,Outpatient Surgical Group 1,4035.97,2623.38,9088.3,13492.72,50
CPT,11762,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,11762,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11762,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11765,HB WEDGE EXCISON SKIN NAIL FOLD,2063.43,1341.23,497.49,572.11,16
CPT,11765,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,11765,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,11765,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,11770,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,11770,Outpatient Surgery Group 3 Global Rate,12510.8,8132.02,22055.0,22787.0,2
CPT,11770,Outpatient Surgical Group 3,12510.8,8132.02,13899.75,20635.92,50
CPT,11771,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,11771,Outpatient Surgery Group 3 Global Rate,12510.8,8132.02,22055.0,22787.0,2
CPT,11771,Outpatient Surgical Group 3,12510.8,8132.02,13899.75,20635.92,50
CPT,11772,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11772,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,11772,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,11900,HB INJECTION INTO SKIN LESIONS =<7,1562.8,1015.82,247.42,284.53,8
CPT,11900,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11900,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11900,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11901,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,11901,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,11901,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,11920,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11920,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11920,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11921,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11921,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11921,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11922,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11922,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11922,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11950,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11950,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11950,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11951,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11951,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11951,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11952,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11952,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11952,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11954,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11954,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,11954,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11960,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,11960,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,11960,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,11970,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,11970,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,11970,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,11971,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11971,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,11971,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,11976,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,11976,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,11976,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,11980,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,11980,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,11980,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,11981,HB INSERT DRUG IMPLANT,1074.29,698.29,160.5,184.58,8
CPT,11981,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,11981,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,11982,HB REMOVE DRUG IMPLANT,739.73,480.82,496.88,571.41,8
CPT,11982,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,11982,Outpatient Surgical Group 0,739.73,480.82,2806.68,4166.87,50
CPT,11983,HB REMOVE W INS DRUG IMPLANT,739.73,480.82,496.88,571.41,8
CPT,11983,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,11983,Outpatient Surgical Group 1,739.73,480.82,9088.3,13492.72,50
CPT,12001,HB SIMPLE LAC REPAIR UP TO 2.5 CM,1797.2150000000001,1168.19,247.42,14761.0,20
CPT,12001,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12001,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12001,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12002,HB SIMPLE LAC REPAIR 2.6-7.5 CM,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,12002,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12002,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12002,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12004,HB SIMPLE LAC REPAIR 7.6-12.5 CM,1797.2150000000001,1168.19,247.42,14761.0,18
CPT,12004,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12004,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12004,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12005,HB SIMPLE LAC REPAIR 12.6-20.0 CM SCALP,2063.43,1341.23,497.49,572.11,8
CPT,12005,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12005,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12005,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12006,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12006,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12006,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12007,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12007,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12007,Outpatient Surgical Group 2,1562.8,1015.82,12162.28,18056.43,50
CPT,12011,HB SIMPLE LAC REPAIR UP TO 2.5 CM FACE,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,12011,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12011,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12011,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12013,HB SIMPLE LAC REPAIR 2.6 - 5.0 CM,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,12013,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12013,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12013,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12014,HB SIMPLE LAC REPAIR 5.1 - 7.5 CM,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,12014,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12014,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12014,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12015,HB SIMPLE LAC REPAIR 7.6-12.5 CM FACE,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,12015,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,12015,Outpatient Surgery Group 2 Global Rate,1562.8,1015.82,14322.0,15354.0,2
CPT,12015,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,12016,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12016,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12016,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12017,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,12017,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12017,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,12018,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,12018,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12018,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,12020,HB TX S WND DEHISC; SMPL -,4035.97,2623.38,762.22,876.55,8
CPT,12020,OUTPATIENT SURGERY CPT GROUP 1,4035.97,2623.38,6417.0,7038.0,2
CPT,12020,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,12020,Outpatient Surgical Group 1,4035.97,2623.38,9088.3,13492.72,50
CPT,12021,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,12021,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12021,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12031,HB INTERM LAC REPAIR UP TO 2.5 CM,2372.935,1542.4099999999999,497.49,14761.0,18
CPT,12031,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12031,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12031,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12032,HB INTERM LAC REPAIR 2.6-7.5 CM SCALP,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12032,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12032,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12032,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12034,HB INTERM LAC REPAIR 7.6-12.5 CM,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12034,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12034,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12034,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12035,HB INTERM LAC REPAIR 12.6-20.0 CM,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12035,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12035,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12035,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12036,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,12036,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,12036,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,12037,Outpatient Grouper - 2,18684.1,12144.66,13036.88,14143.2,24
CPT,12037,Outpatient Surgery Group 2 Global Rate,18684.1,12144.66,14322.0,15354.0,2
CPT,12037,Outpatient Surgical Group 2,18684.1,12144.66,12162.28,18056.43,50
CPT,12041,HB INTERM LAC REPAIR UP TO 2.5 CM,2063.43,1341.23,497.49,572.11,8
CPT,12041,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,12041,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12041,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12042,HB INTERM LAC REPAIR 2.6-7.5 CM,2063.43,1341.23,497.49,572.11,8
CPT,12042,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,12042,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12042,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12044,HB INTERM LAC REPAIR 7.6-12.5 CM,5246.73,3410.37,13270.0,14761.0,2
CPT,12044,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,12044,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,12044,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,12045,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,12045,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,12045,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,12046,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,12046,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12046,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,12047,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,12047,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12047,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,12051,HB INTERM LAC REPAIR UP TO 2.5 CM FACE,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12051,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,12051,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12051,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12052,HB INTERM LAC REPAIR 2.6-5.0 CM,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12052,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,12052,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12052,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12053,HB INTERM LAC REPAIR 5.1-7.5 CM,2063.43,1341.23,497.49,572.11,8
CPT,12053,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12053,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12053,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,12054,HB INTERM LAC REPAIR 7.6-12.5 CM,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,12054,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12054,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12054,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12055,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,12055,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,12055,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,12056,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,12056,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12056,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,12057,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,12057,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,12057,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,13100,HB COMPLEX REPAIR 1.1 TO 2.5 CM TRUNK,4641.349999999999,3016.875,762.22,14761.0,10
CPT,13100,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13100,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,13100,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,13101,HB COMPLEX REPAIR 2.6 TO 7.5 CM TRUNK,4035.97,2623.38,762.22,876.55,16
CPT,13101,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13101,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,13101,Outpatient Surgical Group 3,4035.97,2623.38,13899.75,20635.92,50
CPT,13102,HB COMPLEX REPAIR EA ADDL 5CM /< TRUNK,2801.02,1820.66,,,0
CPT,13102,Outpatient Grouper - 0,2801.02,1820.66,9059.94,9827.82,24
CPT,13102,Outpatient Surgical Group 1,2801.02,1820.66,9088.3,13492.72,50
CPT,13120,HB COMPLEX REPAIR 1.1 TO 2.5 CM,5246.73,3410.37,13270.0,14761.0,2
CPT,13120,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13120,Outpatient Surgery Group 2 Global Rate,4035.97,2623.38,14322.0,15354.0,2
CPT,13120,Outpatient Surgical Group 2,4035.97,2623.38,12162.28,18056.43,50
CPT,13121,HB COMPLEX REPAIR 2.6 TO 7.5 CM,4035.97,2623.38,762.22,876.55,8
CPT,13121,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13121,Outpatient Surgery Group 3 Global Rate,4035.97,2623.38,22055.0,22787.0,2
CPT,13121,Outpatient Surgical Group 3,4035.97,2623.38,13899.75,20635.92,50
CPT,13122,HB CMPLX RPR HEAD/EXTR @ADD 5CM,8738.51,5680.03,,,0
CPT,13122,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,13122,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,13122,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,13131,HB COMPLEX REPAIR 1.1 TO 2.5 CM FOREHEAD,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,13131,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,13131,Outpatient Surgery Group 2 Global Rate,2063.43,1341.23,14322.0,15354.0,2
CPT,13131,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,13132,HB COMPLEX REPAIR 2.6 TO 7.5 CM FOREHEAD,4641.349999999999,3016.875,762.22,14761.0,10
CPT,13132,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13132,Outpatient Surgery Group 3 Global Rate,4035.97,2623.38,22055.0,22787.0,2
CPT,13132,Outpatient Surgical Group 3,4035.97,2623.38,13899.75,20635.92,50
CPT,13133,HB CMPLX RPR FACE/HANDS @ADD 5CM,8738.51,5680.03,,,0
CPT,13133,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,13133,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,13133,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,13151,HB COMPLEX REPAIR 1.1 TO 2.5 CM EYE,4641.349999999999,3016.875,762.22,14761.0,18
CPT,13151,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13151,Outpatient Surgery Group 3 Global Rate,4035.97,2623.38,22055.0,22787.0,2
CPT,13151,Outpatient Surgical Group 3,4035.97,2623.38,13899.75,20635.92,50
CPT,13152,HB COMPLEX REPAIR 2.6 TO 7.5 CM EYELID,4035.97,2623.38,762.22,876.55,8
CPT,13152,Outpatient Grouper - 0,4035.97,2623.38,9059.94,9827.82,24
CPT,13152,Outpatient Surgery Group 3 Global Rate,4035.97,2623.38,22055.0,22787.0,2
CPT,13152,Outpatient Surgical Group 3,4035.97,2623.38,13899.75,20635.92,50
CPT,13153,HB CMPLX RPR EYELID @ADD 5CM,8738.51,5680.03,,,0
CPT,13153,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,13153,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,13153,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,13160,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,13160,Outpatient Surgery Group 2 Global Rate,7948.54,5166.55,14322.0,15354.0,2
CPT,13160,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,14000,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14000,Outpatient Surgery Group 2 Global Rate,7948.54,5166.55,14322.0,15354.0,2
CPT,14000,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,14001,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14001,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,14001,Outpatient Surgical Group 3,7948.54,5166.55,13899.75,20635.92,50
CPT,14020,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14020,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,14020,Outpatient Surgical Group 3,7948.54,5166.55,13899.75,20635.92,50
CPT,14021,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14021,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,14021,Outpatient Surgical Group 3,7948.54,5166.55,13899.75,20635.92,50
CPT,14040,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14040,Outpatient Surgery Group 2 Global Rate,7948.54,5166.55,14322.0,15354.0,2
CPT,14040,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,14041,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,14041,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,14041,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,14060,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14060,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,14060,Outpatient Surgical Group 3,7948.54,5166.55,13899.75,20635.92,50
CPT,14061,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,14061,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,14061,Outpatient Surgical Group 3,7948.54,5166.55,13899.75,20635.92,50
CPT,14301,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,14301,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,14301,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,14302,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,14302,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,14302,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,14350,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,14350,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,14350,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15002,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15002,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15002,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15003,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15003,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15003,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15004,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15004,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15004,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15005,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15005,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15040,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15040,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15040,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15050,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15050,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15050,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15101,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15101,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15101,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15111,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15111,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15111,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15115,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15115,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15115,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15116,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15116,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15116,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15121,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15121,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15121,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15130,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15130,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15131,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15131,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15131,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15135,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15135,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15135,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15136,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15136,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15136,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15150,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15150,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15150,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15151,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15151,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15151,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15152,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15152,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15152,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15155,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15155,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15155,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15156,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15156,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15156,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15157,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15157,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15157,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15200,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15200,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15200,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15201,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15201,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15201,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15220,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15220,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15220,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15221,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15221,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15221,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15240,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15240,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15240,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15241,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15241,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15241,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15260,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15260,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15260,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15261,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15261,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15261,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15271,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15271,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15271,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15272,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15272,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15272,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15273,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15273,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15273,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15274,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15274,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15274,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15275,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15275,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15276,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15276,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15276,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15277,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15277,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15277,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15278,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15278,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15278,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15570,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15570,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15570,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15572,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15572,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15572,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15574,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15574,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15574,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15576,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15576,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15576,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15600,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15600,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15600,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15610,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15610,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15610,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15620,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15620,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15620,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15630,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15630,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15630,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15650,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15650,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,15650,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15730,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15730,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15730,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15731,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15731,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15731,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15733,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15733,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15733,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15734,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15734,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15734,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15736,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15736,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15736,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15738,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15738,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15738,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15740,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15740,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15750,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15750,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15750,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15756,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15756,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,15756,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15757,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15757,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,15757,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15758,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15758,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,15758,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15760,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15760,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15769,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15769,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15769,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,15770,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15770,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15770,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15771,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15771,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15771,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,15772,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15772,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15773,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15773,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15773,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15774,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15774,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15775,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15775,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15775,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15776,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15776,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15776,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15777,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15777,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15778,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,15778,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,15778,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15780,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15780,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15780,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15781,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15781,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,15781,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15782,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15782,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,15782,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15783,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15783,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15783,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15786,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15786,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15786,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15787,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15787,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15787,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15788,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15788,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15789,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15789,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15792,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,15792,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15793,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15793,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,15819,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15819,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15819,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15820,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15820,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15820,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15821,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15821,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15821,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15822,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15822,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15822,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15823,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15823,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15823,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15824,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15824,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15824,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15825,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15825,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15825,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15826,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15826,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15826,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15828,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15828,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15828,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15829,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15829,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15829,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,15830,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,15830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15830,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15832,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15832,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15832,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15833,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15833,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15833,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15834,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15834,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15834,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15835,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15835,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15835,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15836,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15836,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15836,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15837,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15837,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15837,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15838,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15838,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15838,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15839,Outpatient Grouper - 2,12510.8,8132.02,13036.88,14143.2,24
CPT,15839,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,15839,Outpatient Surgical Group 1,12510.8,8132.02,9088.3,13492.72,50
CPT,15840,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15840,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15840,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15841,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15841,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15841,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15842,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15842,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15842,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,15845,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15845,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15845,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15847,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15847,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15850,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15851,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15851,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15851,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15852,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15852,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15852,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15853,Ambulatory Surgery: Default Rate,368.04,239.23,,,0
CPT,15853,HB REMOVAL SUTURES OR STAPLES,4553.275000000001,2959.6299999999997,,,0
CPT,15853,Outpatient Grouper - 0,368.04,239.23,9059.94,9827.82,24
CPT,15854,Ambulatory Surgery: Default Rate,368.04,239.23,,,0
CPT,15854,HB REMOVAL SUTURES AND STAPLES,368.04,239.23,,,0
CPT,15854,Outpatient Grouper - 0,368.04,239.23,9059.94,9827.82,24
CPT,15860,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,15860,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,15860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,15876,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15876,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15876,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15877,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15877,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15877,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15878,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15878,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15878,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15879,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15879,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15879,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15920,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15920,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15920,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15922,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15922,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15922,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15931,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15931,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15931,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15933,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15933,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15933,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15934,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15934,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15934,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15935,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15935,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15935,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15936,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15936,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15936,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15937,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15937,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15937,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15940,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15940,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,15940,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15941,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15941,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15941,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15944,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15944,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15944,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15945,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15945,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15945,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15946,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15946,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15946,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15950,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15950,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15950,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15951,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15951,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15951,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15952,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,15952,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15952,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15953,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15953,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15953,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15956,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,15956,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,15956,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,15958,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,15958,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,15958,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,15999,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,15999,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,16000,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,16000,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,16000,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,16020,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,16020,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,16020,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,16025,HB BURN DRESSING MEDIUM,1562.8,1015.82,247.42,284.53,8
CPT,16025,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,16025,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,16025,Outpatient Surgical Group 2,1562.8,1015.82,12162.28,18056.43,50
CPT,16030,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,16030,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,16030,Outpatient Surgical Group 2,2063.43,1341.23,12162.28,18056.43,50
CPT,16035,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,16035,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,16035,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,16036,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,16036,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,16036,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17000,HB DESTRUCT BENIGN NONFACE 1ST LE,1562.8,1015.82,247.42,284.53,8
CPT,17000,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,17000,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,17000,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,17003,HB DESTRUCT PREMALIG LES 2-14,1673.3,1087.64,,,0
CPT,17003,OUTPATIENT SURGERY CPT GROUP 1,1673.3,1087.64,6417.0,7038.0,2
CPT,17003,Outpatient Grouper - 0,1673.3,1087.64,9059.94,9827.82,24
CPT,17003,Outpatient Surgical Group 0,1673.3,1087.64,2806.68,4166.87,50
CPT,17004,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,17004,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,17004,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,17106,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17106,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17106,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17107,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17107,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17107,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17108,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17108,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,17108,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17110,HB DESTRUCTION BENIGN LESIONS 1-14,1562.8,1015.82,247.42,284.53,8
CPT,17110,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,17110,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,17110,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,17111,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17111,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17111,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17250,HB CHEMICAL CAUTERIZATION/TISSUE,1562.8,1015.82,247.42,284.53,8
CPT,17250,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,17250,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,17250,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,17260,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17260,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17260,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17261,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17261,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17261,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17262,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17262,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17262,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17263,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17263,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17263,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17264,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17264,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17264,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17266,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17266,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17266,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17270,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17270,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17270,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17271,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17271,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17271,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17272,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17272,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17272,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17273,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17273,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17273,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17274,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17274,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17274,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17276,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17276,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17276,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17280,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17280,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17280,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17281,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17281,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17281,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17282,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17282,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17282,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17283,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17283,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17283,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17284,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17284,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17284,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17286,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17286,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17286,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17311,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17311,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17312,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17312,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17313,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17313,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17313,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17314,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17314,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17314,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17315,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,17315,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17315,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,17340,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17340,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17360,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17360,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17380,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17380,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,17999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,17999,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,19000,HB ASPIRATION BREAST CYST,6845.335,4449.47,876.1,14761.0,18
CPT,19000,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,19000,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,19000,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,19001,HB ASPIRATION BREAST CYST ADDL,1787.44,1161.84,13270.0,14761.0,2
CPT,19001,OUTPATIENT SURGERY CPT GROUP 1,1787.44,1161.84,6417.0,7038.0,2
CPT,19001,Outpatient Grouper - 0,1787.44,1161.84,9059.94,9827.82,24
CPT,19001,Outpatient Surgical Group 0,1787.44,1161.84,2806.68,4166.87,50
CPT,19020,Outpatient Grouper - 3,11474.0,7458.1,14341.63,15558.59,24
CPT,19020,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,19020,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,19030,OUTPATIENT SURGERY CPT GROUP 1,2517.76,1636.54,6417.0,7038.0,2
CPT,19030,Outpatient Grouper - 0,2517.76,1636.54,9059.94,9827.82,24
CPT,19081,HB BIOPSY BREAST W MAM PRIM,11474.0,7458.1,2017.5,2320.13,8
CPT,19081,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,19081,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,19081,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,19082,HB BIOPSY BREAST W MAM EA ADDL,10648.9,6921.78,,,0
CPT,19082,Outpatient Grouper - 0,10648.9,6921.78,9059.94,9827.82,24
CPT,19082,Outpatient Surgery Group 2 Global Rate,10648.9,6921.78,14322.0,15354.0,2
CPT,19083,HB BIOPSY BREAST W US PRIM,13195.1,8576.815,2017.5,14761.0,10
CPT,19083,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,19083,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,19083,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,19084,HB BIOPSY BREAST W US EA ADDL,9503.03,6176.969999999999,13270.0,14761.0,2
CPT,19084,Outpatient Grouper - 0,8263.52,5371.29,9059.94,9827.82,24
CPT,19084,Outpatient Surgery Group 2 Global Rate,8263.52,5371.29,14322.0,15354.0,2
CPT,19085,HB BIOPSY BREAST W MRI PRIM,11474.0,7458.1,2017.5,2320.13,8
CPT,19085,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,19085,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,19085,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,19086,HB BIOPSY BREAST W MRI EA ADDL,10798.0,7018.7,,,0
CPT,19086,Outpatient Grouper - 0,10798.0,7018.7,9059.94,9827.82,24
CPT,19086,Outpatient Surgery Group 2 Global Rate,10798.0,7018.7,14322.0,15354.0,2
CPT,19100,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,19100,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,19100,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,19101,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19101,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19101,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,19105,OUTPATIENT SURGERY CPT GROUP 1,18491.3,12019.34,6417.0,7038.0,2
CPT,19105,Outpatient Grouper - 4,18491.3,12019.34,19724.25,21397.98,24
CPT,19105,Outpatient Surgical Group 1,18491.3,12019.34,9088.3,13492.72,50
CPT,19110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,19112,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19112,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,19112,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19120,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,19120,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19125,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19125,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,19125,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19126,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,19126,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19126,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19281,HB LOC BREAST DEV W MAM PRIM,5952.47,3869.11,2017.5,2320.13,8
CPT,19281,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,19281,Outpatient Grouper - 2,5952.47,3869.11,13036.88,14143.2,24
CPT,19282,HB LOC BREAST DEV W MAM EA ADL,4001.35,2600.88,,,0
CPT,19282,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,19282,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,19283,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,19283,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,19284,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,19284,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,19285,HB LOC BREAST DEV W US PRIM,6845.335,4449.47,876.1,14761.0,10
CPT,19285,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,19285,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,19286,HB LOC BREAST DEV W US EA ADDL,4001.35,2600.88,,,0
CPT,19286,OUTPATIENT SURGERY CPT GROUP 1,4001.35,2600.88,6417.0,7038.0,2
CPT,19286,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,19287,HB LOC BREAST DEV W MRI PRIM,5952.47,3869.11,876.1,1007.52,8
CPT,19287,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,19287,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,19288,Outpatient Grouper - 0,4001.35,2600.88,9059.94,9827.82,24
CPT,19288,Outpatient Surgery Group 2 Global Rate,4001.35,2600.88,14322.0,15354.0,2
CPT,19294,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,19294,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,19294,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,19296,"HB PLACEMENT, CATH RADIOELEMENT",30443.3,19788.15,11915.27,13702.56,8
CPT,19296,OUTPATIENT SURGERY CPT GROUP 1,30443.3,19788.15,6417.0,7038.0,2
CPT,19296,Outpatient Grouper - 6,30443.3,19788.15,28632.25,34209.93,24
CPT,19296,Outpatient Surgical Group 9,30443.3,19788.15,36513.58,54208.97,50
CPT,19297,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,19297,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,19297,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,19298,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,19298,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19298,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,19300,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19300,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19300,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19301,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19301,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,19301,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19302,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19302,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19302,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,19303,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19303,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19303,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,19305,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19306,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,19306,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19307,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19307,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19316,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19316,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19316,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19318,Outpatient Grouper - 5,17527.3,11392.75,25486.19,27649.53,24
CPT,19318,Outpatient Surgery Group 5 Global Rate,17527.3,11392.75,32992.0,34883.0,2
CPT,19318,Outpatient Surgical Group 4,17527.3,11392.75,17187.58,25517.11,50
CPT,19324,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19325,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,19325,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19325,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,19328,OUTPATIENT SURGERY CPT GROUP 1,18491.3,12019.34,6417.0,7038.0,2
CPT,19328,Outpatient Grouper - 4,18491.3,12019.34,19724.25,21397.98,24
CPT,19328,Outpatient Surgical Group 1,18491.3,12019.34,9088.3,13492.72,50
CPT,19330,OUTPATIENT SURGERY CPT GROUP 1,17527.3,11392.75,6417.0,7038.0,2
CPT,19330,Outpatient Grouper - 4,17527.3,11392.75,19724.25,21397.98,24
CPT,19330,Outpatient Surgical Group 1,17527.3,11392.75,9088.3,13492.72,50
CPT,19340,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19340,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19340,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,19342,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,19342,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19342,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19350,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,19350,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19350,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19355,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19355,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19355,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19357,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,19357,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19357,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,19361,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,19361,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19361,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,19364,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19364,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19364,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,19366,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19367,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19367,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19367,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,19368,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19368,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19368,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19369,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19369,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19369,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19370,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19370,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,19370,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19371,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19371,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,19371,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,19380,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,19380,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,19380,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,19396,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,19396,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,19396,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,19499,Outpatient Grouper - 3,18491.3,12019.34,14341.63,15558.59,24
CPT,19499,Outpatient Surgical Group 2,18491.3,12019.34,12162.28,18056.43,50
CPT,20100,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,20100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20101,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,20101,Outpatient Surgery Group 4 Global Rate,7948.54,5166.55,26623.0,28144.0,2
CPT,20101,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,20102,HB EXPL PNTRTNG WND;ABD/FLNK,10333.08,6716.5,13270.0,14761.0,2
CPT,20102,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,20102,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,20102,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,20103,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,20103,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,20103,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,20150,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,20150,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20150,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,20200,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,20200,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,20200,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,20205,Outpatient Grouper - 2,12510.8,8132.02,13036.88,14143.2,24
CPT,20205,Outpatient Surgery Group 3 Global Rate,12510.8,8132.02,22055.0,22787.0,2
CPT,20205,Outpatient Surgical Group 3,12510.8,8132.02,13899.75,20635.92,50
CPT,20206,HB BIOPSY MUSCLE PERC NEEDLE,13195.1,8576.815,2017.5,14761.0,10
CPT,20206,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,20206,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,20220,HB BIOPSY BONE SUPERFICIAL,13195.1,8576.815,2017.5,14761.0,10
CPT,20220,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,20220,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,20225,HB BIOPSY BONE DEEP,15834.105,10292.17,2017.5,14761.0,10
CPT,20225,Outpatient Grouper - 2,13768.8,8949.72,13036.88,14143.2,24
CPT,20225,Outpatient Surgery Group 2 Global Rate,13768.8,8949.72,14322.0,15354.0,2
CPT,20225,Outpatient Surgical Group 2,13768.8,8949.72,12162.28,18056.43,50
CPT,20240,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20240,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,20240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,20245,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20245,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20245,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20250,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20250,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20250,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20251,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20251,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20251,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20500,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,20500,Outpatient Surgical Group 0,6745.34,4384.47,2806.68,4166.87,50
CPT,20501,"HB SINUS INJECTION, DIAGNOSTIC",2309.26,1501.02,13270.0,14761.0,2
CPT,20501,Outpatient Grouper - 0,2008.04,1305.23,9059.94,9827.82,24
CPT,20520,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,194.82,224.05,8
CPT,20520,HB REMOVE FB MUSCLE SIMPLE,11474.0,7458.1,2017.5,2320.13,8
CPT,20520,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,20520,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,20525,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,13270.0,14761.0,2
CPT,20525,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20525,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,20525,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20526,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,20526,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20526,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20527,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,20527,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20527,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20550,HB INJ SING TENDON SHEATH/LIG,2415.58,1570.13,367.57,14761.0,10
CPT,20550,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,20550,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20550,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20551,HB INJ TENDON ORIGIN/INSERT,2100.52,1365.34,367.57,422.7,8
CPT,20551,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,20551,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20551,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20552,HB CHRONIC PAIN CNTR PROCEDURES 1,1953.82,1269.98,367.57,422.7,8
CPT,20552,HB MUSCLE TRIGGER PT INJ 1-2,2415.58,1570.13,367.57,14761.0,20
CPT,20552,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,20552,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20552,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20553,HB TRIGGER PT INJ >3 MUSCLES,2520.61,1638.4,367.57,422.7,8
CPT,20553,OUTPATIENT SURGERY CPT GROUP 1,2520.61,1638.4,6417.0,7038.0,2
CPT,20553,Outpatient Grouper - 0,2520.61,1638.4,9059.94,9827.82,24
CPT,20553,Outpatient Surgical Group 0,2520.61,1638.4,2806.68,4166.87,50
CPT,20555,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20555,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20555,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20560,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20560,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,20561,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20561,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,20600,HB DRAIN/INJ SMALL JOINT/BURSA WO US,2415.585,1570.13,367.57,14761.0,10
CPT,20600,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20600,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20604,HB DRAIN/INJ SMALL JOINT/BURSA W/US,2705.45,1758.54,367.57,14761.0,10
CPT,20604,OUTPATIENT SURGERY CPT GROUP 1,2352.56,1529.16,6417.0,7038.0,2
CPT,20604,Outpatient Grouper - 0,2352.56,1529.16,9059.94,9827.82,24
CPT,20604,Outpatient Surgical Group 0,2352.56,1529.16,2806.68,4166.87,50
CPT,20605,HB DRAIN/INJ INTERM JOINT/BURSA WO US,2898.695,1884.155,367.57,14761.0,18
CPT,20605,Outpatient Grouper - 0,2520.61,1638.4,9059.94,9827.82,24
CPT,20605,Outpatient Surgery Group 2 Global Rate,2520.61,1638.4,14322.0,15354.0,2
CPT,20605,Outpatient Surgical Group 0,2520.61,1638.4,2806.68,4166.87,50
CPT,20606,HB DRAIN/INJ INTERM JOINT/BURSA W/US,3134.23,2037.25,862.32,14761.0,18
CPT,20606,Outpatient Grouper - 1,2725.42,1771.52,10495.38,11385.92,24
CPT,20606,Outpatient Surgery Group 2 Global Rate,2725.42,1771.52,14322.0,15354.0,2
CPT,20606,Outpatient Surgical Group 0,2725.42,1771.52,2806.68,4166.87,50
CPT,20610,HB DRAIN/INJ MAJOR JOINT/BURSA WO US,3335.35,2167.975,367.57,14761.0,18
CPT,20610,Outpatient Grouper - 0,2900.31,1885.2,9059.94,9827.82,24
CPT,20610,Outpatient Surgery Group 3 Global Rate,2900.31,1885.2,22055.0,22787.0,2
CPT,20610,Outpatient Surgical Group 0,2900.31,1885.2,2806.68,4166.87,50
CPT,20611,HB DRAIN/INJ MAJOR JOINT/BURSA W/US,3521.1549999999997,2288.755,367.57,14761.0,18
CPT,20611,Outpatient Grouper - 0,3061.87,1990.22,9059.94,9827.82,24
CPT,20611,Outpatient Surgery Group 3 Global Rate,3061.87,1990.22,22055.0,22787.0,2
CPT,20611,Outpatient Surgical Group 0,3061.87,1990.22,2806.68,4166.87,50
CPT,20612,HB ASPIR/INJECT GANGLION CYST(S),2100.52,1365.34,367.57,422.7,8
CPT,20612,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,20612,Outpatient Surgery Group 2 Global Rate,2100.52,1365.34,14322.0,15354.0,2
CPT,20612,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,20615,HB ASPIR/INJECT BONE CYST,5952.47,3869.11,876.1,1007.52,8
CPT,20615,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,20615,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,20615,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,20650,HB INSERT AND REMOVE BONE PIN,14957.369999999999,9722.289999999999,4040.15,14761.0,10
CPT,20650,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20650,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20650,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20660,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,20660,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,20660,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,20661,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20661,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20661,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20662,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20662,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20662,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20663,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20663,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20663,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20664,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,20664,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,20664,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20665,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20665,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20665,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20670,HB REMOVAL OF SUPPORT IMPLANT,13195.1,8576.815,2017.5,14761.0,10
CPT,20670,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,20670,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,20670,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,20680,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20680,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20680,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20690,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20690,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,20690,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,20692,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20692,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20692,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20693,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20693,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20693,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20694,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20694,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,20694,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20696,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20696,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20696,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20697,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,20697,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20697,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,20700,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20701,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20702,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20703,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20704,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20705,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20802,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,20802,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,20802,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,20805,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,20805,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,20805,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20808,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,20808,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,20808,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20816,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20816,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,20816,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20822,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20822,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,20822,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20824,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20824,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,20824,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20827,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20827,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20827,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,20838,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,20838,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,20838,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,20900,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20900,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20900,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20902,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20902,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20902,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,20910,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20910,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20910,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20912,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20912,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20912,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20920,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,20920,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20920,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,20922,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,20922,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20922,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,20924,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20924,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,20924,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,20930,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20931,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20931,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20932,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20932,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,20933,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20933,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,20934,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20934,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,20936,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20936,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20937,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20937,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20937,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20938,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20938,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,20938,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20939,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,20939,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20939,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,20950,Outpatient Grouper - 1,8930.94,5805.11,10495.38,11385.92,24
CPT,20950,Outpatient Surgical Group 0,8930.94,5805.11,2806.68,4166.87,50
CPT,20955,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,20955,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20955,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,20956,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20956,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20956,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,20957,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20957,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20957,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,20962,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,20962,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20962,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,20969,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,20969,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20969,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,20970,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,20970,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20970,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,20972,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20972,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20972,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,20973,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,20973,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,20973,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,20974,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20974,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,20975,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20975,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,20979,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20979,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,20982,HB ABLATION R/F BONE,113260.51,73619.33,13270.0,18424.85,10
CPT,20982,Outpatient Grouper - 5,98487.4,64016.81,25486.19,27649.53,24
CPT,20982,Outpatient Surgery Group 2 Global Rate,98487.4,64016.81,14322.0,15354.0,2
CPT,20982,Outpatient Surgical Group 7,98487.4,64016.81,27131.25,40279.73,50
CPT,20983,HB ABLATION CRYO BONE,38758.7,25193.15,8895.29,14761.0,10
CPT,20983,Outpatient Grouper - 6,38758.7,25193.15,28632.25,34209.93,24
CPT,20983,Outpatient Surgery Group 2 Global Rate,38758.7,25193.15,14322.0,15354.0,2
CPT,20983,Outpatient Surgical Group 7,38758.7,25193.15,27131.25,40279.73,50
CPT,20985,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,20999,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,20999,Outpatient Surgical Group 3,2224.9,1446.19,13899.75,20635.92,50
CPT,21010,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21010,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21010,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21011,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,21011,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,21011,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,21012,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,21012,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21012,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21013,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,21013,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,21013,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21014,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,21014,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21014,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21015,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21015,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21015,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21016,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21016,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21016,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21025,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21025,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21025,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21026,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21026,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21026,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21029,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21029,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21029,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21030,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21030,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21030,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21031,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21031,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21031,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21032,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21032,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21032,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21034,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21034,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21034,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21040,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21040,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21040,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21044,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21044,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21044,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21045,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21045,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21045,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21046,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21046,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21046,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21047,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21047,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21047,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21048,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21048,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21048,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21049,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21049,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21049,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21050,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21050,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21050,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21060,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21060,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21060,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21070,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21070,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21070,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21073,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,21073,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21073,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21076,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21076,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21076,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21077,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21077,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21077,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21079,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21079,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21079,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21080,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21080,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21080,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21081,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21081,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21081,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21082,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21082,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21082,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21083,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21083,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21083,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21084,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21084,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21084,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21085,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21085,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21085,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21086,Outpatient Grouper - 5,12101.2,7865.78,25486.19,27649.53,24
CPT,21086,Outpatient Surgery Group 2 Global Rate,12101.2,7865.78,14322.0,15354.0,2
CPT,21086,Outpatient Surgical Group 7,12101.2,7865.78,27131.25,40279.73,50
CPT,21087,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21087,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21087,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21088,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21088,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21088,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21089,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21089,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21100,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21116,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,21116,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21120,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21121,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21121,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21121,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21122,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21122,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21122,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21123,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21123,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21123,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21125,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21125,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21125,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21127,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21127,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21127,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,21137,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21137,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21137,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21138,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21138,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21138,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21139,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21139,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21139,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21141,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21141,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21142,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21142,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21142,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21143,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21143,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21143,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21145,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21145,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21145,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21146,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21146,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21146,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21147,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21147,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21147,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21150,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21150,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21150,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21151,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21151,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21151,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21154,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21154,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21154,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21155,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21155,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21155,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21159,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21159,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21159,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21160,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21160,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21160,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21172,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21172,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21172,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21175,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21175,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21175,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21179,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21179,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21179,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21180,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21180,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21180,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21181,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21181,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21181,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21182,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21182,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21182,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21183,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21183,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21183,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21184,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21184,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21184,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21188,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21188,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21188,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21193,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21193,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21193,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21194,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21194,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21194,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21195,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21195,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21195,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21196,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21196,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21196,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21198,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21198,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21198,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21199,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21199,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21199,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21206,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21206,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21206,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21208,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21208,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21208,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21209,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21209,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21209,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21210,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21210,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21210,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21215,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21215,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21215,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21230,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21230,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21230,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21235,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21235,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21235,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21240,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21240,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21240,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21242,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21242,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21242,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21243,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21243,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21243,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21244,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21244,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21244,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21245,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21245,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21245,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21246,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21246,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21246,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21247,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21247,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21247,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21248,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21248,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21248,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21249,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21249,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21249,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21255,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21255,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21255,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21256,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21256,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21256,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21260,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21260,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21260,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21261,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21261,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21261,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21263,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21263,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21263,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21267,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21267,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21267,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21268,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21268,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21268,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21270,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21270,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21270,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21275,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21275,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21275,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21280,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21280,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21282,Outpatient Grouper - 2,12101.2,7865.78,13036.88,14143.2,24
CPT,21282,Outpatient Surgery Group 4 Global Rate,12101.2,7865.78,26623.0,28144.0,2
CPT,21282,Outpatient Surgical Group 5,12101.2,7865.78,19539.84,29009.34,50
CPT,21295,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21295,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21295,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21296,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21296,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21296,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21299,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21299,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21310,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21315,HB CL TX NASAL BONE FX W/ MANIP W/O STAB,6745.34,4384.47,1844.47,2121.14,8
CPT,21315,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,21315,Outpatient Surgery Group 2 Global Rate,6745.34,4384.47,14322.0,15354.0,2
CPT,21315,Outpatient Surgical Group 2,6745.34,4384.47,12162.28,18056.43,50
CPT,21320,Outpatient Grouper - 2,12101.2,7865.78,13036.88,14143.2,24
CPT,21320,Outpatient Surgery Group 2 Global Rate,12101.2,7865.78,14322.0,15354.0,2
CPT,21320,Outpatient Surgical Group 2,12101.2,7865.78,12162.28,18056.43,50
CPT,21325,Outpatient Grouper - 3,12101.2,7865.78,14341.63,15558.59,24
CPT,21325,Outpatient Surgery Group 4 Global Rate,12101.2,7865.78,26623.0,28144.0,2
CPT,21325,Outpatient Surgical Group 4,12101.2,7865.78,17187.58,25517.11,50
CPT,21330,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21330,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21330,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21335,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21335,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21335,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21336,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21336,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21336,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21337,Outpatient Grouper - 2,12101.2,7865.78,13036.88,14143.2,24
CPT,21337,Outpatient Surgery Group 2 Global Rate,12101.2,7865.78,14322.0,15354.0,2
CPT,21337,Outpatient Surgical Group 2,12101.2,7865.78,12162.28,18056.43,50
CPT,21338,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21338,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21338,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21339,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21339,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21339,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21340,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21340,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21340,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21343,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21343,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21343,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21344,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21344,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21344,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21345,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,21345,Outpatient Surgery Group 3 Global Rate,6745.34,4384.47,22055.0,22787.0,2
CPT,21345,Outpatient Surgical Group 7,6745.34,4384.47,27131.25,40279.73,50
CPT,21346,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21346,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21346,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21347,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21347,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21347,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21348,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21348,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21348,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21355,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21355,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21355,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21356,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21356,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21356,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21360,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21360,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21360,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21365,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21365,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21365,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21366,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21366,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21366,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21385,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21385,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21385,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21386,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21386,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21386,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21387,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21387,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21387,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21390,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21390,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21390,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21395,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21395,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21395,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21400,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,21400,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,21400,Outpatient Surgical Group 2,2956.96,1922.02,12162.28,18056.43,50
CPT,21401,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,21401,Outpatient Surgery Group 2 Global Rate,6745.34,4384.47,14322.0,15354.0,2
CPT,21401,Outpatient Surgical Group 3,6745.34,4384.47,13899.75,20635.92,50
CPT,21406,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21406,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21406,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21407,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21407,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21407,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21408,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21408,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21408,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21421,Outpatient Grouper - 3,12101.2,7865.78,14341.63,15558.59,24
CPT,21421,Outpatient Surgery Group 4 Global Rate,12101.2,7865.78,26623.0,28144.0,2
CPT,21421,Outpatient Surgical Group 4,12101.2,7865.78,17187.58,25517.11,50
CPT,21422,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21422,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21422,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21423,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21423,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21423,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21431,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21431,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21431,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21432,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21432,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21432,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21433,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21433,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21433,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21435,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21435,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21435,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21436,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21436,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21436,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21440,Outpatient Grouper - 3,12101.2,7865.78,14341.63,15558.59,24
CPT,21440,Outpatient Surgery Group 3 Global Rate,12101.2,7865.78,22055.0,22787.0,2
CPT,21440,Outpatient Surgical Group 3,12101.2,7865.78,13899.75,20635.92,50
CPT,21445,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21445,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21445,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21450,HB CLOSED TX MANDIBLAR FX WO MANI,2956.96,1922.02,634.11,729.23,8
CPT,21450,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,21450,Outpatient Surgery Group 3 Global Rate,2956.96,1922.02,22055.0,22787.0,2
CPT,21450,Outpatient Surgical Group 3,2956.96,1922.02,13899.75,20635.92,50
CPT,21451,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,21451,Outpatient Surgery Group 4 Global Rate,6745.34,4384.47,26623.0,28144.0,2
CPT,21451,Outpatient Surgical Group 4,6745.34,4384.47,17187.58,25517.11,50
CPT,21452,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21452,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21452,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21453,Outpatient Grouper - 5,22997.3,14948.25,25486.19,27649.53,24
CPT,21453,Outpatient Surgery Group 3 Global Rate,22997.3,14948.25,22055.0,22787.0,2
CPT,21453,Outpatient Surgical Group 3,22997.3,14948.25,13899.75,20635.92,50
CPT,21454,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21454,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21454,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21461,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21461,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21461,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21462,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21462,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21462,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,21465,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21465,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21465,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,21470,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21470,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21470,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21480,HB TM JOINT DISLOCATION,2224.9,1446.19,298.7,343.5,8
CPT,21480,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,21480,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,21480,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,21485,HB CL TX TMJ DISLOCATION; COMPLIC,6745.34,4384.47,1844.47,2121.14,8
CPT,21485,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,21485,Outpatient Surgery Group 2 Global Rate,6745.34,4384.47,14322.0,15354.0,2
CPT,21485,Outpatient Surgical Group 2,6745.34,4384.47,12162.28,18056.43,50
CPT,21490,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21490,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21490,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21497,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21497,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21497,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21499,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21499,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21501,HB I&D DEEP ABSC SFT TISS NK/THOR,12510.8,8132.02,3563.79,4098.36,16
CPT,21501,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,21501,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,21501,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,21502,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21502,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21502,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21510,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21510,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21550,HB BIOPSY NECK/THORAX SFT TISS,13195.1,8576.815,2017.5,14761.0,10
CPT,21550,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,21550,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,21550,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,21552,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,21552,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,21552,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,21554,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21554,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21554,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21555,HB EXC NECK LES SC < 3 CM,11474.0,7458.1,2017.5,2320.13,8
CPT,21555,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,21555,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,21555,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,21556,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21556,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21556,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21557,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21557,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21557,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21558,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21558,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21558,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21600,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,21600,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21600,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21601,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21601,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21601,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,21602,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21602,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21602,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,21603,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21603,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21603,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,21610,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,21610,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21610,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21615,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21615,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21615,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21616,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21616,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21616,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21620,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21620,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21627,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21627,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21627,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21630,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21630,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21630,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21632,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21632,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21632,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21685,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21685,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21685,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21700,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21700,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21705,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21705,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21705,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21720,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21720,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21720,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21725,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,21725,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21725,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21740,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21740,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21742,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21742,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,21742,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21743,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,21743,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,21743,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,21750,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21750,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,21750,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21811,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21811,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21811,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21812,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21812,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21812,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21813,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21813,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21813,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21820,HB CL TX STERNUM FX,2558.645,1663.12,298.7,14761.0,10
CPT,21820,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,21820,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,21820,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,21825,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,21825,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,21825,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,21899,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,21920,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,21920,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,21920,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,21925,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21925,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21925,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,21930,HB EXC BACK LESS SC < 3 CM,11474.0,7458.1,2017.5,2320.13,8
CPT,21930,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,21930,Outpatient Surgery Group 3 Global Rate,11474.0,7458.1,22055.0,22787.0,2
CPT,21930,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,21931,Outpatient Grouper - 3,11474.0,7458.1,14341.63,15558.59,24
CPT,21931,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,21931,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,21932,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21932,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21932,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21933,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21933,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,21933,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21935,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,21935,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21935,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,21936,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,21936,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,21936,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22010,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22010,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22015,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22015,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22100,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22100,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22100,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22101,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22101,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22101,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22102,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22102,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22102,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22103,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22103,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22103,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22110,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22110,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22112,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22112,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22112,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22114,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22114,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22114,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22116,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22116,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22116,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22206,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22206,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22207,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22207,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22208,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22208,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22210,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22210,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22210,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22212,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22212,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22212,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22214,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22214,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22214,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22216,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22216,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22216,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22220,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22220,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22220,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22222,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22222,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22222,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22224,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22224,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22224,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22226,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22226,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22226,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22310,HB CL TX VERTEBRAL BODY FX WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,22310,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,22310,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,22310,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,22315,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,22315,Outpatient Surgery Group 2 Global Rate,16289.4,10588.11,14322.0,15354.0,2
CPT,22315,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,22318,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22318,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22318,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22319,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22319,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22319,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22325,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22325,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22325,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22326,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22326,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22326,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22327,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22327,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22327,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22328,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22328,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22328,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22505,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,22505,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22505,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22510,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,22510,Outpatient Grouper - 4,16289.4,10588.11,19724.25,21397.98,24
CPT,22510,Outpatient Surgical Group 5,16289.4,10588.11,19539.84,29009.34,50
CPT,22511,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,22511,Outpatient Grouper - 4,16289.4,10588.11,19724.25,21397.98,24
CPT,22511,Outpatient Surgical Group 5,16289.4,10588.11,19539.84,29009.34,50
CPT,22512,OUTPATIENT SURGERY CPT GROUP 1,17069.3,11095.05,6417.0,7038.0,2
CPT,22512,Outpatient Grouper - 0,17069.3,11095.05,9059.94,9827.82,24
CPT,22512,Outpatient Surgical Group 7,17069.3,11095.05,27131.25,40279.73,50
CPT,22513,HB KYPHOPLASTY T-SPINE W IMG,38758.7,25193.15,8895.29,14761.0,10
CPT,22513,Outpatient Grouper - 6,38758.7,25193.15,28632.25,34209.93,24
CPT,22513,Outpatient Surgery Group 2 Global Rate,38758.7,25193.15,14322.0,15354.0,2
CPT,22513,Outpatient Surgical Group 5,38758.7,25193.15,19539.84,29009.34,50
CPT,22514,HB KYPHOPLASTY L-SPINE W IMG,38758.7,25193.15,8895.29,14761.0,10
CPT,22514,Outpatient Grouper - 6,38758.7,25193.15,28632.25,34209.93,24
CPT,22514,Outpatient Surgery Group 2 Global Rate,38758.7,25193.15,14322.0,15354.0,2
CPT,22514,Outpatient Surgical Group 5,38758.7,25193.15,19539.84,29009.34,50
CPT,22515,HB KYPHOPLASTY ADDL SPINE W IMG,30218.4,19641.96,13270.0,14761.0,2
CPT,22515,OUTPATIENT SURGERY CPT GROUP 1,30218.4,19641.96,6417.0,7038.0,2
CPT,22515,Outpatient Grouper - 0,30218.4,19641.96,9059.94,9827.82,24
CPT,22515,Outpatient Surgical Group 7,30218.4,19641.96,27131.25,40279.73,50
CPT,22526,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,22526,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22527,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,22527,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,22532,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22532,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22532,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22533,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22533,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22533,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22534,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22534,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22534,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22548,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22548,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22548,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22551,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22551,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22551,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22552,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,22552,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22554,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22554,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22554,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22556,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22556,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22556,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22558,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22558,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22558,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22585,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22585,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22585,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22586,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22586,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22586,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,22590,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22590,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22590,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22595,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22595,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22595,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22600,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22600,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22600,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22610,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22610,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22610,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22612,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22612,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22612,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22614,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22614,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22614,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,22630,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22630,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22630,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22632,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22632,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22632,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22633,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,22633,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22633,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,22634,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22634,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22634,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22800,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22800,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22800,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22802,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22802,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22802,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22804,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22804,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22804,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22808,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22808,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22808,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,22810,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22810,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22810,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,22812,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22812,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,22812,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22818,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22818,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22818,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22819,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22819,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,22819,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,22830,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22830,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22830,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22836,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,22836,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,22837,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,22837,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,22838,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,22838,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,22840,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22840,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22841,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22841,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22841,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22842,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22842,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22842,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22843,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22843,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22843,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22844,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22844,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22844,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22845,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22845,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22845,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22846,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22846,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22846,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22847,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22847,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22847,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22848,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22848,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22848,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22849,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22849,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22849,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22850,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22850,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22850,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22852,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22852,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22852,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22853,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22853,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22854,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22854,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22855,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22855,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22855,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22856,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22856,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22856,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22857,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22857,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,22857,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22858,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22858,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22858,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,22859,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22859,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22860,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,22860,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,22860,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,22861,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22861,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22862,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,22862,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,22864,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22864,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22865,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22865,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22867,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,22867,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22867,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,22868,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,22868,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,22869,HB INS STABL DEV W IMG GD LUMBAR SINGLE,98487.4,64016.81,16021.61,18424.85,8
CPT,22869,Outpatient Grouper - 6,98487.4,64016.81,28632.25,34209.93,24
CPT,22869,Outpatient Surgery Group 4 Global Rate,98487.4,64016.81,26623.0,28144.0,2
CPT,22869,Outpatient Surgical Group 1,98487.4,64016.81,9088.3,13492.72,50
CPT,22870,Outpatient Grouper - 0,48362.0,31435.3,9059.94,9827.82,24
CPT,22870,Outpatient Surgery Group 4 Global Rate,48362.0,31435.3,26623.0,28144.0,2
CPT,22899,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,22899,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,22900,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,22900,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,22900,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,22901,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,22901,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22901,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22902,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,22902,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,22902,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22903,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,22903,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22903,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,22904,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,22904,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,22904,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22905,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,22905,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,22905,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,22999,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,22999,Outpatient Surgical Group 3,2224.9,1446.19,13899.75,20635.92,50
CPT,23000,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23000,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23000,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23020,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23030,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23030,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23030,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,23031,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23031,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23031,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23035,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23035,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23035,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23040,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23040,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23040,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23044,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23044,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23044,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23065,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23065,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,23065,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,23066,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23066,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23066,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23071,Outpatient Grouper - 3,11474.0,7458.1,14341.63,15558.59,24
CPT,23071,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,23071,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,23073,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23073,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23073,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23075,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23075,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23075,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23076,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23076,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23076,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23077,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23077,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23077,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23078,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23078,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23078,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23101,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23101,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23101,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23105,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23105,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23105,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23106,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23106,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23106,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23107,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23107,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23107,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23120,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23120,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23125,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23125,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23125,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23130,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23130,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23140,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23140,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23140,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23145,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23145,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23145,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23146,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23146,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23146,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23150,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23150,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23150,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23155,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23155,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23155,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23156,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23156,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23156,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23170,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23170,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23170,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23172,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23172,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23172,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23174,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23174,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23174,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23180,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23180,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23180,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23182,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23182,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23182,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23184,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23184,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23184,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23190,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23190,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23190,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23195,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23195,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23195,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23200,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23200,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23210,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23210,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23210,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23220,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23220,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23220,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23330,Outpatient Grouper - 1,6058.66,3938.13,10495.38,11385.92,24
CPT,23330,Outpatient Surgical Group 1,6058.66,3938.13,9088.3,13492.72,50
CPT,23333,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23333,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,23333,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23334,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23334,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23334,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23335,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23335,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23335,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,23350,HB ARTHROGRAM SHOULDER INJ UNI,5924.56,3850.96,,,0
CPT,23350,OUTPATIENT SURGERY CPT GROUP 1,5924.56,3850.96,6417.0,7038.0,2
CPT,23350,Outpatient Grouper - 0,5924.56,3850.96,9059.94,9827.82,24
CPT,23395,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23395,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23395,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23397,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23397,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23397,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23400,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23400,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23400,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23405,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23405,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23405,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23406,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23406,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23406,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23410,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23410,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,23410,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23412,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23412,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23412,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23415,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23415,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,23415,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23420,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23420,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23430,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23430,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23430,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23440,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,23440,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23440,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23450,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23450,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23450,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23455,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23455,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23455,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23460,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23460,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23460,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23462,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23462,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23462,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23465,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23465,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23465,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23466,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23466,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23466,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23470,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,23470,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,23470,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,23472,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,23472,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,23472,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23473,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23473,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,23473,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23474,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23474,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,23474,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23480,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,23480,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23480,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23485,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23485,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23485,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23490,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23490,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23490,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23491,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23491,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23491,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23500,HB CL TX CLAVICULAR FX; WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,23500,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23500,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23500,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23505,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23505,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,23505,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,23515,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23515,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23515,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23520,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,23520,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,23520,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,23525,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23525,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23525,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23530,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23530,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23530,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23532,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23532,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23532,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23540,HB CL TX ACLAV DISLOC; WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,23540,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23540,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23540,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23545,OUTPATIENT SURGERY CPT GROUP 1,2669.91,1735.44,6417.0,7038.0,2
CPT,23545,Outpatient Grouper - 0,2669.91,1735.44,9059.94,9827.82,24
CPT,23545,Outpatient Surgical Group 1,2669.91,1735.44,9088.3,13492.72,50
CPT,23550,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23550,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23552,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23552,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23552,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23570,HB CL TX SCAPULAR FX; WO MANIP,2558.645,1663.12,298.7,14761.0,20
CPT,23570,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23570,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23570,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23575,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,23575,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,23575,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,23585,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23585,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23585,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23600,HB CL TX PROX HUM FX; WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,23600,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23600,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23600,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23605,HB HUMERAL NECK FX W/MANIP,7014.7,4559.555,1992.81,14761.0,18
CPT,23605,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,23605,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,23605,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,23615,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23615,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23615,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23616,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23616,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23616,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23620,HB HUMERAL FX WO MANIPULATE CLOSE,2558.645,1663.12,298.7,14761.0,18
CPT,23620,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23620,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23620,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23625,HB CL TX GR TUBEROSITY FX; W MANIP,6099.75,3964.84,1992.81,2291.73,16
CPT,23625,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,23625,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,23625,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,23630,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23630,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23630,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,23650,HB CL TX SHLDR DISL W MANIP; WO ANESTH,2558.645,1663.12,298.7,14761.0,12
CPT,23650,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,23650,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23650,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23655,"HB CL TX SHLDR DISL,MANIP;ANES",7014.7,4559.555,1992.81,14761.0,10
CPT,23655,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,23655,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,23655,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,23660,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23660,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23660,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23665,HB CL TX SHLDR DISLOC & FX GT; W MANIP,7014.7,4559.555,1992.81,14761.0,10
CPT,23665,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,23665,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,23665,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,23670,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23670,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23675,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,23675,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,23675,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,23680,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23680,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23680,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23700,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23700,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,23800,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23800,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23800,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,23802,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23802,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,23802,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,23900,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23900,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,23900,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23920,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,23920,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,23920,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,23921,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,23921,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,23921,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,23929,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,23929,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,23930,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,23930,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,23931,HB I&D UPPER ARM/ELBOW BURSA,11474.0,7458.1,2017.5,2320.13,8
CPT,23931,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,23931,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,23931,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,23935,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,23935,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,23935,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24000,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24000,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24000,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24006,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24006,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24006,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24065,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,24065,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,24065,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,24066,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,24066,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24066,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24071,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24071,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24071,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24073,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24073,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24073,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24075,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,24075,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24075,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24076,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,24076,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24076,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24077,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,24077,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24077,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24079,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24079,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24079,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24100,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,24100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24101,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24101,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24101,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24102,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24102,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24102,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24105,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24105,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24105,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24110,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24115,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24115,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24115,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24116,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24116,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24116,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24120,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24120,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24125,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24125,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24125,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24126,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24126,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24126,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24130,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24130,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24134,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24134,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24134,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24136,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24136,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24136,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24138,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24138,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24138,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24140,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24140,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24140,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24145,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24145,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24145,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24147,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24147,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24147,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24149,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24149,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24149,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24150,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24150,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24150,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24152,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24152,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24152,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24155,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24155,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24155,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24160,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24160,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24164,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24164,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24164,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24200,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,24200,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,24201,Outpatient Grouper - 2,12510.8,8132.02,13036.88,14143.2,24
CPT,24201,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,24201,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,24220,HB ARTHROGRAM ELBOW INJ UNILAT,6970.34,4530.72,,,0
CPT,24220,Outpatient Grouper - 0,6970.34,4530.72,9059.94,9827.82,24
CPT,24300,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,24300,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,24300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24301,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24301,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24301,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24305,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24305,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24305,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24310,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24310,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24310,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24320,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24320,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24320,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24330,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24330,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24330,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24331,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24331,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24331,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24332,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24332,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24332,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24340,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24340,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24340,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24341,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24341,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24341,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24342,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24342,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24342,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24343,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24343,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24343,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24344,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24344,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24344,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24345,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24345,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24345,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24346,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24346,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24346,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24357,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,24357,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,24357,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,24358,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24358,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24358,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24359,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24359,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24359,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24360,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24360,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24360,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24361,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,24361,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24361,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24362,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24362,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24362,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24363,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,24363,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,24363,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24365,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24365,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24365,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24366,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,24366,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24366,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24370,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,24370,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,24370,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,24371,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,24371,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,24371,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24400,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24400,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24400,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24410,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24410,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24410,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24420,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24420,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24430,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24430,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24430,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24435,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24435,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24435,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24470,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24470,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24470,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24495,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,24495,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24495,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24498,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24498,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24498,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24500,HB CL TX HUMERUS FX WO MANIP,2558.645,1663.12,298.7,14761.0,20
CPT,24500,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24500,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24500,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24505,HB HUMERAL SHAFT FX W/ MANIP,7014.7,4559.555,1992.81,14761.0,18
CPT,24505,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24505,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,24505,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,24515,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24515,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24515,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24516,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24516,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24516,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24530,HB CL TX SC/TC HUM FX WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,24530,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24530,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24530,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24535,HB FX HUMERAL W MANIPULATION,6099.75,3964.84,1992.81,2291.73,8
CPT,24535,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24535,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,24535,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,24538,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,24538,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24538,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24545,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24545,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24545,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24546,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24546,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24546,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24560,HB CL TX EC HUM FX WO MANIP,2224.9,1446.19,298.7,343.5,16
CPT,24560,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24560,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24560,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24565,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,24565,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,24565,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24566,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24566,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24566,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24575,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24575,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24575,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24576,HB CL TX C HUMERUS FX WO MANIP,2224.9,1446.19,298.7,343.5,8
CPT,24576,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24576,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24576,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24577,HB CL TX C HUMERUS FX W MANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,24577,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24577,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,24577,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,24579,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24579,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24579,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24582,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24582,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24582,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24586,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24586,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24586,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24587,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24587,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24587,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24600,HB ELBOW DISLOCATION,2558.645,1663.12,298.7,14761.0,18
CPT,24600,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24600,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24600,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24605,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24605,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,24605,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,24615,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24615,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24620,HB CL TX MONTGG ELB FX W MANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,24620,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,24620,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,24620,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,24635,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24635,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24635,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24640,HB CL TX NURSEMAID ELBOW W MANIP,2224.9,1446.19,298.7,343.5,8
CPT,24640,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24640,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24640,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,24650,HB CL TX RADIAL HD/NECK FX; WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,24650,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24650,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24650,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,24655,HB CL TX RAD HD/NECK FX;W MAN,6099.75,3964.84,1992.81,2291.73,16
CPT,24655,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24655,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,24655,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,24665,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24665,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24665,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24666,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24666,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24666,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24670,HB CL TX ULNAR FX; PROX END WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,24670,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,24670,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,24670,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,24675,HB CL TX ULN FRC PROX END WMNP,6099.75,3964.84,1992.81,2291.73,8
CPT,24675,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,24675,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,24675,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,24685,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24685,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24685,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24800,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,24800,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24800,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,24802,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24802,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,24802,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,24900,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24900,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24920,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24920,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24920,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,24925,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,24925,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,24925,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,24930,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24930,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24931,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24931,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24931,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,24935,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24935,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,24935,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24940,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,24940,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,24940,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,24999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,24999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25000,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25000,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25000,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25001,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25001,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25020,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25020,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25020,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25023,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25023,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25023,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25024,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25024,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25024,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25025,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25025,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25025,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25028,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25028,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25028,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25031,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25031,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25031,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25035,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25035,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25035,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25040,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25040,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25040,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25065,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,25065,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,25065,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,25066,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25066,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25066,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25071,Outpatient Grouper - 3,11474.0,7458.1,14341.63,15558.59,24
CPT,25071,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,25073,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25073,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25073,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25075,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25075,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25075,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25076,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25076,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25076,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25077,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25077,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25077,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25078,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25078,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25078,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25085,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25085,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25085,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25101,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25101,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25101,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25105,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25105,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25105,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25107,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25107,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25107,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25109,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25109,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25109,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25110,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25110,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25111,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25111,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25111,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25112,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25112,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25112,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25115,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25115,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25115,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25116,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25116,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25116,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25118,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25118,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25118,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25119,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25119,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25119,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25120,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25120,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25125,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25125,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25125,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25126,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25126,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25126,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25130,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25130,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25135,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25135,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25135,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25136,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25136,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25136,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25145,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25145,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25145,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25150,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25150,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25150,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25151,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25151,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25151,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25170,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25170,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25170,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,25210,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25210,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25210,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25215,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25215,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25215,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25230,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25230,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25230,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25240,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25240,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25240,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25246,HB ARTHROGRAM WRIST INJ UNILAT,6970.34,4530.72,,,0
CPT,25246,OUTPATIENT SURGERY CPT GROUP 1,6970.34,4530.72,6417.0,7038.0,2
CPT,25246,Outpatient Grouper - 0,6970.34,4530.72,9059.94,9827.82,24
CPT,25248,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25248,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25248,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25250,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25250,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25250,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25251,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25251,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25251,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25259,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25259,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25259,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25260,HB REP TENDN/MSCL - FARM.WRIST,16289.4,10588.11,4040.15,4646.17,8
CPT,25260,Outpatient Grouper - 4,16289.4,10588.11,19724.25,21397.98,24
CPT,25260,Outpatient Surgery Group 4 Global Rate,16289.4,10588.11,26623.0,28144.0,2
CPT,25260,Outpatient Surgical Group 4,16289.4,10588.11,17187.58,25517.11,50
CPT,25263,Outpatient Grouper - 4,38758.7,25193.15,19724.25,21397.98,24
CPT,25263,Outpatient Surgery Group 2 Global Rate,38758.7,25193.15,14322.0,15354.0,2
CPT,25263,Outpatient Surgical Group 2,38758.7,25193.15,12162.28,18056.43,50
CPT,25265,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25265,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25265,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25270,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25270,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25270,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25272,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25272,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25272,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25274,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25274,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25274,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25275,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25275,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25275,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25280,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25280,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25290,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25290,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25290,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25295,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25295,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25295,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25300,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25300,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25300,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25301,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25301,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25301,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25310,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25310,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25310,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25312,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25312,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25312,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25315,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25315,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25315,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25316,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25316,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25316,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25320,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25320,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25320,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25332,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25332,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25332,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25335,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25335,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25335,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25337,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25337,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25337,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25350,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25350,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25350,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25355,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25355,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25355,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25360,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25360,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25360,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25365,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25365,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25365,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25370,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25370,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25370,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25375,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25375,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25375,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25390,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25390,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25390,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25391,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25391,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25391,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25392,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25392,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25392,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25393,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25393,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25393,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25394,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25394,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25394,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,253T,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25400,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25405,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25405,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25405,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25415,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25415,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25415,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25420,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25420,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25420,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25425,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25425,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25425,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25426,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25426,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25426,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25430,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25430,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25430,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25431,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25431,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25431,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25440,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25440,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25440,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25441,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,25441,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25441,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25442,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,25442,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25442,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25443,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25443,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25443,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25444,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25444,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25444,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25445,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25445,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25445,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25446,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,25446,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,25446,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,25447,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25447,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25447,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25449,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25449,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25449,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25450,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25450,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25450,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25455,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25455,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25455,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25490,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25490,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25490,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25491,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25491,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25491,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25492,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25492,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25492,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25500,HB CL TX RAD SHFT FX; WO MANIP,2224.9,1446.19,298.7,343.5,16
CPT,25500,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25500,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25500,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25505,HB CL TX RADIAL SHFT FX WMANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,25505,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,25505,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,25505,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,25515,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25515,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25515,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25520,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,25520,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,25520,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,25525,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25525,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25525,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25526,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25526,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25526,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25530,HB CL TX ULNAR SHFT FX WOMANIP,2436.81,1583.925,298.7,14761.0,18
CPT,25530,OUTPATIENT SURGERY CPT GROUP 1,2118.97,1377.33,6417.0,7038.0,2
CPT,25530,Outpatient Grouper - 0,2118.97,1377.33,9059.94,9827.82,24
CPT,25530,Outpatient Surgical Group 0,2118.97,1377.33,2806.68,4166.87,50
CPT,25535,HB CL TX ULNAR SHFT FX W MANIP,2224.9,1446.19,298.7,343.5,8
CPT,25535,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25535,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25535,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,25545,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25545,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25545,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25560,HB RAD/ULNAR SHAFT FX WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,25560,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25560,Outpatient Surgery Group 2 Global Rate,2224.9,1446.19,14322.0,15354.0,2
CPT,25560,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25565,HB CL TX RADIAL&ULNA FX WMANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,25565,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,25565,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,25565,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,25574,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25574,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25574,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25575,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25575,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25575,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25600,HB CL TX DSTL RADIAL FX/EPIPHYSL SEP WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,25600,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25600,Outpatient Surgery Group 2 Global Rate,2224.9,1446.19,14322.0,15354.0,2
CPT,25600,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25605,HB DIST RAD/COLLES FX W MANIP,7014.7,4559.555,1992.81,14761.0,18
CPT,25605,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,25605,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,25605,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,25606,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25606,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25606,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25607,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25607,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25607,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25608,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25608,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25608,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25609,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25609,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25609,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25622,HB CL TX CARPAL SCAPHOID FX; WO MANIP,2224.9,1446.19,298.7,343.5,8
CPT,25622,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25622,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25622,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25624,HB CL TX CARPL SCAPHOID FX W MANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,25624,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,25624,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,25624,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,25628,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25628,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25628,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25630,HB CLTX CARPL BONE FX WO MANIP EA BONE,2558.645,1663.12,298.7,14761.0,10
CPT,25630,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25630,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25630,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25635,HB CLTX CARPL BONE FX W MANIP EA BONE,6099.75,3964.84,1992.81,2291.73,8
CPT,25635,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,25635,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,25635,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,25645,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25645,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25645,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25650,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25650,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25650,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,25651,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,25651,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25651,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,25652,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25652,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25652,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,25660,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25660,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25660,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,25670,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25670,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25671,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25671,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25671,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25675,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25675,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25675,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,25676,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25676,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25676,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25680,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,25680,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,25680,Outpatient Surgical Group 2,2224.9,1446.19,12162.28,18056.43,50
CPT,25685,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25685,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25685,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25690,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,25690,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,25690,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,25695,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25695,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25695,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25800,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25800,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25800,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25805,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25805,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25805,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25810,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25810,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25810,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25820,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25820,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25820,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,25825,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25825,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25825,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25830,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,25830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25830,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,25900,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25900,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,25900,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25905,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25905,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,25905,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25907,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25907,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25907,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25909,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25909,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,25909,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25915,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25915,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,25915,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25920,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25920,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25920,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25922,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25922,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25922,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25924,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,25924,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,25924,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,25927,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,25927,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25927,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,25929,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,25929,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,25929,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25931,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,25931,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,25931,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,25999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,25999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26010,HB I&D ABSCESS FINGER SIMPLE,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,26010,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,26010,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,26010,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,26011,HB I&D ABSCESS FINGER COMPLICATED,13195.1,8576.815,2017.5,14761.0,10
CPT,26011,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,26011,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,26011,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,26020,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26020,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26025,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26025,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26025,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26030,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26030,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26030,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26034,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26034,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26034,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26035,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26035,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26035,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26037,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26037,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26037,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26040,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26040,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26040,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26045,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26045,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26045,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26055,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26055,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26055,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26060,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,26060,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,26060,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,26070,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26070,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26070,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26075,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26075,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26075,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26080,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26080,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26080,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26105,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26105,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26105,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26110,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26111,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26111,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26111,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26113,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26113,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26113,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26115,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26115,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26115,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26116,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26116,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26116,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26117,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26117,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26117,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26118,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26118,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26118,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26121,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26121,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26121,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26123,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26123,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26123,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26125,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26125,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26125,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26130,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26130,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26135,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26135,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26135,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26140,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26140,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26140,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26145,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26145,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26145,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26160,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26160,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26160,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26170,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26170,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26170,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26180,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26180,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26180,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26185,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26185,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26185,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26200,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26200,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26205,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26205,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26205,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26210,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26210,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26210,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26215,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26215,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26215,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26230,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26230,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26230,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26235,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26235,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26235,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26236,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26236,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26236,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26250,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26250,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26250,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26260,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26260,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26260,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26262,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26262,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26262,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26320,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26320,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26320,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26340,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26340,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26340,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,26341,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26341,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26341,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26350,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26350,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26350,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26352,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26352,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26352,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26356,Outpatient Grouper - 4,16289.4,10588.11,19724.25,21397.98,24
CPT,26356,Outpatient Surgery Group 4 Global Rate,16289.4,10588.11,26623.0,28144.0,2
CPT,26356,Outpatient Surgical Group 4,16289.4,10588.11,17187.58,25517.11,50
CPT,26357,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26357,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26357,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26358,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26358,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26358,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26370,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26370,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26370,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26372,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26372,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26372,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26373,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26373,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26373,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26390,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26390,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26390,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26392,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26392,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26392,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26410,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,26410,Outpatient Surgery Group 3 Global Rate,6099.75,3964.84,22055.0,22787.0,2
CPT,26410,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,26412,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26412,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26412,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26415,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26415,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26415,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26416,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26416,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26416,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26418,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,26418,Outpatient Surgery Group 4 Global Rate,6099.75,3964.84,26623.0,28144.0,2
CPT,26418,Outpatient Surgical Group 4,6099.75,3964.84,17187.58,25517.11,50
CPT,26420,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26420,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26420,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26426,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26426,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26426,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26428,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26428,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26428,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26432,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26432,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26432,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26433,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26433,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26433,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26434,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26434,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26434,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26437,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26437,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26437,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26440,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26440,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26440,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26442,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26442,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26442,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26445,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26445,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26445,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26449,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26449,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26449,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26450,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26450,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26450,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26455,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26455,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26455,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26460,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26460,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26460,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26471,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26471,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26471,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26474,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26474,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26474,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26476,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26476,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26476,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26477,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26477,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26477,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26478,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26478,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26478,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26479,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26479,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26479,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26480,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26480,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26480,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26483,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26483,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26483,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26485,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26485,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26485,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26489,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26489,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26489,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26490,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26490,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26490,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26492,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26492,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26492,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26494,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26494,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26494,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26496,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26496,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26496,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26497,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26497,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26497,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26498,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26498,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26498,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26499,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26499,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26499,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26500,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26500,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26500,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26502,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26502,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26502,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26508,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26508,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26508,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26510,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26510,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26510,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26516,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26516,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26516,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26517,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26517,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26517,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26518,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26518,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26518,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26520,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26520,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26520,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26525,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26525,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26525,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26530,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26530,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26530,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26531,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26531,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26531,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26535,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26535,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26535,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26536,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26536,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26536,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26540,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26540,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26540,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26541,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26541,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26541,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26542,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26542,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26542,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26545,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26545,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26545,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26546,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26546,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26546,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26548,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26548,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26548,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26550,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26550,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26550,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26551,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26551,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26551,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26553,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26553,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26553,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26554,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26554,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26554,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26555,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26555,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26555,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26556,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,26556,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26556,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26560,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26560,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26560,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26561,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26561,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26561,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26562,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26562,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26562,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26565,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26565,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26565,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26567,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26567,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26567,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26568,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26568,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26568,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26580,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26580,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26580,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26587,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26587,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26587,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26590,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26590,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26590,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26591,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,26591,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,26591,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,26593,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26593,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26593,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26596,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26596,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26596,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26600,"HB CL TX MC FX,SGLWO MNP EA BN",2558.645,1663.12,298.7,14761.0,20
CPT,26600,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26600,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26600,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26605,"HB CL TX MC FX, SGL; W MANIP",2558.645,1663.12,298.7,14761.0,10
CPT,26605,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26605,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26605,Outpatient Surgical Group 2,2224.9,1446.19,12162.28,18056.43,50
CPT,26607,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,26607,Outpatient Surgery Group 2 Global Rate,16289.4,10588.11,14322.0,15354.0,2
CPT,26607,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,26608,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26608,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26608,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26615,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,26615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26615,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26641,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26641,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26641,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26645,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,26645,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,26645,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,26650,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26650,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26650,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26665,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,26665,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26665,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26670,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26670,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26670,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26675,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,26675,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,26675,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,26676,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26676,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26676,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26685,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26685,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26685,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26686,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,26686,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26686,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26700,HB CL TX MCP DISLOC SGL W MANIP,2224.9,1446.19,298.7,343.5,8
CPT,26700,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26700,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26700,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26705,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,26705,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,26705,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,26706,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,26706,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26706,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26715,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26715,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26715,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26720,HB FINGER SHAFT PROX FX,2558.645,1663.12,298.7,14761.0,18
CPT,26720,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26720,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26720,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26725,HB CL TX PHALANG SHFT FX; W MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,26725,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26725,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26725,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26727,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26727,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26727,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,26735,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26735,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26735,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26740,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26740,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26740,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26742,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,26742,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,26742,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,26746,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26746,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26746,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26750,HB CL TX D PHAL FX FGR/THMB; WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,26750,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26750,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26750,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26755,HB DIST PHALANGEAL FX W/MANIP,2224.9,1446.19,298.7,343.5,8
CPT,26755,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26755,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26755,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26756,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,26756,Outpatient Surgery Group 2 Global Rate,16289.4,10588.11,14322.0,15354.0,2
CPT,26756,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,26765,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,26765,Outpatient Surgery Group 4 Global Rate,16289.4,10588.11,26623.0,28144.0,2
CPT,26765,Outpatient Surgical Group 4,16289.4,10588.11,17187.58,25517.11,50
CPT,26770,HB CL TX IP JNT D W MANIP ; WO ANESTH,2224.9,1446.19,298.7,343.5,8
CPT,26770,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,26770,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,26770,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,26775,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26775,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26775,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26776,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26776,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26776,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26785,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,26785,Outpatient Surgery Group 2 Global Rate,16289.4,10588.11,14322.0,15354.0,2
CPT,26785,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,26820,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26820,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,26820,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,26841,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26841,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26841,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26842,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26842,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26842,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26843,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26843,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26843,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26844,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26844,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26844,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26850,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26850,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26850,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26852,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26852,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26852,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26860,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26860,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26860,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26861,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26861,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26861,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,26862,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26862,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,26862,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,26863,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26863,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26863,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26910,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,26910,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,26910,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,26951,Outpatient Grouper - 2,15440.2,10036.13,13036.88,14143.2,24
CPT,26951,Outpatient Surgery Group 2 Global Rate,15440.2,10036.13,14322.0,15354.0,2
CPT,26951,Outpatient Surgical Group 2,15440.2,10036.13,12162.28,18056.43,50
CPT,26952,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,26952,Outpatient Surgery Group 4 Global Rate,16289.4,10588.11,26623.0,28144.0,2
CPT,26952,Outpatient Surgical Group 4,16289.4,10588.11,17187.58,25517.11,50
CPT,26989,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,26989,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26990,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26990,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26990,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26991,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,26991,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,26991,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,26992,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,26992,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,26992,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27000,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,27000,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,27000,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27001,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27001,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27001,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27003,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27003,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27003,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27005,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27005,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27006,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27006,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27006,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27025,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27025,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27025,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27027,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27027,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27027,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27030,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27030,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27030,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27033,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27033,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27033,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27035,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27035,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27035,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27036,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27036,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27036,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27040,HB BIOPSY PELVIS/HIP ST SUPF,11474.0,7458.1,2017.5,2320.13,8
CPT,27040,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,27040,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,27040,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,27041,HB BIOPSY PELVIS/HIP ST DEEP,13195.1,8576.815,2017.5,14761.0,10
CPT,27041,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,27041,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,27041,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,27043,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27043,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27043,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27045,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27045,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27045,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27047,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27047,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27047,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27048,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27048,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27048,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27049,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27049,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27049,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27050,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27050,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27050,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27052,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27052,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27052,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27054,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27054,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27054,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27057,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27057,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27057,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27059,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27059,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27059,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27060,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27060,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27060,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27062,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27062,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27062,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27065,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27065,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27065,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27066,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27066,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27066,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27067,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27067,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27067,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27070,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27070,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27070,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27071,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27071,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27071,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27075,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27075,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27075,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,27076,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27076,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27076,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27077,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27077,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27077,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,27078,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27078,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27078,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27080,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27080,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27080,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27086,HB REM FB PELVIS OR HIP; SQ,8820.95,5733.62,3563.79,4098.36,8
CPT,27086,OUTPATIENT SURGERY CPT GROUP 1,8820.95,5733.62,6417.0,7038.0,2
CPT,27086,Outpatient Grouper - 2,8820.95,5733.62,13036.88,14143.2,24
CPT,27086,Outpatient Surgical Group 1,8820.95,5733.62,9088.3,13492.72,50
CPT,27087,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,27087,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,27087,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,27090,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27090,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27090,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27091,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27091,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27091,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27093,HB ARTHROGRAM HIP INJ WO ANES,1766.59,1148.28,,,0
CPT,27093,OUTPATIENT SURGERY CPT GROUP 1,1766.59,1148.28,6417.0,7038.0,2
CPT,27093,Outpatient Grouper - 0,1766.59,1148.28,9059.94,9827.82,24
CPT,27095,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27095,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27096,HB CHRONIC PAIN CNTR PROCEDURES 3,8829.34,5739.07,,,0
CPT,27096,HB SI JOINT ANES/STEROID INJ W IMG,4698.15,3053.8,13270.0,14761.0,2
CPT,27096,OUTPATIENT SURGERY CPT GROUP 1,4698.15,3053.8,6417.0,7038.0,2
CPT,27096,Outpatient Grouper - 0,4698.15,3053.8,9059.94,9827.82,24
CPT,27096,Outpatient Surgical Group 1,4698.15,3053.8,9088.3,13492.72,50
CPT,27097,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27097,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27097,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27098,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27098,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27098,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27100,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27100,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27100,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27105,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27105,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27105,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27110,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27110,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27110,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27111,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27111,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27111,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27120,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27122,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27122,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27122,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27125,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27125,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27125,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27130,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27130,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27132,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27132,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27132,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27134,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27134,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27134,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27137,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27137,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27137,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27138,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27138,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27138,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27140,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27140,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27146,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27146,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27146,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27147,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27147,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27147,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27151,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27151,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27151,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27156,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27156,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27156,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27158,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27158,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27158,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27161,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27161,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27161,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27165,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27165,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27165,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27170,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27170,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27170,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27175,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27175,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27175,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27176,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27176,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27176,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27177,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27177,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27177,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27178,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27178,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27178,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27179,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27179,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27179,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27181,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27181,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27181,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27185,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27185,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27185,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27187,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27187,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27187,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27197,HB CL TX PELV RNG FX WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,27197,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27197,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27197,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27198,Outpatient Grouper - 0,2669.91,1735.44,9059.94,9827.82,24
CPT,27198,Outpatient Surgery Group 2 Global Rate,2669.91,1735.44,14322.0,15354.0,2
CPT,27198,Outpatient Surgical Group 2,2669.91,1735.44,12162.28,18056.43,50
CPT,27200,HB COCCYGEAL FRACTURE,2224.9,1446.19,298.7,343.5,8
CPT,27200,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27200,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27200,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,27202,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27202,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27202,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27215,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,27215,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27215,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27216,Outpatient Grouper - 4,36738.1,23879.76,19724.25,21397.98,24
CPT,27216,Outpatient Surgery Group 4 Global Rate,36738.1,23879.76,26623.0,28144.0,2
CPT,27216,Outpatient Surgical Group 4,36738.1,23879.76,17187.58,25517.11,50
CPT,27217,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27217,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27217,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27218,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27218,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27218,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27220,HB CL TX OF ACETABULUM X(S); WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,27220,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27220,Outpatient Surgery Group 2 Global Rate,2224.9,1446.19,14322.0,15354.0,2
CPT,27220,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,27222,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27222,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27222,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27226,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27226,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27226,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27227,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27227,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27227,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27228,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27228,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27228,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27230,HB CL TX PROX FEM FX WO MANIP,2224.9,1446.19,298.7,343.5,16
CPT,27230,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27230,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27230,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27232,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27232,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27232,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27235,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27235,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27235,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27236,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27236,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27236,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27238,HB CL TX INTER/PERI/SBTRCHNTC FEM FX WO MANIP,7929.65,5154.27,13270.0,14761.0,2
CPT,27238,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27238,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,27238,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27240,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27240,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27240,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27244,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27244,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27244,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27245,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27245,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27245,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27246,HB CL TX GTR TROCHNTRC FX WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,27246,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27246,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27246,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27248,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27248,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27248,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27250,HB HIP DISLOCATION,2558.645,1663.12,298.7,14761.0,10
CPT,27250,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27250,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27250,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27252,HB CL TX TRAUMA HIPDISLC WANES,6099.75,3964.84,1992.81,2291.73,8
CPT,27252,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,27252,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,27252,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27253,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27253,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27253,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27254,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27254,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27254,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27256,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27256,Outpatient Surgery Group 2 Global Rate,2224.9,1446.19,14322.0,15354.0,2
CPT,27256,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,27257,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27257,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,27257,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27258,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27258,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27258,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27259,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27259,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27259,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27265,"HB ARTHROPLASTY, HIP DISL W/O ANES",2558.645,1663.12,298.7,14761.0,10
CPT,27265,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27265,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27265,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27266,"HB ARTHROPLASTY, HIP DISL W/ ANES",6099.75,3964.84,1992.81,2291.73,8
CPT,27266,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27266,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27266,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27267,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,27267,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,27267,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,27268,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27268,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27268,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27269,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27269,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27269,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27275,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27275,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27278,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27278,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,27279,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27279,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27279,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27280,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27280,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27282,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27282,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27282,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27284,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27284,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27284,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27286,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27286,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27286,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27290,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27290,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27290,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27295,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27295,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27295,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27299,Outpatient Grouper - 0,38758.7,25193.15,9059.94,9827.82,24
CPT,27299,Outpatient Surgical Group 1,38758.7,25193.15,9088.3,13492.72,50
CPT,27301,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,27301,Outpatient Surgery Group 3 Global Rate,12510.8,8132.02,22055.0,22787.0,2
CPT,27301,Outpatient Surgical Group 3,12510.8,8132.02,13899.75,20635.92,50
CPT,27303,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27303,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27303,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27305,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27305,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27305,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27306,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,27306,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,27306,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,27307,Outpatient Grouper - 4,18356.5,11931.73,19724.25,21397.98,24
CPT,27307,Outpatient Surgery Group 4 Global Rate,18356.5,11931.73,26623.0,28144.0,2
CPT,27307,Outpatient Surgical Group 3,18356.5,11931.73,13899.75,20635.92,50
CPT,27310,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27310,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27310,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27323,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27323,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,27323,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27324,OUTPATIENT SURGERY CPT GROUP 1,12510.8,8132.02,6417.0,7038.0,2
CPT,27324,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,27324,Outpatient Surgical Group 1,12510.8,8132.02,9088.3,13492.72,50
CPT,27325,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27325,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27325,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27326,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27326,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27326,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27327,Outpatient Grouper - 3,11474.0,7458.1,14341.63,15558.59,24
CPT,27327,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,27327,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,27328,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27328,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27328,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27329,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27329,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27329,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27330,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27330,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27330,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27331,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27331,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27331,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27332,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27332,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27332,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27333,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27333,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27333,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27334,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27334,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27334,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27335,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27335,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27335,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27337,OUTPATIENT SURGERY CPT GROUP 1,12510.8,8132.02,6417.0,7038.0,2
CPT,27337,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,27337,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,27339,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27339,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27339,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27340,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27340,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27340,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27345,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27345,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27345,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27347,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27347,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27347,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27350,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27350,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27350,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27355,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27355,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27355,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27356,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27356,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27356,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27357,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27357,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27357,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27358,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27358,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27358,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27360,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27360,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27360,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27364,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27364,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27364,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27365,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27365,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27365,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27369,HB ARTHROGRAM KNEE INJ UNILAT,1072.01,696.81,,,0
CPT,27369,OUTPATIENT SURGERY CPT GROUP 1,1072.01,696.81,6417.0,7038.0,2
CPT,27369,Outpatient Grouper - 0,1072.01,696.81,9059.94,9827.82,24
CPT,27372,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,27372,Outpatient Surgery Group 3 Global Rate,12510.8,8132.02,22055.0,22787.0,2
CPT,27372,Outpatient Surgical Group 7,12510.8,8132.02,27131.25,40279.73,50
CPT,27380,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27380,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27380,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27381,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27381,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27381,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27385,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27385,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27385,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27386,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27386,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27386,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27390,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27390,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27390,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27391,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27391,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27391,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27392,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27392,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27392,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27393,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27393,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27393,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27394,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27394,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27394,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27395,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27395,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27395,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27396,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27396,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27396,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27397,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27397,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27397,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27400,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27403,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27403,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27403,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27405,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27405,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27405,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27407,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27407,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27407,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27409,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27409,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27409,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27412,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27412,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27412,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,27415,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27415,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,27415,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,27416,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27416,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,27416,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27418,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27418,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27418,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27420,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27420,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27422,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27422,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27422,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,27424,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27424,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27424,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27425,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27425,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27425,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,27427,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27427,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27427,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27428,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27428,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,27428,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27429,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27429,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27429,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27430,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27430,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27430,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27435,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27435,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27435,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27437,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27437,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27437,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27438,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27438,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27438,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27440,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27440,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27440,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,27441,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27441,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27441,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27442,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27442,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27442,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27443,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27443,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27443,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27445,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27445,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27445,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27446,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27446,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,27446,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,27447,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27447,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,27447,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27448,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27448,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27448,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27450,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27450,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27450,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27454,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27454,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27454,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27455,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27455,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27455,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27457,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27457,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27457,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27465,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27465,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27465,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27466,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27466,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27466,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27468,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27468,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27468,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27470,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27470,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27470,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27472,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27472,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27472,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27475,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27475,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27475,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27477,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27477,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27477,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27479,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27479,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27479,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27485,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27485,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27485,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27486,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27486,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27486,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27487,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27487,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27487,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27488,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27488,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27488,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27495,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27495,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27495,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27496,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27496,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27496,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27497,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27497,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27497,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27498,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27498,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27498,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27499,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27499,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27499,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27500,HB CL TX FEMORAL SHAFT FX WO MANIP,2224.9,1446.19,298.7,343.5,16
CPT,27500,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27500,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27500,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27501,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27501,Outpatient Surgical Group 2,2224.9,1446.19,12162.28,18056.43,50
CPT,27502,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27502,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27503,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,27503,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,27506,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27506,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27506,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27507,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27507,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27507,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27508,HB CL TX D FEM FX WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,27508,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27508,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27508,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27509,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27509,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27509,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27510,HB CL TX FEMUR FX OR EPIPHYS SEP W MANIP,6099.75,3964.84,1992.81,2291.73,8
CPT,27510,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27510,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,27510,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27511,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27511,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27511,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27513,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27513,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27513,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27514,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27514,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27514,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27516,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27516,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27516,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27517,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27517,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27517,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27519,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27519,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27519,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27520,"HB CLOSED TX PTLLR FX,WO MANIP",2558.645,1663.12,298.7,14761.0,18
CPT,27520,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27520,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27520,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27524,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27524,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27524,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,27530,"HB CL TX PROX TIB FX, WO MANIP",2558.645,1663.12,298.7,14761.0,20
CPT,27530,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27530,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27530,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27532,HB CL TX PROX TIBIAL FX W SK TRCT W OR W/O MANIP,16289.4,10588.11,4040.15,4646.17,8
CPT,27532,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,27532,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,27532,Outpatient Surgical Group 1,16289.4,10588.11,9088.3,13492.72,50
CPT,27535,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27535,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27535,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27536,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27536,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27536,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27538,HB CL TX IC SP ORTUBEROSITY W OR W/O MANIP,2224.9,1446.19,298.7,343.5,8
CPT,27538,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27538,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27538,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27540,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27540,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27550,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27550,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27550,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27552,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27552,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27552,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27556,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27556,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27556,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27557,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27557,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27557,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27558,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27558,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27558,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27560,HB PATELLAR DISLOCATION,2224.9,1446.19,298.7,343.5,16
CPT,27560,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27560,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27560,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27562,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27562,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27562,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27566,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27566,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27566,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27570,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27570,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27570,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27580,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27580,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27580,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27590,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27590,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27590,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27591,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27591,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27591,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27592,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27592,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27592,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27594,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27594,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27594,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27596,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27596,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27596,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27598,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27598,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27598,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27599,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27599,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27600,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27600,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27601,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27601,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27601,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27602,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27602,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27602,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27603,HB DRAIN LOWER LEG DEEP ABSC/HEMATOMA,12510.8,8132.02,3563.79,4098.36,8
CPT,27603,OUTPATIENT SURGERY CPT GROUP 1,12510.8,8132.02,6417.0,7038.0,2
CPT,27603,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,27603,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,27604,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27604,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27604,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27605,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27605,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,27605,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27606,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27606,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27606,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27607,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27607,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27607,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27610,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27610,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27610,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27612,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27612,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27612,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27613,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,27613,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,27613,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,27614,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27614,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27614,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27615,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27615,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27616,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27616,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27616,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27618,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27618,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27618,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27619,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27619,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27619,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27620,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27620,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27620,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27625,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27625,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27625,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27626,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27626,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27626,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27630,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27630,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27630,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27632,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27632,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27632,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27634,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27634,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27634,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27635,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27635,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27635,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27637,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27637,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27637,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27638,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27638,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27638,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27640,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27640,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27640,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27641,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27641,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27641,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27645,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27645,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27645,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27646,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27646,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27646,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27647,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27647,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27647,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27648,HB ARTHROGRAM ANKLE INJ UNILAT,5924.56,3850.96,,,0
CPT,27648,OUTPATIENT SURGERY CPT GROUP 1,5924.56,3850.96,6417.0,7038.0,2
CPT,27648,Outpatient Grouper - 0,5924.56,3850.96,9059.94,9827.82,24
CPT,27650,Outpatient Grouper - 5,38758.7,25193.15,25486.19,27649.53,24
CPT,27650,Outpatient Surgery Group 3 Global Rate,38758.7,25193.15,22055.0,22787.0,2
CPT,27650,Outpatient Surgical Group 3,38758.7,25193.15,13899.75,20635.92,50
CPT,27652,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27652,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27652,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27654,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27654,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27654,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27656,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27656,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27656,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27658,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27658,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27658,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27659,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27659,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27659,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27664,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27664,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27664,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27665,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27665,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27665,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27675,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27675,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27675,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27676,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27676,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27676,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27680,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27680,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27680,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27681,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27681,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27681,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27685,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27685,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27685,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27686,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27686,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27686,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27687,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27687,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27687,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27690,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27690,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27690,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27691,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27691,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27691,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27692,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27692,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27692,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27695,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27695,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27695,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27696,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27696,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27696,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27698,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27698,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27698,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27700,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27700,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27700,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,27702,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27702,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27702,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27703,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27703,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27703,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27704,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27704,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27704,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27705,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27705,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27705,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27707,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27707,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27707,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27709,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27709,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27709,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27712,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27712,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27712,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27715,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27715,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27715,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27720,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27720,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27720,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27722,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27722,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27722,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27724,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27724,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27724,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27725,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27725,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27725,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27726,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27726,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27726,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27727,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27727,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27727,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27730,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27730,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27730,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27732,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27732,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27732,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27734,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27734,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27734,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27740,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27740,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27742,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,27742,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27742,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27745,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27745,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27745,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27750,HB CL TX TIB SHFT FX W/O MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,27750,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27750,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27750,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27752,HB FX TIBIAL SHAFT W MANIPULATION,6099.75,3964.84,1992.81,2291.73,8
CPT,27752,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27752,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27752,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27756,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27756,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27756,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27758,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27758,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27758,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27759,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27759,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27759,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27760,HB CL TX MEDIAL ANKLE FX W/O MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,27760,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27760,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27760,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27762,HB FX MEDIAL MALLEOLUS W MANIPUL,6099.75,3964.84,1992.81,2291.73,8
CPT,27762,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27762,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27762,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27766,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27766,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27766,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27767,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27767,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27767,Outpatient Surgical Group 2,2224.9,1446.19,12162.28,18056.43,50
CPT,27768,HB CL TX POST ANKLE FX W/MANIP,7014.7,4559.555,1992.81,14761.0,10
CPT,27768,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27768,Outpatient Grouper - 0,6099.75,3964.84,9059.94,9827.82,24
CPT,27768,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27769,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27769,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27769,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27780,HB CL TX PRX FIB/SHFT FX WOMNP,2558.645,1663.12,298.7,14761.0,18
CPT,27780,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27780,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27780,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27781,HB CL TX PROX FIB/SHFT FX WMAN,6099.75,3964.84,1992.81,2291.73,8
CPT,27781,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,27781,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27784,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27784,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27784,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27786,HB CL TX DSTL FIB FX WO MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,27786,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27786,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27788,HB CL TX DISTL FIB FX W MANIP,3070.37,1995.74,298.7,14761.0,18
CPT,27788,Outpatient Grouper - 0,2669.88,1735.42,9059.94,9827.82,24
CPT,27788,Outpatient Surgical Group 1,2669.88,1735.42,9088.3,13492.72,50
CPT,27792,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27792,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27792,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27808,HB CL TX BIMALLEOLAR ANKLE FX W/O MANIP,2224.9,1446.19,298.7,343.5,16
CPT,27808,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27808,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27808,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27810,HB BIMALLEOLAR ANKLE FX CLD W/MAN,7014.7,4559.555,1992.81,14761.0,20
CPT,27810,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27810,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,27810,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27814,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27814,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27814,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27816,HB TRIMALLEOLAR ANK FX W/O MAN,2558.645,1663.12,298.7,14761.0,18
CPT,27816,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27816,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27816,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27818,HB TRIMALLEOLAR ANK FX W/MAN,7014.7,4559.555,1992.81,14761.0,18
CPT,27818,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27818,Outpatient Grouper - 1,6099.75,3964.84,10495.38,11385.92,24
CPT,27818,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27822,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27822,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27822,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27823,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27823,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27823,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27824,HB CL TX WB DSTL TIB WO MANIP,2224.9,1446.19,298.7,343.5,8
CPT,27824,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27824,Outpatient Surgery Group 2 Global Rate,2224.9,1446.19,14322.0,15354.0,2
CPT,27824,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27825,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27825,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,27825,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,27826,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27826,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27826,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27827,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27827,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27827,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27828,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27828,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27828,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27829,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27829,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27829,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27830,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27830,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27830,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27831,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27831,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,27831,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27832,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27832,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27832,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27840,HB ANKLE DISLOCATION W/O ANES,2558.645,1663.12,298.7,14761.0,10
CPT,27840,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,27840,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,27840,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,27842,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,27842,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,27842,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,27846,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27846,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27846,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27848,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27848,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27848,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27860,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,27860,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,27860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27870,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27870,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27870,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27871,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27871,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27871,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,27880,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,27880,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,27880,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27881,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27881,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27881,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27882,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27882,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,27882,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,27884,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,27884,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27884,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27886,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27886,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,27886,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27888,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,27888,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27888,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,27889,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27889,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,27889,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27892,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27892,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27892,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27893,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27893,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,27893,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27894,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,27894,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,27894,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,27899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,27899,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,28001,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28001,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,28001,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28002,HB MISCELLANEOUS PROCEDURE,7929.65,5154.27,13270.0,14761.0,2
CPT,28002,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,28002,Outpatient Surgery Group 2 Global Rate,6099.75,3964.84,14322.0,15354.0,2
CPT,28002,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,28003,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28003,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28003,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28005,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28005,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28005,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28008,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28008,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28008,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28010,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,28010,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,28010,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,28011,OUTPATIENT SURGERY CPT GROUP 1,7319.7,4757.81,6417.0,7038.0,2
CPT,28011,Outpatient Grouper - 3,7319.7,4757.81,14341.63,15558.59,24
CPT,28011,Outpatient Surgical Group 3,7319.7,4757.81,13899.75,20635.92,50
CPT,28020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28022,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28022,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28022,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28024,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28024,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28024,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28035,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28035,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28035,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28039,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28039,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28039,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28041,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28041,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28041,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28043,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,28043,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28043,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28045,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,28045,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28045,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28046,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,28046,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28046,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28047,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28047,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28047,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28050,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28050,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28050,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28052,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28052,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28052,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28054,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28054,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28054,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28055,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28055,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28055,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28060,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28060,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28060,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28062,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28062,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28062,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28070,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28070,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28070,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28072,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28072,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28072,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28080,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,28080,Outpatient Surgery Group 3 Global Rate,6099.75,3964.84,22055.0,22787.0,2
CPT,28080,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,28086,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28086,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28086,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28088,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28088,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28088,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28090,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28090,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28090,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28092,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28092,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28092,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28100,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28102,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28102,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28102,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28103,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28103,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28103,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28104,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28104,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28104,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28106,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28106,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28106,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28107,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28107,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28107,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28108,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28108,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28108,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28110,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28110,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28111,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28111,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28111,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28112,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28112,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28112,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28113,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28113,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28113,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28114,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28114,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28114,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28116,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28116,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28116,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28118,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28118,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28118,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28119,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28119,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28119,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28120,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28120,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,28122,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28122,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28122,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28124,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28124,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28124,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28126,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28126,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28126,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28130,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28140,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28140,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28140,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28150,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28150,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28150,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28153,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28153,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28153,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28160,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28160,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28160,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28171,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28171,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28171,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28173,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28173,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28173,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28175,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28175,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28175,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28190,HB FB REMOVE FOOT SQ,5952.47,3869.11,876.1,1007.52,8
CPT,28190,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,28190,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,28190,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,28192,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,28192,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,28192,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,28193,HB COMPLIC REM FB FROM FOOT,11474.0,7458.1,2017.5,2320.13,8
CPT,28193,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,28193,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,28193,Outpatient Surgical Group 4,11474.0,7458.1,17187.58,25517.11,50
CPT,28200,HB REPAIR FOOT FLEXOR TENDON EACH,8738.51,5680.03,4040.15,4646.17,8
CPT,28200,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28200,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28200,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28202,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28202,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28202,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28208,HB REPAIR FOOT EXTENSOR TENDON EACH,16289.4,10588.11,4040.15,4646.17,8
CPT,28208,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,28208,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,28208,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,28210,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28210,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28210,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28220,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28220,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28220,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28222,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28222,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28222,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28225,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28225,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28225,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28226,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28226,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28226,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28230,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28230,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28230,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28232,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,28232,Outpatient Grouper - 3,6099.75,3964.84,14341.63,15558.59,24
CPT,28232,Outpatient Surgical Group 3,6099.75,3964.84,13899.75,20635.92,50
CPT,28234,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28234,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28234,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28238,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28238,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28238,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28240,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28240,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28250,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28250,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28260,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28260,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28260,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28261,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28261,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28261,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28262,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28262,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28262,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28264,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,28264,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28270,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28270,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28270,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28272,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28272,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28272,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28280,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28280,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28280,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28285,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28285,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28285,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28286,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28286,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28286,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28288,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28288,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28288,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28289,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28289,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28289,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28291,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28291,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28291,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28292,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28292,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28292,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28295,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28295,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28295,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28296,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28296,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28296,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28297,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28297,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28297,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28298,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28298,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28298,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28299,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28299,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28299,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,28300,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28300,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28300,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28302,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28302,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28302,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28304,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28304,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28304,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28305,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28305,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28305,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28306,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28306,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28306,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28307,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28307,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,28307,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28308,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28308,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28308,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28309,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28309,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28309,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28310,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28310,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28310,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28312,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28312,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28312,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28313,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28313,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28313,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28315,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28315,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28315,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28320,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28320,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28320,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28322,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28322,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28322,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28340,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28340,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28340,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28341,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28341,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28341,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28344,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28344,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28344,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28345,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28345,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28345,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28360,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28360,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28360,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,28400,HB CL TX CALCANEAL FX;WO MANIP,2558.645,1663.12,298.7,14761.0,10
CPT,28400,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28400,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28400,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,28405,OUTPATIENT SURGERY CPT GROUP 1,2108.91,1370.79,6417.0,7038.0,2
CPT,28405,Outpatient Grouper - 0,2108.91,1370.79,9059.94,9827.82,24
CPT,28405,Outpatient Surgical Group 2,2108.91,1370.79,12162.28,18056.43,50
CPT,28406,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28406,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28406,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28415,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28415,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28415,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28420,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28420,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28420,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28430,HB CL TX TALUS FX; WO MANIP,2224.9,1446.19,298.7,343.5,16
CPT,28430,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28430,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28430,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28435,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,28435,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,28435,Outpatient Surgical Group 2,6099.75,3964.84,12162.28,18056.43,50
CPT,28436,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28436,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28436,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28445,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28445,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28445,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28446,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28446,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28446,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28450,HB TX TARSAL BONE FX;WO MANIPU,2558.645,1663.12,298.7,14761.0,10
CPT,28450,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28450,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28450,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28455,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,28455,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,28455,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28456,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28456,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28456,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28465,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28465,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28465,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28470,HB CL TX METATARSAL FX;WOMANIP,2558.645,1663.12,298.7,14761.0,20
CPT,28470,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28470,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28470,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28475,HB CL TX METATARSAL FX;W MANIP,2224.9,1446.19,298.7,343.5,8
CPT,28475,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28475,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28475,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28476,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28476,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28476,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28485,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28485,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28485,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28490,HB CL TX FX GT PHALANX(S); W/O MANIP,2558.645,1663.12,298.7,14761.0,18
CPT,28490,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28490,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28490,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28495,HB FX TOE W MANIPULATION,2224.9,1446.19,298.7,343.5,8
CPT,28495,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28495,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28495,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28496,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28496,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28496,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28505,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28505,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28505,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28510,HB TOES 2-5 FX W/O MAINIP,2436.81,1583.925,298.7,14761.0,18
CPT,28510,OUTPATIENT SURGERY CPT GROUP 1,2118.97,1377.33,6417.0,7038.0,2
CPT,28510,Outpatient Grouper - 0,2118.97,1377.33,9059.94,9827.82,24
CPT,28510,Outpatient Surgical Group 0,2118.97,1377.33,2806.68,4166.87,50
CPT,28515,HB TOES 2-5 FX W/MAINIP,2224.9,1446.19,298.7,343.5,8
CPT,28515,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28515,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28515,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28525,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,28525,Outpatient Surgery Group 3 Global Rate,16289.4,10588.11,22055.0,22787.0,2
CPT,28525,Outpatient Surgical Group 3,16289.4,10588.11,13899.75,20635.92,50
CPT,28530,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28530,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28530,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28531,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28531,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28531,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28540,HB CL TX TARSAL BONE DISLO; WO ANESTH,2224.9,1446.19,298.7,343.5,8
CPT,28540,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28540,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28540,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28545,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,28545,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,28545,Outpatient Surgical Group 1,16289.4,10588.11,9088.3,13492.72,50
CPT,28546,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28546,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28546,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28555,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28555,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28555,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28570,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28570,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28570,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28575,OUTPATIENT SURGERY CPT GROUP 1,16289.4,10588.11,6417.0,7038.0,2
CPT,28575,Outpatient Grouper - 2,16289.4,10588.11,13036.88,14143.2,24
CPT,28575,Outpatient Surgical Group 1,16289.4,10588.11,9088.3,13492.72,50
CPT,28576,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28576,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28576,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28585,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28585,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28585,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28600,HB CL TX TMT JNT DISL; WO ANESTHESIA,2224.9,1446.19,298.7,343.5,8
CPT,28600,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28600,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28600,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28605,OUTPATIENT SURGERY CPT GROUP 1,2669.91,1735.44,6417.0,7038.0,2
CPT,28605,Outpatient Grouper - 0,2669.91,1735.44,9059.94,9827.82,24
CPT,28605,Outpatient Surgical Group 1,2669.91,1735.44,9088.3,13492.72,50
CPT,28606,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28606,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28606,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28615,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28615,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28630,HB METATARSAL-PHALANGEAL DISLOC,2224.9,1446.19,298.7,343.5,8
CPT,28630,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28630,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28630,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28635,OUTPATIENT SURGERY CPT GROUP 1,6099.75,3964.84,6417.0,7038.0,2
CPT,28635,Outpatient Grouper - 2,6099.75,3964.84,13036.88,14143.2,24
CPT,28635,Outpatient Surgical Group 1,6099.75,3964.84,9088.3,13492.72,50
CPT,28636,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28636,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28636,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28645,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28645,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28645,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28660,HB INTERPHALANGEAL DISLOCATION,2224.9,1446.19,298.7,343.5,8
CPT,28660,OUTPATIENT SURGERY CPT GROUP 1,2224.9,1446.19,6417.0,7038.0,2
CPT,28660,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28660,Outpatient Surgical Group 0,2224.9,1446.19,2806.68,4166.87,50
CPT,28665,HB CL TX IP JOINT DISL; W ANESTH,2539.84,1650.9,330.7,380.3,8
CPT,28665,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,28665,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,28665,Outpatient Surgical Group 1,2539.84,1650.9,9088.3,13492.72,50
CPT,28666,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28666,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28666,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28675,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28675,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28675,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,28705,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28705,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28705,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28715,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28715,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28715,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28725,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28725,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28725,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28730,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28730,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28730,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28735,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28735,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28735,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28737,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28737,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,28737,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,28740,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28740,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28740,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28750,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28750,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28750,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28755,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28755,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28755,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28760,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,28760,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,28760,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,28800,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28800,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28805,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28805,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28805,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,28810,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28810,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28810,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28820,Outpatient Grouper - 3,16289.4,10588.11,14341.63,15558.59,24
CPT,28820,Outpatient Surgery Group 2 Global Rate,16289.4,10588.11,14322.0,15354.0,2
CPT,28820,Outpatient Surgical Group 2,16289.4,10588.11,12162.28,18056.43,50
CPT,28825,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,28825,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,28825,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,28890,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,28890,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,28899,Outpatient Grouper - 0,2224.9,1446.19,9059.94,9827.82,24
CPT,28899,Outpatient Surgical Group 1,2224.9,1446.19,9088.3,13492.72,50
CPT,29000,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29000,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29000,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29010,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29010,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29010,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29015,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29015,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29015,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29035,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29035,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29035,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29040,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29040,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29040,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29044,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29044,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29044,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29046,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29046,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29046,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29049,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,29049,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29049,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29055,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,29055,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29055,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29058,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,29058,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29058,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29065,HB CAST APP - LONG ARM,2539.84,1650.9,330.7,380.3,8
CPT,29065,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29065,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29065,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29075,HB CAST APP - SHORT ARM,2539.84,1650.9,330.7,380.3,16
CPT,29075,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29075,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29075,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29085,HB CAST GAUNTLET,1344.46,873.9,196.48,225.95,8
CPT,29085,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29085,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29085,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29086,HB CAST APP - THUMB/FINGER,1344.46,873.9,196.48,225.95,8
CPT,29086,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29086,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29086,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29105,HB SPLINT APP - LONG ARM,1546.125,1004.98,196.48,14761.0,20
CPT,29105,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29105,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29105,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29125,HB SPLINT APP - SHORT ARM,1235.425,803.025,160.5,14761.0,18
CPT,29125,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,29125,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,29125,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,29126,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,29126,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,29126,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,29130,"HB APPLICATION, FINGER SPLINT",1192.76,775.29,160.5,14761.0,18
CPT,29130,OUTPATIENT SURGERY CPT GROUP 1,1037.19,674.17,6417.0,7038.0,2
CPT,29130,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,29130,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,29131,HB APPLY FINGER SPLINT; DYNAMIC,1037.19,674.17,73.96,85.06,16
CPT,29131,OUTPATIENT SURGERY CPT GROUP 1,1037.19,674.17,6417.0,7038.0,2
CPT,29131,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,29131,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,29200,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29200,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29200,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29240,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,29240,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,29240,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,29260,OUTPATIENT SURGERY CPT GROUP 1,401.31,260.85,6417.0,7038.0,2
CPT,29260,Outpatient Grouper - 0,401.31,260.85,9059.94,9827.82,24
CPT,29260,Outpatient Surgical Group 0,401.31,260.85,2806.68,4166.87,50
CPT,29280,HB STRAPPING HAND/FINGER,401.31,260.85,73.96,85.06,8
CPT,29280,OUTPATIENT SURGERY CPT GROUP 1,401.31,260.85,6417.0,7038.0,2
CPT,29280,Outpatient Grouper - 0,401.31,260.85,9059.94,9827.82,24
CPT,29280,Outpatient Surgical Group 0,401.31,260.85,2806.68,4166.87,50
CPT,29305,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29305,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29305,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29325,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29325,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29325,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29345,HB CAST APP - LONG LEG,2539.84,1650.9,330.7,380.3,16
CPT,29345,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29345,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29345,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29355,HB CAST APP - LONG LEG WALK CAST,2539.84,1650.9,330.7,380.3,8
CPT,29355,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29355,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29355,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29358,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,29358,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29358,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29365,HB CAST LONG LEG/THIGH TO ANKLE,2539.84,1650.9,330.7,380.3,8
CPT,29365,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29365,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29365,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29405,HB CAST APP - SHORT LEG,2920.825,1898.54,330.7,14761.0,20
CPT,29405,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29405,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29405,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29425,HB CAST APP - SHORT LEG WALK CAST,2539.84,1650.9,330.7,380.3,8
CPT,29425,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29425,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29425,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29435,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29435,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29435,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29440,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,29440,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29440,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,29445,HB CAST APP - RIGID TOTAL CONTACT LEG CAST,2539.84,1650.9,330.7,380.3,8
CPT,29445,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29445,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29445,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29450,HB CAST APP - CLUBFOOT W/ MANI,1344.46,873.9,196.48,225.95,8
CPT,29450,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29450,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29450,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29505,HB SPLINT APP - LONG LEG,1546.125,1004.98,196.48,14761.0,18
CPT,29505,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29505,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29515,HB SPLINT APP - SHORT LEG,1546.125,1004.98,196.48,14761.0,20
CPT,29515,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29515,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29520,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,29520,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,29530,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,29530,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,29540,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29540,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29550,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,29550,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,29580,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29580,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29581,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29581,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29584,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29584,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29700,"HB REM GAUNTLET,BOOT - BDY CST",2539.84,1650.9,330.7,380.3,16
CPT,29700,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29700,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29700,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29705,HB REM/BIVALVE - FULL ARM/LEG,2539.84,1650.9,330.7,380.3,8
CPT,29705,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29705,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29705,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29710,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29710,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29710,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29720,HB CAST - REPAIR,1344.46,873.9,196.48,225.95,8
CPT,29720,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29720,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29720,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29730,HB CAST - WINDOWING,1344.46,873.9,196.48,225.95,8
CPT,29730,OUTPATIENT SURGERY CPT GROUP 1,1344.46,873.9,6417.0,7038.0,2
CPT,29730,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29730,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29740,HB CAST WEDGING,2539.84,1650.9,330.7,380.3,8
CPT,29740,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29740,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29740,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29750,OUTPATIENT SURGERY CPT GROUP 1,2539.84,1650.9,6417.0,7038.0,2
CPT,29750,Outpatient Grouper - 0,2539.84,1650.9,9059.94,9827.82,24
CPT,29750,Outpatient Surgical Group 0,2539.84,1650.9,2806.68,4166.87,50
CPT,29799,Outpatient Grouper - 0,1344.46,873.9,9059.94,9827.82,24
CPT,29799,Outpatient Surgical Group 0,1344.46,873.9,2806.68,4166.87,50
CPT,29800,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29800,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29800,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29804,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29804,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29804,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29805,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29805,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29805,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29806,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29806,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29806,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29807,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29807,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29807,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29819,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29819,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29819,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29820,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29820,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29820,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29821,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29821,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29821,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29822,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29822,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29822,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29823,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29823,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29823,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29824,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29824,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29824,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,29825,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29825,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29825,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29826,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29826,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29826,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29827,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29827,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29827,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,29828,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29828,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29828,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29830,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29830,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29834,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29834,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29834,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29835,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29835,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29835,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29836,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29836,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29836,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29837,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29837,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29837,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29838,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29838,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29838,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29840,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29840,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29840,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29843,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29843,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29843,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29844,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29844,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29844,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29845,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29845,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29845,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29846,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29846,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29846,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29847,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29847,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29847,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29848,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29848,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29848,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29850,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29850,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29850,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29851,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,29851,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29851,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29855,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29855,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29855,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29856,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29856,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29856,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29860,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29860,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29860,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29861,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29861,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29861,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29862,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29862,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,29862,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29863,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29863,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29863,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29866,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29866,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,29866,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29867,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29867,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,29867,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29868,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29868,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29868,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29870,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29870,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29870,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29871,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29871,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29871,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29873,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29873,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29873,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,29874,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29874,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29874,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29875,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29875,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29875,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29876,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29876,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29876,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29877,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29877,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29877,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29879,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29879,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29879,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29880,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29880,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29880,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29881,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29881,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29881,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29882,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29882,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,29882,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29883,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29883,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,29883,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29884,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29884,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29884,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29885,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29885,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29885,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29886,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29886,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29886,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29887,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29887,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29887,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29888,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29888,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,29888,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29889,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29889,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,29889,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29891,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29891,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29891,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29892,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,29892,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29892,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29893,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,29893,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29893,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,29894,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29894,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29894,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29895,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29895,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29895,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29897,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29897,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29897,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29898,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29898,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29898,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29899,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29899,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,29899,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29900,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29900,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29900,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29901,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29901,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29901,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29902,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29902,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,29902,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29904,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29904,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29904,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29905,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29905,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29905,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29906,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,29906,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29906,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,29907,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29907,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,29907,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29914,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29914,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29914,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29915,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29915,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29915,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29916,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,29916,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,29916,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,29999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,29999,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30000,HB DR ABSC/HEMATOMA NASAL INT,2070.32,1345.71,289.16,332.53,8
CPT,30000,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,30000,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,30020,HB DR ABSC/HEMATOMA NASAL SEPTUM,3400.5,2210.325,634.11,14761.0,10
CPT,30020,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,30020,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,30100,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30115,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30115,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30115,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30117,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30117,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30117,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30118,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30118,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30118,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30124,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30124,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30124,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30125,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30125,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30125,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30130,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30140,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30140,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30140,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30150,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30150,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30150,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30160,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30160,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,30160,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30200,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30200,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,30200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30210,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30210,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30210,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30220,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30220,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30300,HB REMOVE INTRANASAL FB,1074.29,698.29,160.5,184.58,8
CPT,30300,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,30300,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,30310,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30310,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30310,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30320,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30320,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30320,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30400,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30400,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,30400,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30410,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30410,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30410,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30420,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30420,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30430,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30430,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30430,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30435,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30435,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30435,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30450,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30450,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30450,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,30460,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30460,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30460,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,30462,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30462,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30462,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,30465,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30465,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30465,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,30468,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30468,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30468,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,30469,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30469,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,30469,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,30520,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30520,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,30520,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30540,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30540,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,30540,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30545,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30545,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30545,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,30560,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,30560,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30580,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30580,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,30580,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30600,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30600,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,30600,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30620,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,30620,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,30620,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,30630,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30630,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,30630,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,30801,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30801,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30801,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30802,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30802,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,30802,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,30901,HB ANT. EPISTAXIS SIMPLE,1182.29,768.49,160.5,14761.0,10
CPT,30901,OUTPATIENT SURGERY CPT GROUP 1,1028.07,668.25,6417.0,7038.0,2
CPT,30901,Outpatient Grouper - 0,1028.07,668.25,9059.94,9827.82,24
CPT,30901,Outpatient Surgical Group 0,1028.07,668.25,2806.68,4166.87,50
CPT,30903,HB ANT. EPISTAXIS COMPLEX,2366.93,1538.505,160.5,14761.0,10
CPT,30903,OUTPATIENT SURGERY CPT GROUP 1,2058.2,1337.83,6417.0,7038.0,2
CPT,30903,Outpatient Grouper - 0,2058.2,1337.83,9059.94,9827.82,24
CPT,30903,Outpatient Surgical Group 1,2058.2,1337.83,9088.3,13492.72,50
CPT,30905,HB POSTERIOR EPISTAXIS INITIAL,1235.425,803.025,160.5,14761.0,10
CPT,30905,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,30905,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,30905,Outpatient Surgical Group 1,1074.29,698.29,9088.3,13492.72,50
CPT,30906,OUTPATIENT SURGERY CPT GROUP 1,1043.82,678.48,6417.0,7038.0,2
CPT,30906,Outpatient Grouper - 0,1043.82,678.48,9059.94,9827.82,24
CPT,30906,Outpatient Surgical Group 1,1043.82,678.48,9088.3,13492.72,50
CPT,30915,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,30915,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,30915,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,30920,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,30920,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,30920,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,30930,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,30930,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,30930,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,30999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,30999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31000,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31000,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31002,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31002,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31002,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31030,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31030,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31030,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31032,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31032,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31032,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31040,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31040,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31040,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31050,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31050,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31050,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31051,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31051,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31051,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31070,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31070,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31070,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31075,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31075,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31075,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31080,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31080,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31080,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31081,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31081,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31081,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31084,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31084,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31084,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31085,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31085,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31085,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31086,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31086,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31086,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31087,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31087,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31087,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31090,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31090,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31090,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31200,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31200,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31201,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31201,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31201,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31205,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31205,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31205,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31225,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31225,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31225,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31230,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31230,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31230,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31231,HB DX NASAL ENDOSCOPY,1840.745,1196.4850000000001,241.74,14761.0,10
CPT,31231,Outpatient Grouper - 0,1600.66,1040.43,9059.94,9827.82,24
CPT,31231,Outpatient Surgical Group 0,1600.66,1040.43,2806.68,4166.87,50
CPT,31233,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31233,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31235,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31235,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31237,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31237,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31237,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31238,OUTPATIENT SURGERY CPT GROUP 1,18282.3,11883.5,6417.0,7038.0,2
CPT,31238,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31238,Outpatient Surgical Group 1,18282.3,11883.5,9088.3,13492.72,50
CPT,31239,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31239,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31239,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31240,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31240,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31241,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31241,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31241,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31242,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31242,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,31243,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31243,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,31253,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31253,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31253,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31254,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31254,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31254,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31255,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31255,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31255,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31256,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31256,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31256,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31257,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31257,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31257,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31259,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31259,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31259,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31267,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31267,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31267,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31276,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31276,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31276,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31287,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31287,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31287,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31288,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31288,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31288,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31290,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31290,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31290,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31291,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31291,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31291,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31292,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31292,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31292,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31293,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31293,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31293,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31294,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31294,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31294,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31295,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31295,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31295,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31296,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31296,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31296,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31297,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31297,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31297,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31298,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31298,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31298,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31299,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31299,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31300,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31300,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31300,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31360,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31360,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31360,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31365,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31365,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31365,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31367,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31367,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,31367,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31368,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31368,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31368,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,31370,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31370,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31370,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31375,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31375,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31375,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31380,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31380,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31380,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31382,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31382,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,31382,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31390,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31390,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31390,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,31395,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31395,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31395,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,31400,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31400,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31420,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31420,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31500,HB ENDOTRACHEAL INTUBATION,2380.875,1547.5700000000002,289.16,14761.0,20
CPT,31500,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,31500,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,31502,HB TRACH TUBE CHANGE,2380.875,1547.5700000000002,289.16,14761.0,10
CPT,31502,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,31502,Outpatient Surgical Group 0,2070.32,1345.71,2806.68,4166.87,50
CPT,31505,"HB LARYNGOSCOPY, INDIRECT DIAGNOSTIC",2080.83,1352.54,13270.0,14761.0,2
CPT,31505,OUTPATIENT SURGERY CPT GROUP 1,1600.66,1040.43,6417.0,7038.0,2
CPT,31505,Outpatient Grouper - 0,1600.66,1040.43,9059.94,9827.82,24
CPT,31505,Outpatient Surgical Group 1,1600.66,1040.43,9088.3,13492.72,50
CPT,31510,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31510,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31510,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31511,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31511,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31511,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31512,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31512,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31512,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31513,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31513,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31513,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31515,OUTPATIENT SURGERY CPT GROUP 1,2426.05,1576.93,6417.0,7038.0,2
CPT,31515,Outpatient Grouper - 0,2426.05,1576.93,9059.94,9827.82,24
CPT,31515,Outpatient Surgical Group 1,2426.05,1576.93,9088.3,13492.72,50
CPT,31520,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31520,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31525,HB DX LARYNGOSCOPY EXCL NB,21024.65,13666.025,2147.29,14761.0,10
CPT,31525,OUTPATIENT SURGERY CPT GROUP 1,18282.3,11883.5,6417.0,7038.0,2
CPT,31525,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31525,Outpatient Surgical Group 1,18282.3,11883.5,9088.3,13492.72,50
CPT,31526,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31526,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31526,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31527,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31527,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31527,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31528,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31528,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31528,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31529,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31529,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31529,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31530,"HB LARYNGOSCOPY,DIRCT,OP,F.B. REMVL",18282.3,11883.5,2147.29,2469.38,8
CPT,31530,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31530,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31530,Outpatient Surgical Group 2,18282.3,11883.5,12162.28,18056.43,50
CPT,31531,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31531,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31531,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31535,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31535,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31535,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31536,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31536,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31536,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31540,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31540,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31540,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31541,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31541,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31541,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31545,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31545,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31545,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31546,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31546,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31546,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31551,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31551,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31551,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31552,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31552,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31552,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31553,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31553,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31553,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31554,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31554,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31554,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31560,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31560,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31560,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31561,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31561,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31561,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31570,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31570,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31570,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31571,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31571,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31571,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31572,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31572,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31572,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31573,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31573,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31573,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31574,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31574,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31574,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31575,"HB ENT-LARYNGO, FLEXE, DX",1840.745,1196.4850000000001,241.74,14761.0,18
CPT,31575,OUTPATIENT SURGERY CPT GROUP 1,1600.66,1040.43,6417.0,7038.0,2
CPT,31575,Outpatient Grouper - 0,1600.66,1040.43,9059.94,9827.82,24
CPT,31575,Outpatient Surgical Group 0,1600.66,1040.43,2806.68,4166.87,50
CPT,31576,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31576,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31576,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31577,OUTPATIENT SURGERY CPT GROUP 1,2426.05,1576.93,6417.0,7038.0,2
CPT,31577,Outpatient Grouper - 0,2426.05,1576.93,9059.94,9827.82,24
CPT,31577,Outpatient Surgical Group 2,2426.05,1576.93,12162.28,18056.43,50
CPT,31578,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31578,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31578,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31579,HB SP VIDEOSTROBOSCOPY - (4) EXT,1819.55,1182.71,483.52,556.05,8
CPT,31579,OUTPATIENT SURGERY CPT GROUP 1,1819.55,1182.71,6417.0,7038.0,2
CPT,31579,Outpatient Grouper - 0,1819.55,1182.71,9059.94,9827.82,24
CPT,31579,Outpatient Surgical Group 1,1819.55,1182.71,9088.3,13492.72,50
CPT,31580,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31580,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31580,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31584,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,31584,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31584,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31587,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31587,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31587,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31590,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31590,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31590,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31591,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31591,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31591,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31592,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31592,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31592,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31599,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31599,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31600,HB TRACHEOSTOMY,13916.36,9045.635,4038.23,14761.0,10
CPT,31600,Outpatient Grouper - 3,12101.2,7865.78,14341.63,15558.59,24
CPT,31600,Outpatient Surgery Group 2 Global Rate,12101.2,7865.78,14322.0,15354.0,2
CPT,31600,Outpatient Surgical Group 4,12101.2,7865.78,17187.58,25517.11,50
CPT,31601,Outpatient Grouper - 3,22997.3,14948.25,14341.63,15558.59,24
CPT,31601,Outpatient Surgery Group 2 Global Rate,22997.3,14948.25,14322.0,15354.0,2
CPT,31601,Outpatient Surgical Group 4,22997.3,14948.25,17187.58,25517.11,50
CPT,31603,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,31603,Outpatient Surgery Group 3 Global Rate,6745.34,4384.47,22055.0,22787.0,2
CPT,31603,Outpatient Surgical Group 1,6745.34,4384.47,9088.3,13492.72,50
CPT,31605,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,31605,Outpatient Surgery Group 2 Global Rate,2070.32,1345.71,14322.0,15354.0,2
CPT,31605,Outpatient Surgical Group 2,2070.32,1345.71,12162.28,18056.43,50
CPT,31610,Outpatient Grouper - 3,22997.3,14948.25,14341.63,15558.59,24
CPT,31610,Outpatient Surgery Group 2 Global Rate,22997.3,14948.25,14322.0,15354.0,2
CPT,31610,Outpatient Surgical Group 4,22997.3,14948.25,17187.58,25517.11,50
CPT,31611,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31611,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,31611,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31612,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31612,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31612,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31613,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31613,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31613,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31614,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31614,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31614,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31615,HB TRACHEOBRONCH THRU OLD INC,3400.5,2210.325,634.11,14761.0,10
CPT,31615,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,31615,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,31615,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,31622,HB DX BRONCHOSCOPE/WASH,21024.65,13666.025,2147.29,14761.0,10
CPT,31622,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31622,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31622,Outpatient Surgical Group 1,18282.3,11883.5,9088.3,13492.72,50
CPT,31623,HB PC BRONCH W/ BRUSHING,18282.3,11883.5,2147.29,14761.0,18
CPT,31623,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31623,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31623,Outpatient Surgical Group 2,18282.3,11883.5,12162.28,18056.43,50
CPT,31624,HB PC BRONCH:ALEVOLAR LAVAGE,18282.3,11883.5,2147.29,14761.0,26
CPT,31624,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31624,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31624,Outpatient Surgical Group 2,18282.3,11883.5,12162.28,18056.43,50
CPT,31625,"HB PC BRONCH W/ BIOPSY, SINGLE/MULTI",18282.3,11883.5,2147.29,14761.0,26
CPT,31625,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31625,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31625,Outpatient Surgical Group 2,18282.3,11883.5,12162.28,18056.43,50
CPT,31626,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31626,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31626,Outpatient Surgical Group 3,25520.1,16588.06,13899.75,20635.92,50
CPT,31627,HB BRONCH W FLUORO COMPTR ASST,11841.8,7697.17,13270.0,14761.0,2
CPT,31627,HB PC BRONCH W/ BRUSHING,18282.3,11883.5,2147.29,2469.38,8
CPT,31627,OUTPATIENT SURGERY CPT GROUP 1,11841.8,7697.17,6417.0,7038.0,2
CPT,31627,Outpatient Grouper - 0,11841.8,7697.17,9059.94,9827.82,24
CPT,31628,HB BRONCH W TB SGL LOBE LUNG BX,18023.5,11715.27,4590.95,14761.0,18
CPT,31628,"HB PC BRONCH W/ BIOPSY, SINGLE/MULTI",18282.3,11883.5,2147.29,2469.38,8
CPT,31628,HB PC BRONCH:ALEVOLAR LAVAGE,18282.3,11883.5,2147.29,2469.38,8
CPT,31628,Outpatient Grouper - 2,18023.5,11715.27,13036.88,14143.2,24
CPT,31628,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31628,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31629,HB ASPIR NDL BIOPSY(S) TRNSBRONCH,18023.5,11715.27,4590.95,14761.0,18
CPT,31629,"HB PC BRONCH W/ BIOPSY, SINGLE/MULTI",18282.3,11883.5,2147.29,2469.38,8
CPT,31629,HB PC BRONCH:ALEVOLAR LAVAGE,18282.3,11883.5,2147.29,2469.38,8
CPT,31629,Outpatient Grouper - 4,18023.5,11715.27,19724.25,21397.98,24
CPT,31629,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31629,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31630,HB BRONCHOSCOPY DILATE/FX REPR,20727.015,13472.555,4590.95,14761.0,10
CPT,31630,Outpatient Grouper - 4,18023.5,11715.27,19724.25,21397.98,24
CPT,31630,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31630,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31631,HB PC BRONCH: TRACH STENT,25520.1,16588.06,8619.78,14761.0,10
CPT,31631,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31631,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31631,Outpatient Surgical Group 2,25520.1,16588.06,12162.28,18056.43,50
CPT,31632,"HB TB LUNG BIOPSY, EA ADDTL LOBE",13322.1,8659.36,13270.0,14761.0,2
CPT,31632,OUTPATIENT SURGERY CPT GROUP 1,13322.1,8659.36,6417.0,7038.0,2
CPT,31632,Outpatient Grouper - 0,13322.1,8659.36,9059.94,9827.82,24
CPT,31632,Outpatient Surgical Group 1,13322.1,8659.36,9088.3,13492.72,50
CPT,31633,HB BRONCHOSCOPY/NEEDLE BX ADDL,12667.3,8233.74,,,0
CPT,31633,OUTPATIENT SURGERY CPT GROUP 1,12667.3,8233.74,6417.0,7038.0,2
CPT,31633,Outpatient Grouper - 0,12667.3,8233.74,9059.94,9827.82,24
CPT,31633,Outpatient Surgical Group 1,12667.3,8233.74,9088.3,13492.72,50
CPT,31634,HB BRONCH W/BALLOON OCCLUSION,25520.1,16588.06,8619.78,14761.0,10
CPT,31634,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31634,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31634,Outpatient Surgical Group 2,25520.1,16588.06,12162.28,18056.43,50
CPT,31635,HB BRONCHOSCOPY; W REMOVAL FB,21024.65,13666.025,2147.29,14761.0,10
CPT,31635,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31635,Outpatient Surgery Group 2 Global Rate,18282.3,11883.5,14322.0,15354.0,2
CPT,31635,Outpatient Surgical Group 2,18282.3,11883.5,12162.28,18056.43,50
CPT,31636,HB PC BRONCH: BRONCH STENT,25520.1,16588.06,8619.78,14761.0,10
CPT,31636,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31636,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31636,Outpatient Surgical Group 4,25520.1,16588.06,17187.58,25517.11,50
CPT,31637,HB PC BRONCH: ADDL BRONCH STENT,22284.9,14485.19,13270.0,14761.0,2
CPT,31637,OUTPATIENT SURGERY CPT GROUP 1,22284.9,14485.19,6417.0,7038.0,2
CPT,31637,Outpatient Grouper - 0,22284.9,14485.19,9059.94,9827.82,24
CPT,31637,Outpatient Surgical Group 1,22284.9,14485.19,9088.3,13492.72,50
CPT,31638,HB PC BRONCH: STENT REVISION,25520.1,16588.06,13270.0,14761.0,2
CPT,31638,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31638,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31638,Outpatient Surgical Group 4,25520.1,16588.06,17187.58,25517.11,50
CPT,31640,HB BRONCHOSCOPY W/ EXCISION OF TUMOR,20727.015,13472.555,4590.95,14761.0,10
CPT,31640,Outpatient Grouper - 4,18023.5,11715.27,19724.25,21397.98,24
CPT,31640,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31640,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31641,"HB BRONCHOSCOPY,TREAT BLOCKAGE",18023.5,11715.27,4590.95,14761.0,10
CPT,31641,Outpatient Grouper - 4,18023.5,11715.27,19724.25,21397.98,24
CPT,31641,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31641,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31643,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31643,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31643,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31645,HB BRONCHOSCOPY CLEAR AIRWAY,18282.3,11883.5,2147.29,14761.0,10
CPT,31645,OUTPATIENT SURGERY CPT GROUP 1,18282.3,11883.5,6417.0,7038.0,2
CPT,31645,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31645,Outpatient Surgical Group 1,18282.3,11883.5,9088.3,13492.72,50
CPT,31646,OUTPATIENT SURGERY CPT GROUP 1,2426.05,1576.93,6417.0,7038.0,2
CPT,31646,Outpatient Grouper - 0,2426.05,1576.93,9059.94,9827.82,24
CPT,31646,Outpatient Surgical Group 1,2426.05,1576.93,9088.3,13492.72,50
CPT,31647,HB BRONCHIAL VALVE INIT INSERT,25520.1,16588.06,13270.0,14761.0,2
CPT,31647,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31647,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31647,Outpatient Surgical Group 2,25520.1,16588.06,12162.28,18056.43,50
CPT,31648,HB BRONCHIAL VALVE REMOV INIT,18023.5,11715.27,13270.0,14761.0,2
CPT,31648,Outpatient Grouper - 4,18023.5,11715.27,19724.25,21397.98,24
CPT,31648,Outpatient Surgery Group 2 Global Rate,18023.5,11715.27,14322.0,15354.0,2
CPT,31648,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31649,OUTPATIENT SURGERY CPT GROUP 1,18282.3,11883.5,6417.0,7038.0,2
CPT,31649,Outpatient Grouper - 2,18282.3,11883.5,13036.88,14143.2,24
CPT,31651,HB BRONCHIAL VALVE INSETN ADDL,22284.9,14485.19,13270.0,14761.0,2
CPT,31651,OUTPATIENT SURGERY CPT GROUP 1,22284.9,14485.19,6417.0,7038.0,2
CPT,31651,Outpatient Grouper - 0,22284.9,14485.19,9059.94,9827.82,24
CPT,31652,HB BRONCH EBUS SAMPLNG 1/2 NODE,18023.5,11715.27,4590.95,14761.0,10
CPT,31652,OUTPATIENT SURGERY CPT GROUP 1,18023.5,11715.27,6417.0,7038.0,2
CPT,31652,Outpatient Grouper - 3,18023.5,11715.27,14341.63,15558.59,24
CPT,31652,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31653,HB BRONCH EBUS SAMPLNG 3/> NODE,18023.5,11715.27,4590.95,14761.0,18
CPT,31653,OUTPATIENT SURGERY CPT GROUP 1,18023.5,11715.27,6417.0,7038.0,2
CPT,31653,Outpatient Grouper - 3,18023.5,11715.27,14341.63,15558.59,24
CPT,31653,Outpatient Surgical Group 2,18023.5,11715.27,12162.28,18056.43,50
CPT,31654,HB BRONCH EBUS IVNTJ PERPH LES,10967.2,7128.68,13270.0,14761.0,2
CPT,31654,OUTPATIENT SURGERY CPT GROUP 1,10967.2,7128.68,6417.0,7038.0,2
CPT,31654,Outpatient Grouper - 0,10967.2,7128.68,9059.94,9827.82,24
CPT,31654,Outpatient Surgical Group 1,10967.2,7128.68,9088.3,13492.72,50
CPT,31660,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31660,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31660,Outpatient Surgical Group 2,25520.1,16588.06,12162.28,18056.43,50
CPT,31661,Outpatient Grouper - 4,25520.1,16588.06,19724.25,21397.98,24
CPT,31661,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,31661,Outpatient Surgical Group 3,25520.1,16588.06,13899.75,20635.92,50
CPT,31717,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31717,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31717,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31720,HB PC SUCTIONING,622.08,404.35,253.26,14761.0,12
CPT,31720,OUTPATIENT SURGERY CPT GROUP 1,622.08,404.35,6417.0,7038.0,2
CPT,31720,Outpatient Grouper - 0,622.08,404.35,9059.94,9827.82,24
CPT,31720,Outpatient Surgical Group 1,622.08,404.35,9088.3,13492.72,50
CPT,31725,HB CATHETER ASPIRATION FIBERSCOPE BEDSIDE,16467.43,10703.83,13270.0,14761.0,2
CPT,31725,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31725,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31725,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31730,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31730,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31730,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31750,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31750,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,31750,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,31755,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,31755,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31755,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31760,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31760,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31766,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31766,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31766,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31770,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31770,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31770,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31775,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31775,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31775,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31780,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31780,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31780,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31781,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31781,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,31781,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,31785,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31785,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31785,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31786,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31786,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,31786,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31800,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,31800,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31805,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,31805,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,31805,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,31820,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,31820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,31825,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31825,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31825,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,31830,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,31830,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,31899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,31899,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32035,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32035,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32035,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32036,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32036,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32036,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32096,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32096,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32096,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32097,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32097,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32097,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32098,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32098,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32098,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32100,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32110,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32110,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32120,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32124,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32124,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32124,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32140,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32141,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32150,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32150,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32150,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32151,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32151,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32151,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32160,HB THORACOTOMY W/ CARDIAC MASSAGE,8847.975,5751.1849999999995,13270.0,14761.0,2
CPT,32160,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32160,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,32160,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32200,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32200,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32215,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32215,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32215,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32220,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32220,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32220,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32225,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32225,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32225,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32310,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32310,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32310,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32320,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32320,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32400,HB BIOPSY LUNG,13195.1,8576.815,2017.5,14761.0,10
CPT,32400,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,32400,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,32400,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,32405,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,32408,HB BIOPSY CORE NDL LUNG/MEDIA PERQ,13195.1,8576.815,2017.5,14761.0,10
CPT,32408,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,32408,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,32408,Outpatient Surgical Group 0,11474.0,7458.1,2806.68,4166.87,50
CPT,32440,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32440,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32440,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32442,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32442,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32442,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32445,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32445,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32445,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32480,Lung Lobectomy,,,18000.0,18000.0,1
CPT,32480,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32480,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32480,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32482,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32482,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32482,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32484,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32484,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32484,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32486,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32486,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32486,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32488,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32488,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32488,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32491,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32491,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32491,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32501,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32503,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32503,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32504,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32504,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32505,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32505,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32505,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32506,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32506,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32507,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32507,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32540,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32550,HB INSERT INDWELLING TUNNEL PLEURAL CATH,11768.73,7649.675,4394.34,14761.0,10
CPT,32550,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,32550,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,32550,Outpatient Surgical Group 1,10233.7,6651.91,9088.3,13492.72,50
CPT,32551,"HB CHEST TUBE PLMT,WTR SL OPN",9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,32551,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,32551,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,32551,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,32552,HB REMOVAL OF PLEURX CATHETER,6044.34,3928.8199999999997,769.85,14761.0,10
CPT,32552,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,32552,Outpatient Surgery Group 2 Global Rate,5255.94,3416.36,14322.0,15354.0,2
CPT,32552,Outpatient Surgical Group 0,5255.94,3416.36,2806.68,4166.87,50
CPT,32553,OUTPATIENT SURGERY CPT GROUP 1,17529.8,11394.37,6417.0,7038.0,2
CPT,32553,Outpatient Grouper - 2,17529.8,11394.37,13036.88,14143.2,24
CPT,32553,Outpatient Surgical Group 0,17529.8,11394.37,2806.68,4166.87,50
CPT,32554,HB THORACENTESIS WO IMG GUIDE,6044.34,3928.8199999999997,769.85,14761.0,10
CPT,32554,OUTPATIENT SURGERY CPT GROUP 1,5255.94,3416.36,6417.0,7038.0,2
CPT,32554,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,32554,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,32555,HB THORACENTESIS W IMG,7253.22,4714.594999999999,769.85,14761.0,10
CPT,32555,OUTPATIENT SURGERY CPT GROUP 1,6307.15,4099.65,6417.0,7038.0,2
CPT,32555,Outpatient Grouper - 1,6307.15,4099.65,10495.38,11385.92,24
CPT,32555,Outpatient Surgical Group 1,6307.15,4099.65,9088.3,13492.72,50
CPT,32556,OUTPATIENT SURGERY CPT GROUP 1,5437.85,3534.6,6417.0,7038.0,2
CPT,32556,Outpatient Grouper - 2,5437.85,3534.6,13036.88,14143.2,24
CPT,32556,Outpatient Surgical Group 1,5437.85,3534.6,9088.3,13492.72,50
CPT,32557,HB DRAINAGE PLEURA W CATH W IMG,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,32557,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,32557,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,32557,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,32560,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,32560,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,32560,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32561,HB LYSE CHEST FIBRIN INIT DAY,5255.94,3416.36,769.85,885.33,8
CPT,32561,OUTPATIENT SURGERY CPT GROUP 1,5255.94,3416.36,6417.0,7038.0,2
CPT,32561,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,32561,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,32562,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,32562,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,32562,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,32601,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,32601,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32601,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32604,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,32604,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32604,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32606,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,32606,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32606,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32607,Outpatient Grouper - 5,25927.2,16852.68,25486.19,27649.53,24
CPT,32607,Outpatient Surgery Group 3 Global Rate,25927.2,16852.68,22055.0,22787.0,2
CPT,32607,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,50
CPT,32608,Outpatient Grouper - 5,25927.2,16852.68,25486.19,27649.53,24
CPT,32608,Outpatient Surgery Group 3 Global Rate,25927.2,16852.68,22055.0,22787.0,2
CPT,32608,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,50
CPT,32609,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,32609,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32609,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32650,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,32650,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32651,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,32651,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32651,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32652,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,32652,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32652,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32653,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,32653,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32653,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32654,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32654,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32654,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32655,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,32655,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32655,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32656,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,32656,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32656,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32658,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32658,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32658,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32659,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32659,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32659,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32661,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32661,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32661,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32662,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32662,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32662,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32663,Lung Lobectomy,,,18000.0,18000.0,1
CPT,32663,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32663,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32663,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32664,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,32664,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32664,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32665,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32665,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32665,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32666,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32666,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32666,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32667,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32667,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32667,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,32668,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32668,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32668,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,32669,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32669,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32669,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32670,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32670,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32671,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32671,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32671,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32672,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32672,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32672,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32673,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32673,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32673,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32674,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32674,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32674,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,32800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32800,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,32800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32810,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32810,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32810,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32815,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32815,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,32815,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32820,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32820,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32850,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32850,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,32850,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32851,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
CPT,32851,Lung Transplants Hospital Services,,,115000.0,115000.0,1
CPT,32851,"Lung ù Double, Transplant",,,247942.77,247942.77,2
CPT,32851,"Lung ù Single, Transplant",,,223148.18,223148.18,2
CPT,32851,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32851,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32851,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,32851,"Transplant: Lung, Bilateral",,,160000.0,160000.0,1
CPT,32851,"Transplant: Lung, Single",,,160000.0,160000.0,1
CPT,32852,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
CPT,32852,Lung Transplants Hospital Services,,,115000.0,115000.0,1
CPT,32852,"Lung ù Double, Transplant",,,247942.77,247942.77,2
CPT,32852,"Lung ù Single, Transplant",,,223148.18,223148.18,2
CPT,32852,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32852,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32852,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32852,"Transplant: Lung, Bilateral",,,160000.0,160000.0,1
CPT,32852,"Transplant: Lung, Single",,,160000.0,160000.0,1
CPT,32853,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
CPT,32853,Lung Transplants Hospital Services,,,115000.0,115000.0,1
CPT,32853,"Lung ù Double, Transplant",,,247942.77,247942.77,2
CPT,32853,"Lung ù Single, Transplant",,,223148.18,223148.18,2
CPT,32853,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32853,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32853,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,32853,"Transplant: Lung, Bilateral",,,160000.0,160000.0,1
CPT,32853,"Transplant: Lung, Single",,,160000.0,160000.0,1
CPT,32854,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
CPT,32854,Lung Transplants Hospital Services,,,115000.0,115000.0,1
CPT,32854,"Lung ù Double, Transplant",,,247942.77,247942.77,2
CPT,32854,"Lung ù Single, Transplant",,,223148.18,223148.18,2
CPT,32854,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32854,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,32854,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,32855,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32855,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32856,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32856,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,32900,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32900,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32905,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32905,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32905,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32906,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32906,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,32906,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,32940,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,32940,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,32940,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32960,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,32960,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,32960,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32994,HB ABLAT THER PULM TUMOR PERQ CRYOABL,25951.8,16868.67,12963.93,14908.52,8
CPT,32994,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,32994,Outpatient Surgery Group 6 Global Rate,25951.8,16868.67,34526.0,35549.0,2
CPT,32994,Outpatient Surgical Group 2,25951.8,16868.67,12162.28,18056.43,50
CPT,32997,HB WHOLE LUNG LAVAGE,12592.72,8185.27,13270.0,14761.0,2
CPT,32997,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,32997,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,32997,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,32998,HB ABLATION R/F CHEST/LUNG UNI,25951.8,16868.67,7264.88,8354.61,8
CPT,32998,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,32998,Outpatient Surgery Group 6 Global Rate,25951.8,16868.67,34526.0,35549.0,2
CPT,32998,Outpatient Surgical Group 2,25951.8,16868.67,12162.28,18056.43,50
CPT,32999,HB UL PROC LOCALIZATION LUNG,5255.94,3416.36,769.85,885.33,8
CPT,32999,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,32999,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,33016,HB PERICARDIOCENTESIS W W/O IMG,9390.095,6103.5650000000005,1934.32,14761.0,12
CPT,33016,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,33016,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,33016,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,33017,HB PERICARD DRAIN 6YR+ W/O CONG CAR ANOM,5272.97,3427.43,13270.0,14761.0,2
CPT,33017,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33017,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33017,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33018,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33018,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33018,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33019,HB PERICARD DRAIN INSERT INDWELL CATH CT GUID,10842.1,7047.37,13270.0,14761.0,2
CPT,33019,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33019,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33019,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33020,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33020,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33020,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33025,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33025,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33025,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33030,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33030,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33030,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33031,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33031,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33031,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33050,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33050,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33050,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33120,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33120,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33130,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33141,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33202,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,13270.0,14761.0,2
CPT,33202,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33202,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33203,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33203,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,33206,HB INSRT NEW OR REPL PERM PCMKR+ATRIAL LEAD,77690.0,50498.5,13031.3,14986.0,8
CPT,33206,Outpatient Grouper - 7,77690.0,50498.5,32948.13,35744.6,24
CPT,33206,Outpatient Surgery Group 3 Global Rate,77690.0,50498.5,22055.0,22787.0,2
CPT,33206,Outpatient Surgical Group 9,77690.0,50498.5,36513.58,54208.97,50
CPT,33207,HB INSRT NEW OR REPL PERM PCMKR+VNTRC LEAD,77690.0,50498.5,13031.3,14986.0,10
CPT,33207,Outpatient Grouper - 7,77690.0,50498.5,32948.13,35744.6,24
CPT,33207,Outpatient Surgery Group 3 Global Rate,77690.0,50498.5,22055.0,22787.0,2
CPT,33207,Outpatient Surgical Group 9,77690.0,50498.5,36513.58,54208.97,50
CPT,33208,HB INSRT NEW OR REPL PERM PCMKR+VNTRC/ATRIAL,77690.0,50498.5,13031.3,14986.0,10
CPT,33208,Outpatient Grouper - 8,77690.0,50498.5,34726.75,37674.38,24
CPT,33208,Outpatient Surgery Group 5 Global Rate,77690.0,50498.5,32992.0,34883.0,2
CPT,33208,Outpatient Surgical Group 9,77690.0,50498.5,36513.58,54208.97,50
CPT,33210,HB INSERT TEMP PACELEAD SGL CL,58079.88,37751.92,13270.0,14761.0,2
CPT,33210,Outpatient Grouper - 6,44676.8,29039.92,28632.25,34209.93,24
CPT,33210,Outpatient Surgery Group 3 Global Rate,44676.8,29039.92,22055.0,22787.0,2
CPT,33210,Outpatient Surgical Group 9,44676.8,29039.92,36513.58,54208.97,50
CPT,33211,Outpatient Grouper - 6,36031.5,23420.48,28632.25,34209.93,24
CPT,33211,Outpatient Surgery Group 3 Global Rate,36031.5,23420.48,22055.0,22787.0,2
CPT,33211,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,50
CPT,33212,Outpatient Grouper - 7,44676.8,29039.92,32948.13,35744.6,24
CPT,33212,Outpatient Surgery Group 7 Global Rate,44676.8,29039.92,36188.0,39001.0,2
CPT,33212,Outpatient Surgical Group 9,44676.8,29039.92,36513.58,54208.97,50
CPT,33213,Outpatient Grouper - 7,77690.0,50498.5,32948.13,35744.6,24
CPT,33213,Outpatient Surgery Group 7 Global Rate,77690.0,50498.5,36188.0,39001.0,2
CPT,33213,Outpatient Surgical Group 9,77690.0,50498.5,36513.58,54208.97,50
CPT,33214,Outpatient Grouper - 8,77690.0,50498.5,34726.75,37674.38,24
CPT,33214,Outpatient Surgery Group 3 Global Rate,77690.0,50498.5,22055.0,22787.0,2
CPT,33214,Outpatient Surgical Group 9,77690.0,50498.5,36513.58,54208.97,50
CPT,33215,HB REPOSITION TRNSVN LEAD-RA/RV,14909.4,9691.11,3919.23,14761.0,10
CPT,33215,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,33215,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,33215,Outpatient Surgical Group 9,14909.4,9691.11,36513.58,54208.97,50
CPT,33216,HB INSERT LEAD SINGLE CHAMBER,44676.8,29039.92,10305.15,14761.0,10
CPT,33216,Outpatient Grouper - 6,44676.8,29039.92,28632.25,34209.93,24
CPT,33216,Outpatient Surgery Group 2 Global Rate,44676.8,29039.92,14322.0,15354.0,2
CPT,33216,Outpatient Surgical Group 9,44676.8,29039.92,36513.58,54208.97,50
CPT,33217,HB INSERT LEAD DUAL CHAMBER,53612.2,34847.93,10305.15,11850.92,8
CPT,33217,Outpatient Grouper - 6,53612.2,34847.93,28632.25,34209.93,24
CPT,33217,Outpatient Surgery Group 2 Global Rate,53612.2,34847.93,14322.0,15354.0,2
CPT,33217,Outpatient Surgical Group 9,53612.2,34847.93,36513.58,54208.97,50
CPT,33218,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33218,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,33218,Outpatient Surgical Group 9,14406.5,9364.23,36513.58,54208.97,50
CPT,33220,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33220,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,33220,Outpatient Surgical Group 9,14406.5,9364.23,36513.58,54208.97,50
CPT,33221,Outpatient Grouper - 7,77815.7,50580.21,32948.13,35744.6,24
CPT,33221,Outpatient Surgery Group 2 Global Rate,77815.7,50580.21,14322.0,15354.0,2
CPT,33221,Outpatient Surgical Group 1,77815.7,50580.21,9088.3,13492.72,50
CPT,33222,HB RELOCATION PCMKR POCKET,7948.54,5166.55,2277.74,14761.0,10
CPT,33222,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,33222,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,33222,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,33223,HB RELOCATION ICD POCKET,7948.54,5166.55,2277.74,14761.0,10
CPT,33223,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,33223,Outpatient Surgery Group 3 Global Rate,7948.54,5166.55,22055.0,22787.0,2
CPT,33223,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,33224,Outpatient Grouper - 8,77690.0,50498.5,34726.75,37674.38,24
CPT,33224,Outpatient Surgery Group 5 Global Rate,77690.0,50498.5,32992.0,34883.0,2
CPT,33224,Outpatient Surgical Group 2,77690.0,50498.5,12162.28,18056.43,50
CPT,33225,HB INSRT BI-V LEAD NEW PCMKR/ICD W/O POCKET REVISION,70778.5,46006.03,13270.0,14761.0,2
CPT,33225,Outpatient Grouper - 8,70778.5,46006.03,34726.75,37674.38,24
CPT,33225,Outpatient Surgery Group 4 Global Rate,70778.5,46006.03,26623.0,28144.0,2
CPT,33225,Outpatient Surgical Group 3,70778.5,46006.03,13899.75,20635.92,50
CPT,33226,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,33226,Outpatient Surgery Group 4 Global Rate,14909.4,9691.11,26623.0,28144.0,2
CPT,33226,Outpatient Surgical Group 3,14909.4,9691.11,13899.75,20635.92,50
CPT,33227,HB REM/REPL PACEMAKER PULSE GEN SINGLE,44676.8,29039.92,10305.15,14761.0,10
CPT,33227,Outpatient Grouper - 7,44676.8,29039.92,32948.13,35744.6,24
CPT,33227,Outpatient Surgery Group 2 Global Rate,44676.8,29039.92,14322.0,15354.0,2
CPT,33227,Outpatient Surgical Group 2,44676.8,29039.92,12162.28,18056.43,50
CPT,33228,HB REM/REPL PACEMAKER PULSE GEN DUAL,77690.0,50498.5,13031.3,14986.0,10
CPT,33228,Outpatient Grouper - 7,77690.0,50498.5,32948.13,35744.6,24
CPT,33228,Outpatient Surgery Group 2 Global Rate,77690.0,50498.5,14322.0,15354.0,2
CPT,33228,Outpatient Surgical Group 2,77690.0,50498.5,12162.28,18056.43,50
CPT,33229,HB REM/REPL PACEMAKER PULSE GEN MULT,77815.7,50580.21,23747.18,27309.26,8
CPT,33229,Outpatient Grouper - 7,77815.7,50580.21,32948.13,35744.6,24
CPT,33229,Outpatient Surgery Group 2 Global Rate,77815.7,50580.21,14322.0,15354.0,2
CPT,33229,Outpatient Surgical Group 2,77815.7,50580.21,12162.28,18056.43,50
CPT,33230,Outpatient Grouper - 10,234423.0,152374.95,43941.81,47671.53,24
CPT,33230,Outpatient Surgery Group 2 Global Rate,234423.0,152374.95,14322.0,15354.0,2
CPT,33230,Outpatient Surgical Group 1,234423.0,152374.95,9088.3,13492.72,50
CPT,33231,HB INS ICD GEN ONLY-BI-V,261951.0,170268.15,13270.0,14761.0,2
CPT,33231,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,33231,Outpatient Surgery Group 2 Global Rate,261951.0,170268.15,14322.0,15354.0,2
CPT,33231,Outpatient Surgical Group 1,261951.0,170268.15,9088.3,13492.72,50
CPT,33233,HB REMOVE PACEMAKER GEN,44676.8,29039.92,10305.15,14761.0,10
CPT,33233,Outpatient Grouper - 4,44676.8,29039.92,19724.25,21397.98,24
CPT,33233,Outpatient Surgery Group 2 Global Rate,44676.8,29039.92,14322.0,15354.0,2
CPT,33233,Outpatient Surgical Group 3,44676.8,29039.92,13899.75,20635.92,50
CPT,33234,HB REMOVE PCMKR LEAD SINGLE,14406.5,9364.23,13270.0,14761.0,2
CPT,33234,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33234,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,33234,Outpatient Surgical Group 3,14406.5,9364.23,13899.75,20635.92,50
CPT,33235,HB REMOVE PCMKR LEAD DUAL,14406.5,9364.23,4531.61,14761.0,10
CPT,33235,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33235,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,33235,Outpatient Surgical Group 3,14406.5,9364.23,13899.75,20635.92,50
CPT,33236,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33236,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33236,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33237,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33237,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33237,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33238,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33238,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33238,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33240,HB INSERT ICD SC/DC GEN. ONLY,234423.0,152374.95,27949.73,32142.19,8
CPT,33240,Outpatient Grouper - 10,234423.0,152374.95,43941.81,47671.53,24
CPT,33240,Outpatient Surgery Group 7 Global Rate,234423.0,152374.95,36188.0,39001.0,2
CPT,33240,Outpatient Surgical Group 9,234423.0,152374.95,36513.58,54208.97,50
CPT,33241,HB REMOVE ICD GEN SINGLE/DUAL,14406.5,9364.23,4531.61,14761.0,10
CPT,33241,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33241,Outpatient Surgery Group 4 Global Rate,14406.5,9364.23,26623.0,28144.0,2
CPT,33241,Outpatient Surgical Group 3,14406.5,9364.23,13899.75,20635.92,50
CPT,33243,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,33243,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33243,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33244,HB REMOVE ICD LEAD SINGLE/DUAL,14406.5,9364.23,4531.61,14761.0,10
CPT,33244,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33244,Outpatient Surgery Group 4 Global Rate,14406.5,9364.23,26623.0,28144.0,2
CPT,33244,Outpatient Surgical Group 3,14406.5,9364.23,13899.75,20635.92,50
CPT,33249,HB INS/REP ICD SNGL/DUAL W LEADS,261951.0,170268.15,13270.0,45911.1,10
CPT,33249,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,33249,Outpatient Surgery Group 5 Global Rate,261951.0,170268.15,32992.0,34883.0,2
CPT,33249,Outpatient Surgical Group 9,261951.0,170268.15,36513.58,54208.97,50
CPT,33250,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33250,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33250,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33251,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33251,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33251,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33254,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33254,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33255,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33255,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33256,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33256,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33257,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33257,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33257,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33258,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33258,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33258,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33259,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33259,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33259,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33261,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33261,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33261,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33262,"HB REMOVE/REPLACE ICD, SINGLE",197175.0,128163.75,27949.73,32142.19,8
CPT,33262,Outpatient Grouper - 10,197175.0,128163.75,43941.81,47671.53,24
CPT,33262,Outpatient Surgery Group 2 Global Rate,197175.0,128163.75,14322.0,15354.0,2
CPT,33262,Outpatient Surgical Group 2,197175.0,128163.75,12162.28,18056.43,50
CPT,33263,"HB REMOVE/REPLACE ICD, DUAL",234423.0,152374.95,13270.0,32142.19,10
CPT,33263,Outpatient Grouper - 10,234423.0,152374.95,43941.81,47671.53,24
CPT,33263,Outpatient Surgery Group 2 Global Rate,234423.0,152374.95,14322.0,15354.0,2
CPT,33263,Outpatient Surgical Group 2,234423.0,152374.95,12162.28,18056.43,50
CPT,33264,HB REMOVE/REPLACE ICD/BI-V,261951.0,170268.15,13270.0,45911.1,10
CPT,33264,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,33264,Outpatient Surgery Group 2 Global Rate,261951.0,170268.15,14322.0,15354.0,2
CPT,33264,Outpatient Surgical Group 2,261951.0,170268.15,12162.28,18056.43,50
CPT,33265,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33265,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33266,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33266,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33267,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33267,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33267,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33268,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33268,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33268,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33269,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33269,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33269,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33270,HB INS/REP SUBQ DEFIBRILLATOR,261951.0,170268.15,13270.0,45911.1,10
CPT,33270,Outpatient Grouper - 10,261951.0,170268.15,43941.81,47671.53,24
CPT,33270,Outpatient Surgery Group 4 Global Rate,261951.0,170268.15,26623.0,28144.0,2
CPT,33270,Outpatient Surgical Group 2,261951.0,170268.15,12162.28,18056.43,50
CPT,33271,Outpatient Grouper - 7,44676.8,29039.92,32948.13,35744.6,24
CPT,33271,Outpatient Surgery Group 4 Global Rate,44676.8,29039.92,26623.0,28144.0,2
CPT,33271,Outpatient Surgical Group 9,44676.8,29039.92,36513.58,54208.97,50
CPT,33272,HB RMVL SUBQ DEFIB ELECTRODE,14406.5,9364.23,4531.61,5211.35,16
CPT,33272,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33272,Outpatient Surgery Group 4 Global Rate,14406.5,9364.23,26623.0,28144.0,2
CPT,33272,Outpatient Surgical Group 0,14406.5,9364.23,2806.68,4166.87,50
CPT,33273,Outpatient Grouper - 4,14406.5,9364.23,19724.25,21397.98,24
CPT,33273,Outpatient Surgery Group 2 Global Rate,14406.5,9364.23,14322.0,15354.0,2
CPT,33273,Outpatient Surgical Group 3,14406.5,9364.23,13899.75,20635.92,50
CPT,33274,HB LEADLESS C PM INS/RPL VENTR,114605.0,74493.25,13270.0,27309.26,12
CPT,33274,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,33274,Outpatient Surgery Group 3 Global Rate,114605.0,74493.25,22055.0,22787.0,2
CPT,33274,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,33275,HB LEADLESS C PM REMOVE VENTR,14909.4,9691.11,3919.23,14761.0,10
CPT,33275,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,33275,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,33275,Outpatient Surgical Group 4,14909.4,9691.11,17187.58,25517.11,50
CPT,33276,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,33276,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33277,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,33277,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33278,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,33278,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33279,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,33279,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33280,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,33280,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33281,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,33281,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33285,HB IMPLANT CARDIAC LOOP RECRDER,44676.8,29039.92,10305.15,14761.0,18
CPT,33285,Outpatient Grouper - 7,44676.8,29039.92,32948.13,35744.6,24
CPT,33285,Outpatient Surgery Group 3 Global Rate,44676.8,29039.92,22055.0,22787.0,2
CPT,33285,Outpatient Surgical Group 4,44676.8,29039.92,17187.58,25517.11,50
CPT,33286,HB REMOVE CARDIAC LOOP RECRDR,5952.47,3869.11,876.1,14761.0,10
CPT,33286,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,33286,Outpatient Surgery Group 2 Global Rate,5952.47,3869.11,14322.0,15354.0,2
CPT,33286,Outpatient Surgical Group 4,5952.47,3869.11,17187.58,25517.11,50
CPT,33287,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,33287,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33288,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,33288,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33289,HB IMPL PRESSURE SENSR W/ANGIO,87584.5,56929.93,13270.0,40708.41,10
CPT,33289,Outpatient Grouper - 10,87584.5,56929.93,43941.81,47671.53,24
CPT,33289,Outpatient Surgery Group 9 Global Rate,87584.5,56929.93,36365.0,36365.0,1
CPT,33289,Outpatient Surgical Group 4,87584.5,56929.93,17187.58,25517.11,50
CPT,33300,HB REPAIR CARDIAC WOUND; WO CPB,8738.51,5680.03,,,0
CPT,33300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33300,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33305,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33305,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33310,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33310,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33310,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33315,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33315,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33315,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33320,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33321,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33321,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33321,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33322,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33322,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33322,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33330,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33330,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33330,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33335,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33335,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33335,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33340,HB LAA CLOSURE W/IMPLANT,80956.18,52621.52,13270.0,14761.0,2
CPT,33340,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33340,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33340,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,33361,HB TAVR-TRANSFEMORAL,75161.77,48855.15,13270.0,14761.0,2
CPT,33361,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33361,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33361,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,33362,HB AORTIC VLV RPLMT;OPEN FEMOL,75161.77,48855.15,13270.0,14761.0,2
CPT,33362,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33362,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33362,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,33363,HB AORTIC VLV RPLMT;OPEN AXLRY,75161.77,48855.15,13270.0,14761.0,2
CPT,33363,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33363,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33363,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,33364,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33364,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33364,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,33365,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33365,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33365,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,33366,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33366,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33366,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33367,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33367,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33367,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,33368,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33368,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33368,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,33369,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33369,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33369,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,33370,HB TRANSCATH PLACE & SUB REMOVAL CEPD PERC,19417.9,12621.64,13270.0,14761.0,2
CPT,33370,Outpatient Grouper - 0,19417.9,12621.64,9059.94,9827.82,24
CPT,33370,Outpatient Surgery Group 3 Global Rate,19417.9,12621.64,22055.0,22787.0,2
CPT,33370,Outpatient Surgical Group 0,19417.9,12621.64,2806.68,4166.87,50
CPT,33390,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33390,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33390,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33391,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33391,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33391,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33404,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33404,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33404,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33405,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33405,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33405,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33406,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33406,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33406,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33410,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33410,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33410,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33411,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33411,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33411,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33412,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33412,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33412,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,33413,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33413,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33413,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,33414,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33414,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33414,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33415,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33415,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33415,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33416,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33416,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33416,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33417,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33417,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33417,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33418,HB REPR TCAT MITRAL VALV INTL,77347.53,50275.89,13270.0,14761.0,2
CPT,33418,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33418,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33418,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33419,HB REPR TCAT MITRAL VALV ADDL,77347.53,50275.89,13270.0,14761.0,2
CPT,33419,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,33419,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33419,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33420,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33420,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33420,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33422,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33422,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33422,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33425,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33425,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33425,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33426,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33426,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33426,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33427,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33427,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33427,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33430,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33430,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33430,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33440,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33440,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33440,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,33460,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33460,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33460,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33463,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33463,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33463,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33464,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33464,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33464,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33465,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33465,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33465,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33468,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33468,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33468,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33470,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33471,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33471,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33471,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33474,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33474,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33474,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33475,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33475,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33475,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33476,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33476,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33476,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33477,HB IMPLT PULM VLV EVASC APPR,56184.385,36519.85,13270.0,14761.0,2
CPT,33477,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33477,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33477,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33478,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33478,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33478,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33496,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33496,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33496,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33500,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33500,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33500,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33501,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33502,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33502,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33502,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33503,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33503,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33503,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,33504,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33504,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33504,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,33505,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33505,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33505,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33506,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33506,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33506,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,33507,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33507,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33508,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,33508,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33509,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33509,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33510,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33510,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33511,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33511,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33512,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33512,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33513,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33513,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33514,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33514,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33516,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33516,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33517,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33517,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33518,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33518,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33519,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33519,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33521,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33521,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33522,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33522,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33523,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33523,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33530,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33530,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33533,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33533,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33534,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33534,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33535,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33535,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33536,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33536,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33542,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33542,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33545,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33548,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33548,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33572,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33572,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33600,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33602,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33602,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33606,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33606,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33608,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33608,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33610,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33610,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33611,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33611,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33612,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33612,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33615,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33615,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33617,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33617,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33619,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33619,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33620,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33620,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33621,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33621,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33621,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33622,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33622,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33622,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33641,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33641,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33645,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33645,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33647,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33647,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33660,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33660,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33665,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33665,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33670,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33670,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33675,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33675,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33676,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33676,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33677,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33677,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33681,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33681,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33684,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33684,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33688,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33688,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33690,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33690,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33692,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33692,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33694,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33694,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33697,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33697,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33702,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33702,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33710,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33710,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33720,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33720,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33722,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33724,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33724,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33726,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33726,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33730,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33730,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33732,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33732,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33735,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33735,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33736,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33736,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33737,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33737,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33741,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33741,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33741,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33745,"HB TRANSCATH INTRACARDIAC SHUNT, INITIAL",81900.1,53235.07,13270.0,14761.0,2
CPT,33745,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33745,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33745,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33746,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33746,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33746,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33750,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33750,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33755,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33755,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33762,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33762,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33764,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33764,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33766,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33766,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33767,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33767,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33768,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33768,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33770,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33770,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33771,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33771,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33774,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33774,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33775,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33775,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33776,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33776,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33777,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33777,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33778,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33778,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33779,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33779,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33780,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33780,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33781,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33781,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33782,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33782,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33783,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33783,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33786,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33786,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33788,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33788,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33800,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33802,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33802,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33803,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33803,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33813,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33813,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33814,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33814,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33820,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,33820,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33822,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,33822,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,33824,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,33824,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33840,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33840,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33845,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33851,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33851,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33852,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33852,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33853,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33853,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33858,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33858,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33858,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33859,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33859,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33859,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33863,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33863,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33864,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33864,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33866,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,33866,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33871,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33871,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33871,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33875,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33875,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33877,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33877,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33880,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33880,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33881,HB REPAIR DECEND AORTA WO SUBCLAV,16171.19,10511.27,13270.0,14761.0,2
CPT,33881,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33881,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33883,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33883,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33884,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33884,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33886,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33886,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33889,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33889,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33891,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33891,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33894,HB EVASC STNT REP COARC AORTA ACRS MAJ SID BRNCH,70068.005,45544.205,13270.0,14761.0,2
CPT,33894,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33894,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33894,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33895,HB EVASC STNT REP COARC AORTA NOT CRS MAJ SID BRNCH,26891.3,17479.35,13270.0,14761.0,2
CPT,33895,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33895,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33895,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33897,HB PERC TRANSL ANGIO NATV RECUR COARC AORTA,48178.14,31315.79,13270.0,14761.0,2
CPT,33897,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33897,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33897,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33900,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,33900,Outpatient Surgery Group 8 Global Rate,102328.0,66513.2,41579.0,42988.0,2
CPT,33900,Outpatient Surgical Group 1,102328.0,66513.2,9088.3,13492.72,50
CPT,33901,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,33901,Outpatient Surgery Group 8 Global Rate,102328.0,66513.2,41579.0,42988.0,2
CPT,33901,Outpatient Surgical Group 1,102328.0,66513.2,9088.3,13492.72,50
CPT,33902,HB PERC PULM ART STENT ABNORM NAT CONN UNI,114605.0,74493.25,22359.49,25713.42,8
CPT,33902,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,33902,Outpatient Surgery Group 9 Global Rate,114605.0,74493.25,36365.0,39072.0,2
CPT,33902,Outpatient Surgical Group 1,114605.0,74493.25,9088.3,13492.72,50
CPT,33903,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,33903,Outpatient Surgery Group 8 Global Rate,102328.0,66513.2,41579.0,42988.0,2
CPT,33903,Outpatient Surgical Group 1,102328.0,66513.2,9088.3,13492.72,50
CPT,33904,Outpatient Grouper - 0,31469.3,20455.05,9059.94,9827.82,24
CPT,33904,Outpatient Surgical Group 0,31469.3,20455.05,2806.68,4166.87,50
CPT,33910,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33910,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33915,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33915,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33916,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33916,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33917,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33917,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33920,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33920,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33922,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33922,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,33924,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33924,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33925,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33925,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33926,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33926,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33927,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33927,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33927,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33928,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33928,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33928,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33929,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33929,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,33929,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,33930,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33930,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33933,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33933,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33935,Heart/Lung Transplant,,,700644.02,700644.02,3
CPT,33935,"Heart/Lung, Transplant",,,340920.66,340920.66,2
CPT,33935,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33935,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,33935,Transplant: Heart/Lung,,,192000.0,192000.0,1
CPT,33940,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33940,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33944,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33944,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33945,Adult Heart - Transplant Event: Combined Hospital and Professional Services,,,67600.0,67600.0,2
CPT,33945,Heart Transplant,,,216949.8,621838.12,5
CPT,33945,Heart Transplants Hospital Services,,,80000.0,80000.0,1
CPT,33945,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33945,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,33945,Transplant: Heart,,,143000.0,143000.0,1
CPT,33946,HB ECMO/ECLS INITIATION VENOUS,20260.38,13169.25,13270.0,14761.0,2
CPT,33946,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33946,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33946,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33947,HB ECMO/ECLS INITIATION ARTERY,13180.065,8567.045,13270.0,14761.0,2
CPT,33947,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33947,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33947,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33948,HB ECMO/ECLS DAILY MGMT-VENOUS,20260.38,13169.25,13270.0,14761.0,2
CPT,33948,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33948,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33948,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33949,HB ECMO/ECLS DAILY MGMT ARTERY,20260.38,13169.25,13270.0,14761.0,2
CPT,33949,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33949,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33949,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33951,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33951,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33951,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33952,HB ECMO/ECLS INSJ PRPH CAN PERC>5,13750.86,8938.060000000001,13270.0,14761.0,2
CPT,33952,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33952,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33952,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33953,HB ECMO/ECLS INSJ PRPH CAN OPEN<5,21401.97,13911.28,13270.0,14761.0,2
CPT,33953,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33953,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33953,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33954,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33954,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33954,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33955,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33955,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33955,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33956,HB ECMO/ECLS INSJ CTR CAN >5YR,21401.97,13911.28,13270.0,14761.0,2
CPT,33956,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33956,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33956,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33957,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33957,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33957,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33958,HB ECMO/ECLS REPOS PRPH CAN PERC>5,15295.85,9942.3,13270.0,14761.0,2
CPT,33958,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33958,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33958,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33959,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33959,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33959,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33962,HB ECMO/ECLS REPOS PRPH CAN OPEN>5,15295.85,9942.3,13270.0,14761.0,2
CPT,33962,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33962,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33962,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33963,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33963,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33963,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33964,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33964,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33964,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33965,HB ECMO/ECLS RMVL PRPH CAN PERC<5,21401.97,13911.28,13270.0,14761.0,2
CPT,33965,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33965,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33965,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33966,HB ECMO/ECLS RMVL PRPH CAN PERC>5,15295.85,9942.3,13270.0,14761.0,2
CPT,33966,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33966,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33966,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33967,HB INSERT INTRA-AORT BALLOON,11282.36,7333.53,13270.0,14761.0,2
CPT,33967,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,33967,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33968,HB REMOV INTRA-AORT BALLOON,1455.8,946.27,13270.0,14761.0,2
CPT,33968,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,33968,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33969,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33969,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33969,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33970,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33970,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33971,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33971,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33973,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33973,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33974,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33974,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,33975,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33975,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33976,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33976,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33977,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33977,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33978,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33978,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33979,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33979,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33980,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33980,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33981,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33981,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33982,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33982,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33983,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33983,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33984,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33984,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33984,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33985,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33985,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33985,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33986,HB ECMO/ECLS RMVL CTR CAN >5YR,15295.85,9942.3,13270.0,14761.0,2
CPT,33986,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33986,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33986,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33987,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33987,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33987,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33988,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33988,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33988,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33989,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33989,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,33989,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33990,HB INS VAD PERQ S&I LT HRT ART ACC ONLY,38714.525,25164.440000000002,13270.0,14761.0,4
CPT,33990,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33990,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33990,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,33990,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",40222.05,26144.33,,,0
CPT,33991,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,13270.0,14761.0,2
CPT,33991,HB INS VAD PERQ S&I LT HRT ART & VEN ACC,40222.05,26144.33,13270.0,14761.0,2
CPT,33991,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33991,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33991,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,33991,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",40222.05,26144.33,,,0
CPT,33992,HB REMOVAL PERQ LT HEART VAD ART/ART & VEN,29194.34,18976.32,13270.0,14761.0,4
CPT,33992,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33992,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33992,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,33992,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",29194.34,18976.32,,,0
CPT,33993,HB REPOSITION VAD DIFF SESSION,27804.14,18072.69,13270.0,14761.0,2
CPT,33993,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33993,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33993,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,33993,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",27804.14,18072.69,,,0
CPT,33995,HB INS VAD PERQ S&I RT HRT VEN ACC ONLY,40222.05,26144.33,13270.0,14761.0,2
CPT,33995,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33995,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,33995,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33995,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",40222.05,26144.33,,,0
CPT,33997,HB REMOVAL PERQ RT HEART VAD VEN,29194.34,18976.32,13270.0,14761.0,2
CPT,33997,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,33997,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,33997,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,33997,"Ventricular Assist Device (VAD), Total Artificial Heart (TAH) Implants",29194.34,18976.32,,,0
CPT,33999,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,194.82,14761.0,10
CPT,33999,Outpatient Grouper - 1,85365.7,55487.71,10495.38,11385.92,24
CPT,33999,Outpatient Surgical Group 1,85365.7,55487.71,9088.3,13492.72,50
CPT,34001,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34001,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34051,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34051,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,34101,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34101,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34101,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34111,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34111,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34111,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34151,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34151,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,34201,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34201,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,34201,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34203,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34203,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34203,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34401,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34401,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34401,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34421,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,34421,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,34421,Outpatient Surgical Group 7,14909.4,9691.11,27131.25,40279.73,50
CPT,34451,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34451,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34451,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34471,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,34471,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34471,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34490,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,34490,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34490,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34501,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34501,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34501,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34502,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34502,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,34510,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34510,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34510,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34520,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,34520,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34520,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34530,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,34530,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34530,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,34701,HB EVASC RPR A-AO NDGFT,32830.61,21339.9,13270.0,14761.0,2
CPT,34701,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34701,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34701,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34702,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34702,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34702,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34703,HB EVASC RPR A-UNILAC NDGFT,31713.78,20613.96,13270.0,14761.0,2
CPT,34703,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34703,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34703,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34704,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34704,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34704,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34705,HB EVAC RPR A-BIILIAC NDGFT,28153.59,18299.83,13270.0,14761.0,2
CPT,34705,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34705,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34705,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34706,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34706,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34706,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34707,HB EVASC RPR ILIO-ILIAC NDGFT,22051.53,14333.49,13270.0,14761.0,2
CPT,34707,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34707,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34707,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34708,HB EVASC RPR ILIO-ILIAC NDGFT,22051.53,14333.49,13270.0,14761.0,2
CPT,34708,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34708,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34708,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34709,HB PLCMT EXTN PROSTH EVASC RPR,12827.33,8337.76,13270.0,14761.0,2
CPT,34709,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34709,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34709,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34710,HB PLCMT EXTN PROSTH EVASC RPR,18972.99,12332.44,13270.0,14761.0,2
CPT,34710,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34710,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34710,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34711,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34711,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34711,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34712,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34712,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,34712,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,34713,HB PERQ ACCESS & CLSR FEM ART,5101.81,3316.18,13270.0,14761.0,2
CPT,34713,Outpatient Grouper - 0,5101.81,3316.18,9059.94,9827.82,24
CPT,34713,Outpatient Surgery Group 4 Global Rate,5101.81,3316.18,26623.0,28144.0,2
CPT,34713,Outpatient Surgical Group 1,5101.81,3316.18,9088.3,13492.72,50
CPT,34714,Outpatient Grouper - 0,6621.68,4304.09,9059.94,9827.82,24
CPT,34714,Outpatient Surgery Group 4 Global Rate,6621.68,4304.09,26623.0,28144.0,2
CPT,34714,Outpatient Surgical Group 1,6621.68,4304.09,9088.3,13492.72,50
CPT,34715,Outpatient Grouper - 0,6621.68,4304.09,9059.94,9827.82,24
CPT,34715,Outpatient Surgery Group 4 Global Rate,6621.68,4304.09,26623.0,28144.0,2
CPT,34715,Outpatient Surgical Group 1,6621.68,4304.09,9088.3,13492.72,50
CPT,34716,HB OPEN AX/SUBCLA ART EXPOS W CONDUIT,6621.68,4304.09,13270.0,14761.0,2
CPT,34716,Outpatient Grouper - 0,6621.68,4304.09,9059.94,9827.82,24
CPT,34716,Outpatient Surgery Group 4 Global Rate,6621.68,4304.09,26623.0,28144.0,2
CPT,34716,Outpatient Surgical Group 1,6621.68,4304.09,9088.3,13492.72,50
CPT,34717,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34717,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,34717,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34718,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34718,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,34718,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34808,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34808,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,34812,HB EXPOSE FEM ART PROSTH UNI,6621.68,4304.09,13270.0,14761.0,2
CPT,34812,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34812,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34813,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34813,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34820,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34830,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34830,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,34831,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34831,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,34832,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34832,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,34833,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34833,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34834,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34834,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,34841,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34841,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34841,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34842,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34842,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34842,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34843,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34843,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34843,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34844,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34844,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34844,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34845,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34845,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34846,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34846,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34846,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34847,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34847,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34847,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,34848,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,34848,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,34848,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,35001,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35001,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35001,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35002,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35002,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35002,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35005,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35005,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35011,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35011,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35011,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,35013,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35013,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35013,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35021,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35021,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35021,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35022,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35022,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35022,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35045,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35045,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35045,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35081,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35081,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35081,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35082,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35082,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35082,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35091,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35091,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35091,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35092,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35092,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35092,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,35102,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35102,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35102,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35103,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35103,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35103,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,35111,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35111,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35111,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35112,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35112,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35112,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35121,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35121,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35121,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35122,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35122,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35122,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35131,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35131,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35131,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35132,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35132,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35132,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35141,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35142,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35142,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35142,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35151,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35151,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35151,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35152,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35152,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35152,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35180,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,35180,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35180,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35182,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35182,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35182,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35184,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35184,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35184,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35188,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35188,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35188,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35189,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35189,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35189,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35190,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35190,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35190,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35201,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35201,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35201,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35206,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,35206,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,35206,Outpatient Surgical Group 4,14909.4,9691.11,17187.58,25517.11,50
CPT,35207,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35207,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35207,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35211,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35211,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,35211,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35216,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35216,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,35216,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35221,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35221,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35221,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35226,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,194.82,14761.0,10
CPT,35226,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,35226,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35226,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35231,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35231,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35231,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35236,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35236,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35236,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35241,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35241,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,35241,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35246,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35246,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35246,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35251,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35251,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35251,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35256,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35256,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35256,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35261,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35261,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35261,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,35266,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35266,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35266,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,35271,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35271,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,35271,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35276,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35276,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35276,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35281,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35281,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35281,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35286,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,13270.0,14761.0,2
CPT,35286,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35286,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35286,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,35301,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35301,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35301,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,35302,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35302,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35303,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35303,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35304,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35304,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35305,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35306,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35306,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35311,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35311,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35311,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35321,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35321,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35321,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35331,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35331,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35331,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35341,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35341,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35341,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35351,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35351,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35351,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35355,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35355,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35355,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35361,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35361,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35361,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35363,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35363,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35363,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35371,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35371,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35371,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35372,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35372,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35372,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35390,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35390,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35390,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35400,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35400,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35500,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35500,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,35500,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,35501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35501,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35506,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35506,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35506,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35508,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35508,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35508,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35509,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35509,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35509,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35510,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35510,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35511,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35511,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35511,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35512,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35512,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35512,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35515,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35515,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35515,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35516,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35516,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35516,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35518,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35518,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35518,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35521,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35521,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35521,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35522,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35522,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35522,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35523,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35523,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35525,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35525,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35525,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35526,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35526,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35526,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35531,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35531,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35531,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35533,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35533,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35533,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35535,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35535,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35536,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35536,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35536,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35537,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35537,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35538,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35538,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35539,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35539,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35556,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35556,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35556,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35558,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35558,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35558,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35560,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35560,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35560,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35563,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35563,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35563,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35565,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35565,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35565,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35566,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35566,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35566,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35570,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35570,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35571,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35571,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35571,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35572,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35572,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,35583,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35583,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35583,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35585,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35585,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35585,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35587,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35587,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35587,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35600,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35601,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35601,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35601,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35606,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35606,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35606,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35612,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35612,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35612,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35616,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35616,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35616,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35621,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35621,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35621,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35623,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35623,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35623,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35626,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35626,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35626,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35631,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35631,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35631,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35632,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35632,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35633,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35633,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35634,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35634,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35636,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35636,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35636,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35637,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35637,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35638,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35638,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35642,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35642,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35642,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35645,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35645,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35645,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35646,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35646,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35646,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,35647,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35647,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35647,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35650,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35650,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35654,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35654,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35654,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35656,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35656,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35656,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35661,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35661,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35661,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35663,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35663,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35663,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35665,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35665,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35665,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35666,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35666,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35666,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35671,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35671,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35671,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35681,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35681,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35681,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35682,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35682,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35682,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35683,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35683,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35683,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35685,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,35685,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35685,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35686,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,35686,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35686,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35691,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35691,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35691,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35693,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35693,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35693,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35694,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35694,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35694,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35695,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35695,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35695,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35697,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35697,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35697,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35700,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,35700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35701,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35701,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35701,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35702,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35702,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35702,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,35703,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35703,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,35703,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,35800,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35800,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35820,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35840,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35840,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35860,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35860,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35860,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,35870,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35870,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,35870,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35875,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35875,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35875,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,35876,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35876,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,35876,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,35879,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35879,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35879,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,35881,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35881,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35881,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,35883,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35883,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35884,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,35884,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35901,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35901,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35901,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,35903,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,35903,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,35903,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,35905,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35905,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,35905,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,35907,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,35907,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,35907,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,36000,HB CATH PLCMT NON-SELECTIVE,382.94,248.91,13270.0,14761.0,2
CPT,36000,Outpatient Grouper - 0,382.94,248.91,9059.94,9827.82,24
CPT,36002,HB PSEUDOANEURYSM INJ EXTREMITY,6044.34,3928.8199999999997,769.85,14761.0,10
CPT,36002,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,36002,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,36005,HB VENOGRAM INJ EXT UNILATERAL,2007.14,1304.64,13270.0,14761.0,2
CPT,36005,Outpatient Grouper - 0,2007.14,1304.64,9059.94,9827.82,24
CPT,36005,Outpatient Surgery Group 2 Global Rate,2007.14,1304.64,14322.0,15354.0,2
CPT,36010,HB CATH INTRO SVC/IVC,7488.11,4867.27,13270.0,14761.0,2
CPT,36010,OUTPATIENT SURGERY CPT GROUP 1,7488.11,4867.27,6417.0,7038.0,2
CPT,36010,Outpatient Grouper - 0,7488.11,4867.27,9059.94,9827.82,24
CPT,36011,HB CATH PLCMT VENOUS 1ST ORD,9345.82,6074.78,13270.0,14761.0,2
CPT,36011,Outpatient Grouper - 0,9345.82,6074.78,9059.94,9827.82,24
CPT,36012,HB CATH PLCMT VENOUS2ND ORD IR,9558.84,6213.25,13270.0,14761.0,2
CPT,36012,Outpatient Grouper - 0,9558.84,6213.25,9059.94,9827.82,24
CPT,36013,HB CATH INTRO RT HEART/PULM AR,7197.44,4678.34,13270.0,14761.0,2
CPT,36013,Outpatient Grouper - 0,7197.44,4678.34,9059.94,9827.82,24
CPT,36014,HB CATH PLCMT RT/LT PULM ART,8878.65,5771.12,13270.0,14761.0,2
CPT,36014,Outpatient Grouper - 0,8878.65,5771.12,9059.94,9827.82,24
CPT,36015,HB CATH PLCMT SEGMENTAL ARTERY,6857.97,4457.68,13270.0,14761.0,2
CPT,36015,OUTPATIENT SURGERY CPT GROUP 1,6857.97,4457.68,6417.0,7038.0,2
CPT,36015,Outpatient Grouper - 0,6857.97,4457.68,9059.94,9827.82,24
CPT,36100,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36140,HB CATH INTRO ARTERY UPPER/LOWER EXT,3574.68,2323.54,13270.0,14761.0,2
CPT,36140,OUTPATIENT SURGERY CPT GROUP 1,3574.68,2323.54,6417.0,7038.0,2
CPT,36140,Outpatient Grouper - 0,3574.68,2323.54,9059.94,9827.82,24
CPT,36160,HB CATH INTRO AORTIC TRANSLUMN,7555.95,4911.37,13270.0,14761.0,2
CPT,36160,OUTPATIENT SURGERY CPT GROUP 1,7555.95,4911.37,6417.0,7038.0,2
CPT,36160,Outpatient Grouper - 0,7555.95,4911.37,9059.94,9827.82,24
CPT,36200,HB CATH AORTA,6621.68,4304.09,13270.0,14761.0,2
CPT,36200,Outpatient Grouper - 0,6621.68,4304.09,9059.94,9827.82,24
CPT,36200,Outpatient Surgery Group 3 Global Rate,6621.68,4304.09,22055.0,22787.0,2
CPT,36215,HB CATH PLCMT THORACIC 1ST ORD,13729.5,8924.18,13270.0,14761.0,2
CPT,36215,Outpatient Grouper - 0,13729.5,8924.18,9059.94,9827.82,24
CPT,36215,Outpatient Surgery Group 3 Global Rate,13729.5,8924.18,22055.0,22787.0,2
CPT,36216,HB CATH PLCMT THORACIC 2ND ORD,15465.0,10052.25,13270.0,14761.0,2
CPT,36216,Outpatient Grouper - 0,15465.0,10052.25,9059.94,9827.82,24
CPT,36216,Outpatient Surgery Group 3 Global Rate,15465.0,10052.25,22055.0,22787.0,2
CPT,36217,HB CATH PLCMT THORACIC 3RD ORD,18661.8,12130.17,13270.0,14761.0,2
CPT,36217,Outpatient Grouper - 0,18661.8,12130.17,9059.94,9827.82,24
CPT,36217,Outpatient Surgery Group 3 Global Rate,18661.8,12130.17,22055.0,22787.0,2
CPT,36218,HB CATH PLCMT THORACIC EA ADDL,2971.31,1931.35,13270.0,14761.0,2
CPT,36218,Outpatient Grouper - 0,2971.31,1931.35,9059.94,9827.82,24
CPT,36221,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36221,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,36221,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36222,"HB PLACE CATH CAR/INOM ART,UNI",44984.35,29239.83,3919.23,14761.0,10
CPT,36222,Outpatient Grouper - 4,44984.35,29239.83,19724.25,21397.98,24
CPT,36222,Outpatient Surgery Group 3 Global Rate,44984.35,29239.83,22055.0,22787.0,2
CPT,36222,Outpatient Surgical Group 1,44984.35,29239.83,9088.3,13492.72,50
CPT,36223,"HB PLACE CATH CAR/INOM ART,UNI",62593.75,40685.94,6731.11,14761.0,10
CPT,36223,Outpatient Grouper - 6,62593.75,40685.94,28632.25,34209.93,24
CPT,36223,Outpatient Surgery Group 3 Global Rate,62593.75,40685.94,22055.0,22787.0,2
CPT,36223,Outpatient Surgical Group 1,62593.75,40685.94,9088.3,13492.72,50
CPT,36224,"HB PLACE CATH CAROTD ART,UNI",64640.25,42016.16,6731.11,14761.0,10
CPT,36224,Outpatient Grouper - 6,64640.25,42016.16,28632.25,34209.93,24
CPT,36224,Outpatient Surgery Group 3 Global Rate,64640.25,42016.16,22055.0,22787.0,2
CPT,36224,Outpatient Surgical Group 1,64640.25,42016.16,9088.3,13492.72,50
CPT,36225,"HB PLACE CATH SUBCLAV ART,UNI",46552.3,30259.0,3919.23,14761.0,10
CPT,36225,Outpatient Grouper - 4,46552.3,30259.0,19724.25,21397.98,24
CPT,36225,Outpatient Surgery Group 3 Global Rate,46552.3,30259.0,22055.0,22787.0,2
CPT,36225,Outpatient Surgical Group 1,46552.3,30259.0,9088.3,13492.72,50
CPT,36226,"HB PLACE CATH VERTEBRL ART,UNI",48598.75,31589.19,6731.11,14761.0,10
CPT,36226,Outpatient Grouper - 6,48598.75,31589.19,28632.25,34209.93,24
CPT,36226,Outpatient Surgery Group 3 Global Rate,48598.75,31589.19,22055.0,22787.0,2
CPT,36226,Outpatient Surgical Group 1,48598.75,31589.19,9088.3,13492.72,50
CPT,36227,"HB PLACE CATH XTRNL CAR,UNI",18387.45,11951.84,13270.0,14761.0,2
CPT,36227,Outpatient Grouper - 0,18387.45,11951.84,9059.94,9827.82,24
CPT,36227,Outpatient Surgery Group 3 Global Rate,18387.45,11951.84,22055.0,22787.0,2
CPT,36227,Outpatient Surgical Group 1,18387.45,11951.84,9088.3,13492.72,50
CPT,36228,"HB PLACE CATH INTRCRNL ART,UNI",27231.6,17700.54,13270.0,14761.0,2
CPT,36228,Outpatient Grouper - 0,27231.6,17700.54,9059.94,9827.82,24
CPT,36228,Outpatient Surgery Group 3 Global Rate,27231.6,17700.54,22055.0,22787.0,2
CPT,36228,Outpatient Surgical Group 1,27231.6,17700.54,9088.3,13492.72,50
CPT,36245,HB CATH PLCMT ABD-EXT 1ST ORD,6621.68,4304.09,13270.0,14761.0,2
CPT,36245,Outpatient Grouper - 0,6621.68,4304.09,9059.94,9827.82,24
CPT,36245,Outpatient Surgery Group 3 Global Rate,6621.68,4304.09,22055.0,22787.0,2
CPT,36246,HB CATH PLCMT ABD-EXT 2ND ORD,9177.45,5965.34,13270.0,14761.0,2
CPT,36246,Outpatient Grouper - 0,9177.45,5965.34,9059.94,9827.82,24
CPT,36246,Outpatient Surgery Group 3 Global Rate,9177.45,5965.34,22055.0,22787.0,2
CPT,36247,HB CATH PLCMT ABD-EXT 3RD ORD,13963.1,9076.02,13270.0,14761.0,2
CPT,36247,Outpatient Grouper - 0,13963.1,9076.02,9059.94,9827.82,24
CPT,36247,Outpatient Surgery Group 3 Global Rate,13963.1,9076.02,22055.0,22787.0,2
CPT,36248,HB CATH PLCMT ABD-EXT EA ADDL,2773.06,1802.49,13270.0,14761.0,2
CPT,36248,OUTPATIENT SURGERY CPT GROUP 1,2773.06,1802.49,6417.0,7038.0,2
CPT,36248,Outpatient Grouper - 0,2773.06,1802.49,9059.94,9827.82,24
CPT,36251,HB INS CATH REN ART 1ST UNILAT,75840.3,49296.2,3919.23,14761.0,10
CPT,36251,Outpatient Grouper - 4,75840.3,49296.2,19724.25,21397.98,24
CPT,36251,Outpatient Surgery Group 3 Global Rate,75840.3,49296.2,22055.0,22787.0,2
CPT,36252,HB INS CATH REN ART 1ST BILAT,82783.6,53809.34,3919.23,4507.11,8
CPT,36252,Outpatient Grouper - 4,82783.6,53809.34,19724.25,21397.98,24
CPT,36252,Outpatient Surgery Group 3 Global Rate,82783.6,53809.34,22055.0,22787.0,2
CPT,36253,HB INS CATH REN ART 2ND+ UNILAT,56322.3,36609.5,6731.11,14761.0,10
CPT,36253,Outpatient Grouper - 6,56322.3,36609.5,28632.25,34209.93,24
CPT,36253,Outpatient Surgery Group 3 Global Rate,56322.3,36609.5,22055.0,22787.0,2
CPT,36254,Outpatient Grouper - 4,70547.8,45856.07,19724.25,21397.98,24
CPT,36254,Outpatient Surgery Group 3 Global Rate,70547.8,45856.07,22055.0,22787.0,2
CPT,36260,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36260,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36261,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36261,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,36262,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36262,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36299,HB UL VASCULAR INJECTION,7753.32,5039.66,13270.0,14761.0,2
CPT,36299,Outpatient Grouper - 0,6742.03,4382.32,9059.94,9827.82,24
CPT,36410,HB VENIPUNCTURE INFNT 3YR/OLDER,105.065,68.295,13270.0,14761.0,4
CPT,36410,"VENIPUNCTURE, AGE 3 YEARS OR OLDER, NECESSITATING PHYSICIAN'S SKILL (SEPARATE PROCEDURE), FOR DIAGNOSTIC OR THERAPEUTIC PURPOSES (NOT TO BE USED FOR ROUTINE VENIPUNCTURE)",90.46,58.8,12.33,12.33,2
CPT,36415,COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE,2308.13,1500.28,11.54,30.9,4
CPT,36415,HB NMDP CT BLOOD SAMPLE,2308.13,1500.28,13270.0,14761.0,2
CPT,36416,"COLLECTION OF CAPILLARY BLOOD SPECIMEN (E.G., FINGER, HEEL, EAR STICK)",129.84,84.4,0.12,0.12,2
CPT,36416,HB LAB COLLECTION CAPILLARY,129.84,84.4,13270.0,14761.0,2
CPT,36416,OUTPATIENT SURGERY CPT GROUP 1,129.84,84.4,6417.0,7038.0,2
CPT,36420,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36420,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36420,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36425,OUTPATIENT SURGERY CPT GROUP 1,739.73,480.82,6417.0,7038.0,2
CPT,36425,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,36425,Outpatient Surgical Group 1,739.73,480.82,9088.3,13492.72,50
CPT,36430,BLOOD,4587.08,2981.6,,,0
CPT,36430,"HB TRANSFUSION, BLOOD COMPLEX",5275.15,3428.8450000000003,544.37,14761.0,20
CPT,36430,INFUSION THERAPY,4587.08,2981.6,2148.0,2209.0,2
CPT,36430,OUTPATIENT SURGERY CPT GROUP 1,4587.08,2981.6,6417.0,7038.0,2
CPT,36430,Outpatient Grouper - 0,4587.08,2981.6,9059.94,9827.82,24
CPT,36430,Outpatient Surgical Group 0,4587.08,2981.6,2806.68,4166.87,50
CPT,36440,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36440,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36440,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36450,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36450,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36450,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36455,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36455,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36455,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36456,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36456,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36460,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36460,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,36460,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36465,OUTPATIENT SURGERY CPT GROUP 1,6801.31,4420.85,6417.0,7038.0,2
CPT,36465,Outpatient Grouper - 2,6801.31,4420.85,13036.88,14143.2,24
CPT,36465,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,50
CPT,36466,OUTPATIENT SURGERY CPT GROUP 1,7948.54,5166.55,6417.0,7038.0,2
CPT,36466,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,36466,Outpatient Surgical Group 1,7948.54,5166.55,9088.3,13492.72,50
CPT,36468,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,36468,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,36468,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,36470,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,36470,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,36471,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,36471,Outpatient Surgical Group 1,2063.43,1341.23,9088.3,13492.72,50
CPT,36473,Outpatient Grouper - 4,17938.8,11660.22,19724.25,21397.98,24
CPT,36473,Outpatient Surgery Group 3 Global Rate,17938.8,11660.22,22055.0,22787.0,2
CPT,36473,Outpatient Surgical Group 5,17938.8,11660.22,19539.84,29009.34,50
CPT,36474,Outpatient Grouper - 0,14189.0,9222.85,9059.94,9827.82,24
CPT,36474,Outpatient Surgery Group 2 Global Rate,14189.0,9222.85,14322.0,15354.0,2
CPT,36475,"HB ENDOVENOUS ABLATION THERAPY RF, 1ST VEIN",17938.8,11660.22,3919.23,4507.11,8
CPT,36475,Outpatient Grouper - 4,17938.8,11660.22,19724.25,21397.98,24
CPT,36475,Outpatient Surgery Group 3 Global Rate,17938.8,11660.22,22055.0,22787.0,2
CPT,36475,Outpatient Surgical Group 5,17938.8,11660.22,19539.84,29009.34,50
CPT,36476,Outpatient Grouper - 0,2162.22,1405.44,9059.94,9827.82,24
CPT,36476,Outpatient Surgical Group 5,2162.22,1405.44,19539.84,29009.34,50
CPT,36478,Outpatient Grouper - 4,17938.8,11660.22,19724.25,21397.98,24
CPT,36478,Outpatient Surgery Group 3 Global Rate,17938.8,11660.22,22055.0,22787.0,2
CPT,36478,Outpatient Surgical Group 5,17938.8,11660.22,19539.84,29009.34,50
CPT,36479,OUTPATIENT SURGERY CPT GROUP 1,2162.22,1405.44,6417.0,7038.0,2
CPT,36479,Outpatient Grouper - 0,2162.22,1405.44,9059.94,9827.82,24
CPT,36479,Outpatient Surgical Group 5,2162.22,1405.44,19539.84,29009.34,50
CPT,36481,HB CATH PLCMT PERC PORTAL VEIN,6928.55,4503.56,13270.0,14761.0,2
CPT,36481,Outpatient Grouper - 0,6928.55,4503.56,9059.94,9827.82,24
CPT,36482,Outpatient Grouper - 6,24975.0,16233.75,28632.25,34209.93,24
CPT,36482,Outpatient Surgery Group 3 Global Rate,24975.0,16233.75,22055.0,22787.0,2
CPT,36482,Outpatient Surgical Group 5,24975.0,16233.75,19539.84,29009.34,50
CPT,36483,Outpatient Grouper - 0,2162.22,1405.44,9059.94,9827.82,24
CPT,36483,Outpatient Surgery Group 2 Global Rate,2162.22,1405.44,14322.0,15354.0,2
CPT,36483,Outpatient Surgical Group 5,2162.22,1405.44,19539.84,29009.34,50
CPT,36500,HB VENOUS SAMPLING,3259.23,2118.5,13270.0,14761.0,2
CPT,36500,Outpatient Grouper - 0,3259.23,2118.5,9059.94,9827.82,24
CPT,36510,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36511,HB THERAPEUTIC APHER WBC,9928.18,6453.32,13270.0,14761.0,4
CPT,36511,INFUSION THERAPY,9928.18,6453.32,2148.0,2209.0,2
CPT,36511,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,36511,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,36512,HB THER APHER FOR RBC'S,9928.18,6453.32,2041.21,14761.0,20
CPT,36512,INFUSION THERAPY,9928.18,6453.32,2148.0,2209.0,2
CPT,36512,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,36512,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,36513,INFUSION THERAPY,7187.9,4672.14,2148.0,2209.0,2
CPT,36513,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,36513,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,36514,"HB THR APHER, PLASMA PHERESIS",9928.18,6453.32,2041.21,14761.0,10
CPT,36514,INFUSION THERAPY,9928.18,6453.32,2148.0,2209.0,2
CPT,36514,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,36514,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,36515,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,36516,HB THR APHER SEL ADS/FIL PL REINF,19737.5,12829.38,5833.92,14761.0,10
CPT,36516,INFUSION THERAPY,19737.5,12829.38,2148.0,2209.0,2
CPT,36516,OUTPATIENT SURGERY CPT GROUP 1,19737.5,12829.38,6417.0,7038.0,2
CPT,36516,Outpatient Grouper - 5,19737.5,12829.38,25486.19,27649.53,24
CPT,36516,Outpatient Surgical Group 7,19737.5,12829.38,27131.25,40279.73,50
CPT,36522,"HB PHOTOPHERESIS, EXTRACORP",19737.5,12829.38,5833.92,14761.0,10
CPT,36522,Outpatient Grouper - 5,19737.5,12829.38,25486.19,27649.53,24
CPT,36522,Outpatient Surgical Group 7,19737.5,12829.38,27131.25,40279.73,50
CPT,36555,HB CATH INSRT NON-TUN 5YR/LESS,9390.095,6103.5650000000005,3919.23,14761.0,10
CPT,36555,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,36555,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36555,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36556,HB CATH INSRT NON-TUN 5YR/M,9390.095,6103.5650000000005,3919.23,14761.0,20
CPT,36556,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,36556,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36556,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36557,Outpatient Grouper - 6,24975.0,16233.75,28632.25,34209.93,24
CPT,36557,Outpatient Surgery Group 2 Global Rate,24975.0,16233.75,14322.0,15354.0,2
CPT,36557,Outpatient Surgical Group 1,24975.0,16233.75,9088.3,13492.72,50
CPT,36558,HB CATH INSRT TUNNLED 5YR/MORE,17145.825,11144.785,3919.23,14761.0,10
CPT,36558,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36558,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,36558,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36560,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36560,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,36560,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,36561,HB INSRT TUNN CVC W/PORT >5YRS,17145.825,11144.785,3919.23,14761.0,10
CPT,36561,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36561,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,36561,Outpatient Surgical Group 5,14909.4,9691.11,19539.84,29009.34,50
CPT,36563,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36563,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36563,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,36565,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36565,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,36565,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,36566,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36566,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36566,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,36568,HB CATH INSRT PICC 5YR/LESS W/O IMG GUID,5255.94,3416.36,1934.32,2224.47,8
CPT,36568,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,36568,Outpatient Surgery Group 2 Global Rate,5255.94,3416.36,14322.0,15354.0,2
CPT,36568,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,36569,HB CATH INSRT PICC 5YR/MORE W/O IMG GUID,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,36569,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36569,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,36569,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36570,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36570,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36570,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36571,HB PAS PORT INSERTION >5 YRS,17145.825,11144.785,3919.23,14761.0,10
CPT,36571,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36571,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,36571,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36572,HB INSERTION PICC RS&I <5 YR,8287.615,5386.95,769.85,14761.0,10
CPT,36572,Outpatient Grouper - 1,7206.22,4684.04,10495.38,11385.92,24
CPT,36572,Outpatient Surgery Group 2 Global Rate,7206.22,4684.04,14322.0,15354.0,2
CPT,36572,Outpatient Surgical Group 1,7206.22,4684.04,9088.3,13492.72,50
CPT,36573,HB INSERTION PICC RS&I 5 YR+,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,36573,Outpatient Grouper - 2,8165.3,5307.45,13036.88,14143.2,24
CPT,36573,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,36573,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36575,HB CATH REPAIR CV OR PICC,6044.34,3928.8199999999997,769.85,14761.0,10
CPT,36575,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,36575,Outpatient Surgery Group 2 Global Rate,5255.94,3416.36,14322.0,15354.0,2
CPT,36575,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,36576,Outpatient Grouper - 1,7739.62,5030.75,10495.38,11385.92,24
CPT,36576,Outpatient Surgery Group 2 Global Rate,7739.62,5030.75,14322.0,15354.0,2
CPT,36576,Outpatient Surgical Group 1,7739.62,5030.75,9088.3,13492.72,50
CPT,36578,OUTPATIENT SURGERY CPT GROUP 1,14909.4,9691.11,6417.0,7038.0,2
CPT,36578,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36578,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36580,HB CATH REPLCMT NON-TUN CV,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,36580,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,36580,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36580,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36581,HB CATH REPLCMT TUNNLED CV,17145.825,11144.785,3919.23,14761.0,10
CPT,36581,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36581,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36582,HB REPL CHEST PORT VIA CATH EX,14909.4,9691.11,3919.23,4507.11,8
CPT,36582,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36582,Outpatient Surgical Group 5,14909.4,9691.11,19539.84,29009.34,50
CPT,36583,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36583,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,36584,HB REPLACE PICC CATH W IMG GUID,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,36584,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,36584,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36584,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36585,HB REPL PAS PORT VIA CATH EXCH,14909.4,9691.11,3919.23,4507.11,8
CPT,36585,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36585,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,36585,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36589,HB CATH REMOVE TUNNLED CV,6044.34,3928.8199999999997,769.85,14761.0,10
CPT,36589,Outpatient Grouper - 1,5255.94,3416.36,10495.38,11385.92,24
CPT,36589,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,36590,HB CATH REMOVE TUNNLED VAD,6044.34,3928.8199999999997,1934.32,14761.0,10
CPT,36590,Outpatient Grouper - 2,5255.94,3416.36,13036.88,14143.2,24
CPT,36590,Outpatient Surgery Group 2 Global Rate,5255.94,3416.36,14322.0,15354.0,2
CPT,36590,Outpatient Surgical Group 1,5255.94,3416.36,9088.3,13492.72,50
CPT,36591,Draw blood off venous device,,,194.02,309.0,2
CPT,36591,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36592,Collect blood from picc,80.11,52.07,223.13,355.35,2
CPT,36592,HB RSH LAB DRAW (PIC/HEMA/CHEMO),80.11,52.07,160.5,184.58,8
CPT,36592,Outpatient Grouper - 0,80.11,52.07,9059.94,9827.82,24
CPT,36593,HB DECLOT VASCULAR DEVICE,2590.715,1683.965,413.02,14761.0,20
CPT,36593,OUTPATIENT SURGERY CPT GROUP 1,2252.8,1464.32,6417.0,7038.0,2
CPT,36593,Outpatient Grouper - 0,2252.8,1464.32,9059.94,9827.82,24
CPT,36593,Outpatient Surgical Group 0,2252.8,1464.32,2806.68,4166.87,50
CPT,36595,HB REMOVE PERICATH OBST CVC,14909.4,9691.11,3919.23,14761.0,10
CPT,36595,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,36595,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,36595,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,36596,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36596,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,36596,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36597,HB CATH REPOSITIONING,10614.89,6899.68,13270.0,14761.0,2
CPT,36597,OUTPATIENT SURGERY CPT GROUP 1,8165.3,5307.45,6417.0,7038.0,2
CPT,36597,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,36597,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,36598,HB CONTRAST INJ INTO CV CATH,1413.34,918.67,262.35,301.7,8
CPT,36598,OUTPATIENT SURGERY CPT GROUP 1,1413.34,918.67,6417.0,7038.0,2
CPT,36598,Outpatient Grouper - 0,1413.34,918.67,9059.94,9827.82,24
CPT,36598,Outpatient Surgical Group 0,1413.34,918.67,2806.68,4166.87,50
CPT,36600,HB ARTERIAL PUNCTURE,1235.425,803.025,160.5,14761.0,12
CPT,36600,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,36620,HB ARTERIAL CATH INSERT PERC,1981.27,1287.8249999999998,13270.0,14761.0,4
CPT,36620,Outpatient Grouper - 0,1708.24,1110.35,9059.94,9827.82,24
CPT,36625,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36625,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,36640,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36640,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36640,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36660,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,36660,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,36660,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36680,HB INTRAOSSEOUS NEEDLE INSERTION,1649.4499999999998,1072.1399999999999,496.88,14761.0,10
CPT,36680,OUTPATIENT SURGERY CPT GROUP 1,1434.3,932.29,6417.0,7038.0,2
CPT,36680,Outpatient Grouper - 0,1434.3,932.29,9059.94,9827.82,24
CPT,36680,Outpatient Surgical Group 0,1434.3,932.29,2806.68,4166.87,50
CPT,36800,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36800,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36800,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36810,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36810,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36810,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36815,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36815,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36815,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36818,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36818,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36818,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,36819,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36819,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36819,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36820,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36820,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36820,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36821,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36821,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36821,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36823,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,36823,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,36823,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,36825,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36825,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36825,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,36830,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36830,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,36831,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36831,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36831,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,36832,Outpatient Grouper - 6,25241.3,16406.85,28632.25,34209.93,24
CPT,36832,Outpatient Surgery Group 4 Global Rate,25241.3,16406.85,26623.0,28144.0,2
CPT,36832,Outpatient Surgical Group 4,25241.3,16406.85,17187.58,25517.11,50
CPT,36833,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36833,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36833,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,36835,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,36835,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,36835,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,36836,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,36836,Outpatient Surgery Group 9 Global Rate,114605.0,74493.25,36365.0,39072.0,2
CPT,36836,Outpatient Surgical Group 1,114605.0,74493.25,9088.3,13492.72,50
CPT,36837,HB AV FISTULA CREAT UP EXT SEP ACC S&I,114605.0,74493.25,22359.49,25713.42,8
CPT,36837,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,36837,Outpatient Surgery Group 9 Global Rate,114605.0,74493.25,36365.0,39072.0,2
CPT,36837,Outpatient Surgical Group 2,114605.0,74493.25,12162.28,18056.43,50
CPT,36838,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36838,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36838,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,36860,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,36860,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,36860,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,36861,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,36861,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,36861,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,36901,HB ACCESS AV DIALYSIS GRAFT EVAL,8165.3,5307.45,1934.32,14761.0,10
CPT,36901,Outpatient Grouper - 2,8165.3,5307.45,13036.88,14143.2,24
CPT,36901,Outpatient Surgical Group 7,8165.3,5307.45,27131.25,40279.73,50
CPT,36902,HB ACCESS AV DIALYSIS GRAFT W PTA,47896.9,31132.99,7099.46,14761.0,10
CPT,36902,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,36902,Outpatient Surgery Group 4 Global Rate,47896.9,31132.99,26623.0,28144.0,2
CPT,36902,Outpatient Surgical Group 7,47896.9,31132.99,27131.25,40279.73,50
CPT,36903,HB ACCESS AV DIALYSIS GRAFT W STENT,102328.0,66513.2,13270.0,14761.0,2
CPT,36903,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,36903,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,36903,Outpatient Surgical Group 7,102328.0,66513.2,27131.25,40279.73,50
CPT,36904,HB THROMBECTOMY/LYSIS DIALYSIS CIRCT,47896.9,31132.99,13270.0,14761.0,2
CPT,36904,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,36904,Outpatient Surgery Group 2 Global Rate,47896.9,31132.99,14322.0,15354.0,2
CPT,36904,Outpatient Surgical Group 9,47896.9,31132.99,36513.58,54208.97,50
CPT,36905,HB THROMBECTOMY/LYSIS W/ PTA DIALYSIS CIRCT,102328.0,66513.2,13270.0,16239.31,10
CPT,36905,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,36905,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,36905,Outpatient Surgical Group 9,102328.0,66513.2,36513.58,54208.97,50
CPT,36906,HB THROMBECTOMY/LYSIS W/ STENT DIALYSIS CIRCT,114605.0,74493.25,13270.0,25713.42,10
CPT,36906,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,36906,Outpatient Surgery Group 3 Global Rate,114605.0,74493.25,22055.0,22787.0,2
CPT,36906,Outpatient Surgical Group 9,114605.0,74493.25,36513.58,54208.97,50
CPT,36907,HB PTA CENTRAL DIALYSIS SEGMENT,56887.9,36977.14,13270.0,14761.0,2
CPT,36907,Outpatient Grouper - 0,56887.9,36977.14,9059.94,9827.82,24
CPT,36907,Outpatient Surgery Group 4 Global Rate,56887.9,36977.14,26623.0,28144.0,2
CPT,36907,Outpatient Surgical Group 4,56887.9,36977.14,17187.58,25517.11,50
CPT,36908,HB STENT PLMT CTR DIALYSIS SEG,85448.1,55541.27,,,0
CPT,36908,Outpatient Grouper - 0,85448.1,55541.27,9059.94,9827.82,24
CPT,36908,Outpatient Surgery Group 2 Global Rate,85448.1,55541.27,14322.0,15354.0,2
CPT,36908,Outpatient Surgical Group 4,85448.1,55541.27,17187.58,25517.11,50
CPT,36909,HB DIALYSIS CIRCUIT EMBOL,114588.0,74482.2,,,0
CPT,36909,Outpatient Grouper - 0,114588.0,74482.2,9059.94,9827.82,24
CPT,36909,Outpatient Surgery Group 2 Global Rate,114588.0,74482.2,14322.0,15354.0,2
CPT,36909,Outpatient Surgical Group 4,114588.0,74482.2,17187.58,25517.11,50
CPT,37140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,37140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37145,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,37145,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,37160,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37160,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,37160,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37180,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37180,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,37180,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37181,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37181,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,37181,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37182,HB SHUNT INSERT HEPATIC TIPS,65796.75,42767.89,13270.0,14761.0,2
CPT,37182,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,37182,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37182,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37183,HB SHUNT REVISION HEPATIC TIPS,47896.9,31132.99,7099.46,14761.0,10
CPT,37183,Outpatient Grouper - 7,47896.9,31132.99,32948.13,35744.6,24
CPT,37183,Outpatient Surgery Group 6 Global Rate,47896.9,31132.99,34526.0,35549.0,2
CPT,37183,Outpatient Surgical Group 1,47896.9,31132.99,9088.3,13492.72,50
CPT,37184,HB THROMBECTOMY PRIM MECH,102328.0,66513.2,13270.0,25713.42,10
CPT,37184,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,37184,Outpatient Surgery Group 3 Global Rate,102328.0,66513.2,22055.0,22787.0,2
CPT,37184,Outpatient Surgical Group 3,102328.0,66513.2,13899.75,20635.92,50
CPT,37185,HB THROMBECTOMY PRIM MECH ADON,8419.68,5472.79,13270.0,14761.0,2
CPT,37185,Outpatient Grouper - 0,8419.68,5472.79,9059.94,9827.82,24
CPT,37185,Outpatient Surgery Group 2 Global Rate,8419.68,5472.79,14322.0,15354.0,2
CPT,37185,Outpatient Surgical Group 3,8419.68,5472.79,13899.75,20635.92,50
CPT,37186,HB THROMBECTOMY SECNDRY MCH,8321.58,5409.03,13270.0,14761.0,2
CPT,37186,Outpatient Grouper - 0,8321.58,5409.03,9059.94,9827.82,24
CPT,37186,Outpatient Surgery Group 2 Global Rate,8321.58,5409.03,14322.0,15354.0,2
CPT,37186,Outpatient Surgical Group 3,8321.58,5409.03,13899.75,20635.92,50
CPT,37187,HB THROMBECTOMY VENOUS MECH,102328.0,66513.2,13270.0,16239.31,10
CPT,37187,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,37187,Outpatient Surgery Group 2 Global Rate,102328.0,66513.2,14322.0,15354.0,2
CPT,37187,Outpatient Surgical Group 3,102328.0,66513.2,13899.75,20635.92,50
CPT,37188,HB THROMBECTOMY VENOUS MECH ADD ON,14909.4,9691.11,13270.0,14761.0,2
CPT,37188,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37188,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,37188,Outpatient Surgical Group 3,14909.4,9691.11,13899.75,20635.92,50
CPT,37191,HB INS VENA CAVA FILTER,28721.245000000003,18668.809999999998,6731.11,14761.0,10
CPT,37191,Outpatient Grouper - 6,24975.0,16233.75,28632.25,34209.93,24
CPT,37191,Outpatient Surgery Group 4 Global Rate,24975.0,16233.75,26623.0,28144.0,2
CPT,37191,Outpatient Surgical Group 2,24975.0,16233.75,12162.28,18056.43,50
CPT,37192,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37192,Outpatient Surgery Group 4 Global Rate,14909.4,9691.11,26623.0,28144.0,2
CPT,37192,Outpatient Surgical Group 2,14909.4,9691.11,12162.28,18056.43,50
CPT,37193,HB REMOVAL VENA CAVA FILTER,14909.4,9691.11,3919.23,14761.0,10
CPT,37193,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37193,Outpatient Surgery Group 4 Global Rate,14909.4,9691.11,26623.0,28144.0,2
CPT,37193,Outpatient Surgical Group 2,14909.4,9691.11,12162.28,18056.43,50
CPT,37195,HB THROMBOLYSIS CEREBRAL IV INFUSION,53235.94499999999,34603.365,413.02,14761.0,9
CPT,37195,Outpatient Grouper - 0,3907.7,2540.01,9059.94,9827.82,24
CPT,37195,Outpatient Surgery Group 2 Global Rate,3907.7,2540.01,14322.0,15354.0,2
CPT,37195,Outpatient Surgical Group 1,3907.7,2540.01,9088.3,13492.72,50
CPT,37197,HB REMOVE INTRAVS FOREIGN BODY,14909.4,9691.11,3919.23,14761.0,10
CPT,37197,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37197,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,37197,Outpatient Surgical Group 2,14909.4,9691.11,12162.28,18056.43,50
CPT,37200,HB BIOPSY TRANSCATHETER,24975.0,16233.75,6731.11,14761.0,10
CPT,37200,Outpatient Grouper - 6,24975.0,16233.75,28632.25,34209.93,24
CPT,37200,Outpatient Surgery Group 2 Global Rate,24975.0,16233.75,14322.0,15354.0,2
CPT,37200,Outpatient Surgical Group 1,24975.0,16233.75,9088.3,13492.72,50
CPT,37211,HB THROMBOLYTIC ART THERAPY,24975.0,16233.75,13270.0,14761.0,2
CPT,37211,Outpatient Grouper - 6,24975.0,16233.75,28632.25,34209.93,24
CPT,37211,Outpatient Surgery Group 2 Global Rate,24975.0,16233.75,14322.0,15354.0,2
CPT,37211,Outpatient Surgical Group 3,24975.0,16233.75,13899.75,20635.92,50
CPT,37212,HB THROMBOLYTIC VENOUS THERAPY,14909.4,9691.11,13270.0,14761.0,2
CPT,37212,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37212,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,37212,Outpatient Surgical Group 3,14909.4,9691.11,13899.75,20635.92,50
CPT,37213,HB THROMBLYTIC ART/VEN THERAPY,8165.3,5307.45,13270.0,14761.0,2
CPT,37213,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,37213,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,37213,Outpatient Surgical Group 3,8165.3,5307.45,13899.75,20635.92,50
CPT,37214,HB CESS THERAPY CATH REMOVAL,8165.3,5307.45,13270.0,14761.0,2
CPT,37214,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,37214,Outpatient Surgery Group 2 Global Rate,8165.3,5307.45,14322.0,15354.0,2
CPT,37214,Outpatient Surgical Group 3,8165.3,5307.45,13899.75,20635.92,50
CPT,37215,HB STENT PLCMT W DIST PROTECT,17547.965,11406.18,13270.0,14761.0,2
CPT,37215,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37215,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,37216,HB STENT PLCMT WO DIST PROTECT,28996.2,18847.53,13270.0,14761.0,2
CPT,37216,Outpatient Grouper - Unlisted,28996.2,18847.53,13030.5,14136.81,24
CPT,37216,Outpatient Surgery Group 4 Global Rate,28996.2,18847.53,26623.0,28144.0,2
CPT,37217,"HB TRNSCTH STNT PLMNT RTR CRTD,UNI",128228.44,83348.49,13270.0,14761.0,2
CPT,37217,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37217,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37217,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,37218,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37218,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37218,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,37220,"HB ANGIO ILIAC, INITIAL VESSEL",47896.9,31132.99,7099.46,14761.0,10
CPT,37220,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,37220,Outpatient Surgery Group 4 Global Rate,47896.9,31132.99,26623.0,28144.0,2
CPT,37220,Outpatient Surgical Group 4,47896.9,31132.99,17187.58,25517.11,50
CPT,37221,"HB STENT, ILIAC INITIAL VESSEL",102328.0,66513.2,13270.0,16239.31,10
CPT,37221,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37221,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37221,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37222,"HB ANGIO ILIAC, ADDL VESSEL",44893.2,29180.58,13270.0,14761.0,2
CPT,37222,Outpatient Grouper - 6,44893.2,29180.58,28632.25,34209.93,24
CPT,37222,Outpatient Surgery Group 2 Global Rate,44893.2,29180.58,14322.0,15354.0,2
CPT,37222,Outpatient Surgical Group 4,44893.2,29180.58,17187.58,25517.11,50
CPT,37223,"HB STENT ILIAC, ADDL VESSEL",48362.0,31435.3,13270.0,14761.0,2
CPT,37223,Outpatient Grouper - 6,48362.0,31435.3,28632.25,34209.93,24
CPT,37223,Outpatient Surgery Group 2 Global Rate,48362.0,31435.3,14322.0,15354.0,2
CPT,37223,Outpatient Surgical Group 4,48362.0,31435.3,17187.58,25517.11,50
CPT,37224,HB ANGIO FEM/POP SYSTEM,47896.9,31132.99,7099.46,14761.0,10
CPT,37224,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,37224,Outpatient Surgery Group 3 Global Rate,47896.9,31132.99,22055.0,22787.0,2
CPT,37224,Outpatient Surgical Group 4,47896.9,31132.99,17187.58,25517.11,50
CPT,37225,HB ATHERECTOMY FEM/POP SYSTEM,102328.0,66513.2,13270.0,25713.42,10
CPT,37225,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37225,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37225,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37226,HB STENT PLACEMENT FEM/POP,102328.0,66513.2,13270.0,16239.31,10
CPT,37226,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37226,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37226,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37227,HB STENT PLCMNT W/ATHRCTMY FEM,114605.0,74493.25,13270.0,25713.42,10
CPT,37227,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,37227,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
CPT,37227,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,37228,HB ANGIO PTA TIB/PERON INI VSL,102328.0,66513.2,13270.0,16239.31,10
CPT,37228,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,37228,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37228,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37229,HB ATHERECTOMY TIB/PERON INI,114605.0,74493.25,13270.0,25713.42,10
CPT,37229,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,37229,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
CPT,37229,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,37230,"HB STENT PLCMNT TIB/PERON, INI VSL",114605.0,74493.25,13270.0,25713.42,10
CPT,37230,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
CPT,37230,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
CPT,37230,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,37231,"HB STENT PLCMNT W/ATH TIB, INITIAL VESSEL",114605.0,74493.25,22359.49,25713.42,8
CPT,37231,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,37231,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
CPT,37231,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,37232,"HB ANGIO TIB/PERONEAL,EA ADDL",38488.9,25017.79,13270.0,14761.0,2
CPT,37232,Outpatient Grouper - 6,38488.9,25017.79,28632.25,34209.93,24
CPT,37232,Outpatient Surgery Group 2 Global Rate,38488.9,25017.79,14322.0,15354.0,2
CPT,37232,Outpatient Surgical Group 4,38488.9,25017.79,17187.58,25517.11,50
CPT,37233,HB ATHERECTOMY TIB/PERON EA,42100.0,27365.0,13270.0,14761.0,2
CPT,37233,Outpatient Grouper - 7,42100.0,27365.0,32948.13,35744.6,24
CPT,37233,Outpatient Surgery Group 2 Global Rate,42100.0,27365.0,14322.0,15354.0,2
CPT,37233,Outpatient Surgical Group 4,42100.0,27365.0,17187.58,25517.11,50
CPT,37234,Outpatient Grouper - 6,41957.6,27272.44,28632.25,34209.93,24
CPT,37234,Outpatient Surgery Group 2 Global Rate,41957.6,27272.44,14322.0,15354.0,2
CPT,37234,Outpatient Surgical Group 4,41957.6,27272.44,17187.58,25517.11,50
CPT,37235,Outpatient Grouper - 6,78725.9,51171.83,28632.25,34209.93,24
CPT,37235,Outpatient Surgery Group 2 Global Rate,78725.9,51171.83,14322.0,15354.0,2
CPT,37235,Outpatient Surgical Group 4,78725.9,51171.83,17187.58,25517.11,50
CPT,37236,HB TRNSCTH PLMNT OPN/PRQ STNT 1ST,102328.0,66513.2,13270.0,16239.31,10
CPT,37236,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37236,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37236,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37237,HB TRNSCTH PLMNT OPN/PRQ STNT EA,77945.7,50664.71,,,0
CPT,37237,Outpatient Grouper - 6,77945.7,50664.71,28632.25,34209.93,24
CPT,37237,Outpatient Surgery Group 2 Global Rate,77945.7,50664.71,14322.0,15354.0,2
CPT,37237,Outpatient Surgical Group 4,77945.7,50664.71,17187.58,25517.11,50
CPT,37238,HB TRNSCTH PLMNT OPN/PRQ STNT SAME,102328.0,66513.2,13270.0,16239.31,10
CPT,37238,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37238,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,37238,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,37239,HB TRNSCTH PLMNT OPN/PRQ STNT EA,85448.1,55541.27,13270.0,14761.0,2
CPT,37239,Outpatient Grouper - 6,85448.1,55541.27,28632.25,34209.93,24
CPT,37239,Outpatient Surgery Group 2 Global Rate,85448.1,55541.27,14322.0,15354.0,2
CPT,37239,Outpatient Surgical Group 4,85448.1,55541.27,17187.58,25517.11,50
CPT,37241,HB VASC EMBOLIZE/OCCLUDE VEN,102328.0,66513.2,13270.0,16239.31,10
CPT,37241,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37241,Outpatient Surgery Group 5 Global Rate,102328.0,66513.2,32992.0,34883.0,2
CPT,37241,Outpatient Surgical Group 0,102328.0,66513.2,2806.68,4166.87,50
CPT,37242,HB VASC EMBOLIZE/OCCLUDE ARTRY,102328.0,66513.2,13270.0,25713.42,10
CPT,37242,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37242,Outpatient Surgery Group 5 Global Rate,102328.0,66513.2,32992.0,34883.0,2
CPT,37242,Outpatient Surgical Group 0,102328.0,66513.2,2806.68,4166.87,50
CPT,37243,HB VASC EMBOLIZE/OCCLUDE ORGAN,102328.0,66513.2,13270.0,16239.31,10
CPT,37243,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37243,Outpatient Surgery Group 5 Global Rate,102328.0,66513.2,32992.0,34883.0,2
CPT,37243,Outpatient Surgical Group 0,102328.0,66513.2,2806.68,4166.87,50
CPT,37244,HB VASC EMBOLIZE/OCCLUDE BLEED,117677.24,76490.205,13270.0,16239.31,10
CPT,37244,HB VASC EMBOLIZE/OCCLUDE BLEED (ED ONLY),133026.48,86467.21,13270.0,14761.0,2
CPT,37244,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,37244,Outpatient Surgery Group 5 Global Rate,102328.0,66513.2,32992.0,34883.0,2
CPT,37244,Outpatient Surgical Group 0,102328.0,66513.2,2806.68,4166.87,50
CPT,37246,HB PTA UE/VISCERAL ARTERY INITIAL,47896.9,31132.99,7099.46,14761.0,10
CPT,37246,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,37246,Outpatient Surgery Group 4 Global Rate,47896.9,31132.99,26623.0,28144.0,2
CPT,37246,Outpatient Surgical Group 1,47896.9,31132.99,9088.3,13492.72,50
CPT,37247,Outpatient Grouper - 0,43025.1,27966.31,9059.94,9827.82,24
CPT,37247,Outpatient Surgery Group 4 Global Rate,43025.1,27966.31,26623.0,28144.0,2
CPT,37248,HB PTA VEIN INITIAL,47896.9,31132.99,7099.46,14761.0,10
CPT,37248,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,37248,Outpatient Surgery Group 4 Global Rate,47896.9,31132.99,26623.0,28144.0,2
CPT,37248,Outpatient Surgical Group 1,47896.9,31132.99,9088.3,13492.72,50
CPT,37249,HB PTA VEIN EA ADDL,43025.1,27966.31,13270.0,14761.0,2
CPT,37249,Outpatient Grouper - 0,43025.1,27966.31,9059.94,9827.82,24
CPT,37249,Outpatient Surgery Group 4 Global Rate,43025.1,27966.31,26623.0,28144.0,2
CPT,37252,HB INTRVASC US NONCORONARY 1ST,25245.7,16409.71,13270.0,14761.0,2
CPT,37252,Outpatient Grouper - 0,25245.7,16409.71,9059.94,9827.82,24
CPT,37253,HB INTRVASC US NONCORONARY ADDL,13362.5,8685.63,13270.0,14761.0,2
CPT,37253,Outpatient Grouper - 0,13362.5,8685.63,9059.94,9827.82,24
CPT,37500,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,37500,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,37500,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,37501,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,37501,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,37565,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,37565,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,37565,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,37600,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37600,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37600,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,37605,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37605,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37605,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,37606,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37606,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37606,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,37607,HB LIGATION OF A-V FISTULA,19382.25,12598.46,13270.0,14761.0,2
CPT,37607,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37607,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,37607,Outpatient Surgical Group 3,14909.4,9691.11,13899.75,20635.92,50
CPT,37609,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,37609,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,37609,Outpatient Surgical Group 2,11474.0,7458.1,12162.28,18056.43,50
CPT,37615,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,37615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37615,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,37616,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37616,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37616,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37617,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37617,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37617,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37618,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37618,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37618,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37619,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,37619,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,37619,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,37650,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37650,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37650,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,37660,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37660,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37660,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,37700,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37700,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37700,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,37718,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37718,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37718,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37722,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37722,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37722,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37735,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37735,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37735,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37760,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37760,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37760,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37761,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,37761,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37761,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,37765,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37765,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,37765,Outpatient Surgical Group 6,14909.4,9691.11,22453.45,33334.94,50
CPT,37766,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,37766,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,37766,Outpatient Surgical Group 6,14909.4,9691.11,22453.45,33334.94,50
CPT,37780,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,37780,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37780,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37785,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37785,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37785,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37788,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,37788,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,37788,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,37790,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,37790,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,37790,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,37799,HB DEPLOY HEMOSTASIS DEVICE,10871.07,7066.195,769.85,14761.0,20
CPT,37799,HB MISCELLANEOUS PROCEDURE,6832.74,4441.28,13270.0,14761.0,2
CPT,37799,Outpatient Grouper - 1,14909.4,9691.11,10495.38,11385.92,24
CPT,37799,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,38100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38100,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38101,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38101,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38101,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38102,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38102,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,38102,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38115,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38115,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38115,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38120,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38120,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38120,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,38129,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,38129,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,38200,HB SPLENOPORTOGRAPHY INJECTION,382.94,248.91,13270.0,14761.0,2
CPT,38200,Outpatient Grouper - 0,382.94,248.91,9059.94,9827.82,24
CPT,38204,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,38204,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38205,HB ALLO PB STEM CELL APHERESIS BD,79678.9,51791.28,13270.0,14761.0,4
CPT,38205,HB NMDP PBSC COLLECTION,79678.9,51791.28,13270.0,14761.0,2
CPT,38205,OUTPATIENT SURGERY CPT GROUP 1,79678.9,51791.28,6417.0,7038.0,2
CPT,38205,Outpatient Grouper - 0,79678.9,51791.28,9059.94,9827.82,24
CPT,38205,Outpatient Surgical Group 1,79678.9,51791.28,9088.3,13492.72,50
CPT,38206,HB AUTO PB STEM CELL APHERESIS BD,9928.18,6453.32,2041.21,14761.0,10
CPT,38206,OUTPATIENT SURGERY CPT GROUP 1,9928.18,6453.32,6417.0,7038.0,2
CPT,38206,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,38206,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,38207,HB BM/PB CRYOPRESVE STEM CELLS,7187.9,4672.14,544.37,14761.0,10
CPT,38207,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38207,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38207,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38208,HB BM/PB WASH HARVST STM CELLS,7187.9,4672.14,544.37,14761.0,10
CPT,38208,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38208,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38208,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38209,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38209,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38209,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38210,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38210,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38210,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38211,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,38211,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,38211,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38212,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,38212,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,38212,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38213,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38213,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38213,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38214,OUTPATIENT SURGERY CPT GROUP 1,7187.9,4672.14,6417.0,7038.0,2
CPT,38214,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38214,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,38215,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,38215,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,38215,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38220,HB DIAG BONE MARROW ASPIRATION ONLY,13195.1,8576.815,2017.5,14761.0,10
CPT,38220,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,38220,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,38220,Outpatient Surgical Group 0,11474.0,7458.1,2806.68,4166.87,50
CPT,38221,HB DIAG BONE MARROW BIOPSY,13195.1,8576.815,2017.5,14761.0,10
CPT,38221,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,38221,Outpatient Grouper - 1,11474.0,7458.1,10495.38,11385.92,24
CPT,38221,Outpatient Surgical Group 0,11474.0,7458.1,2806.68,4166.87,50
CPT,38222,HB DIAG BONE MARROW BX & ASPIR,14387.404999999999,9351.815,3563.79,14761.0,10
CPT,38222,OUTPATIENT SURGERY CPT GROUP 1,12510.8,8132.02,6417.0,7038.0,2
CPT,38222,Outpatient Grouper - 2,12510.8,8132.02,13036.88,14143.2,24
CPT,38222,Outpatient Surgical Group 0,12510.8,8132.02,2806.68,4166.87,50
CPT,38230,HB NMDP CORD BLOOD COLLECTION,178241.0,115856.65,2041.21,14761.0,10
CPT,38230,Outpatient Grouper - 2,178241.0,115856.65,13036.88,14143.2,24
CPT,38230,Outpatient Surgery Group 2 Global Rate,178241.0,115856.65,14322.0,15354.0,2
CPT,38230,Outpatient Surgical Group 1,178241.0,115856.65,9088.3,13492.72,50
CPT,38232,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,38232,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38232,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,38240,Allogeneic Bone Marrow/Stem Cell- Related,126827.0,82437.55,352797.12,352797.12,3
CPT,38240,Allogeneic Bone Marrow/Stem Cell-Unrelated,126827.0,82437.55,433374.24,433374.24,3
CPT,38240,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,126827.0,82437.55,352797.12,352797.12,3
CPT,38240,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,126827.0,82437.55,433374.24,433374.24,3
CPT,38240,Allogeneic Related BMT,126827.0,82437.55,223148.18,223148.18,2
CPT,38240,Allogeneic Unrelated BMT (including cord blood),126827.0,82437.55,272736.32,272736.32,2
CPT,38240,Allogenic: Related (Sibling) Donor,126827.0,82437.55,98800.0,98800.0,2
CPT,38240,Allogenic: Unrelated Donor,126827.0,82437.55,98800.0,98800.0,2
CPT,38240,Bone Marrow Transplants Hospital Services-Allogeneic,126827.0,82437.55,115000.0,115000.0,1
CPT,38240,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",126827.0,82437.55,140000.0,140000.0,1
CPT,38240,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",126827.0,82437.55,160000.0,160000.0,1
CPT,38240,General Transplant Services,126827.0,82437.55,,,0
CPT,38240,Hematopoietic Cell Transplant - Adult,126827.0,82437.55,,,0
CPT,38240,Other Transplant Services,126827.0,82437.55,,,0
CPT,38240,Outpatient Grouper - 5,126827.0,82437.55,25486.19,27649.53,24
CPT,38240,Outpatient Surgery Group 7 Global Rate,126827.0,82437.55,36188.0,39001.0,2
CPT,38240,Outpatient Surgical Group 1,126827.0,82437.55,9088.3,13492.72,50
CPT,38241,Autologous BMT,9928.18,6453.32,154963.84,154963.84,2
CPT,38241,Autologous Bone Marrow/Stem Cell (Single),9928.18,6453.32,233190.89,233190.89,3
CPT,38241,Autologous/Autologous BMT (tandems),9928.18,6453.32,223148.18,223148.18,2
CPT,38241,Autologous: High Dose Chemotherapy with Stem Cell Rescue: Hematolgic,9928.18,6453.32,56160.0,56160.0,2
CPT,38241,Autologous: High Dose Chemotherapy with Stem Cell Rescue: Solid Tumor,9928.18,6453.32,56160.0,56160.0,2
CPT,38241,Bone Marrow Transplants Autologous,9928.18,6453.32,105000.0,105000.0,1
CPT,38241,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,9928.18,6453.32,120000.0,120000.0,1
CPT,38241,General Transplant Services,9928.18,6453.32,,,0
CPT,38241,HB HEMATOPOIETIC PROG CELL HPC; AUTO TRANS,9928.18,6453.32,13270.0,14761.0,2
CPT,38241,Hematopoietic Cell Transplant - Adult,9928.18,6453.32,,,0
CPT,38241,Other Transplant Services,9928.18,6453.32,,,0
CPT,38241,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,38241,Outpatient Surgery Group 7 Global Rate,9928.18,6453.32,36188.0,39001.0,2
CPT,38241,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,38242,Allogeneic Bone Marrow/Stem Cell- Related,9928.18,6453.32,352797.12,352797.12,3
CPT,38242,Allogeneic Bone Marrow/Stem Cell-Unrelated,9928.18,6453.32,433374.24,433374.24,3
CPT,38242,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,9928.18,6453.32,352797.12,352797.12,3
CPT,38242,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,9928.18,6453.32,433374.24,433374.24,3
CPT,38242,Allogeneic Related BMT,9928.18,6453.32,223148.18,223148.18,2
CPT,38242,Allogeneic Unrelated BMT (including cord blood),9928.18,6453.32,272736.32,272736.32,2
CPT,38242,Allogenic: Related (Sibling) Donor,9928.18,6453.32,98800.0,98800.0,2
CPT,38242,Allogenic: Unrelated Donor,9928.18,6453.32,98800.0,98800.0,2
CPT,38242,Bone Marrow Transplants Hospital Services-Allogeneic,9928.18,6453.32,115000.0,115000.0,1
CPT,38242,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",9928.18,6453.32,140000.0,140000.0,1
CPT,38242,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",9928.18,6453.32,160000.0,160000.0,1
CPT,38242,General Transplant Services,9928.18,6453.32,,,0
CPT,38242,HB ALLOGENEIC LYMPHOCYTE INFUSIONS,9928.18,6453.32,2041.21,2347.39,8
CPT,38242,Hematopoietic Cell Transplant - Adult,9928.18,6453.32,,,0
CPT,38242,OUTPATIENT SURGERY CPT GROUP 1,9928.18,6453.32,6417.0,7038.0,2
CPT,38242,Other Transplant Services,9928.18,6453.32,,,0
CPT,38242,Outpatient Grouper - 2,9928.18,6453.32,13036.88,14143.2,24
CPT,38242,Outpatient Surgical Group 1,9928.18,6453.32,9088.3,13492.72,50
CPT,38243,Autologous BMT,,,154963.84,154963.84,2
CPT,38243,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
CPT,38243,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
CPT,38243,Autologous: High Dose Chemotherapy with Stem Cell Rescue: Hematolgic,,,56160.0,56160.0,2
CPT,38243,Autologous: High Dose Chemotherapy with Stem Cell Rescue: Solid Tumor,,,56160.0,56160.0,2
CPT,38243,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
CPT,38243,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
CPT,38243,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,38243,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,38243,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38300,Outpatient Grouper - 2,12510.8,8132.02,13036.88,14143.2,24
CPT,38300,Outpatient Surgical Group 1,12510.8,8132.02,9088.3,13492.72,50
CPT,38305,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,38305,Outpatient Surgery Group 2 Global Rate,12510.8,8132.02,14322.0,15354.0,2
CPT,38305,Outpatient Surgical Group 2,12510.8,8132.02,12162.28,18056.43,50
CPT,38308,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38308,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38308,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38380,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38380,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38380,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38381,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38381,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,38381,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38382,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38382,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38382,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38500,Outpatient Grouper - 3,19893.2,12930.58,14341.63,15558.59,24
CPT,38500,Outpatient Surgery Group 2 Global Rate,19893.2,12930.58,14322.0,15354.0,2
CPT,38500,Outpatient Surgical Group 2,19893.2,12930.58,12162.28,18056.43,50
CPT,38505,HB BIOPSY LYMPH NODE,13195.1,8576.815,2017.5,14761.0,10
CPT,38505,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,38505,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,38505,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,38510,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38510,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38510,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38520,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38520,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38520,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38525,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38525,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38525,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38530,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38530,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38530,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38531,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,38531,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38531,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,38542,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38542,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38542,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38550,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,38550,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,38555,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38555,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,38555,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,38562,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38562,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38562,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38564,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38564,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38564,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38570,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38570,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,38570,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,38571,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38571,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,38571,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,38572,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38572,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38572,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,38573,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38573,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38573,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,38589,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,38589,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,38700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38700,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38700,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,38720,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38720,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,38720,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,38724,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38724,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,38724,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,38740,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38740,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38745,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,38745,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,38745,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,38746,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38746,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,38746,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38747,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38747,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,38747,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38760,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,38760,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,38765,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38765,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,38765,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38770,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38770,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38770,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38780,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,38780,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,38780,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,38790,HB INJECTION FOR LYMPHANGIOGRAPHY,4717.73,3066.52,13270.0,14761.0,2
CPT,38790,OUTPATIENT SURGERY CPT GROUP 1,4717.73,3066.52,6417.0,7038.0,2
CPT,38790,Outpatient Grouper - 0,4717.73,3066.52,9059.94,9827.82,24
CPT,38792,HB RADIOACTIVE TRACER ID SENTINEL NODE,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,38792,OUTPATIENT SURGERY CPT GROUP 1,6279.86,4081.91,6417.0,7038.0,2
CPT,38792,Outpatient Grouper - 0,6279.86,4081.91,9059.94,9827.82,24
CPT,38794,Outpatient Grouper - 0,14446.9,9390.49,9059.94,9827.82,24
CPT,38794,Outpatient Surgery Group 2 Global Rate,14446.9,9390.49,14322.0,15354.0,2
CPT,38900,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,38999,HB INJECTION FOR LYMPHATIC ID/MAPPING,7187.9,4672.14,544.37,626.03,8
CPT,38999,Outpatient Grouper - 0,7187.9,4672.14,9059.94,9827.82,24
CPT,38999,Outpatient Surgical Group 1,7187.9,4672.14,9088.3,13492.72,50
CPT,39000,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39000,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,39000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39010,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39010,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,39010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39200,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39200,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,39200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39220,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39220,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,39220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39401,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,39401,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,39401,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,39402,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,39402,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,39402,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,39499,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39499,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39501,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,39501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39503,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39503,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,39503,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,39540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,39540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39541,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39541,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,39541,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39545,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,39545,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39560,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39560,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,39560,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39561,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39561,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,39561,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,39599,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,39599,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,40490,HB BIOPSY OF LIP,2070.32,1345.71,289.16,332.53,8
CPT,40490,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,40490,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,40500,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40500,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40500,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40510,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40510,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40510,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40520,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40520,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40520,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40525,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40525,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40525,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40527,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40527,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40527,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40530,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40530,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40530,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40650,HB RPR LIP THRU&THRU/VERM BORDER,2956.96,1922.02,634.11,729.23,8
CPT,40650,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40650,Outpatient Surgery Group 3 Global Rate,2956.96,1922.02,22055.0,22787.0,2
CPT,40650,Outpatient Surgical Group 3,2956.96,1922.02,13899.75,20635.92,50
CPT,40652,HB RPR LIP FT;UP HLF VRT HGHT,3400.5,2210.325,634.11,14761.0,10
CPT,40652,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40652,Outpatient Surgery Group 3 Global Rate,2956.96,1922.02,22055.0,22787.0,2
CPT,40652,Outpatient Surgical Group 3,2956.96,1922.02,13899.75,20635.92,50
CPT,40654,HB REP LIP FT;>1/2 V HT / COMP,7757.16,5042.155000000001,1844.47,14761.0,10
CPT,40654,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,40654,Outpatient Surgery Group 3 Global Rate,6745.34,4384.47,22055.0,22787.0,2
CPT,40654,Outpatient Surgical Group 3,6745.34,4384.47,13899.75,20635.92,50
CPT,40700,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40700,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,40700,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,40701,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40701,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,40701,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,40702,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40702,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,40702,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,40720,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40720,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,40720,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,40761,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40761,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,40761,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,40799,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,40799,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40800,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,40800,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,40800,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,40801,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40801,Outpatient Surgery Group 2 Global Rate,2956.96,1922.02,14322.0,15354.0,2
CPT,40801,Outpatient Surgical Group 2,2956.96,1922.02,12162.28,18056.43,50
CPT,40804,OUTPATIENT SURGERY CPT GROUP 1,5226.9,3397.48,6417.0,7038.0,2
CPT,40804,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,40804,Outpatient Surgical Group 0,5226.9,3397.48,2806.68,4166.87,50
CPT,40805,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40805,Outpatient Surgery Group 2 Global Rate,2956.96,1922.02,14322.0,15354.0,2
CPT,40805,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,40806,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40806,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,40806,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,40808,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,40808,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40808,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,40810,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40810,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40810,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40812,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40812,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40812,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40814,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40814,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40814,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40816,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40816,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40816,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40818,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40818,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,40818,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,40819,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40819,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40819,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,40820,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,40820,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,40820,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40830,HB REPAIR VEST MOUTH <2.5 CM,2070.32,1345.71,289.16,332.53,8
CPT,40830,OUTPATIENT SURGERY CPT GROUP 1,2070.32,1345.71,6417.0,7038.0,2
CPT,40830,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,40830,Outpatient Surgical Group 0,2070.32,1345.71,2806.68,4166.87,50
CPT,40831,"HB CL LAC, MTH VESTIB; >2.5 CM",2956.96,1922.02,634.11,729.23,8
CPT,40831,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,40831,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,40831,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,40840,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40840,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40840,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,40842,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40842,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40842,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,40843,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,40843,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,40843,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,40844,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40844,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,40844,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,40845,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,40845,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,40845,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,40899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,40899,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41000,HB I&D ABSC/CYST TONGUE FOM; LINGUAL,2956.96,1922.02,634.11,729.23,8
CPT,41000,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,41000,Outpatient Surgical Group 2,2956.96,1922.02,12162.28,18056.43,50
CPT,41005,OUTPATIENT SURGERY CPT GROUP 1,2070.32,1345.71,6417.0,7038.0,2
CPT,41005,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,41005,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,41006,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41006,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41006,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41007,OUTPATIENT SURGERY CPT GROUP 1,6745.34,4384.47,6417.0,7038.0,2
CPT,41007,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,41007,Outpatient Surgical Group 1,6745.34,4384.47,9088.3,13492.72,50
CPT,41008,OUTPATIENT SURGERY CPT GROUP 1,12101.2,7865.78,6417.0,7038.0,2
CPT,41008,Outpatient Grouper - 2,12101.2,7865.78,13036.88,14143.2,24
CPT,41008,Outpatient Surgical Group 1,12101.2,7865.78,9088.3,13492.72,50
CPT,41009,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,41009,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,41009,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,41010,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41015,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41015,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,41015,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41016,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41016,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41016,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41017,OUTPATIENT SURGERY CPT GROUP 1,12101.2,7865.78,6417.0,7038.0,2
CPT,41017,Outpatient Grouper - 2,12101.2,7865.78,13036.88,14143.2,24
CPT,41017,Outpatient Surgical Group 1,12101.2,7865.78,9088.3,13492.72,50
CPT,41018,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41018,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41018,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41019,OUTPATIENT SURGERY CPT GROUP 1,22997.3,14948.25,6417.0,7038.0,2
CPT,41019,Outpatient Grouper - 3,22997.3,14948.25,14341.63,15558.59,24
CPT,41019,Outpatient Surgical Group 1,22997.3,14948.25,9088.3,13492.72,50
CPT,41100,HB BIOPSY TONGUE ANTERIOR TWO-THIRDS,3844.04,2498.63,13270.0,14761.0,2
CPT,41100,HB MISCELLANEOUS PROCEDURE,3844.04,2498.63,13270.0,14761.0,2
CPT,41100,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,41100,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,41100,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,41105,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41105,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41105,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41108,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41108,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,41108,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,4110F,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,41110,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41112,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41112,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41112,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41113,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41113,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41113,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41114,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41114,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41114,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41115,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41115,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41115,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41116,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41116,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41116,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41120,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,41120,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,41120,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,41130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,41130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41135,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41135,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,41135,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,41140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,41140,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,41145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41145,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,41145,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,41150,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41150,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,41150,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,41153,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41153,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,41153,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,41155,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,41155,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,41155,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,41250,HB TONGUE LAC REPAIR UNDER 2.6 CM,1434.3,932.29,496.88,571.41,8
CPT,41250,Outpatient Grouper - 0,1434.3,932.29,9059.94,9827.82,24
CPT,41250,Outpatient Surgery Group 2 Global Rate,1434.3,932.29,14322.0,15354.0,2
CPT,41250,Outpatient Surgical Group 2,1434.3,932.29,12162.28,18056.43,50
CPT,41251,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,41251,Outpatient Surgery Group 2 Global Rate,2070.32,1345.71,14322.0,15354.0,2
CPT,41251,Outpatient Surgical Group 2,2070.32,1345.71,12162.28,18056.43,50
CPT,41252,HB RPR TONGUE >2.5/COMPLEX,2070.32,1345.71,289.16,332.53,8
CPT,41252,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,41252,Outpatient Surgery Group 2 Global Rate,2070.32,1345.71,14322.0,15354.0,2
CPT,41252,Outpatient Surgical Group 2,2070.32,1345.71,12162.28,18056.43,50
CPT,41510,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41510,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41512,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,41512,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,41520,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41520,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,41520,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41530,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41530,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41530,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41599,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,41599,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41800,HB I&D ABCESS/CYST DENTOALVEOLAR,1074.29,698.29,160.5,184.58,8
CPT,41800,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,41800,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,41800,Outpatient Surgical Group 1,1074.29,698.29,9088.3,13492.72,50
CPT,41805,OUTPATIENT SURGERY CPT GROUP 1,6745.34,4384.47,6417.0,7038.0,2
CPT,41805,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,41805,Outpatient Surgical Group 4,6745.34,4384.47,17187.58,25517.11,50
CPT,41806,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41806,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41806,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41820,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41821,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41821,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41821,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,41822,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41822,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41822,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41823,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41823,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41823,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,41825,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41825,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41825,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41826,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41826,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41826,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41827,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,41827,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41827,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41828,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41828,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41828,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,41830,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41830,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41850,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,41850,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41850,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41870,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41870,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41870,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,41872,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,41872,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41872,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,41874,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,41874,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41874,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,41899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,41899,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,41899,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42000,HB DRAINAGE OF ABSCESS OF PALATE UVULA,2070.32,1345.71,289.16,332.53,8
CPT,42000,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,42000,Outpatient Surgery Group 2 Global Rate,2070.32,1345.71,14322.0,15354.0,2
CPT,42000,Outpatient Surgical Group 2,2070.32,1345.71,12162.28,18056.43,50
CPT,42100,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42104,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42104,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42104,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42106,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42106,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42106,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42107,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42107,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42107,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42120,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42120,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42140,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42140,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42140,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42145,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42145,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42145,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42160,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42160,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42180,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,42180,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,42180,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,42182,Outpatient Grouper - 3,22997.3,14948.25,14341.63,15558.59,24
CPT,42182,Outpatient Surgery Group 2 Global Rate,22997.3,14948.25,14322.0,15354.0,2
CPT,42182,Outpatient Surgical Group 2,22997.3,14948.25,12162.28,18056.43,50
CPT,42200,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42200,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42200,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42205,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42205,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42205,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42210,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42210,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42210,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42215,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42215,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,42215,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42220,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42220,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42220,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42225,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42225,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42225,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42226,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42226,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42226,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42227,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42227,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42227,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42235,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42235,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42235,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42260,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42260,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42260,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42280,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42280,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42280,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,42281,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42281,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42281,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42299,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42299,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42300,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42300,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42305,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42305,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42305,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42310,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42310,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42310,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42320,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42320,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42330,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42330,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42330,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42335,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42335,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42335,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42340,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42340,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42340,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42400,HB BIOPSY SALIVARY GLAND NDL,5952.47,3869.11,876.1,1007.52,8
CPT,42400,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,42400,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,42400,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,42405,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42405,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42405,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42408,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42408,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42408,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42409,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42409,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42409,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42410,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42410,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42410,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42415,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42415,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42415,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42420,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42420,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,42420,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42425,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42425,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,42425,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42426,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42426,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,42426,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42440,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42440,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42440,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42450,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42450,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42450,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42500,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42500,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42500,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42505,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42505,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42505,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42507,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42507,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42507,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42509,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42509,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42509,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42510,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42510,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42510,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42550,OUTPATIENT SURGERY CPT GROUP 1,1260.23,819.15,6417.0,7038.0,2
CPT,42550,Outpatient Grouper - 0,1260.23,819.15,9059.94,9827.82,24
CPT,42600,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42600,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42650,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42660,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42660,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42660,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42665,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42665,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42665,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42699,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,42699,Outpatient Surgical Group 2,2070.32,1345.71,12162.28,18056.43,50
CPT,42700,HB I&D ABSCESS PERITONSILAR,2070.32,1345.71,289.16,332.53,8
CPT,42700,OUTPATIENT SURGERY CPT GROUP 1,2070.32,1345.71,6417.0,7038.0,2
CPT,42700,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,42700,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,42720,OUTPATIENT SURGERY CPT GROUP 1,11470.3,7455.69,6417.0,7038.0,2
CPT,42720,Outpatient Grouper - 2,11470.3,7455.69,13036.88,14143.2,24
CPT,42720,Outpatient Surgical Group 1,11470.3,7455.69,9088.3,13492.72,50
CPT,42725,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42725,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42725,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42800,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42800,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,42800,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42804,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42804,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42804,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42806,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42806,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42806,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42808,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42808,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42808,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42809,HB FB THROAT REMOVAL,1434.3,932.29,496.88,571.41,8
CPT,42809,OUTPATIENT SURGERY CPT GROUP 1,1434.3,932.29,6417.0,7038.0,2
CPT,42809,Outpatient Grouper - 0,1434.3,932.29,9059.94,9827.82,24
CPT,42809,Outpatient Surgical Group 0,1434.3,932.29,2806.68,4166.87,50
CPT,42810,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42810,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42810,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42815,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42815,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42815,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42820,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42820,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42821,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42821,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42821,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,42825,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42825,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42825,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42826,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42826,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42826,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42830,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42831,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42831,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42831,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42835,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42835,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42835,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42836,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42836,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42836,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42842,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42842,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42842,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,42844,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42844,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42844,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,42845,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42845,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42860,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42860,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42860,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42870,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42870,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42870,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42890,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42890,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,42890,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42892,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,42892,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,42892,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,42894,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,42894,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42894,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42900,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42900,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42950,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42950,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42950,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42953,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,42953,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,42953,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42955,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42955,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42955,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42960,OUTPATIENT SURGERY CPT GROUP 1,2956.96,1922.02,6417.0,7038.0,2
CPT,42960,Outpatient Grouper - 0,2956.96,1922.02,9059.94,9827.82,24
CPT,42960,Outpatient Surgical Group 1,2956.96,1922.02,9088.3,13492.72,50
CPT,42961,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42961,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42961,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42962,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,42962,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42962,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,42970,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,42970,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42970,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42971,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,42971,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,42972,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,42972,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,42972,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,42975,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42975,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,42999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,42999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43020,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
CPT,43020,Outpatient Surgery Group 4 Global Rate,6745.34,4384.47,26623.0,28144.0,2
CPT,43020,Outpatient Surgical Group 1,6745.34,4384.47,9088.3,13492.72,50
CPT,43030,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43030,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43030,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43045,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43045,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43045,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43100,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43101,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43101,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43101,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43107,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43107,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43107,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43108,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43108,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43108,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43112,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43112,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43112,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43113,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43113,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43113,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43116,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43116,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43116,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43117,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43117,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43117,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43118,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43118,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43118,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43121,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43121,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43121,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43122,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43122,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43122,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43123,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43123,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43123,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43124,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43124,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43124,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43130,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43130,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43135,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43135,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43180,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43180,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43180,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43191,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43191,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43191,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43192,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43192,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43192,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43193,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43193,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43193,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43194,OUTPATIENT SURGERY CPT GROUP 1,7455.34,4845.97,6417.0,7038.0,2
CPT,43194,Outpatient Grouper - 2,7455.34,4845.97,13036.88,14143.2,24
CPT,43194,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",7455.34,4845.97,,,0
CPT,43194,Outpatient Surgical Group 1,7455.34,4845.97,9088.3,13492.72,50
CPT,43195,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43195,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43195,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43196,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43196,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43196,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43197,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43197,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43197,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43198,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43198,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43198,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43200,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43200,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43201,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43201,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43201,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43202,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43202,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43202,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43204,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43204,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43204,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43205,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43205,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43205,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43206,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43206,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43206,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43210,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43210,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43210,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43210,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43211,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43211,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43211,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43212,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43212,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43212,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43213,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43213,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43213,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43214,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43214,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43214,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43215,OUTPATIENT SURGERY CPT GROUP 1,7455.34,4845.97,6417.0,7038.0,2
CPT,43215,Outpatient Grouper - 2,7455.34,4845.97,13036.88,14143.2,24
CPT,43215,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",7455.34,4845.97,,,0
CPT,43215,Outpatient Surgical Group 1,7455.34,4845.97,9088.3,13492.72,50
CPT,43216,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43216,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43216,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43217,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43217,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43217,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43220,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43220,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43226,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43226,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43226,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43227,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43227,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43227,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43229,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43229,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43229,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43231,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43231,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43231,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43232,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43232,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43232,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43233,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43233,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43233,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43235,HB CATH UNLISTED PROCEDURES,3283.21,2134.09,13270.0,14761.0,2
CPT,43235,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43235,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43235,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43235,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43236,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43236,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43236,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43236,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43237,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43237,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43237,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43237,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43238,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43238,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43238,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43238,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43239,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,43239,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,43239,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",5226.9,3397.48,,,0
CPT,43239,Outpatient Surgical Group 2,5226.9,3397.48,12162.28,18056.43,50
CPT,43240,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43240,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43241,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43241,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43241,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43242,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43242,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43242,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43242,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43243,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43243,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43243,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43244,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43244,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43244,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43245,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43245,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43245,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43245,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43246,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43246,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43246,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43247,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,43247,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,43247,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",5226.9,3397.48,,,0
CPT,43247,Outpatient Surgical Group 2,5226.9,3397.48,12162.28,18056.43,50
CPT,43248,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43248,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43248,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43248,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43249,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43249,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43249,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43249,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43250,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43250,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43250,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43250,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43251,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43251,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43251,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43251,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43252,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43252,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43252,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43253,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43253,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43253,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43254,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43254,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43254,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43254,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43255,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43255,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43255,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43255,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43257,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43257,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43257,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43259,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43259,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43259,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43259,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43260,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43260,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43260,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43261,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43261,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43261,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43261,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43262,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43262,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43262,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43262,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43263,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43263,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43263,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43264,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43264,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43264,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43264,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43265,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43265,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43265,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43265,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43266,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43266,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43266,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43266,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43270,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43270,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43270,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43273,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,43273,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43273,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43274,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43274,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43274,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43274,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43275,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43275,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43275,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43276,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43276,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43276,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43276,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43277,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43277,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43277,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,43277,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43278,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43278,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43278,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43279,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43279,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43280,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43280,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43280,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,43281,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43281,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43281,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,43282,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43282,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43282,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,43283,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43283,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43283,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43284,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43284,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43284,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43285,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43285,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43285,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43286,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43286,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43286,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43287,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43287,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43287,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43288,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43288,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43288,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43289,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43289,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,43290,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43290,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43290,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43291,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43291,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43300,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43305,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43305,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43310,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43310,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43310,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43312,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43312,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43312,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43313,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43313,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43313,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,43314,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43314,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43314,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,43320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43320,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43325,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43325,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43325,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43327,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43327,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43327,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43328,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43328,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43328,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43330,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43330,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43330,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43331,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43331,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43331,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43332,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43332,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43332,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43333,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43333,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43333,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43334,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43334,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43334,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43335,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43335,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43335,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43336,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43336,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,43336,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43337,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43337,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,43337,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43338,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43338,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43338,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43340,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43340,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43340,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43341,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43341,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43341,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43351,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43351,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43351,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43352,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43352,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43352,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43360,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43360,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43360,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43361,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43361,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43361,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43400,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43405,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43405,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43405,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43410,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43410,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43410,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43415,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43415,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43415,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43420,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43420,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43420,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43425,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43425,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43425,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43450,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43450,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43450,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43453,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43453,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43453,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43460,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43460,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43460,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43496,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43496,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43496,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43497,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43497,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43497,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43499,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43499,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43500,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43500,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43501,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43502,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43502,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43502,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43510,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43510,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43520,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43520,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43605,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43605,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43610,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43610,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43611,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43611,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43611,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43620,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43620,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43620,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43621,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43621,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43621,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43622,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43622,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43622,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43631,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43631,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43631,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43632,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43632,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43632,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43633,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43633,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43633,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43634,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43634,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43634,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43635,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43635,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43635,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43640,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43640,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43640,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43641,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43641,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43641,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43644,Bariatric Services: Gastric Bypass (traditional and laparoscopic) or Biliopancreatic Bypass,,,26000.0,26000.0,1
CPT,43644,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43645,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43645,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43647,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,43647,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43647,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43648,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43648,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43648,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43651,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43651,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43651,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,43652,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43652,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43652,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,43653,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43653,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43653,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,43659,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43659,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,43752,HB PLCMT NG TUBE BY W FLUORO,961.65,625.07,13270.0,14761.0,2
CPT,43752,OUTPATIENT SURGERY CPT GROUP 1,739.73,480.82,6417.0,7038.0,2
CPT,43752,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,43752,Outpatient Surgical Group 0,739.73,480.82,2806.68,4166.87,50
CPT,43753,HB GASTRIC LAVAGE/INTUB OD,4564.63,2967.01,387.75,14761.0,10
CPT,43753,OUTPATIENT SURGERY CPT GROUP 1,3969.24,2580.01,6417.0,7038.0,2
CPT,43753,Outpatient Grouper - 0,3969.24,2580.01,9059.94,9827.82,24
CPT,43753,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,50
CPT,43754,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43754,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,43754,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43755,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43755,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,43755,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43756,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43756,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43756,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43757,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,43757,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43757,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,43761,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,43761,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,43761,Outpatient Surgical Group 0,4202.01,2731.31,2806.68,4166.87,50
CPT,43762,HB REPLACE GTUBE NO REVJ TRC,4832.3099999999995,3141.005,302.84,14761.0,10
CPT,43762,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,43762,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,43762,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,43763,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,43763,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,43763,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,43770,Bariatric Services: Gastric Banding (traditional and laparoscopic)- Realize Band and Lap-Band,,,23000.0,23000.0,1
CPT,43770,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43770,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43770,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43771,Bariatric Services: Gastric Banding (traditional and laparoscopic)- Realize Band and Lap-Band,,,23000.0,23000.0,1
CPT,43771,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43771,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43771,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43772,Bariatric Services: Gastric Banding (traditional and laparoscopic)- Realize Band and Lap-Band,,,23000.0,23000.0,1
CPT,43772,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43772,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43772,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43773,Bariatric Services: Gastric Banding (traditional and laparoscopic)- Realize Band and Lap-Band,,,23000.0,23000.0,1
CPT,43773,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43773,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43773,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43774,Bariatric Services: Gastric Banding (traditional and laparoscopic)- Realize Band and Lap-Band,,,23000.0,23000.0,1
CPT,43774,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,43774,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43774,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,43775,Bariatric Services: Gastric Sleeve,,,16000.0,16000.0,1
CPT,43775,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,43775,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43775,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,43800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43800,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43810,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43810,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43810,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43820,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43825,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43825,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43825,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,43830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43830,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43831,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43831,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,43831,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43832,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43832,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43832,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43840,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43840,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43842,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43842,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43842,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43843,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,43843,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43843,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43845,Bariatric Services: Duodenal Switch,,,28000.0,28000.0,1
CPT,43845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43845,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,43846,Bariatric Services: Gastric Bypass (traditional and laparoscopic) or Biliopancreatic Bypass,,,26000.0,26000.0,1
CPT,43846,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43846,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43846,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,43847,Bariatric Services: Gastric Bypass (traditional and laparoscopic) or Biliopancreatic Bypass,,,26000.0,26000.0,1
CPT,43847,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43847,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43847,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43848,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43848,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43848,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,43850,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43855,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43860,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43860,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43865,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43865,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43865,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43870,OUTPATIENT SURGERY CPT GROUP 1,6110.14,3971.59,6417.0,7038.0,2
CPT,43870,Outpatient Grouper - 3,6110.14,3971.59,14341.63,15558.59,24
CPT,43870,Outpatient Surgical Group 1,6110.14,3971.59,9088.3,13492.72,50
CPT,43880,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43880,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,43880,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43881,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43881,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43882,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,43882,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,43886,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43886,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43886,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43887,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,43887,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,43887,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43888,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,43888,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,43888,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,43999,Outpatient Grouper - 2,5221.94,3394.26,13036.88,14143.2,24
CPT,43999,Outpatient Surgical Group 1,5221.94,3394.26,9088.3,13492.72,50
CPT,44005,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44005,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,44005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44010,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44010,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44015,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44015,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44015,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44020,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44020,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44020,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44021,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44021,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44021,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44025,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44025,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44025,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44050,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44050,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44050,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44055,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44055,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44055,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44110,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44110,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44111,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44111,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44111,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44121,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44121,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44121,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44125,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44125,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44125,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44126,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44126,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44126,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44127,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44127,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44127,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,44128,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44128,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44128,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44132,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44132,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44132,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44133,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44133,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44133,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44135,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,2
CPT,44135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44135,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44135,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44136,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44136,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44136,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44137,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44137,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44139,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44139,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44139,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44141,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44143,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44143,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44143,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44144,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44144,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44144,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44145,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44145,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44146,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44146,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44146,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44147,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44147,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44147,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44150,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44150,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44150,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44151,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44151,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44151,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44155,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44155,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44155,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44156,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44156,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44156,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44157,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44157,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44158,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44158,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44160,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44160,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44180,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,44180,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44180,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44186,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,44186,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,44186,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44187,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44187,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44187,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44188,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44188,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44202,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,44202,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44202,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44203,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,44203,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44203,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44204,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,44204,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44204,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44205,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44205,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44206,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44206,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44206,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,44207,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44207,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44207,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,44208,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44208,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44208,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,44210,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44210,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44210,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,44211,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44211,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44211,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,44212,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44212,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,44212,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,44213,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44213,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44213,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,44227,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44227,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44227,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,44238,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,44238,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,44300,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44300,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44310,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44310,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44310,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44312,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44312,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44312,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44314,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44314,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44314,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44316,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44316,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44316,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44320,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44322,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44322,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44322,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44340,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44340,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44340,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44345,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44345,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,44345,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44346,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44346,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,44346,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44360,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44360,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44360,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44361,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44361,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44361,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44363,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44363,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44363,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44364,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44364,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44364,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44365,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44365,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44365,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44366,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44366,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44366,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44369,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44369,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44369,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44370,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44370,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44370,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,44372,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44372,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44372,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44373,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44373,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44373,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44376,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44376,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44376,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44377,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44377,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44377,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44378,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44378,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44378,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,44379,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44379,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,44379,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,44380,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44380,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44380,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44381,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44381,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,44382,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44382,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44384,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44384,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44384,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44385,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44385,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44385,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44386,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44386,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44386,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44388,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44388,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44388,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44389,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44389,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44390,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44390,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44390,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44391,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44391,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44391,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44392,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44392,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44392,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44394,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44394,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44394,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44401,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44401,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44402,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44402,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44402,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44403,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44403,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44403,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44404,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44404,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44404,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44405,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44405,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44405,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44406,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44406,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44406,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44407,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44407,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44407,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44408,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44408,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44408,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44500,OUTPATIENT SURGERY CPT GROUP 1,5226.9,3397.48,6417.0,7038.0,2
CPT,44500,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,44500,Outpatient Surgical Group 1,5226.9,3397.48,9088.3,13492.72,50
CPT,44602,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,44602,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44602,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44603,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44603,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44603,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44604,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44604,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44604,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44605,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44615,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44615,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44615,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44620,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44620,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44625,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44625,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44625,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44626,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44626,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44626,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44640,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44640,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44640,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44650,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44650,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44660,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44660,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44660,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44661,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44661,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,44661,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44680,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44680,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44680,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44700,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44701,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44701,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,44705,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44705,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44715,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44715,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44720,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44720,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44721,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44721,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44799,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,44799,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44800,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44820,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44850,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44850,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44850,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44899,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44899,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44900,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44900,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44950,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,44950,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44950,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44955,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,44955,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,44955,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44960,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,44960,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,44960,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,44970,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,44970,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,44970,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,44979,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,44979,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,45000,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,45000,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,45000,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,45005,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,45005,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,45005,Outpatient Surgical Group 2,12214.3,7939.3,12162.28,18056.43,50
CPT,45020,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45100,OUTPATIENT SURGERY CPT GROUP 1,11911.7,7742.61,6417.0,7038.0,2
CPT,45100,Outpatient Grouper - 2,11911.7,7742.61,13036.88,14143.2,24
CPT,45100,Outpatient Surgical Group 1,11911.7,7742.61,9088.3,13492.72,50
CPT,45108,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45108,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45108,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45110,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45110,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45111,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45111,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45111,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45112,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45112,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45112,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45113,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45113,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45113,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45114,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45114,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45114,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45116,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45116,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45116,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45119,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45119,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45119,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45120,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45121,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45121,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45121,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45123,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,45123,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,45123,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45126,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45126,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45126,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,45130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45130,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,45130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45135,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45135,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45136,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45136,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45136,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45150,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45150,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45150,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45160,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45160,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45171,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45171,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,45171,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,45172,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,45172,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45172,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,45190,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45190,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45190,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,45300,OUTPATIENT SURGERY CPT GROUP 1,5263.02,3420.96,6417.0,7038.0,2
CPT,45300,Outpatient Grouper - 1,5263.02,3420.96,10495.38,11385.92,24
CPT,45300,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",5263.02,3420.96,,,0
CPT,45300,Outpatient Surgical Group 1,5263.02,3420.96,9088.3,13492.72,50
CPT,45303,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45303,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45303,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45305,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45305,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45305,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45307,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45307,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45307,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45308,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45308,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45308,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45309,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45309,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45309,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45315,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45315,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45315,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45317,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45317,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45317,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45320,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45320,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45321,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45321,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45321,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45327,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45327,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,45327,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,45330,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45330,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45330,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45331,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45331,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45331,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45331,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45332,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45332,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45332,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45333,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45333,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45333,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45334,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45334,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45334,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45335,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45335,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45335,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45337,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45337,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45337,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45338,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45338,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45338,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45340,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45340,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45341,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45341,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45342,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45342,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45346,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45346,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45346,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45347,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45347,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45347,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45349,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45349,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45349,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45350,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45350,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45378,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45378,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45378,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45378,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45379,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45379,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45380,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45380,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45380,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45380,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45381,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45381,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45381,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45382,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45382,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45382,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45384,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45384,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45385,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45385,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45385,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45386,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45386,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45386,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45388,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45388,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45388,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45388,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45389,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45389,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45390,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45390,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45390,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
CPT,45390,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45391,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45391,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45391,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45392,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45392,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45392,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45393,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45393,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45393,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45395,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45395,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,45397,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45397,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45398,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45398,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45398,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45399,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45399,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45400,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45400,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45402,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45402,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45499,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,45499,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,45500,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,45500,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45500,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45505,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,45505,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45505,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45520,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45520,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45520,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,45540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45540,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45541,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,45541,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45541,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45550,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45550,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,45550,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45560,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,45560,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45560,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45562,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45562,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,45562,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45563,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45563,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45563,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45800,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45805,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45805,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45805,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45820,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45825,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,45825,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,45825,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45900,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45900,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,45900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45905,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45905,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45905,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45910,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45910,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,45915,HB REMOVE FECAL IMPACTION OR FB,14046.425,9130.18,1468.18,14761.0,10
CPT,45915,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,45915,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,45915,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,45990,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,45990,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,45990,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,45999,HB RECTAL PROLAPSE MAN REDUC,5552.49,3609.12,1135.25,1305.54,8
CPT,45999,Outpatient Grouper - 1,5552.49,3609.12,10495.38,11385.92,24
CPT,45999,Outpatient Surgical Group 1,5552.49,3609.12,9088.3,13492.72,50
CPT,46020,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46020,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46030,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46030,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46030,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46040,HB ABSCESS ISCHOIO/PERIANAL,12214.3,7939.3,1468.18,1688.4,16
CPT,46040,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46040,Outpatient Surgery Group 2 Global Rate,12214.3,7939.3,14322.0,15354.0,2
CPT,46040,Outpatient Surgical Group 3,12214.3,7939.3,13899.75,20635.92,50
CPT,46045,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46045,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46045,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46050,HB I&D PERIANAL ABSCESS,6385.36,4150.485000000001,1135.25,14761.0,18
CPT,46050,OUTPATIENT SURGERY CPT GROUP 1,5552.49,3609.12,6417.0,7038.0,2
CPT,46050,Outpatient Grouper - 1,5552.49,3609.12,10495.38,11385.92,24
CPT,46050,Outpatient Surgical Group 1,5552.49,3609.12,9088.3,13492.72,50
CPT,46060,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46060,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46060,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46070,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46070,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46070,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46080,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46080,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46080,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46083,HB INC THROMBOSED HEMORRHOID EXT,4202.01,2731.31,302.84,348.27,8
CPT,46083,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,46083,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,46083,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,46200,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46200,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46220,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46220,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46220,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46221,OUTPATIENT SURGERY CPT GROUP 1,5552.49,3609.12,6417.0,7038.0,2
CPT,46221,Outpatient Grouper - 1,5552.49,3609.12,10495.38,11385.92,24
CPT,46221,Outpatient Surgical Group 1,5552.49,3609.12,9088.3,13492.72,50
CPT,46230,OUTPATIENT SURGERY CPT GROUP 1,11911.7,7742.61,6417.0,7038.0,2
CPT,46230,Outpatient Grouper - 2,11911.7,7742.61,13036.88,14143.2,24
CPT,46230,Outpatient Surgical Group 2,11911.7,7742.61,12162.28,18056.43,50
CPT,46250,Outpatient Grouper - 3,11911.7,7742.61,14341.63,15558.59,24
CPT,46250,Outpatient Surgery Group 3 Global Rate,11911.7,7742.61,22055.0,22787.0,2
CPT,46250,Outpatient Surgical Group 3,11911.7,7742.61,13899.75,20635.92,50
CPT,46255,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46255,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46255,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46257,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46257,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46257,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46258,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46258,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46258,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46260,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46260,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46260,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46261,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46261,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,46261,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46262,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46262,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,46262,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46270,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46270,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46270,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46275,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46275,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46275,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46280,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,46280,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46285,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46285,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46285,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46288,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46288,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46288,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46320,HB HEMORRHOID ENUC/EXC,12214.3,7939.3,1468.18,1688.4,8
CPT,46320,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46320,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46320,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46500,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46500,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,46500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46505,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46505,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46505,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46600,HB ANOSCOPY DIAGNOSTIC,1074.29,698.29,160.5,184.58,8
CPT,46600,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,46600,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,46600,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,46601,OUTPATIENT SURGERY CPT GROUP 1,739.73,480.82,6417.0,7038.0,2
CPT,46601,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,46601,Outpatient Surgical Group 0,739.73,480.82,2806.68,4166.87,50
CPT,46604,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46604,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46604,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46606,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46606,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46606,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46607,OUTPATIENT SURGERY CPT GROUP 1,12214.3,7939.3,6417.0,7038.0,2
CPT,46607,Outpatient Grouper - 2,12214.3,7939.3,13036.88,14143.2,24
CPT,46607,Outpatient Surgical Group 1,12214.3,7939.3,9088.3,13492.72,50
CPT,46608,OUTPATIENT SURGERY CPT GROUP 1,5552.49,3609.12,6417.0,7038.0,2
CPT,46608,Outpatient Grouper - 2,5552.49,3609.12,13036.88,14143.2,24
CPT,46608,Outpatient Surgical Group 1,5552.49,3609.12,9088.3,13492.72,50
CPT,46610,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46610,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46611,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46611,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46612,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46612,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46612,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46614,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46614,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46614,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46615,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46615,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46615,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46700,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46700,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46705,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46705,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46705,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46706,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46706,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46706,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46707,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46707,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46707,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,46710,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46710,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,46712,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46712,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,46715,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46715,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46715,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46716,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46716,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46716,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46730,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46730,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46730,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46735,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46735,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,46735,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46740,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46740,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,46740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46742,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46742,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,46742,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46744,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46744,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46744,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,46746,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46746,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46746,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,46748,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46748,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,46748,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,46750,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46750,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46750,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46751,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,46751,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46751,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46753,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46753,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46753,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46754,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46754,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46754,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46760,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46760,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46761,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46761,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46761,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,46900,OUTPATIENT SURGERY CPT GROUP 1,2063.43,1341.23,6417.0,7038.0,2
CPT,46900,Outpatient Grouper - 0,2063.43,1341.23,9059.94,9827.82,24
CPT,46900,Outpatient Surgical Group 0,2063.43,1341.23,2806.68,4166.87,50
CPT,46910,OUTPATIENT SURGERY CPT GROUP 1,7948.54,5166.55,6417.0,7038.0,2
CPT,46910,Outpatient Grouper - 2,7948.54,5166.55,13036.88,14143.2,24
CPT,46910,Outpatient Surgical Group 2,7948.54,5166.55,12162.28,18056.43,50
CPT,46916,OUTPATIENT SURGERY CPT GROUP 1,1562.8,1015.82,6417.0,7038.0,2
CPT,46916,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,46916,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,46917,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46917,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46917,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46922,OUTPATIENT SURGERY CPT GROUP 1,11911.7,7742.61,6417.0,7038.0,2
CPT,46922,Outpatient Grouper - 3,11911.7,7742.61,14341.63,15558.59,24
CPT,46922,Outpatient Surgical Group 1,11911.7,7742.61,9088.3,13492.72,50
CPT,46924,OUTPATIENT SURGERY CPT GROUP 1,11911.7,7742.61,6417.0,7038.0,2
CPT,46924,Outpatient Grouper - 3,11911.7,7742.61,14341.63,15558.59,24
CPT,46924,Outpatient Surgical Group 1,11911.7,7742.61,9088.3,13492.72,50
CPT,46930,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46930,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,46930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46940,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46940,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,46940,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,46942,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46942,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,46942,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46945,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46945,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46945,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46946,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,46946,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46946,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,46947,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,46947,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,46947,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,46948,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,46948,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,46948,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,46999,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,46999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47000,HB BIOPSY LIVER,13195.1,8576.815,2017.5,14761.0,10
CPT,47000,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,47000,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,47000,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,47001,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,47001,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,47010,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47010,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47015,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,47015,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47015,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,47100,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47120,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,47122,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47122,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47122,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,47125,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47125,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47125,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,47130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47130,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47130,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,47133,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47133,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47133,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,47135,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,2
CPT,47135,Liver Transplant,,,485809.05,485809.05,3
CPT,47135,Liver Transplants Hospital Services,,,115000.0,115000.0,1
CPT,47135,"Liver ù Deceased and Living, Transplant",,,247942.77,247942.77,2
CPT,47135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47135,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,47135,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,47135,"Transplant: Liver, Cadaveric Donor",,,182000.0,182000.0,1
CPT,47140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47140,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,47141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47141,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47141,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,47142,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47142,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47142,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,47143,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47143,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47144,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47144,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47145,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47146,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,47146,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47147,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,47147,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47300,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47350,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47350,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47350,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47360,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47360,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47360,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47361,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47361,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47361,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,47362,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47362,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47362,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47370,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,47370,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47370,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,47371,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,47371,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47371,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,47379,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,47379,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,47380,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47380,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47380,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47381,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47381,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47381,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47382,HB ABLATION R/F LIVER,25951.8,16868.67,7264.88,8354.61,8
CPT,47382,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,47382,Outpatient Surgery Group 6 Global Rate,25951.8,16868.67,34526.0,35549.0,2
CPT,47382,Outpatient Surgical Group 7,25951.8,16868.67,27131.25,40279.73,50
CPT,47383,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,47383,Outpatient Surgery Group 6 Global Rate,25951.8,16868.67,34526.0,35549.0,2
CPT,47383,Outpatient Surgical Group 7,25951.8,16868.67,27131.25,40279.73,50
CPT,47399,Adult Liver - Transplant Event: Combined Hospital and Professional Services,5952.47,3869.11,95680.0,95680.0,2
CPT,47399,General Transplant Services,5952.47,3869.11,,,0
CPT,47399,Organ Transplants,7738.2,5029.83,,,0
CPT,47399,Other Transplant Services,5952.47,3869.11,,,0
CPT,47399,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,47399,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,47400,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47400,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47400,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47420,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47420,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47420,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47425,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47425,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47425,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47460,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47460,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47460,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47480,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47480,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47480,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47490,HB CHOLECYTOSTOMY S&I,10233.7,6651.91,13270.0,14761.0,2
CPT,47490,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47490,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47490,Outpatient Surgical Group 1,10233.7,6651.91,9088.3,13492.72,50
CPT,47531,HB INJECTION FOR CHOLANGIOGRAM EXISTING ACCESS,10233.7,6651.91,4394.34,14761.0,10
CPT,47531,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47531,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47531,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47532,HB INJECTION FOR CHOLANGIOGRAM NEW ACCESS,10233.7,6651.91,13270.0,14761.0,2
CPT,47532,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47532,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47532,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47533,HB PLMT BILIARY DRAINAGE CATH EXTERNAL,10233.7,6651.91,13270.0,14761.0,2
CPT,47533,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47533,Outpatient Surgery Group 2 Global Rate,10233.7,6651.91,14322.0,15354.0,2
CPT,47533,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47534,HB PLMT BILI DRAINAGE CATH INTERNAL-EXTERNAL,10233.7,6651.91,13270.0,14761.0,2
CPT,47534,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47534,Outpatient Surgery Group 2 Global Rate,10233.7,6651.91,14322.0,15354.0,2
CPT,47534,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47535,HB CONVERSION EXT BIL DRG CATH,10233.7,6651.91,13270.0,14761.0,2
CPT,47535,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47535,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47535,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47536,HB EXCHANGE BILIARY DRG CATH,10233.7,6651.91,4394.34,14761.0,10
CPT,47536,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47536,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47536,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47537,HB REMOVAL BILIARY DRG CATH,5226.9,3397.48,1167.44,14761.0,10
CPT,47537,OUTPATIENT SURGERY CPT GROUP 1,5226.9,3397.48,6417.0,7038.0,2
CPT,47537,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,47537,Outpatient Surgical Group 1,5226.9,3397.48,9088.3,13492.72,50
CPT,47538,HB PERQ PLMT BILE DUCT STENT EXISTING ACCESS,25951.8,16868.67,7264.88,14761.0,10
CPT,47538,OUTPATIENT SURGERY CPT GROUP 1,25951.8,16868.67,6417.0,7038.0,2
CPT,47538,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,47538,Outpatient Surgical Group 3,25951.8,16868.67,13899.75,20635.92,50
CPT,47539,OUTPATIENT SURGERY CPT GROUP 1,25951.8,16868.67,6417.0,7038.0,2
CPT,47539,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,47539,Outpatient Surgical Group 3,25951.8,16868.67,13899.75,20635.92,50
CPT,47540,HB PERQ PLMT BILE DUCT STENT,25951.8,16868.67,13270.0,14761.0,2
CPT,47540,OUTPATIENT SURGERY CPT GROUP 1,25951.8,16868.67,6417.0,7038.0,2
CPT,47540,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,47540,Outpatient Surgical Group 3,25951.8,16868.67,13899.75,20635.92,50
CPT,47541,HB PLMT ACCESS BIL TREE SM BWL,10233.7,6651.91,13270.0,14761.0,2
CPT,47541,OUTPATIENT SURGERY CPT GROUP 1,10233.7,6651.91,6417.0,7038.0,2
CPT,47541,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,47541,Outpatient Surgical Group 3,10233.7,6651.91,13899.75,20635.92,50
CPT,47542,OUTPATIENT SURGERY CPT GROUP 1,23009.7,14956.31,6417.0,7038.0,2
CPT,47542,Outpatient Grouper - 0,23009.7,14956.31,9059.94,9827.82,24
CPT,47542,Outpatient Surgical Group 3,23009.7,14956.31,13899.75,20635.92,50
CPT,47543,HB ENDOLUMINAL BX BILIARY TREE,13072.2,8496.93,13270.0,14761.0,2
CPT,47543,OUTPATIENT SURGERY CPT GROUP 1,13072.2,8496.93,6417.0,7038.0,2
CPT,47543,Outpatient Grouper - 0,13072.2,8496.93,9059.94,9827.82,24
CPT,47543,Outpatient Surgical Group 3,13072.2,8496.93,13899.75,20635.92,50
CPT,47544,Outpatient Grouper - 0,13695.2,8901.88,9059.94,9827.82,24
CPT,47544,Outpatient Surgery Group 3 Global Rate,13695.2,8901.88,22055.0,22787.0,2
CPT,47544,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,50
CPT,47550,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,47550,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,47550,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47552,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,47552,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,47552,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47553,HB BILIARY ENDO PERC T-TUBE W/ BX SNGL/MULT,10224.0,6645.6,13270.0,14761.0,2
CPT,47553,Outpatient Grouper - 6,10224.0,6645.6,28632.25,34209.93,24
CPT,47553,Outpatient Surgery Group 3 Global Rate,10224.0,6645.6,22055.0,22787.0,2
CPT,47553,Outpatient Surgical Group 3,10224.0,6645.6,13899.75,20635.92,50
CPT,47554,Outpatient Grouper - 6,25927.2,16852.68,28632.25,34209.93,24
CPT,47554,Outpatient Surgery Group 3 Global Rate,25927.2,16852.68,22055.0,22787.0,2
CPT,47554,Outpatient Surgical Group 3,25927.2,16852.68,13899.75,20635.92,50
CPT,47555,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,47555,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47555,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,47556,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,47556,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,47556,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,47562,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,47562,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,47562,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,47563,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,47563,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,47563,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,47564,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,47564,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,47564,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,47570,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47570,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,47570,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47579,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,47579,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,47600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47600,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47605,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47610,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47610,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,47610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47612,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47612,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47612,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47620,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47620,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,47620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47700,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47701,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47701,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47701,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47711,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47711,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47711,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47712,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47712,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47712,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47715,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47715,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47715,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47720,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47720,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47720,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47721,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47721,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47721,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47740,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47740,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47740,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47741,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47741,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47741,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47760,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47760,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47760,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47765,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47765,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47765,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47780,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47780,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47780,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47785,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47785,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47785,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,47800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47800,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,47800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47801,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47801,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,47801,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47802,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47802,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47802,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47900,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,47900,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,47900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,47999,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,47999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48000,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48000,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48000,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,48001,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48001,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48001,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,48020,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48020,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48020,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48100,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48102,HB BIOPSY PANCREAS,11474.0,7458.1,2017.5,2320.13,8
CPT,48102,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,48102,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,48102,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,48105,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48105,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48145,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48145,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48146,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48146,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48146,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,48148,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48148,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48148,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48150,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48150,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48150,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,48152,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48152,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48152,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,48153,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48153,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48153,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,48154,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48154,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48154,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,48155,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48155,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48155,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,48160,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48160,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,48160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,48400,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,48400,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48500,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48500,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48510,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48510,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48520,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48520,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48545,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,48545,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48547,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48547,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48547,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48548,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,48548,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48550,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48550,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48551,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,48552,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,48554,Liver Transplant,,,485809.05,485809.05,3
CPT,48554,Outpatient Surgery Group 9 Global Rate,,,36365.0,39072.0,2
CPT,48554,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48554,Pancreas Transplant,,,291486.71,291486.71,3
CPT,48554,"Pancreas, Transplant",,,123970.87,123970.87,2
CPT,48554,Transplant: Pancreas,,,107000.0,107000.0,1
CPT,48556,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,48556,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,48999,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,48999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49000,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49000,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49002,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49002,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49002,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49010,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49010,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,49010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49013,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49013,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49013,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49014,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49014,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49014,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49020,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49020,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,49020,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49040,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49040,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,49040,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49060,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49060,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,49060,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49062,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49062,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49062,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49082,HB ABD PARACENTESIS,6010.94,3907.1099999999997,1167.44,14761.0,20
CPT,49082,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49082,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,49082,Outpatient Surgical Group 0,5226.9,3397.48,2806.68,4166.87,50
CPT,49083,HB PARACENTESIS W IMG,6010.94,3907.1099999999997,1167.44,14761.0,10
CPT,49083,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49083,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,49083,Outpatient Surgical Group 1,5226.9,3397.48,9088.3,13492.72,50
CPT,49084,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49084,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49084,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49180,HB BIOPSY RETROPERITONEAL MASS,13195.1,8576.815,2017.5,14761.0,10
CPT,49180,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,49180,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,49180,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,49185,HB SCLEROTX FLUID COLLECTION,5952.47,3869.11,2017.5,2320.13,8
CPT,49185,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,49185,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,49185,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,49203,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,49203,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49204,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49204,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49205,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49205,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49215,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49215,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49215,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49220,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,49250,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49250,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49250,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49255,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,49255,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49255,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49320,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49320,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49320,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49321,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49321,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49321,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49322,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49322,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,49322,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49323,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49323,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49323,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,49324,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49324,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49324,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49325,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49325,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49325,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49326,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,49326,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49326,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49327,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,49327,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49329,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49329,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,49400,OUTPATIENT SURGERY CPT GROUP 1,869.13,564.93,6417.0,7038.0,2
CPT,49400,Outpatient Grouper - 0,869.13,564.93,9059.94,9827.82,24
CPT,49402,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49402,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49402,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49405,HB DRAINAGE VISCERA W IMG,13195.1,8576.815,2017.5,14761.0,10
CPT,49405,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,49405,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,49405,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,49406,HB DRAINAGE RETRO/PERITON W IMG,13195.1,8576.815,2017.5,14761.0,10
CPT,49406,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,49406,Outpatient Surgery Group 2 Global Rate,11474.0,7458.1,14322.0,15354.0,2
CPT,49406,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,49407,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49407,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49407,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49411,Outpatient Grouper - 2,17529.8,11394.37,13036.88,14143.2,24
CPT,49411,Outpatient Surgical Group 4,17529.8,11394.37,17187.58,25517.11,50
CPT,49412,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49412,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49418,HB INSERT ABD. PLEURX CATH,11768.73,7649.675,4394.34,14761.0,10
CPT,49418,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,49418,Outpatient Surgery Group 2 Global Rate,10233.7,6651.91,14322.0,15354.0,2
CPT,49418,Outpatient Surgical Group 2,10233.7,6651.91,12162.28,18056.43,50
CPT,49419,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49419,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49419,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49421,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49421,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49421,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49422,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,49422,Outpatient Surgery Group 2 Global Rate,14909.4,9691.11,14322.0,15354.0,2
CPT,49422,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,49423,HB EXCHANGE PREVIOUS DRAINAGE CATH,8581.77,5578.15,2362.11,14761.0,10
CPT,49423,OUTPATIENT SURGERY CPT GROUP 1,7462.41,4850.57,6417.0,7038.0,2
CPT,49423,Outpatient Grouper - 2,7462.41,4850.57,13036.88,14143.2,24
CPT,49423,Outpatient Surgical Group 1,7462.41,4850.57,9088.3,13492.72,50
CPT,49424,HB INJ PREVIOUS DRAINAGE CATH,2289.62,1488.25,13270.0,14761.0,2
CPT,49424,OUTPATIENT SURGERY CPT GROUP 1,2289.62,1488.25,6417.0,7038.0,2
CPT,49424,Outpatient Grouper - 0,2289.62,1488.25,9059.94,9827.82,24
CPT,49425,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49425,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49425,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49426,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49426,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49426,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49427,OUTPATIENT SURGERY CPT GROUP 1,1990.98,1294.14,6417.0,7038.0,2
CPT,49427,Outpatient Grouper - 0,1990.98,1294.14,9059.94,9827.82,24
CPT,49428,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49428,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49428,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49429,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49429,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49429,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,49435,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49435,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49435,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49436,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,49436,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49436,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49440,HB PLCMT PERC GASTROSTOMY TUBE,7462.41,4850.57,2362.11,14761.0,10
CPT,49440,Outpatient Grouper - 2,7462.41,4850.57,13036.88,14143.2,24
CPT,49440,Outpatient Surgery Group 2 Global Rate,7462.41,4850.57,14322.0,15354.0,2
CPT,49440,Outpatient Surgical Group 2,7462.41,4850.57,12162.28,18056.43,50
CPT,49441,HB PLACE DUOD/JEJ TUBE PERC,7462.41,4850.57,13270.0,14761.0,2
CPT,49441,Outpatient Grouper - 2,7462.41,4850.57,13036.88,14143.2,24
CPT,49441,Outpatient Surgery Group 2 Global Rate,7462.41,4850.57,14322.0,15354.0,2
CPT,49441,Outpatient Surgical Group 2,7462.41,4850.57,12162.28,18056.43,50
CPT,49442,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49442,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49442,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49446,HB TUBE CHANGE G-TUBE TO GJ,7462.41,4850.57,2362.11,14761.0,10
CPT,49446,Outpatient Grouper - 2,7462.41,4850.57,13036.88,14143.2,24
CPT,49446,Outpatient Surgery Group 2 Global Rate,7462.41,4850.57,14322.0,15354.0,2
CPT,49446,Outpatient Surgical Group 2,7462.41,4850.57,12162.28,18056.43,50
CPT,49450,HB REPLACE G/C TUBE PERC,5226.9,3397.48,1167.44,14761.0,10
CPT,49450,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49450,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,49450,Outpatient Surgical Group 2,5226.9,3397.48,12162.28,18056.43,50
CPT,49451,HB TUBE REPLACE DUOD/JEJ,6010.94,3907.1099999999997,1167.44,14761.0,18
CPT,49451,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49451,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,49451,Outpatient Surgical Group 2,5226.9,3397.48,12162.28,18056.43,50
CPT,49452,HB TUBE REPLACE GJ,5226.9,3397.48,1167.44,14761.0,10
CPT,49452,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49452,Outpatient Surgery Group 2 Global Rate,5226.9,3397.48,14322.0,15354.0,2
CPT,49452,Outpatient Surgical Group 2,5226.9,3397.48,12162.28,18056.43,50
CPT,49460,HB TUBE FIX G-GOLON,5226.9,3397.48,1167.44,1342.55,8
CPT,49460,OUTPATIENT SURGERY CPT GROUP 1,5226.9,3397.48,6417.0,7038.0,2
CPT,49460,Outpatient Grouper - 2,5226.9,3397.48,13036.88,14143.2,24
CPT,49460,Outpatient Surgical Group 1,5226.9,3397.48,9088.3,13492.72,50
CPT,49465,HB G-COLON CONTRAST INJECTION,1075.67,699.19,300.99,14761.0,10
CPT,49465,OUTPATIENT SURGERY CPT GROUP 1,1075.67,699.19,6417.0,7038.0,2
CPT,49465,Outpatient Grouper - 0,1075.67,699.19,9059.94,9827.82,24
CPT,49465,Outpatient Surgical Group 1,1075.67,699.19,9088.3,13492.72,50
CPT,49491,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49491,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49491,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,49492,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49492,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49492,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,49495,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49495,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49495,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49496,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49496,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49496,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49500,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49500,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49500,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49501,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49501,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49501,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49505,Outpatient Grouper - 4,10233.7,6651.91,19724.25,21397.98,24
CPT,49505,Outpatient Surgery Group 4 Global Rate,10233.7,6651.91,26623.0,28144.0,2
CPT,49505,Outpatient Surgical Group 4,10233.7,6651.91,17187.58,25517.11,50
CPT,49507,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49507,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49507,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49520,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49520,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49520,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,49521,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49521,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49521,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49525,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49525,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49525,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49540,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49540,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49540,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49550,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49550,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49550,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,49553,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49553,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49553,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49555,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49555,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49555,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,49557,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49557,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49557,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,49560,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49561,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49565,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49566,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49568,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49570,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49572,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49580,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49582,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49585,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49587,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49590,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49591,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49591,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49591,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49592,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49592,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49592,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49593,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49593,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49593,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49594,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49594,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49594,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49595,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49595,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49595,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49596,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49596,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49596,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49600,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49600,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49600,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49605,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49605,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,49606,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49606,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49606,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49610,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49610,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49611,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49611,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49611,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49613,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49613,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49613,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49614,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49614,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49614,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49615,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,49615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49615,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49616,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49616,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49616,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49617,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49617,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49617,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49618,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49618,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,49618,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49621,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49621,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49621,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49622,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49622,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49622,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49623,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,49623,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,49650,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49650,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49650,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,49651,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,49651,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49651,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,49652,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49653,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49654,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49655,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49656,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49657,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,49659,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,49659,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,49900,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49900,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,49900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49904,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49904,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49904,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,49905,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49905,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,49905,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49906,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,49906,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,49999,HB MISCELLANEOUS PROCEDURE,6944.05,4513.635,1167.44,14761.0,10
CPT,49999,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,49999,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,50010,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50010,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50040,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50040,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50040,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50045,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50045,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50045,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,50060,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50060,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50060,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50065,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50065,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50065,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50070,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50070,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50070,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50075,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50075,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50075,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50080,Outpatient Grouper - 5,21841.6,14197.04,25486.19,27649.53,24
CPT,50080,Outpatient Surgery Group 3 Global Rate,21841.6,14197.04,22055.0,22787.0,2
CPT,50080,Outpatient Surgical Group 7,21841.6,14197.04,27131.25,40279.73,50
CPT,50081,Outpatient Grouper - 5,21841.6,14197.04,25486.19,27649.53,24
CPT,50081,Outpatient Surgery Group 3 Global Rate,21841.6,14197.04,22055.0,22787.0,2
CPT,50081,Outpatient Surgical Group 7,21841.6,14197.04,27131.25,40279.73,50
CPT,50100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50100,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50125,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50125,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50125,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50130,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50135,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50135,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50200,"HB BX RENAL/KIDNEY,PERC",13195.1,8576.815,2017.5,14761.0,10
CPT,50200,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,50200,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,50200,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,50205,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50205,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50205,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50220,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50220,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50225,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50225,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50225,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50230,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50230,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50230,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50234,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50234,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50234,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50236,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50236,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50236,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50240,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50240,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50250,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50250,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50280,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50280,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50280,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50290,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50290,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50290,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50300,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50300,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50320,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50320,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50323,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50323,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50325,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50325,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50327,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50327,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50328,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50328,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50329,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50329,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50340,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50340,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50340,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50360,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50360,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50360,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,50365,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50365,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50365,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,50370,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50370,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50370,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50380,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50380,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50380,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50382,"HB CHANGE URETER STENT, PERCUT",12855.0,8355.75,2550.78,2933.4,8
CPT,50382,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,50382,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,50382,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,50384,HB REMOVE URETER STENT PERCUT,14783.26,9609.119999999999,2550.78,14761.0,10
CPT,50384,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,50384,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,50384,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,50385,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50385,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50385,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50386,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50386,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50386,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50387,HB NEPHROURETHRAL CATH CHANGE,14783.26,9609.119999999999,2550.78,14761.0,10
CPT,50387,Outpatient Grouper - 2,12855.0,8355.75,13036.88,14143.2,24
CPT,50387,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,50387,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,50389,HB REMOVE TUBE NEPHROSTOMY,4078.42,2650.97,831.13,14761.0,10
CPT,50389,OUTPATIENT SURGERY CPT GROUP 1,4078.42,2650.97,6417.0,7038.0,2
CPT,50389,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,50389,Outpatient Surgical Group 2,4078.42,2650.97,12162.28,18056.43,50
CPT,50390,HB ASPIR/INJECT RENAL CYST,6845.335,4449.47,876.1,14761.0,10
CPT,50390,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,50390,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,50390,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,50391,OUTPATIENT SURGERY CPT GROUP 1,3979.18,2586.47,6417.0,7038.0,2
CPT,50391,Outpatient Grouper - 0,3979.18,2586.47,9059.94,9827.82,24
CPT,50391,Outpatient Surgical Group 0,3979.18,2586.47,2806.68,4166.87,50
CPT,50396,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50396,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50396,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50400,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,50400,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50405,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,50405,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50405,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50430,HB NJX PX NFROSGRM &/URTRGRM NEW ACCESS,4078.42,2650.97,831.13,955.79,8
CPT,50430,OUTPATIENT SURGERY CPT GROUP 1,4078.42,2650.97,6417.0,7038.0,2
CPT,50430,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,50430,Outpatient Surgical Group 1,4078.42,2650.97,9088.3,13492.72,50
CPT,50431,HB NJX PX NFROSGRM &/URTRGRM EXISTING ACCESS,4078.42,2650.97,13270.0,14761.0,2
CPT,50431,OUTPATIENT SURGERY CPT GROUP 1,4078.42,2650.97,6417.0,7038.0,2
CPT,50431,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,50431,Outpatient Surgical Group 1,4078.42,2650.97,9088.3,13492.72,50
CPT,50432,HB PLMT NEPHROSTOMY CATHETER,12855.0,8355.75,2550.78,14761.0,10
CPT,50432,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,50432,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,50432,Outpatient Surgical Group 1,12855.0,8355.75,9088.3,13492.72,50
CPT,50433,HB PLMT NEPHROURETERAL CATHETER,14499.9,9424.93,4294.62,14761.0,10
CPT,50433,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50433,Outpatient Grouper - 3,14499.9,9424.93,14341.63,15558.59,24
CPT,50433,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,50434,HB CONVERT NEPHROSTOMY CATHETER,12855.0,8355.75,2550.78,14761.0,10
CPT,50434,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,50434,Outpatient Grouper - 1,12855.0,8355.75,10495.38,11385.92,24
CPT,50434,Outpatient Surgical Group 1,12855.0,8355.75,9088.3,13492.72,50
CPT,50435,HB CHANGE NEPHROSTOMY CATH,12855.0,8355.75,2550.78,14761.0,10
CPT,50435,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,50435,Outpatient Grouper - 1,12855.0,8355.75,10495.38,11385.92,24
CPT,50435,Outpatient Surgical Group 1,12855.0,8355.75,9088.3,13492.72,50
CPT,50436,HB DILAT XST TRC NDURLGC PX,14499.9,9424.93,13270.0,14761.0,2
CPT,50436,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50436,Outpatient Grouper - 3,14499.9,9424.93,14341.63,15558.59,24
CPT,50436,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,50437,HB DILAT XST TRC NEW ACCESS RCS,14499.9,9424.93,4294.62,14761.0,10
CPT,50437,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50437,Outpatient Grouper - 4,14499.9,9424.93,19724.25,21397.98,24
CPT,50437,Outpatient Surgical Group 9,14499.9,9424.93,36513.58,54208.97,50
CPT,50500,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50500,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50520,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50520,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50525,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50525,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50525,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50526,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50526,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50526,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,50540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50541,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,50541,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50541,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,50542,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,50542,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50542,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,50543,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50543,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50543,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,50544,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50544,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50544,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,50545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50545,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50545,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50546,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50546,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50546,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50547,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50547,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50547,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50548,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50548,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50548,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50549,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,50549,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,50551,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50551,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50551,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50553,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50553,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50553,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50555,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50555,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50555,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50557,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50557,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50557,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50561,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50561,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50561,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50562,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50562,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50562,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,50570,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50570,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50570,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50572,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50572,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50572,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50574,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50574,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50574,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50575,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50575,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,50575,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50576,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50576,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50576,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50580,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50580,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50580,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50590,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50590,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,50590,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,50592,HB ABLATION RENAL MICROWAVE UN,29844.684999999998,19399.045,7264.88,14761.0,10
CPT,50592,Outpatient Grouper - 6,25951.8,16868.67,28632.25,34209.93,24
CPT,50592,Outpatient Surgery Group 6 Global Rate,25951.8,16868.67,34526.0,35549.0,2
CPT,50592,Outpatient Surgical Group 5,25951.8,16868.67,19539.84,29009.34,50
CPT,50593,HB ABLATION CRYO RENAL UNILAT,23108.5,15020.52,12963.93,14908.52,8
CPT,50593,Outpatient Grouper - 6,23108.5,15020.52,28632.25,34209.93,24
CPT,50593,Outpatient Surgery Group 5 Global Rate,23108.5,15020.52,32992.0,34883.0,2
CPT,50593,Outpatient Surgical Group 3,23108.5,15020.52,13899.75,20635.92,50
CPT,50600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50600,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50605,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50606,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50606,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,50610,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50610,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50620,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50620,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50630,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50630,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50630,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50650,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50650,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50660,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50660,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50660,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50684,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50684,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,50686,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50686,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,50686,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,50688,OUTPATIENT SURGERY CPT GROUP 1,33479.3,21761.55,6417.0,7038.0,2
CPT,50688,Outpatient Grouper - 2,33479.3,21761.55,13036.88,14143.2,24
CPT,50688,Outpatient Surgical Group 1,33479.3,21761.55,9088.3,13492.72,50
CPT,50690,OUTPATIENT SURGERY CPT GROUP 1,2224.42,1445.87,6417.0,7038.0,2
CPT,50690,Outpatient Grouper - 0,2224.42,1445.87,9059.94,9827.82,24
CPT,50693,HB PLMT URETERAL STENT PRQ PRE-EXISTING TRACT,14499.9,9424.93,4294.62,14761.0,10
CPT,50693,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50693,Outpatient Grouper - 4,14499.9,9424.93,19724.25,21397.98,24
CPT,50693,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,50694,HB PLMT URETERAL STENT PRQ NEW ACCESS,14499.9,9424.93,4294.62,14761.0,10
CPT,50694,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50694,Outpatient Grouper - 4,14499.9,9424.93,19724.25,21397.98,24
CPT,50694,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,50695,HB PLMT URETERAL STENT PRQ NEW ACCESS W/NEPH CATH,14499.9,9424.93,4294.62,14761.0,10
CPT,50695,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,50695,Outpatient Grouper - 4,14499.9,9424.93,19724.25,21397.98,24
CPT,50695,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,50700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50700,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50705,Outpatient Grouper - 0,16946.7,11015.36,9059.94,9827.82,24
CPT,50705,Outpatient Surgery Group 2 Global Rate,16946.7,11015.36,14322.0,15354.0,2
CPT,50706,HB URETERAL BALLOON DIL W IMG GUIDANCE,16946.7,11015.36,13270.0,14761.0,2
CPT,50706,Outpatient Grouper - 0,16946.7,11015.36,9059.94,9827.82,24
CPT,50706,Outpatient Surgery Group 2 Global Rate,16946.7,11015.36,14322.0,15354.0,2
CPT,50715,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50715,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50715,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50722,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50722,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50722,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50725,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50725,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50725,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50727,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50727,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,50727,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50728,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50728,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,50728,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50740,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50740,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50740,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50750,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50750,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50750,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50760,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50760,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50760,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50770,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50770,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50770,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50780,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50780,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50780,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50782,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50782,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50782,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50783,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50783,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50783,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50785,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50785,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50785,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50800,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50810,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50810,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50810,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50815,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50815,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50815,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50820,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,50820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50825,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50825,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,50825,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,50830,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50830,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50830,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,50840,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50840,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,50840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50845,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50845,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50860,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50860,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,50860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50900,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50900,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50920,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50920,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50920,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50930,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50930,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50940,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,50940,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,50940,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50945,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50945,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50945,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,50947,HB CYSTOSCOPY,4078.42,2650.97,831.13,955.79,8
CPT,50947,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50947,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50947,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,50948,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,50948,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,50948,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,50949,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,50949,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,50951,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50951,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50951,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50953,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50953,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50953,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50955,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50955,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50955,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50957,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50957,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50957,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50961,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50961,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50961,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50970,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50970,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50970,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50972,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50972,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,50972,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50974,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50974,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50974,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50976,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50976,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,50976,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,50980,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,50980,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,50980,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51020,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51020,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51030,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51030,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51030,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51040,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51040,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51040,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51045,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,51045,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51045,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51050,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51050,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51050,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51060,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,51060,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51060,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51065,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51065,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51065,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51080,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,51080,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,51080,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51100,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51100,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,51100,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,51101,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51101,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,51101,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51102,HB DRAIN BL W/CATH INSERTION,14783.26,9609.119999999999,2550.78,14761.0,20
CPT,51102,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,51102,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,51102,Outpatient Surgical Group 1,12855.0,8355.75,9088.3,13492.72,50
CPT,51500,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51500,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51500,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51520,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51520,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51520,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51525,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51525,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51525,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51530,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51530,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51530,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51535,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51535,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51535,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51550,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51550,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,51550,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51555,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51555,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,51555,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51565,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51565,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51565,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51570,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51570,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51570,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,51575,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51575,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51575,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51580,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51580,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51580,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51585,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51585,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51585,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51590,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51590,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,51590,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51595,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51595,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,51595,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51596,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51596,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,51596,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,51597,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51597,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,51597,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51600,HB CYSTOGRAM/VCUG INJ,410.93499999999995,267.105,13270.0,14761.0,2
CPT,51600,Outpatient Grouper - 0,357.34,232.27,9059.94,9827.82,24
CPT,51600,Outpatient Surgery Group 2 Global Rate,357.34,232.27,14322.0,15354.0,2
CPT,51605,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51605,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,51610,HB URETHROCYSTOGRAM RETRO INJ,721.545,469.005,13270.0,14761.0,2
CPT,51610,Outpatient Grouper - 0,627.43,407.83,9059.94,9827.82,24
CPT,51610,Outpatient Surgery Group 2 Global Rate,627.43,407.83,14322.0,15354.0,2
CPT,51700,HB BLADDER INSTILLATION/IRRGTN,4832.3099999999995,3141.005,302.84,14761.0,18
CPT,51700,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,51700,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,51700,Outpatient Surgical Group 0,4202.01,2731.31,2806.68,4166.87,50
CPT,51701,"HB CATHERIZATION, STRAIGHT",1235.425,803.025,160.5,14761.0,10
CPT,51701,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,51701,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,51702,"HB CATHETERIZATION, INDWELLING",1235.425,803.025,160.5,14761.0,20
CPT,51702,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,51702,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,51703,HB INSERT FOLEY CATH COMPLICATED,3775.695,2454.205,194.82,14761.0,18
CPT,51703,OUTPATIENT SURGERY CPT GROUP 1,3283.21,2134.09,6417.0,7038.0,2
CPT,51703,Outpatient Grouper - 0,3283.21,2134.09,9059.94,9827.82,24
CPT,51703,Outpatient Surgical Group 0,3283.21,2134.09,2806.68,4166.87,50
CPT,51705,HB CYSTOSTOMY TUBE CHANGE,4832.3099999999995,3141.005,302.84,14761.0,18
CPT,51705,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,51705,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,51705,Outpatient Surgical Group 0,4202.01,2731.31,2806.68,4166.87,50
CPT,51710,HB CHNGE CYSTO TUBE COMPLICATD,4690.1900000000005,3048.62,831.13,14761.0,18
CPT,51710,OUTPATIENT SURGERY CPT GROUP 1,4078.42,2650.97,6417.0,7038.0,2
CPT,51710,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,51710,Outpatient Surgical Group 1,4078.42,2650.97,9088.3,13492.72,50
CPT,51715,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51715,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,51715,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51720,"HB INSTILATN OF ANTICARCINOGENIC, BLADDER",4202.01,2731.31,831.13,14761.0,10
CPT,51720,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,51720,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,51720,Outpatient Surgical Group 0,4202.01,2731.31,2806.68,4166.87,50
CPT,51725,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51725,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,51725,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51726,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,51726,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,51726,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,51727,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51727,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,51727,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51728,HB CYSTOMETROGRAM W/VP,4078.42,2650.97,831.13,955.79,8
CPT,51728,OUTPATIENT SURGERY CPT GROUP 1,4078.42,2650.97,6417.0,7038.0,2
CPT,51728,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,51728,Outpatient Surgical Group 1,4078.42,2650.97,9088.3,13492.72,50
CPT,51729,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,51729,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,51729,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51736,HB UROFLOWMETRY (SIMPLE),731.58,475.53,160.5,14761.0,10
CPT,51736,OUTPATIENT SURGERY CPT GROUP 1,731.58,475.53,6417.0,7038.0,2
CPT,51736,Outpatient Grouper - 0,731.58,475.53,9059.94,9827.82,24
CPT,51736,Outpatient Surgical Group 0,731.58,475.53,2806.68,4166.87,50
CPT,51741,OUTPATIENT SURGERY CPT GROUP 1,3283.21,2134.09,6417.0,7038.0,2
CPT,51741,Outpatient Grouper - 0,3283.21,2134.09,9059.94,9827.82,24
CPT,51741,Outpatient Surgical Group 0,3283.21,2134.09,2806.68,4166.87,50
CPT,51784,OUTPATIENT SURGERY CPT GROUP 1,3283.21,2134.09,6417.0,7038.0,2
CPT,51784,Outpatient Grouper - 0,3283.21,2134.09,9059.94,9827.82,24
CPT,51784,Outpatient Surgical Group 0,3283.21,2134.09,2806.68,4166.87,50
CPT,51785,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,51785,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,51785,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,51792,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51792,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,51792,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,51797,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51797,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,51797,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,51798,HB POST-VOID RESIDUAL MEASUREMENT,418.29,271.885,73.96,14761.0,18
CPT,51798,OUTPATIENT SURGERY CPT GROUP 1,363.73,236.42,6417.0,7038.0,2
CPT,51798,Outpatient Grouper - 0,363.73,236.42,9059.94,9827.82,24
CPT,51798,Outpatient Surgical Group 0,363.73,236.42,2806.68,4166.87,50
CPT,51800,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51800,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51820,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51820,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,51820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51840,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51840,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51841,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51841,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51841,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51845,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,51845,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51845,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51860,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51860,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51865,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51865,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51865,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51880,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,51880,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51880,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51900,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,51900,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51900,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51920,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51920,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,51920,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51925,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51925,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,51925,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51940,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51940,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51940,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,51960,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,51960,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,51960,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,51980,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,51980,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,51980,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,51990,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,51990,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51990,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,51992,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,51992,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,51992,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,51999,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,51999,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52000,HB CYSTOSCOPY,4690.1900000000005,3048.62,831.13,14761.0,18
CPT,52000,Outpatient Grouper - 1,4078.42,2650.97,10495.38,11385.92,24
CPT,52000,Outpatient Surgery Group 2 Global Rate,4078.42,2650.97,14322.0,15354.0,2
CPT,52000,Outpatient Surgical Group 1,4078.42,2650.97,9088.3,13492.72,50
CPT,52001,HB CYSTO W MULTI OBSTR CLOT REM,16674.9,10838.685000000001,4294.62,14761.0,10
CPT,52001,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,52001,Outpatient Grouper - 2,14499.9,9424.93,13036.88,14143.2,24
CPT,52001,Outpatient Surgical Group 2,14499.9,9424.93,12162.28,18056.43,50
CPT,52005,HB CYTOURETHROSCOPY,12855.0,8355.75,2550.78,2933.4,16
CPT,52005,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,52005,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52005,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52007,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52007,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52007,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52010,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,52010,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52010,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52204,HB CYSTOSCOPY W/ BIOPSY,12855.0,8355.75,2550.78,2933.4,8
CPT,52204,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,52204,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52204,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52214,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52214,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52214,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52224,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52224,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52224,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52234,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52234,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52234,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52235,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52235,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52235,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52240,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52240,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52240,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52250,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,52250,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52260,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,52260,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52260,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52265,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,52265,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52265,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,52270,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,52270,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52270,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52275,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52275,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52276,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52276,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52276,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52277,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52277,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52277,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52281,HB CYSTO W/ DILATION URETHRA STRT,14783.26,9609.119999999999,2550.78,14761.0,18
CPT,52281,Outpatient Grouper - 2,12855.0,8355.75,13036.88,14143.2,24
CPT,52281,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52281,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52282,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52282,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52282,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,52283,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52283,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52283,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52284,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52284,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,52285,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,52285,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52285,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52287,Outpatient Grouper - 2,12855.0,8355.75,13036.88,14143.2,24
CPT,52287,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52287,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52290,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52290,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52290,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52300,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52300,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52300,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52301,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52301,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52301,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52305,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52305,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52305,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52310,HB CYSTO W/ STENT REMOVE (SIMPLE),14783.26,9609.119999999999,2550.78,14761.0,18
CPT,52310,Outpatient Grouper - 2,12855.0,8355.75,13036.88,14143.2,24
CPT,52310,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52310,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52315,HB CYSTO REM FB/ST URE/BLD;COM,12855.0,8355.75,2550.78,2933.4,8
CPT,52315,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,52315,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,52315,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,52317,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52317,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52317,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,52318,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52318,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52318,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52320,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52320,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52320,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,52325,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52325,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,52325,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52327,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52327,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52327,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52330,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52330,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52330,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52332,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52332,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52332,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52334,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52334,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52334,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52341,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52341,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52341,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52342,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52342,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52342,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52343,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52343,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52343,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52344,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52344,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52344,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52345,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52345,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52345,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52346,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52346,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52346,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52351,HB CYSTOURETHROSCOPY,14499.9,9424.93,4294.62,4938.81,8
CPT,52351,Outpatient Grouper - 3,14499.9,9424.93,14341.63,15558.59,24
CPT,52351,Outpatient Surgery Group 3 Global Rate,14499.9,9424.93,22055.0,22787.0,2
CPT,52351,Outpatient Surgical Group 3,14499.9,9424.93,13899.75,20635.92,50
CPT,52352,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52352,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52352,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52353,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52353,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52353,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52354,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52354,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52354,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52355,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52355,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,52355,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52356,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52356,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52356,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52400,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52400,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52402,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52402,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52402,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52441,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,52441,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52441,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,52442,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,52442,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52442,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,52450,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52450,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52450,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52500,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52500,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52500,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,52601,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52601,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,52601,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52630,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52630,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52630,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52640,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52640,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52640,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,52647,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52647,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52647,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,52648,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52648,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52648,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,52649,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,52649,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52649,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,52700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,52700,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,52700,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53000,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53000,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53010,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53020,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53025,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53025,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53025,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53040,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53040,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53040,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53060,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,53060,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,53060,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,53080,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53080,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53080,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,53085,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53085,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53085,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53200,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53210,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53210,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,53210,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,53215,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53215,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,53215,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,53220,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53220,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53220,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53230,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53230,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53230,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53235,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53235,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53235,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,53240,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53240,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53240,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53250,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53250,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53260,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53260,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53260,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53265,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53265,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53265,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53270,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53270,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53275,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53275,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53400,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,53405,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53405,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53405,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53410,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53410,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53410,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53415,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,53415,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,53415,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53420,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53420,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53420,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,53425,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53425,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53425,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53430,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53430,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53430,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53431,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53431,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53431,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53440,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,53440,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53440,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53442,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53442,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53442,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53444,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,53444,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53444,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53445,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,53445,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,53445,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53446,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,53446,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53446,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53447,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53447,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,53447,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53448,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,53448,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,53448,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53449,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53449,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53449,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53450,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53450,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53451,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,53451,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,53451,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53452,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53452,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53452,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53453,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53453,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53454,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,53454,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53460,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53460,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53500,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53500,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53500,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,53502,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53502,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53502,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53505,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53505,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53505,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53510,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53510,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53510,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53515,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53515,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53515,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53520,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,53520,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,53520,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53600,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,53600,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,53600,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,53601,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53601,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,53601,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53605,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53605,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,53605,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53620,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53620,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,53620,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,53621,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53621,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,53621,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53660,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53660,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,53660,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53661,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53661,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,53661,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53665,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53665,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53665,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53850,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,53850,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53850,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,53852,Outpatient Grouper - 5,14499.9,9424.93,25486.19,27649.53,24
CPT,53852,Outpatient Surgery Group 3 Global Rate,14499.9,9424.93,22055.0,22787.0,2
CPT,53852,Outpatient Surgical Group 9,14499.9,9424.93,36513.58,54208.97,50
CPT,53854,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,53854,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53854,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53855,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,53855,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,53855,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,53860,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,53860,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,53860,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,53899,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,53899,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,54000,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54000,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54000,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54001,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,54001,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,54001,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,54015,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54015,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54015,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54050,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54050,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54050,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,54055,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54055,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54055,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54056,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54056,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54056,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,54057,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54057,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54057,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54060,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54060,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54060,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54065,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54065,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54065,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54100,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54100,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54100,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54105,OUTPATIENT SURGERY CPT GROUP 1,12510.8,8132.02,6417.0,7038.0,2
CPT,54105,Outpatient Grouper - 3,12510.8,8132.02,14341.63,15558.59,24
CPT,54105,Outpatient Surgical Group 1,12510.8,8132.02,9088.3,13492.72,50
CPT,54110,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54111,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54111,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54111,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54112,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54112,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,54112,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54115,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54115,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54115,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54125,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54125,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54125,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,54130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54130,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54135,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,54135,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,54135,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54150,"HB CIRCUM., BY CLAMP OR DEVICE",12855.0,8355.75,2550.78,2933.4,8
CPT,54150,OUTPATIENT SURGERY CPT GROUP 1,12855.0,8355.75,6417.0,7038.0,2
CPT,54150,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,54150,Outpatient Surgical Group 1,12855.0,8355.75,9088.3,13492.72,50
CPT,54160,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54160,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54161,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54161,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54161,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54162,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54162,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54162,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54163,OUTPATIENT SURGERY CPT GROUP 1,12184.8,7920.12,6417.0,7038.0,2
CPT,54163,Outpatient Grouper - 3,12184.8,7920.12,14341.63,15558.59,24
CPT,54163,Outpatient Surgical Group 2,12184.8,7920.12,12162.28,18056.43,50
CPT,54164,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54164,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54164,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54200,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,54200,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,54200,Outpatient Surgical Group 0,4202.01,2731.31,2806.68,4166.87,50
CPT,54205,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54205,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54205,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54220,HB IRRIG CRPR CVERNSA PRIAPISM,4832.3099999999995,3141.005,302.84,14761.0,10
CPT,54220,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,54220,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,54220,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,54230,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54231,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54231,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54235,HB INJ CRPRA CVRNS W PHRM AGNT,3982.95,2588.92,302.84,348.27,8
CPT,54235,Outpatient Grouper - 0,3982.95,2588.92,9059.94,9827.82,24
CPT,54235,Outpatient Surgical Group 0,3982.95,2588.92,2806.68,4166.87,50
CPT,54240,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54240,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54240,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,54250,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54250,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54250,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,54300,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54300,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54300,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54304,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54304,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54304,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54308,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54308,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54308,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54312,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54312,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54312,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54316,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54316,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54316,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54318,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54318,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54318,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54322,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54322,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54322,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54324,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54324,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54324,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54326,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54326,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54326,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54328,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54328,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54328,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54332,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54332,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54332,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54336,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54336,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54336,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54340,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54340,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54340,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54344,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54344,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54344,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54348,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54348,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54348,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54352,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54352,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54352,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54360,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54360,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54360,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54380,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54380,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54380,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54385,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54385,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54385,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54390,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54390,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54390,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54400,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,54400,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54401,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,54401,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54401,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54405,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,54405,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54405,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54406,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54406,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54406,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54408,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54408,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54408,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54410,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,54410,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,54410,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54411,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,54411,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54411,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54415,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54415,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54415,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54416,Outpatient Grouper - 8,8092.5599999999995,5260.165,34726.75,37674.38,24
CPT,54416,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54416,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54417,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,54417,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54417,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54420,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54420,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54420,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54430,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,54430,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54430,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54435,Outpatient Grouper - 4,14499.9,9424.93,19724.25,21397.98,24
CPT,54435,Outpatient Surgery Group 4 Global Rate,14499.9,9424.93,26623.0,28144.0,2
CPT,54435,Outpatient Surgical Group 4,14499.9,9424.93,17187.58,25517.11,50
CPT,54437,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54437,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54437,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54438,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,54438,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54438,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,54440,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54440,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54440,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54450,HB FORESKIN MANIPULATION/ADHESIONS & STRTCHNG,4202.01,2731.31,302.84,348.27,8
CPT,54450,OUTPATIENT SURGERY CPT GROUP 1,4202.01,2731.31,6417.0,7038.0,2
CPT,54450,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,54450,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,54500,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54500,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,54500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54505,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54505,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54505,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54512,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54512,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54512,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54520,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54520,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54520,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54522,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54522,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54522,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54530,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54530,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54530,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54535,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54535,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54535,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54550,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54550,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54560,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54560,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54560,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54600,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54600,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54620,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54620,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54620,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54640,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54640,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54640,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54650,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,54650,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54660,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54660,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,54660,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,54670,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54670,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54680,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54680,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54680,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54690,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,54690,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54690,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,54692,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,54692,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,54692,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,54699,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,54699,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,54700,HB I&D TEST/SCROTUM EPIDIDYMIS,14783.26,9609.119999999999,2550.78,14761.0,10
CPT,54700,Outpatient Grouper - 3,12855.0,8355.75,14341.63,15558.59,24
CPT,54700,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,54700,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,54800,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54800,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,54800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,54830,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54840,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54840,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54840,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54860,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54860,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54860,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,54861,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54861,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54861,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54865,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,54865,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54865,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,54900,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54900,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54900,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,54901,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,54901,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,54901,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,55000,HB PUNCTURE ASPIR HYDROCELE W/WO INJ MED,5952.47,3869.11,876.1,1007.52,8
CPT,55000,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,55000,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,55040,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,55040,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55040,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,55041,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,55041,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55041,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,55060,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55060,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55060,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,55100,HB DRAINAGE OF SCROTAL WALL ABSCESS,13195.1,8576.815,2017.5,14761.0,10
CPT,55100,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,55100,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,55110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55110,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55150,OUTPATIENT SURGERY CPT GROUP 1,14499.9,9424.93,6417.0,7038.0,2
CPT,55150,Outpatient Grouper - 3,14499.9,9424.93,14341.63,15558.59,24
CPT,55150,Outpatient Surgical Group 1,14499.9,9424.93,9088.3,13492.72,50
CPT,55175,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55175,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,55175,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55180,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55180,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55180,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55200,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55200,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55250,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55250,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55300,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,55400,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55400,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55500,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,55500,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,55500,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,55520,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55520,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55520,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,55530,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55530,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55530,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,55535,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,55535,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55535,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,55540,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,55540,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,55540,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,55550,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,55550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,55550,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,55559,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,55559,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,55600,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55605,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55605,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,55605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55650,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55650,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,55650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55680,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55680,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55680,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55700,HB BIOPSY PROSTATE,14783.26,9609.119999999999,2550.78,14761.0,10
CPT,55700,Outpatient Grouper - 2,12855.0,8355.75,13036.88,14143.2,24
CPT,55700,Outpatient Surgery Group 2 Global Rate,12855.0,8355.75,14322.0,15354.0,2
CPT,55700,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,50
CPT,55705,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,55705,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,55705,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55706,Outpatient Grouper - 2,13744.0,8933.6,13036.88,14143.2,24
CPT,55706,Outpatient Surgery Group 2 Global Rate,13744.0,8933.6,14322.0,15354.0,2
CPT,55706,Outpatient Surgical Group 2,13744.0,8933.6,12162.28,18056.43,50
CPT,55720,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55720,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55720,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55725,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55725,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55725,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55801,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55801,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,55801,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55810,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55810,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,55810,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55812,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55812,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55812,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55815,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55815,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55815,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55821,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55821,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55821,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55831,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55831,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55831,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55840,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55840,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55840,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55842,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55842,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55842,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55845,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55845,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55845,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55860,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55860,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,55860,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,55862,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55862,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,55862,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55865,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,55865,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,55865,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55866,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,55866,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,55866,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55867,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,55867,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,55867,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55870,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,55870,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,55870,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55873,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,55873,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,55873,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,55874,HB TRANSPERINEAL PLCMT BIODEGRADEABLE MATRL,16946.0,11014.9,6330.06,7279.57,8
CPT,55874,OUTPATIENT SURGERY CPT GROUP 1,16946.0,11014.9,6417.0,7038.0,2
CPT,55874,Outpatient Grouper - 6,16946.0,11014.9,28632.25,34209.93,24
CPT,55874,Outpatient Surgical Group 9,16946.0,11014.9,36513.58,54208.97,50
CPT,55875,Outpatient Grouper - 5,16946.0,11014.9,25486.19,27649.53,24
CPT,55875,Outpatient Surgery Group 9 Global Rate,16946.0,11014.9,36365.0,36365.0,1
CPT,55875,Outpatient Surgical Group 9,16946.0,11014.9,36513.58,54208.97,50
CPT,55876,HB PLCMT RT DEV/MARKER PROSTATE,17529.8,11394.37,1703.74,1959.3,8
CPT,55876,Outpatient Grouper - 2,17529.8,11394.37,13036.88,14143.2,24
CPT,55876,Outpatient Surgery Group 2 Global Rate,17529.8,11394.37,14322.0,15354.0,2
CPT,55876,Outpatient Surgical Group 9,17529.8,11394.37,36513.58,54208.97,50
CPT,55880,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,55880,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,55880,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55899,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,55899,Outpatient Surgical Group 1,4202.01,2731.31,9088.3,13492.72,50
CPT,55920,OUTPATIENT SURGERY CPT GROUP 1,30395.5,19757.08,6417.0,7038.0,2
CPT,55920,Outpatient Grouper - 4,30395.5,19757.08,19724.25,21397.98,24
CPT,55920,Outpatient Surgical Group 1,30395.5,19757.08,9088.3,13492.72,50
CPT,55970,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55970,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,55980,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,55980,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56405,HB I & D VULVA/PERINEUM,2128.3849999999998,1383.45,378.77,14761.0,10
CPT,56405,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,56405,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,56405,Outpatient Surgical Group 1,1850.78,1203.01,9088.3,13492.72,50
CPT,56420,HB I&D BARTHOLIN ABSCESS,1756.52,1141.74,250.49,288.07,8
CPT,56420,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,56420,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,56420,Outpatient Surgical Group 1,1756.52,1141.74,9088.3,13492.72,50
CPT,56440,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,56440,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,56440,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,56441,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,56441,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56441,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56442,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,56442,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56442,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56501,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,56501,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,56501,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,56515,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,56515,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,56515,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,56605,"HB BIOPSY, VULVA 1ST LESION",2990.6,1943.89,1084.23,14761.0,10
CPT,56605,OUTPATIENT SURGERY CPT GROUP 1,2990.6,1943.89,6417.0,7038.0,2
CPT,56605,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,56605,Outpatient Surgical Group 1,2990.6,1943.89,9088.3,13492.72,50
CPT,56606,HB BX VULVA/PERINEUM EA ADDL LES,1689.38,1098.1,,,0
CPT,56606,OUTPATIENT SURGERY CPT GROUP 1,1689.38,1098.1,6417.0,7038.0,2
CPT,56606,Outpatient Grouper - 0,1689.38,1098.1,9059.94,9827.82,24
CPT,56606,Outpatient Surgical Group 1,1689.38,1098.1,9088.3,13492.72,50
CPT,56620,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56620,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,56620,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,56625,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56625,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,56625,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,56630,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,56630,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,56630,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56631,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,56631,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,56631,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56632,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,56632,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,56632,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,56633,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,56633,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,56633,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56634,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,56634,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,56634,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56637,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,56637,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,56637,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,56640,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,56640,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,56640,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,56700,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,56700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,56740,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56740,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,56740,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,56800,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56800,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,56800,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,56805,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56805,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,56805,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,56810,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,56810,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,56810,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,56820,HB COLPOSCOPY OF VULVA,1756.52,1141.74,250.49,288.07,8
CPT,56820,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,56820,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,56820,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,56821,HB VULVA COLPOSC W BX,1850.78,1203.01,378.77,435.59,8
CPT,56821,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,56821,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,56821,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,57000,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57000,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57010,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57010,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57010,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57020,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57020,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57020,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57022,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57022,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,57022,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57023,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57023,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57023,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57061,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57061,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57061,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57065,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57065,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57065,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57100,HB BIOPSY OF VAGINA,2990.6,1943.89,1084.23,1246.87,8
CPT,57100,OUTPATIENT SURGERY CPT GROUP 1,2990.6,1943.89,6417.0,7038.0,2
CPT,57100,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,57100,Outpatient Surgical Group 0,2990.6,1943.89,2806.68,4166.87,50
CPT,57105,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57105,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57105,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57106,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57106,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57106,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57107,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57107,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57107,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57109,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57109,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57109,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57110,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57110,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57111,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57111,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57111,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57112,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57120,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57130,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57130,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57135,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,57135,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,57135,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,57150,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,57150,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,57155,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57155,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,57155,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57156,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,57156,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,57156,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,57160,HB PESSARY FITTING,1756.52,1141.74,250.49,288.07,8
CPT,57160,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,57160,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,57160,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,57170,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,57170,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,57180,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,57180,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,57180,Outpatient Surgical Group 1,1756.52,1141.74,9088.3,13492.72,50
CPT,57200,OUTPATIENT SURGERY CPT GROUP 1,21672.0,14086.8,6417.0,7038.0,2
CPT,57200,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,57200,Outpatient Surgical Group 1,21672.0,14086.8,9088.3,13492.72,50
CPT,57210,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57210,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57210,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57220,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57220,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57220,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57230,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57230,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57230,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57240,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57240,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57240,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57250,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57250,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57250,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57260,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57260,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57260,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57265,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57265,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,57265,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,57267,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,57267,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57267,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57268,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57268,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57268,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57270,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57270,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57270,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57280,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57280,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57282,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57282,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57282,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57283,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57283,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57284,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57284,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57284,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57285,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57285,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57285,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57287,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57287,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57287,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,57288,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57288,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57288,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,57289,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57289,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57289,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57291,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57291,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57291,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57292,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57292,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57292,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57295,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57295,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57295,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57296,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57296,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57300,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57300,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57300,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57305,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57305,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57307,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57307,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57307,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57308,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57308,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57308,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57310,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57310,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57310,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57311,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57311,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57311,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57320,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57320,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57320,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57330,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57330,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57330,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57335,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57335,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57335,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57400,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57400,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57410,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57410,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57415,OUTPATIENT SURGERY CPT GROUP 1,21672.0,14086.8,6417.0,7038.0,2
CPT,57415,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,57415,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,57420,HB COLPOSCOPY OF VAGINA,1850.78,1203.01,378.77,435.59,8
CPT,57420,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,57420,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,57421,HB EXAM/BIOPSY OF VAG W/SCOPE,2990.6,1943.89,1084.23,1246.87,8
CPT,57421,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,57421,Outpatient Surgical Group 0,2990.6,1943.89,2806.68,4166.87,50
CPT,57423,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,57423,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57423,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,57425,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,57425,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57425,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,57426,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57426,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57426,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57452,HB COLPOSCOPY,1756.52,1141.74,250.49,288.07,8
CPT,57452,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,57452,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,57452,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,57454,HB COLPOSCOPY W/CERVICAL BIO,1850.78,1203.01,378.77,435.59,8
CPT,57454,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,57454,Outpatient Surgery Group 2 Global Rate,1850.78,1203.01,14322.0,15354.0,2
CPT,57454,Outpatient Surgical Group 1,1850.78,1203.01,9088.3,13492.72,50
CPT,57455,HB CERVIC COLP W CERVIX BX,1850.78,1203.01,378.77,435.59,8
CPT,57455,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,57455,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,57455,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,57456,HB CERV COLP W EC CURETT,1850.78,1203.01,378.77,435.59,8
CPT,57456,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,57456,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,57456,Outpatient Surgical Group 1,1850.78,1203.01,9088.3,13492.72,50
CPT,57460,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57460,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57461,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57461,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57461,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57465,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,57465,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,57500,HB BIOPSY OF CERVIX,3439.2,2235.48,1084.23,14761.0,10
CPT,57500,OUTPATIENT SURGERY CPT GROUP 1,2990.6,1943.89,6417.0,7038.0,2
CPT,57500,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,57500,Outpatient Surgical Group 1,2990.6,1943.89,9088.3,13492.72,50
CPT,57505,HB ENDOCERVICAL CURETTAGE,2990.6,1943.89,1084.23,1246.87,8
CPT,57505,OUTPATIENT SURGERY CPT GROUP 1,2990.6,1943.89,6417.0,7038.0,2
CPT,57505,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,57505,Outpatient Surgical Group 0,2990.6,1943.89,2806.68,4166.87,50
CPT,57510,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57510,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57511,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,57511,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57513,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57513,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57513,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57520,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57520,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,57520,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57522,HB LOOP ELECTRODE EXCISION PROC,21672.0,14086.8,3959.11,4552.98,8
CPT,57522,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,57522,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,57522,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,57530,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57530,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57530,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57531,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57531,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57531,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,57540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,57545,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,57545,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57550,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57550,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57555,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,57555,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,57555,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57556,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,57556,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,57556,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,57558,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57558,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57558,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57700,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,57720,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57720,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,57720,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,57800,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,57800,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,57800,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,58100,"HB BIOPSY, ENDOMETRIAL",2020.0,1313.0,250.49,14761.0,18
CPT,58100,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,58100,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,58100,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,58110,HB BX DONE W/COLPOSCOPY ADD-ON,1215.74,790.23,,,0
CPT,58110,OUTPATIENT SURGERY CPT GROUP 1,1215.74,790.23,6417.0,7038.0,2
CPT,58110,Outpatient Grouper - 0,1215.74,790.23,9059.94,9827.82,24
CPT,58110,Outpatient Surgical Group 0,1215.74,790.23,2806.68,4166.87,50
CPT,58120,HB D&C DIAG OR THERAP NOT OB,20542.2,13352.43,3959.11,4552.98,8
CPT,58120,Outpatient Grouper - 3,20542.2,13352.43,14341.63,15558.59,24
CPT,58120,Outpatient Surgery Group 2 Global Rate,20542.2,13352.43,14322.0,15354.0,2
CPT,58120,Outpatient Surgical Group 2,20542.2,13352.43,12162.28,18056.43,50
CPT,58140,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58140,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58140,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58145,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,58145,Outpatient Surgery Group 4 Global Rate,21672.0,14086.8,26623.0,28144.0,2
CPT,58145,Outpatient Surgical Group 5,21672.0,14086.8,19539.84,29009.34,50
CPT,58146,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58146,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,58146,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58150,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58150,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58150,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58152,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58152,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58152,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58180,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58180,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58180,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58200,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58200,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58210,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58210,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,58210,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,58240,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58240,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,58240,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58260,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58260,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58260,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58262,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58262,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58262,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58263,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58263,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58263,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58267,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58267,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58267,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58270,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58270,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58270,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58275,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58275,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58275,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58280,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58280,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58280,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58285,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58285,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58285,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58290,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58290,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58290,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58291,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58291,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58291,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58292,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58292,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58292,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58293,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58294,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58294,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58294,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58300,HB IUD INSERTION,537.78,349.56,,,0
CPT,58300,Outpatient Grouper - 0,537.78,349.56,9059.94,9827.82,24
CPT,58300,Outpatient Surgical Group 0,537.78,349.56,2806.68,4166.87,50
CPT,58301,HB IUD REMOVAL,2128.3849999999998,1383.45,378.77,14761.0,10
CPT,58301,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,58301,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,58301,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,58321,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,58321,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,58321,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,58322,Ambulatory Surgery: Default Rate,1756.52,1141.74,,,0
CPT,58322,HB ARTIFICAL INSEM/INTRA- UT,1756.52,1141.74,250.49,288.07,8
CPT,58322,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,58322,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,58322,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,58323,Laboratory Services,,,77.48,77.49,2
CPT,58323,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,58323,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,58340,HB HYSTEROSALPINGOGRAM INJECT,792.99,515.44,,,0
CPT,58340,OUTPATIENT SURGERY CPT GROUP 1,792.99,515.44,6417.0,7038.0,2
CPT,58340,Outpatient Grouper - 0,792.99,515.44,9059.94,9827.82,24
CPT,58345,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58345,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58345,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58346,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58346,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58346,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,58350,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58350,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58350,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58353,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58353,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58353,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58356,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58356,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58356,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,58400,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58410,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58410,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58410,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58520,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58520,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58540,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58541,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58541,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58541,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58542,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58542,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58542,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58543,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58543,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58543,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58544,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58544,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58544,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58545,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58545,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58545,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58546,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58546,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58546,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58548,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58548,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58550,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58550,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58550,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58552,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58552,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58552,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58553,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58553,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58553,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58554,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58554,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58554,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,58555,HB HYSTEROSCOPY,21672.0,14086.8,3959.11,4552.98,8
CPT,58555,OUTPATIENT SURGERY CPT GROUP 1,21672.0,14086.8,6417.0,7038.0,2
CPT,58555,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,58555,Outpatient Surgical Group 1,21672.0,14086.8,9088.3,13492.72,50
CPT,58558,HB HYSTEROSCOPY BX ENDM-PLYPT,21672.0,14086.8,3959.11,4552.98,8
CPT,58558,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,58558,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,58558,Outpatient Surgical Group 3,21672.0,14086.8,13899.75,20635.92,50
CPT,58559,HB HYSTEROSCOPY W LYSIS INTRAUT ADHESIONS,30395.5,19757.08,6146.81,7068.83,8
CPT,58559,Outpatient Grouper - 3,30395.5,19757.08,14341.63,15558.59,24
CPT,58559,Outpatient Surgery Group 3 Global Rate,30395.5,19757.08,22055.0,22787.0,2
CPT,58559,Outpatient Surgical Group 2,30395.5,19757.08,12162.28,18056.43,50
CPT,58560,HB HYSTEROSCOPY DIV/RESECT INTRAUT SEPTUM,30395.5,19757.08,6146.81,7068.83,8
CPT,58560,Outpatient Grouper - 4,30395.5,19757.08,19724.25,21397.98,24
CPT,58560,Outpatient Surgery Group 3 Global Rate,30395.5,19757.08,22055.0,22787.0,2
CPT,58560,Outpatient Surgical Group 3,30395.5,19757.08,13899.75,20635.92,50
CPT,58561,HB HYSTEROSCOPY W RMVL LEIOMYOMATA,30395.5,19757.08,6146.81,7068.83,8
CPT,58561,Outpatient Grouper - 4,30395.5,19757.08,19724.25,21397.98,24
CPT,58561,Outpatient Surgery Group 3 Global Rate,30395.5,19757.08,22055.0,22787.0,2
CPT,58561,Outpatient Surgical Group 3,30395.5,19757.08,13899.75,20635.92,50
CPT,58562,HB HYSTEROSCOPY W RMVL IMPCTD FOREIGN BODY,21672.0,14086.8,3959.11,4552.98,8
CPT,58562,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,58562,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,58562,Outpatient Surgical Group 3,21672.0,14086.8,13899.75,20635.92,50
CPT,58563,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58563,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58563,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58565,Outpatient Grouper - 5,30395.5,19757.08,25486.19,27649.53,24
CPT,58565,Outpatient Surgery Group 3 Global Rate,30395.5,19757.08,22055.0,22787.0,2
CPT,58565,Outpatient Surgical Group 7,30395.5,19757.08,27131.25,40279.73,50
CPT,58570,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58570,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58570,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58571,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58571,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58571,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58572,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58572,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58572,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58573,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58573,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58573,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58575,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58575,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58575,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58578,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58578,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,58579,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,58579,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58580,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58580,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,58600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58600,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58600,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58605,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,58605,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58611,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58611,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58611,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58615,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58615,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58615,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58660,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58660,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,58660,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58661,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58661,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58661,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58662,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58662,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58662,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58670,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58670,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58671,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58671,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58671,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58672,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58672,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58672,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58673,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58673,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58673,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58674,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58674,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58674,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,58679,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58679,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,58700,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58700,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58720,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,58720,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58720,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58740,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58740,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58740,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58750,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58750,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58750,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58752,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58752,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58752,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58760,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58760,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58760,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58770,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58770,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58770,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58800,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58800,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58800,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58805,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58805,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58805,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58820,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58820,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58822,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58822,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58822,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58825,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58825,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58825,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58900,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,58900,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,58900,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58920,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58920,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,58920,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58925,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58925,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58925,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,58940,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58940,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58940,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58943,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58943,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58943,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58950,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,58950,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58950,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58951,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58951,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58951,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58952,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58952,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,58952,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,58953,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58953,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58953,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58954,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58954,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,58954,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58956,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58956,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,58957,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58957,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58958,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,58958,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,58960,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,58960,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,58960,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58970,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58970,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,58970,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,58974,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58974,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,58974,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58976,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,58976,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,58976,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,58999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,58999,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59000,HB AMNIOCENTESIS,2990.6,1943.89,1084.23,1246.87,8
CPT,59000,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,59000,Outpatient Surgical Group 1,2990.6,1943.89,9088.3,13492.72,50
CPT,59001,"HB AMNIOCENTESIS, THERAPEUTIC",1850.78,1203.01,13270.0,14761.0,2
CPT,59001,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,59001,Outpatient Surgical Group 1,1850.78,1203.01,9088.3,13492.72,50
CPT,59012,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59012,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59012,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59015,HB CHORIONIC VILLUS SAMPLING,2990.6,1943.89,1084.23,1246.87,8
CPT,59015,Outpatient Grouper - 1,2990.6,1943.89,10495.38,11385.92,24
CPT,59015,Outpatient Surgery Group 2 Global Rate,2990.6,1943.89,14322.0,15354.0,2
CPT,59015,Outpatient Surgical Group 1,2990.6,1943.89,9088.3,13492.72,50
CPT,59020,FETAL CONTRACTION STRESS TEST,,,411.57,655.46,2
CPT,59020,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59020,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59020,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,59025,FETAL NON-STRESS TEST,1756.52,1141.74,411.57,655.46,2
CPT,59025,HB FETAL NON-STRESS TEST,1756.52,1141.74,250.49,14761.0,20
CPT,59025,OUTPATIENT SURGERY CPT GROUP 1,1756.52,1141.74,6417.0,7038.0,2
CPT,59025,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,59025,Outpatient Surgical Group 0,1756.52,1141.74,2806.68,4166.87,50
CPT,59030,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59030,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59030,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59050,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59050,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,59051,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59051,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,59070,HB TRANS ABD AMNIOINFUSION W/US,1850.78,1203.01,13270.0,14761.0,2
CPT,59070,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,59070,Outpatient Surgery Group 3 Global Rate,1850.78,1203.01,22055.0,22787.0,2
CPT,59070,Outpatient Surgical Group 1,1850.78,1203.01,9088.3,13492.72,50
CPT,59072,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59072,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59072,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59074,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59074,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,59074,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59076,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59076,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,59076,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59100,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,59100,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,59100,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59120,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,59120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,59120,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59121,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,59121,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59121,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59130,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59130,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59130,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59135,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,59136,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59136,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,59136,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59140,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59140,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59150,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,59150,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59150,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59151,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,59151,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59151,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,59160,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59160,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,59160,Outpatient Surgical Group 3,21672.0,14086.8,13899.75,20635.92,50
CPT,59200,HB INSERT CERVICAL DILATOR,2128.39,1383.455,378.77,14761.0,10
CPT,59200,OUTPATIENT SURGERY CPT GROUP 1,1850.78,1203.01,6417.0,7038.0,2
CPT,59200,Outpatient Grouper - 0,1850.78,1203.01,9059.94,9827.82,24
CPT,59200,Outpatient Surgical Group 0,1850.78,1203.01,2806.68,4166.87,50
CPT,59300,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59300,Outpatient Surgery Group 3 Global Rate,21672.0,14086.8,22055.0,22787.0,2
CPT,59300,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,59320,"HB CERCLAGE CERVIX, PREGNANCY VAGINAL",20542.2,13352.43,3959.11,14761.0,10
CPT,59320,Outpatient Grouper - 3,20542.2,13352.43,14341.63,15558.59,24
CPT,59320,Outpatient Surgery Group 3 Global Rate,20542.2,13352.43,22055.0,22787.0,2
CPT,59320,Outpatient Surgical Group 1,20542.2,13352.43,9088.3,13492.72,50
CPT,59325,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59325,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59325,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59350,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59350,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59400,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59400,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59409,HB VAGINAL DELIVERY,24922.809999999998,16199.824999999999,3959.11,14761.0,10
CPT,59409,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59409,Outpatient Surgery Group 6 Global Rate,21672.0,14086.8,34526.0,35549.0,2
CPT,59409,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,59410,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59410,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59412,HB BREECH VERSION ATTEMPT,21672.0,14086.8,3959.11,14761.0,10
CPT,59412,OUTPATIENT SURGERY CPT GROUP 1,21672.0,14086.8,6417.0,7038.0,2
CPT,59412,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59412,Outpatient Surgical Group 0,21672.0,14086.8,2806.68,4166.87,50
CPT,59414,HB REMOVAL OF RETAINED PLACENTA,24922.809999999998,16199.824999999999,3959.11,14761.0,12
CPT,59414,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59414,Outpatient Surgery Group 2 Global Rate,21672.0,14086.8,14322.0,15354.0,2
CPT,59414,Outpatient Surgical Group 2,21672.0,14086.8,12162.28,18056.43,50
CPT,59425,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,59426,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59430,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,59510,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59510,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59514,HB C-SECTION ONLY ED,31972.22,20781.94,13270.0,14761.0,2
CPT,59514,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59514,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59515,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59515,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59525,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,59525,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59610,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59610,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59612,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,59612,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59612,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59614,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,59614,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59618,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59618,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59620,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59620,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59622,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,59622,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59812,HB SURG TX INCOMPL ABORTION,21672.0,14086.8,3959.11,4552.98,8
CPT,59812,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59812,Outpatient Surgery Group 3 Global Rate,21672.0,14086.8,22055.0,22787.0,2
CPT,59812,Outpatient Surgical Group 5,21672.0,14086.8,19539.84,29009.34,50
CPT,59820,HB SURG TX MSD ABORT;1ST TRIM,21672.0,14086.8,3959.11,4552.98,8
CPT,59820,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59820,Outpatient Surgery Group 3 Global Rate,21672.0,14086.8,22055.0,22787.0,2
CPT,59820,Outpatient Surgical Group 5,21672.0,14086.8,19539.84,29009.34,50
CPT,59821,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,59821,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59821,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,59830,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59830,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59830,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,59840,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59840,Outpatient Surgery Group 3 Global Rate,21672.0,14086.8,22055.0,22787.0,2
CPT,59840,Outpatient Surgical Group 5,21672.0,14086.8,19539.84,29009.34,50
CPT,59841,HB INDUCED ABORTION BY DILAT AND EVAC,21672.0,14086.8,3959.11,4552.98,8
CPT,59841,Outpatient Grouper - 3,21672.0,14086.8,14341.63,15558.59,24
CPT,59841,Outpatient Surgery Group 3 Global Rate,21672.0,14086.8,22055.0,22787.0,2
CPT,59841,Outpatient Surgical Group 5,21672.0,14086.8,19539.84,29009.34,50
CPT,59850,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59850,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59850,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59851,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59851,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59851,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59852,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59852,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59852,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59855,HB INDUCED ABORT BY 1/> VAG SUPPOS,21427.35,13927.78,13270.0,14761.0,2
CPT,59855,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59855,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,59855,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59856,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,59856,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,59856,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59857,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,59857,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,59857,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,59866,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59866,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59866,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,59870,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,59870,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,59870,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,59871,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,59871,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,59871,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,59897,Outpatient Grouper - 0,1756.52,1141.74,9059.94,9827.82,24
CPT,59897,Outpatient Surgical Group 1,1756.52,1141.74,9088.3,13492.72,50
CPT,59898,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,59898,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,59899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,59899,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,60000,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,60000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60100,HB BIOPSY THYROID PERC NDL,5952.47,3869.11,876.1,1007.52,8
CPT,60100,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,60100,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,60100,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,60200,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60200,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,60200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,60210,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60210,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,60210,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60212,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60212,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,60212,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60220,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60220,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,60220,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60225,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60225,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,60225,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60240,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60240,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,60240,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60252,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60252,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,60252,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60254,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,60254,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,60254,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,60260,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60260,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,60260,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60270,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,60270,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,60270,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60271,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60271,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,60271,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60280,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60280,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,60280,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,60281,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60281,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,60281,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,60300,HB ASPIR/INJECT THYROID CYST,5952.47,3869.11,876.1,1007.52,8
CPT,60300,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,60300,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,60300,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,60500,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60500,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,60500,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,60502,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60502,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,60502,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60505,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60505,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,60505,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60512,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,60512,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,60512,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,60520,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60520,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,60520,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60521,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60521,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,60521,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60522,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60522,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,60522,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,60540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60540,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,60540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60545,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,60545,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60600,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,60600,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,60605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,60605,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,60605,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,60650,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60650,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,60650,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,60659,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,60659,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,60699,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,60699,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61000,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61000,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,61000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61001,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61001,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,61001,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61020,HB REMOVE BRAIN CAVITY FLUID,6874.78,4468.61,1108.58,1274.87,8
CPT,61020,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,61020,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,61020,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,61026,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61026,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,61026,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61050,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61050,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,61050,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61055,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,61055,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,61055,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,61070,HB PUNCTURE OF SHUNT TUBING,5252.42,3414.0699999999997,862.32,14761.0,12
CPT,61070,OUTPATIENT SURGERY CPT GROUP 1,4567.31,2968.75,6417.0,7038.0,2
CPT,61070,Outpatient Grouper - 1,4567.31,2968.75,10495.38,11385.92,24
CPT,61070,Outpatient Surgical Group 1,4567.31,2968.75,9088.3,13492.72,50
CPT,61105,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61105,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,61105,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61107,HB MISCELLANEOUS PROCEDURE,7838.5,5095.03,13270.0,14761.0,4
CPT,61107,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61107,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61107,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61108,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61108,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61108,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61120,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61120,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61150,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61150,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61150,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61151,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61151,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61151,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61154,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61154,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61154,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61156,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61156,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61156,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61210,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61210,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61210,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61215,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,61215,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61215,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61250,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61250,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61250,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61253,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61253,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61253,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61304,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61304,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61304,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61305,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61305,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61312,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61312,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61312,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61313,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61313,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61313,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61314,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61314,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61314,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61315,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61315,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61315,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61316,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61316,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61316,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61320,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61320,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61320,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61321,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61321,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61321,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61322,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61322,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61322,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61323,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61323,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61323,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61330,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,61330,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61330,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61333,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61333,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61333,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61340,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61340,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61340,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61343,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61343,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61343,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61345,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61345,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61345,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61450,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61450,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61450,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61458,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61458,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61458,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61460,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61460,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61460,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61500,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,61500,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61501,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61501,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61510,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61510,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61510,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61512,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61512,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61512,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61514,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61514,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61514,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61516,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61516,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61516,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61517,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61517,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61517,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61518,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61518,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61518,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61519,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61519,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61519,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61520,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61520,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61520,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61521,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61521,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61521,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61522,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61522,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61522,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61524,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61524,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61524,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61526,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61526,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61526,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61530,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61530,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61530,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61531,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,61531,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61531,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61533,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61533,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61533,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61534,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61534,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61534,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61535,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61535,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61535,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61536,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61536,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61536,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61537,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61537,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61537,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61538,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61538,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61538,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61539,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61539,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61539,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61540,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61540,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61541,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61541,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61541,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61543,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61543,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61543,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61544,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61544,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61544,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61545,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61545,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61546,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61546,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61546,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61548,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61548,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61548,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61550,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61550,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61550,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61552,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61552,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61552,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61556,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61556,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61556,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61557,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61557,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61557,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61558,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61558,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61558,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61559,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61559,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61559,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61563,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61563,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61563,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61564,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61564,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61564,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61566,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61566,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61566,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61567,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61567,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61567,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61570,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61570,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61570,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61571,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61571,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61571,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61575,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61575,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61575,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61576,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61576,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61576,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61580,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61580,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61580,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61580,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61581,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61581,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61581,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61581,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61582,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61582,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61582,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61582,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61583,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61583,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61583,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61583,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61584,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61584,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61584,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61584,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61585,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61585,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61585,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61585,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61586,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61586,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61586,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61586,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61590,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61590,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61590,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61590,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61591,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61591,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61591,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61591,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61592,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61592,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61592,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61592,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61595,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61595,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61595,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61595,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61596,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61596,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61596,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61596,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61597,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61597,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61597,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61597,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61598,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61598,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61598,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61598,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61600,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61600,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61600,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61601,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61601,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61601,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61605,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61605,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61605,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61606,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61606,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61606,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61607,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61607,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61607,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61608,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61608,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61608,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61611,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61611,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61611,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61613,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61613,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61613,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61615,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61615,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,61615,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61615,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61616,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61616,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,61616,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61616,Skull Base Surgery (1-6 days; Level of Care thereafter),,,20000.0,20000.0,1
CPT,61618,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61618,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61618,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61619,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61619,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61619,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61623,HB ENDOVSC TEMP BALLN ART OCCLUSN,102328.0,66513.2,13270.0,14761.0,2
CPT,61623,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,61623,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,61623,Outpatient Surgical Group 6,102328.0,66513.2,22453.45,33334.94,50
CPT,61624,HB EMBOLIZATION CNS,73325.055,47661.284999999996,13270.0,14761.0,2
CPT,61624,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,61624,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61624,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61626,HB EMBOLIZATION EXTRACRANIAL,102328.0,66513.2,13270.0,14761.0,2
CPT,61626,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,61626,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,61626,Outpatient Surgical Group 7,102328.0,66513.2,27131.25,40279.73,50
CPT,61630,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61630,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61635,HB ANGIOPLASTY CRANIAL W STENT,36245.27,23559.43,13270.0,14761.0,2
CPT,61635,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61635,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61640,HB DIL CRANIAL VASOSPASM INIT,36245.3,23559.45,13270.0,14761.0,2
CPT,61640,Outpatient Grouper - Unlisted,36245.3,23559.45,13030.5,14136.81,24
CPT,61640,Outpatient Surgery Group 4 Global Rate,36245.3,23559.45,26623.0,28144.0,2
CPT,61641,HB DIL CRANIAL VASOSPASM ADDL,14498.1,9423.77,13270.0,14761.0,2
CPT,61641,Outpatient Grouper - Unlisted,14498.1,9423.77,13030.5,14136.81,24
CPT,61641,Outpatient Surgery Group 2 Global Rate,14498.1,9423.77,14322.0,15354.0,2
CPT,61642,Outpatient Grouper - Unlisted,28996.2,18847.53,13030.5,14136.81,24
CPT,61642,Outpatient Surgery Group 2 Global Rate,28996.2,18847.53,14322.0,15354.0,2
CPT,61645,HB PERQ ART M-THROMBECT &/NFS UNI,85460.7,55549.46,13270.0,14761.0,2
CPT,61645,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61645,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61650,HB EVASC PRLNG ADMN RX AGNT 1ST,151515.22,98484.89,13270.0,14761.0,2
CPT,61650,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61650,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,61650,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,61651,HB EVASC PRLNG ADMN RX AGNT ADD,144055.37,93635.99,13270.0,14761.0,2
CPT,61651,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61651,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,61651,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,61680,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61680,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61680,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61682,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61682,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61682,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61684,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61684,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61684,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,61686,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61686,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61686,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61690,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61690,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61690,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61692,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61692,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61692,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,61697,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61697,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61697,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61698,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61698,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61698,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61700,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61700,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61702,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61702,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61702,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,61703,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61703,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61703,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61705,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61705,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,61705,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61708,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61708,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61708,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61710,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61710,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61710,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61711,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61711,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61711,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,61720,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,61720,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61720,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61720,Pallidotomy,,,18000.0,18000.0,1
CPT,61735,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61735,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61735,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61736,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61736,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61736,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61737,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61737,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61737,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61750,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61750,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61750,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61751,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61751,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61751,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61760,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,61760,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61770,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,61770,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61770,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61781,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61781,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,61782,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61782,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,61783,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61783,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,61790,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,61790,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61790,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61791,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,61791,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61791,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61796,Gamma Knife,,,24420.0,24420.0,1
CPT,61796,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,61796,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,61796,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,61797,Gamma Knife,,,24420.0,24420.0,1
CPT,61797,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,61797,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61797,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,61798,Gamma Knife,,,24420.0,24420.0,1
CPT,61798,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,61798,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,61798,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,61799,Gamma Knife,,,24420.0,24420.0,1
CPT,61799,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,61799,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61799,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,61800,Gamma Knife,,,24420.0,24420.0,1
CPT,61800,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,61800,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,61800,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,61850,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61850,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61850,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61860,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61860,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,61860,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61863,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61863,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61863,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61864,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61864,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61864,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61867,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61867,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61867,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61868,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61868,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,61868,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61870,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,61880,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,61880,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,61880,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61885,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,61885,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,61885,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,61886,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,61886,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,61886,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,61888,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,61888,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,61888,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,61889,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,61889,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,61891,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,61891,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,61892,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,61892,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62000,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,62000,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62000,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62005,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62005,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62005,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62010,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62010,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62010,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62100,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62100,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62100,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62115,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62115,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62115,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62117,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62117,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62117,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,62120,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62120,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62121,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62121,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,62121,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62140,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62140,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62140,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62141,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62141,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62141,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62142,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62142,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62142,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62143,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62143,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62143,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62145,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62145,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62145,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62146,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62146,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62146,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62147,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62147,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62147,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62148,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62148,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62148,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62160,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62160,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62160,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62161,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62161,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,62161,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62162,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62162,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,62162,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62163,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,62164,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62164,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62164,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62165,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62165,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62165,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62180,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62180,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,62180,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62190,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62190,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,62190,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62192,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62192,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,62192,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62194,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62194,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,62194,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62200,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62200,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62200,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62201,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62201,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62201,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62220,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62220,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62223,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62223,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,62223,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62225,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62225,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,62225,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62230,HB MISCELLANEOUS PROCEDURE,33176.11,21564.47,13270.0,14761.0,2
CPT,62230,Outpatient Grouper - 5,25520.1,16588.06,25486.19,27649.53,24
CPT,62230,Outpatient Surgery Group 2 Global Rate,25520.1,16588.06,14322.0,15354.0,2
CPT,62230,Outpatient Surgical Group 2,25520.1,16588.06,12162.28,18056.43,50
CPT,62252,HB CSF SHUNT REPROGRAM,1436.665,933.835,373.44,14761.0,12
CPT,62252,OUTPATIENT SURGERY CPT GROUP 1,1249.27,812.03,6417.0,7038.0,2
CPT,62252,Outpatient Grouper - 0,1249.27,812.03,9059.94,9827.82,24
CPT,62252,Outpatient Surgical Group 1,1249.27,812.03,9088.3,13492.72,50
CPT,62256,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,62256,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62256,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62258,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,62258,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,62258,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62263,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62263,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62263,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62264,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62264,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62264,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62267,"HB PERC ASPIR, SPINAL DISC TISS DX",5952.47,3869.11,876.1,14761.0,10
CPT,62267,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,62267,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,62267,Outpatient Surgical Group 1,5952.47,3869.11,9088.3,13492.72,50
CPT,62268,HB MISCELLANEOUS PROCEDURE,6874.78,4468.61,1108.58,1274.87,8
CPT,62268,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62268,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62268,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62269,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62269,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,62269,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62270,HB PUNCTURE L-SPINE DIAG,6322.95,4109.92,862.32,14761.0,20
CPT,62270,OUTPATIENT SURGERY CPT GROUP 1,5498.21,3573.84,6417.0,7038.0,2
CPT,62270,Outpatient Grouper - 1,5498.21,3573.84,10495.38,11385.92,24
CPT,62270,Outpatient Surgical Group 1,5498.21,3573.84,9088.3,13492.72,50
CPT,62272,HB DRAINAGE CSF FLUID,4385.125,2850.33,862.32,14761.0,10
CPT,62272,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,62272,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,62272,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,62273,HB INJ EPIDURAL OR BLOOD PATCH,7905.994999999999,5138.9,862.32,14761.0,10
CPT,62273,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62273,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62273,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62280,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62280,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62280,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62281,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62281,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62281,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62282,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,62282,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62282,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62284,HB MYELOGRAM INJ,5358.68,3483.14,13270.0,14761.0,2
CPT,62284,Outpatient Grouper - 0,5358.68,3483.14,9059.94,9827.82,24
CPT,62284,Outpatient Surgery Group 2 Global Rate,5358.68,3483.14,14322.0,15354.0,2
CPT,62287,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,62287,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,62287,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,62290,HB INJ DISCOGRAM L-SPINE,6510.31,4231.7,,,0
CPT,62290,Outpatient Grouper - 0,6510.31,4231.7,9059.94,9827.82,24
CPT,62290,Outpatient Surgery Group 2 Global Rate,6510.31,4231.7,14322.0,15354.0,2
CPT,62291,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62291,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62292,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,62292,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,62292,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62294,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,62294,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,62294,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,62302,HB MYELOGRAM C-SPINE VIA LP W S&I,13069.6,8495.24,983.77,14761.0,10
CPT,62302,Outpatient Grouper - 1,13069.6,8495.24,10495.38,11385.92,24
CPT,62302,Outpatient Surgery Group 2 Global Rate,13069.6,8495.24,14322.0,15354.0,2
CPT,62302,Outpatient Surgical Group 1,13069.6,8495.24,9088.3,13492.72,50
CPT,62303,HB MYELOGRAM T-SPINE VIA LP W S&I,13069.6,8495.24,983.77,14761.0,10
CPT,62303,Outpatient Grouper - 1,13069.6,8495.24,10495.38,11385.92,24
CPT,62303,Outpatient Surgery Group 2 Global Rate,13069.6,8495.24,14322.0,15354.0,2
CPT,62303,Outpatient Surgical Group 1,13069.6,8495.24,9088.3,13492.72,50
CPT,62304,HB MYELOGRAM L-SPINE VIA LP W S&I,13069.6,8495.24,983.77,14761.0,10
CPT,62304,Outpatient Grouper - 1,13069.6,8495.24,10495.38,11385.92,24
CPT,62304,Outpatient Surgery Group 2 Global Rate,13069.6,8495.24,14322.0,15354.0,2
CPT,62304,Outpatient Surgical Group 1,13069.6,8495.24,9088.3,13492.72,50
CPT,62305,HB MYELOGRAM 2/MORE REGN VIA LP W S&I,13069.6,8495.24,983.77,14761.0,10
CPT,62305,Outpatient Grouper - 1,13069.6,8495.24,10495.38,11385.92,24
CPT,62305,Outpatient Surgery Group 2 Global Rate,13069.6,8495.24,14322.0,15354.0,2
CPT,62305,Outpatient Surgical Group 1,13069.6,8495.24,9088.3,13492.72,50
CPT,62320,HB INJ EPIDURAL CERV/THOR,6597.67,4288.49,13270.0,14761.0,2
CPT,62320,OUTPATIENT SURGERY CPT GROUP 1,6597.67,4288.49,6417.0,7038.0,2
CPT,62320,Outpatient Grouper - 1,6597.67,4288.49,10495.38,11385.92,24
CPT,62320,Outpatient Surgical Group 1,6597.67,4288.49,9088.3,13492.72,50
CPT,62321,HB INJ INTERLAMINAR CERV/THOR,12575.5,8174.08,862.32,14761.0,10
CPT,62321,OUTPATIENT SURGERY CPT GROUP 1,12575.5,8174.08,6417.0,7038.0,2
CPT,62321,Outpatient Grouper - 1,12575.5,8174.08,10495.38,11385.92,24
CPT,62321,Outpatient Surgical Group 1,12575.5,8174.08,9088.3,13492.72,50
CPT,62322,HB INJ EPIDURAL L/S-SPINE,6597.67,4288.49,1108.58,1274.87,8
CPT,62322,OUTPATIENT SURGERY CPT GROUP 1,6597.67,4288.49,6417.0,7038.0,2
CPT,62322,Outpatient Grouper - 1,6597.67,4288.49,10495.38,11385.92,24
CPT,62322,Outpatient Surgical Group 1,6597.67,4288.49,9088.3,13492.72,50
CPT,62323,HB INJ INTERLAMINAR LUMBAR/SACRAL,12575.5,8174.08,862.32,14761.0,10
CPT,62323,OUTPATIENT SURGERY CPT GROUP 1,12575.5,8174.08,6417.0,7038.0,2
CPT,62323,Outpatient Grouper - 1,12575.5,8174.08,10495.38,11385.92,24
CPT,62323,Outpatient Surgical Group 1,12575.5,8174.08,9088.3,13492.72,50
CPT,62324,HB EPIDURAL INJ CATH CERV/THOR,8937.21,5809.19,13270.0,14761.0,4
CPT,62324,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62324,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62324,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62325,HB INJ INTERLAMINAR CERV/THOR W/ INDWELL CATH,6874.78,4468.61,13270.0,14761.0,2
CPT,62325,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62325,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62325,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62326,HB IR INJ EPIDURAL LS SPINE,6874.78,4468.61,13270.0,14761.0,2
CPT,62326,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62326,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62326,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62327,HB INJ INTERLAMINAR LUMBAR/SACRAL W/ INDWELL CATH,6874.78,4468.61,13270.0,14761.0,2
CPT,62327,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,62327,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,62327,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,62328,HB DIAG LUMB SPINAL PUNCT W/ FLUORO/CT,8571.44,5571.4349999999995,862.32,14761.0,10
CPT,62328,OUTPATIENT SURGERY CPT GROUP 1,7453.43,4844.73,6417.0,7038.0,2
CPT,62328,Outpatient Grouper - 1,7453.43,4844.73,10495.38,11385.92,24
CPT,62328,Outpatient Surgical Group 1,7453.43,4844.73,9088.3,13492.72,50
CPT,62329,HB THERA LUMB SPINAL PUNCT DRN CSF W/ FLUORO/CT,5768.37,3749.44,13270.0,14761.0,2
CPT,62329,OUTPATIENT SURGERY CPT GROUP 1,5768.37,3749.44,6417.0,7038.0,2
CPT,62329,Outpatient Grouper - 1,5768.37,3749.44,10495.38,11385.92,24
CPT,62329,Outpatient Surgical Group 1,5768.37,3749.44,9088.3,13492.72,50
CPT,62350,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,62350,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62350,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62351,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,62351,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62351,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,62355,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,62355,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62355,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62360,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,62360,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62360,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62361,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,62361,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62361,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62362,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,62362,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62362,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62365,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,62365,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62365,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,62367,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62367,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62367,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62368,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62368,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62368,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,62369,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62369,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62369,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,62370,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,62370,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62370,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,62380,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,62380,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,62380,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63001,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63001,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63001,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63003,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63003,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63003,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63005,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63005,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63005,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63011,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63011,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63011,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63012,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63012,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63012,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63015,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63015,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63015,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63016,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63016,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63016,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63017,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63017,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63017,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63020,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63020,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63020,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63030,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63030,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63030,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63035,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63035,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63035,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63040,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63040,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63040,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63042,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63042,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63042,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63043,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,63043,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63043,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63044,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,63044,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63044,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63045,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63045,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63045,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63046,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63046,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63046,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63047,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63047,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63047,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63048,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63048,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63048,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63050,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63050,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63051,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63051,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63052,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63052,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63052,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,63053,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63053,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63053,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,63055,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63055,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63055,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63056,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63056,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63056,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63057,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63057,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63057,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63064,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63064,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63064,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63066,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63066,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63066,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,63075,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63075,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63075,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63076,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,63076,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63076,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63077,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63077,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63077,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63078,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63078,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63078,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63081,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63081,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63081,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63082,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63082,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63082,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63085,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63085,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63085,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63086,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63086,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63086,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63087,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63087,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63087,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,63088,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63088,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63088,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63090,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63090,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63090,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63091,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63091,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63091,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63101,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63101,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63101,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63102,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63102,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63102,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63103,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63103,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63103,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63170,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63170,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63170,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63172,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63172,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63172,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63173,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63173,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63173,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63180,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63182,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,63185,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63185,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63185,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63190,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63190,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63190,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63191,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63191,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63191,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63194,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63195,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63196,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63197,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63197,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63197,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63198,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63199,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63200,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63200,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63200,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63250,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63250,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63250,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,63251,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63251,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63251,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,63252,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63252,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63252,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,63265,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63265,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63265,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63266,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63266,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63266,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63267,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,63267,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63267,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63268,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63268,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63268,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63270,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63270,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63270,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63271,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63271,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63271,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63272,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63272,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63272,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63273,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63273,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63273,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63275,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63275,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63275,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63276,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63276,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63276,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63277,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63277,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63277,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63278,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63278,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63278,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63280,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63280,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63280,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63281,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63281,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63281,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63282,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63282,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63282,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63283,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63283,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63283,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63285,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63285,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63285,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,63286,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63286,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63286,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,63287,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63287,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63287,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,63290,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63290,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63290,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,63295,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63295,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63300,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63300,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63301,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63301,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63301,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63302,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63302,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63302,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63303,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63303,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63303,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63304,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63304,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63304,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63305,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63305,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63305,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,63306,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63306,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63306,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,63307,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63307,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63307,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63308,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63308,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63308,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,63600,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63600,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63610,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,63610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63620,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63620,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,63620,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,63621,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,63621,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,63621,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,63650,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63650,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63650,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63655,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,63655,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63655,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,63661,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,63661,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63662,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,63662,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63662,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63663,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63663,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63663,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63664,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,63664,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63664,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63685,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,63685,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63685,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63688,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,63688,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,63688,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63700,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63700,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63700,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63702,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63702,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63702,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63704,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63704,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63704,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63706,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63706,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63706,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,63707,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63707,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63707,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63709,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63709,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63709,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63710,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63710,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63710,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63740,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,63740,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,63740,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,63741,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,63741,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,63741,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,63744,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,63744,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,63744,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,63746,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,63746,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,63746,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64400,"HB INJECT NERV BLCK,TRIGEMINAL EACH BRANCH",2100.52,1365.34,367.57,422.7,8
CPT,64400,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64400,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64405,HB INJ ANESTH/STEROID GRTR OCCPTL NRV,2100.52,1365.34,367.57,422.7,16
CPT,64405,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64405,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64405,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64408,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64408,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64408,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64415,HB INJ ANES/STER BRACH PLEXUS W/ IMG,12240.564999999999,7956.365,1108.58,14761.0,10
CPT,64415,OUTPATIENT SURGERY CPT GROUP 1,10644.0,6918.6,6417.0,7038.0,2
CPT,64415,Outpatient Grouper - 1,10644.0,6918.6,10495.38,11385.92,24
CPT,64415,Outpatient Surgical Group 1,10644.0,6918.6,9088.3,13492.72,50
CPT,64416,HB INJ ANES/STER BRACH PLEX CONT INF W/ IMG,12108.445,7870.49,1108.58,14761.0,10
CPT,64416,OUTPATIENT SURGERY CPT GROUP 1,10528.5,6843.53,6417.0,7038.0,2
CPT,64416,Outpatient Grouper - 1,10528.5,6843.53,10495.38,11385.92,24
CPT,64416,Outpatient Surgical Group 1,10528.5,6843.53,9088.3,13492.72,50
CPT,64417,HB INJ ANESTH/STER AXILLARY NRV W/ IMG,12108.439999999999,7870.49,1108.58,14761.0,18
CPT,64417,OUTPATIENT SURGERY CPT GROUP 1,10528.5,6843.53,6417.0,7038.0,2
CPT,64417,Outpatient Grouper - 1,10528.5,6843.53,10495.38,11385.92,24
CPT,64417,Outpatient Surgical Group 1,10528.5,6843.53,9088.3,13492.72,50
CPT,64418,HB INJ ANESTH/STEROID SUPRASCAPULAR NERVE,6322.95,4109.92,862.32,14761.0,10
CPT,64418,OUTPATIENT SURGERY CPT GROUP 1,5498.21,3573.84,6417.0,7038.0,2
CPT,64418,Outpatient Grouper - 1,5498.21,3573.84,10495.38,11385.92,24
CPT,64418,Outpatient Surgical Group 1,5498.21,3573.84,9088.3,13492.72,50
CPT,64420,HB INJ ANES/STER INTRCSTL NRV SINGLE LVL,4385.13,2850.335,862.32,14761.0,10
CPT,64420,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64420,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64421,HB INJ ANES/STER INTECSTL NRV EA ADDL LVL,6874.78,4468.61,13270.0,14761.0,2
CPT,64421,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64421,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64425,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64425,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64425,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64430,HB INJ ANESTH/STEROID PUDENDAL NERVE,7905.985000000001,5138.889999999999,1108.58,14761.0,10
CPT,64430,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64430,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64430,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64435,HB INJ ANES/STEROID PARACERVICAL BLOCK,3813.16,2478.55,862.32,991.67,8
CPT,64435,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64435,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64435,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64445,HB INJ ANES/STER SCIATIC NRV W/ IMG,10824.84,7036.15,862.32,14761.0,10
CPT,64445,OUTPATIENT SURGERY CPT GROUP 1,9412.9,6118.39,6417.0,7038.0,2
CPT,64445,Outpatient Grouper - 1,9412.9,6118.39,10495.38,11385.92,24
CPT,64445,Outpatient Surgical Group 0,9412.9,6118.39,2806.68,4166.87,50
CPT,64446,HB INJ ANES/STER SCIATIC CONT INF W/ IMG,12107.810000000001,7870.08,1108.58,14761.0,10
CPT,64446,OUTPATIENT SURGERY CPT GROUP 1,10528.5,6843.53,6417.0,7038.0,2
CPT,64446,Outpatient Grouper - 1,10528.5,6843.53,10495.38,11385.92,24
CPT,64446,Outpatient Surgical Group 1,10528.5,6843.53,9088.3,13492.72,50
CPT,64447,HB INJ ANES/STER FEM NRV W/ IMG,10675.195,6938.88,862.32,14761.0,18
CPT,64447,OUTPATIENT SURGERY CPT GROUP 1,9282.78,6033.81,6417.0,7038.0,2
CPT,64447,Outpatient Grouper - 1,9282.78,6033.81,10495.38,11385.92,24
CPT,64447,Outpatient Surgical Group 1,9282.78,6033.81,9088.3,13492.72,50
CPT,64448,HB INJ ANES/STER FEM NRV CONT INF CATH W/ IMG,12108.435000000001,7870.485000000001,1108.58,14761.0,12
CPT,64448,OUTPATIENT SURGERY CPT GROUP 1,10528.5,6843.53,6417.0,7038.0,2
CPT,64448,Outpatient Grouper - 1,10528.5,6843.53,10495.38,11385.92,24
CPT,64448,Outpatient Surgical Group 1,10528.5,6843.53,9088.3,13492.72,50
CPT,64449,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64449,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64449,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64450,HB INJ ANES/STEROID PERIPHERAL NERVE,5153.27,3349.63,862.32,14761.0,20
CPT,64450,OUTPATIENT SURGERY CPT GROUP 1,4481.1,2912.72,6417.0,7038.0,2
CPT,64450,Outpatient Grouper - 1,4481.1,2912.72,10495.38,11385.92,24
CPT,64450,Outpatient Surgical Group 1,4481.1,2912.72,9088.3,13492.72,50
CPT,64451,HB INJ ANESTHETIC/STEROID SI JOINT W/ IMG,6322.95,4109.92,862.32,14761.0,10
CPT,64451,OUTPATIENT SURGERY CPT GROUP 1,5498.21,3573.84,6417.0,7038.0,2
CPT,64451,Outpatient Grouper - 1,5498.21,3573.84,10495.38,11385.92,24
CPT,64451,Outpatient Surgical Group 1,5498.21,3573.84,9088.3,13492.72,50
CPT,64454,OUTPATIENT SURGERY CPT GROUP 1,5498.21,3573.84,6417.0,7038.0,2
CPT,64454,Outpatient Grouper - 1,5498.21,3573.84,10495.38,11385.92,24
CPT,64454,Outpatient Surgical Group 0,5498.21,3573.84,2806.68,4166.87,50
CPT,64455,"HB N BLOCK INJ, PLANTAR DIGIT",2100.52,1365.34,367.57,422.7,8
CPT,64455,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64455,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64455,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64461,HB PVB THORACIC SINGLE INJ SITE,3813.16,2478.55,13270.0,14761.0,2
CPT,64461,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64461,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64461,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64462,HB PVB THORACIC 2ND+ INJ SITE,3995.74,2597.23,13270.0,14761.0,2
CPT,64462,OUTPATIENT SURGERY CPT GROUP 1,3995.74,2597.23,6417.0,7038.0,2
CPT,64462,Outpatient Grouper - 0,3995.74,2597.23,9059.94,9827.82,24
CPT,64462,Outpatient Surgical Group 1,3995.74,2597.23,9088.3,13492.72,50
CPT,64463,HB PVB THORACIC CONT INFUSION,3813.16,2478.55,13270.0,14761.0,2
CPT,64463,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64463,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64463,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64479,HB INJ C/T-SPINE TRNSFORAM INI- IMG GUIDE INCL,8937.19,5809.17,13270.0,14761.0,2
CPT,64479,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64479,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64479,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64480,OUTPATIENT SURGERY CPT GROUP 1,4310.32,2801.71,6417.0,7038.0,2
CPT,64480,Outpatient Grouper - 0,4310.32,2801.71,9059.94,9827.82,24
CPT,64480,Outpatient Surgical Group 1,4310.32,2801.71,9088.3,13492.72,50
CPT,64483,HB INJ L/S-SPINE TRNSFORAM INI-IMG GUIDE INCL,7905.985000000001,5138.889999999999,1108.58,14761.0,10
CPT,64483,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64483,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64483,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64484,HB INJ L/S-SPINE TRNSFORAM ADL-IMG GUIDE INCL,4169.09,2709.91,13270.0,14761.0,2
CPT,64484,OUTPATIENT SURGERY CPT GROUP 1,4169.09,2709.91,6417.0,7038.0,2
CPT,64484,Outpatient Grouper - 0,4169.09,2709.91,9059.94,9827.82,24
CPT,64484,Outpatient Surgical Group 1,4169.09,2709.91,9088.3,13492.72,50
CPT,64486,HB TAP BLOCK BY INJECTION UNILATERAL,5761.46,3744.95,13270.0,14761.0,2
CPT,64486,OUTPATIENT SURGERY CPT GROUP 1,5761.46,3744.95,6417.0,7038.0,2
CPT,64486,Outpatient Grouper - 0,5761.46,3744.95,9059.94,9827.82,24
CPT,64486,Outpatient Surgical Group 1,5761.46,3744.95,9088.3,13492.72,50
CPT,64487,HB TAP BLOCK BY CONTINUOUS INFUSION UNILATERAL,5761.46,3744.95,13270.0,14761.0,2
CPT,64487,OUTPATIENT SURGERY CPT GROUP 1,5761.46,3744.95,6417.0,7038.0,2
CPT,64487,Outpatient Grouper - 0,5761.46,3744.95,9059.94,9827.82,24
CPT,64487,Outpatient Surgical Group 1,5761.46,3744.95,9088.3,13492.72,50
CPT,64488,HB TAP BLOCK BY INJECTION BILATERAL,5761.46,3744.95,13270.0,14761.0,2
CPT,64488,OUTPATIENT SURGERY CPT GROUP 1,5761.46,3744.95,6417.0,7038.0,2
CPT,64488,Outpatient Grouper - 0,5761.46,3744.95,9059.94,9827.82,24
CPT,64488,Outpatient Surgical Group 1,5761.46,3744.95,9088.3,13492.72,50
CPT,64489,HB TAP BLOCK BY CONTINUOUS INFUSION BILATERAL,5761.46,3744.95,13270.0,14761.0,2
CPT,64489,OUTPATIENT SURGERY CPT GROUP 1,5761.46,3744.95,6417.0,7038.0,2
CPT,64489,Outpatient Grouper - 0,5761.46,3744.95,9059.94,9827.82,24
CPT,64489,Outpatient Surgical Group 1,5761.46,3744.95,9088.3,13492.72,50
CPT,64490,HB INJ C/T-SPINE FACET FRST,6874.78,4468.61,13270.0,14761.0,2
CPT,64490,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64490,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64490,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64491,OUTPATIENT SURGERY CPT GROUP 1,3870.35,2515.73,6417.0,7038.0,2
CPT,64491,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,64491,Outpatient Surgical Group 1,3870.35,2515.73,9088.3,13492.72,50
CPT,64492,OUTPATIENT SURGERY CPT GROUP 1,3870.35,2515.73,6417.0,7038.0,2
CPT,64492,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,64492,Outpatient Surgical Group 1,3870.35,2515.73,9088.3,13492.72,50
CPT,64493,HB INJ L/S-SPINE FACET FIRST,6874.78,4468.61,1108.58,14761.0,10
CPT,64493,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64493,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64493,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64494,HB INJ L/S-SPINE FACET SECOND,3870.35,2515.73,,,0
CPT,64494,OUTPATIENT SURGERY CPT GROUP 1,3870.35,2515.73,6417.0,7038.0,2
CPT,64494,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,64494,Outpatient Surgical Group 1,3870.35,2515.73,9088.3,13492.72,50
CPT,64495,OUTPATIENT SURGERY CPT GROUP 1,3870.35,2515.73,6417.0,7038.0,2
CPT,64495,Outpatient Grouper - 0,3870.35,2515.73,9059.94,9827.82,24
CPT,64495,Outpatient Surgical Group 1,3870.35,2515.73,9088.3,13492.72,50
CPT,64505,HB INJ ANES SPHENOPALATE GANG,2415.58,1570.13,367.57,14761.0,10
CPT,64505,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64505,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64505,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64510,HB INJ C-SPINE STELLATE GANGLN,6874.78,4468.61,1108.58,14761.0,10
CPT,64510,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64510,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64517,HB INJ SUP HYPOGASTRIC PLXUS,6874.78,4468.61,13270.0,14761.0,2
CPT,64517,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64517,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64517,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64520,HB INJ T/L-SPINE SYMPATHETIC,6874.78,4468.61,13270.0,14761.0,2
CPT,64520,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64520,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64530,HB CELIAC PLEXUS INJ WO/W IMAGE,6874.78,4468.61,1108.58,14761.0,10
CPT,64530,OUTPATIENT SURGERY CPT GROUP 1,6874.78,4468.61,6417.0,7038.0,2
CPT,64530,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64530,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64553,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64553,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64553,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64555,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64555,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64555,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,64561,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64561,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64561,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,64566,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64566,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64566,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,64568,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,64568,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64568,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64569,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64569,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64569,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64570,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64570,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64570,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64575,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64575,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,64575,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64580,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64580,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,64580,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64581,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,64581,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64581,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,64582,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,64582,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64582,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64583,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,64583,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64583,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64584,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,64584,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64584,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,64585,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64585,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64585,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64590,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
CPT,64590,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64590,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64595,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64595,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64595,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64596,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,64596,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,64597,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64597,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,64598,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64598,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,64600,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,64600,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64605,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64605,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64605,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64610,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64610,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64611,HB CHEMODENERV SALIV GLANDS,2100.52,1365.34,367.57,422.7,8
CPT,64611,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64611,Outpatient Surgery Group 2 Global Rate,2100.52,1365.34,14322.0,15354.0,2
CPT,64611,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64612,HB CHEMODENERVATION;FACIAL NERVE,2100.52,1365.34,367.57,422.7,8
CPT,64612,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64612,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64615,HB ABN CHEMODNERV FACIAL/TRIGEM/CERV MUSC MIG,2100.52,1365.34,367.57,422.7,8
CPT,64615,HB CHEMODENERV MUSC MIGRAINE,2100.52,1365.34,367.57,422.7,16
CPT,64615,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64615,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64615,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,64616,"HB BOTOX, CERVICAL SPINAL MUSCLES",2100.52,1365.34,367.57,422.7,8
CPT,64616,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64616,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64616,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64617,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,64617,Outpatient Grouper - 1,2100.52,1365.34,10495.38,11385.92,24
CPT,64617,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64620,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,64620,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64624,Outpatient Grouper - 3,13722.6,8919.69,14341.63,15558.59,24
CPT,64624,Outpatient Surgical Group 0,13722.6,8919.69,2806.68,4166.87,50
CPT,64625,Outpatient Grouper - 3,13722.6,8919.69,14341.63,15558.59,24
CPT,64625,Outpatient Surgery Group 2 Global Rate,13722.6,8919.69,14322.0,15354.0,2
CPT,64625,Outpatient Surgical Group 3,13722.6,8919.69,13899.75,20635.92,50
CPT,64628,"HB INTRAOSS DES LUMB/SAC W/FLUORO GDN, 1ST 2",98487.4,64016.81,16021.61,18424.85,8
CPT,64628,Outpatient Grouper - 6,98487.4,64016.81,28632.25,34209.93,24
CPT,64628,Outpatient Surgery Group 2 Global Rate,98487.4,64016.81,14322.0,15354.0,2
CPT,64628,Outpatient Surgical Group 0,98487.4,64016.81,2806.68,4166.87,50
CPT,64629,"HB INTRAOSS DES LUMB/SAC W/FLUORO GDN, EA ADDL",48362.0,31435.3,,,0
CPT,64629,Outpatient Grouper - 0,48362.0,31435.3,9059.94,9827.82,24
CPT,64629,Outpatient Surgery Group 2 Global Rate,48362.0,31435.3,14322.0,15354.0,2
CPT,64629,Outpatient Surgical Group 0,48362.0,31435.3,2806.68,4166.87,50
CPT,64630,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,64630,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64632,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64632,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64632,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64633,Outpatient Grouper - 3,13722.6,8919.69,14341.63,15558.59,24
CPT,64633,Outpatient Surgical Group 3,13722.6,8919.69,13899.75,20635.92,50
CPT,64634,OUTPATIENT SURGERY CPT GROUP 1,4140.95,2691.62,6417.0,7038.0,2
CPT,64634,Outpatient Grouper - 0,4140.95,2691.62,9059.94,9827.82,24
CPT,64635,OUTPATIENT SURGERY CPT GROUP 1,13722.6,8919.69,6417.0,7038.0,2
CPT,64635,Outpatient Grouper - 3,13722.6,8919.69,14341.63,15558.59,24
CPT,64635,Outpatient Surgical Group 3,13722.6,8919.69,13899.75,20635.92,50
CPT,64636,OUTPATIENT SURGERY CPT GROUP 1,4140.95,2691.62,6417.0,7038.0,2
CPT,64636,Outpatient Grouper - 0,4140.95,2691.62,9059.94,9827.82,24
CPT,64640,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64640,Outpatient Surgical Group 1,6874.78,4468.61,9088.3,13492.72,50
CPT,64642,HB CHEMODENERV 1 EXTRM 1-4 MUS,3813.16,2478.55,862.32,991.67,8
CPT,64642,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64642,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64643,HB CHEMODENERV 1 EXTRM 1-4 EA,1281.97,833.28,,,0
CPT,64643,Outpatient Grouper - 0,1281.97,833.28,9059.94,9827.82,24
CPT,64644,HB CHEMODENERV 1 EXTRM 5/>MUS,3813.16,2478.55,862.32,991.67,8
CPT,64644,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64644,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64645,HB CHEMODENERV 1 EXTRM 5/> EA,1281.97,833.28,,,0
CPT,64645,OUTPATIENT SURGERY CPT GROUP 1,1281.97,833.28,6417.0,7038.0,2
CPT,64645,Outpatient Grouper - 0,1281.97,833.28,9059.94,9827.82,24
CPT,64646,HB CHEMODENERV TRUNK MUSC 1-5,3813.16,2478.55,862.32,991.67,8
CPT,64646,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64646,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64646,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64647,HB CHEMODENERV TRUNK MUSC 6/>,3813.16,2478.55,862.32,991.67,8
CPT,64647,OUTPATIENT SURGERY CPT GROUP 1,3813.16,2478.55,6417.0,7038.0,2
CPT,64647,Outpatient Grouper - 1,3813.16,2478.55,10495.38,11385.92,24
CPT,64647,Outpatient Surgical Group 1,3813.16,2478.55,9088.3,13492.72,50
CPT,64650,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64650,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64653,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64653,Outpatient Surgical Group 0,2100.52,1365.34,2806.68,4166.87,50
CPT,64680,HB DESTR W NEURLYTC CELC PLEXS,6874.78,4468.61,13270.0,14761.0,2
CPT,64680,Outpatient Grouper - 1,6874.78,4468.61,10495.38,11385.92,24
CPT,64680,Outpatient Surgical Group 2,6874.78,4468.61,12162.28,18056.43,50
CPT,64681,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,64681,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64702,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64702,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64704,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64704,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64708,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64708,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64708,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64712,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64712,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64712,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64713,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64713,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64713,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64714,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64714,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64714,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64716,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64716,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64716,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64718,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64718,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64718,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64719,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64719,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64719,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64721,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64721,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64721,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64722,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64722,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64726,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64726,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64726,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64727,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64727,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64727,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64732,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64732,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64734,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64734,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64736,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64736,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64736,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64738,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64738,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64738,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64740,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64740,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64742,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64742,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64742,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64744,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64744,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64744,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64746,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64746,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64746,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64755,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64755,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,64755,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64760,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64760,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,64760,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64763,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64763,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64763,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64766,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64766,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,64766,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64771,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64771,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64771,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64772,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64772,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64772,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64774,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64774,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64774,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64776,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64776,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64776,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64778,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64778,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64778,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64782,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64782,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64782,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64783,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64783,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64784,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64784,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64784,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64786,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64786,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64786,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64787,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64787,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64787,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64788,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64788,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64788,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64790,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64790,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64790,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64792,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64792,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64792,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64795,OUTPATIENT SURGERY CPT GROUP 1,13722.6,8919.69,6417.0,7038.0,2
CPT,64795,Outpatient Grouper - 3,13722.6,8919.69,14341.63,15558.59,24
CPT,64795,Outpatient Surgical Group 2,13722.6,8919.69,12162.28,18056.43,50
CPT,64802,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64802,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64802,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64804,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,64804,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64804,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64809,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64809,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,64809,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64818,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64818,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,64818,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,64820,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64820,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64821,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64821,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64822,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64822,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64823,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64823,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64831,Outpatient Grouper - 4,13722.6,8919.69,19724.25,21397.98,24
CPT,64831,Outpatient Surgery Group 3 Global Rate,13722.6,8919.69,22055.0,22787.0,2
CPT,64831,Outpatient Surgical Group 4,13722.6,8919.69,17187.58,25517.11,50
CPT,64832,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64832,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64834,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64834,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64834,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64835,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64835,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64835,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64836,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64836,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64836,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64837,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64837,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64837,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64840,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64840,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64840,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64856,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64856,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64856,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64857,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64857,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64857,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64858,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64858,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64858,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64859,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64859,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64859,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64861,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,64861,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64861,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64862,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64862,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64862,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64864,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64864,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64864,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64865,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64865,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,64865,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64866,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64866,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,64866,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64868,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,64868,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,64868,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64872,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64872,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64874,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64874,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64874,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64876,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64876,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64876,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64885,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64885,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,64885,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64886,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64886,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,64886,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64890,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64890,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64890,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64891,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64891,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64891,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64892,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64892,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64892,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64893,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64893,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64893,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64895,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64895,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64895,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64896,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64896,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64896,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64897,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64897,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64897,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64898,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64898,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64898,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,64901,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64901,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64901,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64902,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64902,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64902,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64905,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64905,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64905,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,64907,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,64907,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64907,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,64910,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64910,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64911,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64911,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,64911,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64912,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,64912,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64912,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64913,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,64913,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,64913,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,64999,HB MISCELLANEOUS PROCEDURE,2415.58,1570.13,367.57,14761.0,12
CPT,64999,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,64999,Outpatient Surgical Group 1,2100.52,1365.34,9088.3,13492.72,50
CPT,65091,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65091,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65091,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65093,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65093,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65093,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65101,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65101,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65101,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65103,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65103,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65103,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65105,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65105,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65105,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65110,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65110,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,65110,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,65112,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65112,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65112,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65114,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65114,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65114,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65125,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65125,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65125,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65130,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65130,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65130,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65135,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65135,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65135,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65140,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65140,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65140,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65150,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65150,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65150,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65155,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65155,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65155,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65175,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65175,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65175,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65205,HB REMOVE FB CONJUNCT SUPERFIC,1074.29,698.29,160.5,184.58,8
CPT,65205,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,65205,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,65205,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,65210,HB REM FB CONJUNCTIVA; EMBEDDED,1434.3,932.29,496.88,571.41,8
CPT,65210,Outpatient Grouper - 0,1434.3,932.29,9059.94,9827.82,24
CPT,65210,Outpatient Surgical Group 0,1434.3,932.29,2806.68,4166.87,50
CPT,65220,"HB REM FB,EXTEYE;CRNL,SLT LAMP",1434.3,932.29,496.88,571.41,8
CPT,65220,Outpatient Grouper - 0,1434.3,932.29,9059.94,9827.82,24
CPT,65220,Outpatient Surgical Group 0,1434.3,932.29,2806.68,4166.87,50
CPT,65222,HB REMOVAL CORNEAL FB W/SLIT LAMP,1074.29,698.29,160.5,184.58,8
CPT,65222,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,65222,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,65222,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,65235,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65235,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65235,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65260,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,65260,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65260,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65265,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65265,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65265,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65270,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65270,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65270,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65272,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65272,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65272,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65273,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,65273,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65275,Outpatient Grouper - 4,10519.4,6837.61,19724.25,21397.98,24
CPT,65275,Outpatient Surgery Group 4 Global Rate,10519.4,6837.61,26623.0,28144.0,2
CPT,65275,Outpatient Surgical Group 4,10519.4,6837.61,17187.58,25517.11,50
CPT,65280,Outpatient Grouper - 3,12868.7,8364.66,14341.63,15558.59,24
CPT,65280,Outpatient Surgery Group 4 Global Rate,12868.7,8364.66,26623.0,28144.0,2
CPT,65280,Outpatient Surgical Group 4,12868.7,8364.66,17187.58,25517.11,50
CPT,65285,Outpatient Grouper - 3,12868.7,8364.66,14341.63,15558.59,24
CPT,65285,Outpatient Surgery Group 4 Global Rate,12868.7,8364.66,26623.0,28144.0,2
CPT,65285,Outpatient Surgical Group 4,12868.7,8364.66,17187.58,25517.11,50
CPT,65286,OUTPATIENT SURGERY CPT GROUP 1,9781.09,6357.71,6417.0,7038.0,2
CPT,65286,Outpatient Grouper - 2,9781.09,6357.71,13036.88,14143.2,24
CPT,65286,Outpatient Surgical Group 1,9781.09,6357.71,9088.3,13492.72,50
CPT,65290,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65290,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65290,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65400,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,65400,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65410,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,65410,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65410,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65420,Outpatient Grouper - 3,9460.09,6149.06,14341.63,15558.59,24
CPT,65420,Outpatient Surgery Group 2 Global Rate,9460.09,6149.06,14322.0,15354.0,2
CPT,65420,Outpatient Surgical Group 2,9460.09,6149.06,12162.28,18056.43,50
CPT,65426,Outpatient Grouper - 3,9460.09,6149.06,14341.63,15558.59,24
CPT,65426,Outpatient Surgery Group 5 Global Rate,9460.09,6149.06,32992.0,34883.0,2
CPT,65426,Outpatient Surgical Group 5,9460.09,6149.06,19539.84,29009.34,50
CPT,65430,Outpatient Grouper - 0,739.73,480.82,9059.94,9827.82,24
CPT,65430,Outpatient Surgical Group 0,739.73,480.82,2806.68,4166.87,50
CPT,65435,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65435,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,65435,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65436,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65436,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65436,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65450,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,65450,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65600,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65710,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65710,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65710,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65730,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65730,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65730,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65750,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65750,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65750,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65755,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65755,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65755,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65756,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65756,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65756,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,65757,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65757,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,65757,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65760,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65760,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65760,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65765,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65765,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65765,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65767,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65767,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65767,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65770,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,65770,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65770,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65771,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65771,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65771,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65772,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65772,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,65772,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65775,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65775,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65775,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65778,OUTPATIENT SURGERY CPT GROUP 1,4132.95,2686.42,6417.0,7038.0,2
CPT,65778,Outpatient Grouper - 2,4132.95,2686.42,13036.88,14143.2,24
CPT,65778,Outpatient Surgical Group 0,4132.95,2686.42,2806.68,4166.87,50
CPT,65779,OUTPATIENT SURGERY CPT GROUP 1,10519.4,6837.61,6417.0,7038.0,2
CPT,65779,Outpatient Grouper - 4,10519.4,6837.61,19724.25,21397.98,24
CPT,65779,Outpatient Surgical Group 0,10519.4,6837.61,2806.68,4166.87,50
CPT,65780,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65780,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65780,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65781,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65781,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65781,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65782,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,65782,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65782,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65785,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,65785,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65785,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65800,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,65800,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65810,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65810,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65810,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,65815,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65815,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65815,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,65820,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65820,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65850,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65850,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65850,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65855,HB ARG/KRYP TRABECULOPLASTY,5445.73,3539.72,683.11,785.58,8
CPT,65855,OUTPATIENT SURGERY CPT GROUP 1,5445.73,3539.72,6417.0,7038.0,2
CPT,65855,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,65855,Outpatient Surgical Group 1,5445.73,3539.72,9088.3,13492.72,50
CPT,65860,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,65860,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65860,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65865,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,65865,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65865,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,65870,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65870,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,65870,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65875,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65875,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65875,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65880,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65880,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,65880,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,65900,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65900,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,65900,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,65920,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65920,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,65920,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,65930,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,65930,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,65930,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66020,Outpatient Grouper - 2,9781.09,6357.71,13036.88,14143.2,24
CPT,66020,Outpatient Surgical Group 1,9781.09,6357.71,9088.3,13492.72,50
CPT,66030,Outpatient Grouper - 2,9781.09,6357.71,13036.88,14143.2,24
CPT,66030,Outpatient Surgical Group 1,9781.09,6357.71,9088.3,13492.72,50
CPT,66130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66130,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,66130,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,66150,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66150,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66150,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66155,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66155,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66155,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66160,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66160,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66160,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66170,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66170,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66170,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66172,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66172,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66172,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66174,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,66174,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66174,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66175,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,66175,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66175,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66179,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66179,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66179,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66180,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66180,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66180,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66183,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66183,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66183,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66184,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66184,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66184,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66185,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66185,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66185,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66225,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66225,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66225,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66250,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66250,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66500,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,66500,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66505,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,66505,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,66505,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66600,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66600,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66600,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66605,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66605,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66605,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66625,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,66625,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66625,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66630,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,66630,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66630,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66635,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66635,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66635,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66680,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66680,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66680,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,66682,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66682,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66682,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66700,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,66700,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66700,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66710,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66710,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66710,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66711,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,66711,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66711,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66720,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66720,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66720,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66740,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66740,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,66761,HB YAG IRIDOTOMY 1 OR MORE,5445.73,3539.72,683.11,785.58,8
CPT,66761,OUTPATIENT SURGERY CPT GROUP 1,5445.73,3539.72,6417.0,7038.0,2
CPT,66761,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,66761,Outpatient Surgical Group 1,5445.73,3539.72,9088.3,13492.72,50
CPT,66762,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,66762,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,66762,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66770,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,66770,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,66770,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66820,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,66820,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,66820,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66821,HB YAG DISCISSION A-CATARACT MEM,5445.73,3539.72,683.11,785.58,8
CPT,66821,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,66821,Outpatient Surgery Group 2 Global Rate,5445.73,3539.72,14322.0,15354.0,2
CPT,66821,Outpatient Surgical Group 2,5445.73,3539.72,12162.28,18056.43,50
CPT,66825,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66825,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66825,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66830,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66830,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66830,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66840,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66840,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66840,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66850,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66850,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,66850,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,66852,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66852,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66852,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66920,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66920,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,66920,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,66930,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66930,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,66930,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66940,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,66940,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,66940,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66982,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66982,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,66982,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,66983,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66983,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,66983,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,66984,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66984,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,66984,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,50
CPT,66985,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66985,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,66985,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,66986,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,66986,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,66986,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,66987,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66987,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,66987,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66988,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66988,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,66988,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,66989,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66989,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,66989,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,66990,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,66991,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,66991,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,66991,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,66999,Outpatient Grouper - 2,9781.09,6357.71,13036.88,14143.2,24
CPT,66999,Outpatient Surgical Group 1,9781.09,6357.71,9088.3,13492.72,50
CPT,67005,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67005,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67005,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67010,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67010,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67010,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67015,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67015,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67015,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67025,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67025,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67025,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67027,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67027,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67027,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67028,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67028,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67028,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67030,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67030,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67031,HB AR/KR/YG SEVER VITREOUS STRAN,5445.73,3539.72,683.11,785.58,8
CPT,67031,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,67031,Outpatient Surgery Group 2 Global Rate,5445.73,3539.72,14322.0,15354.0,2
CPT,67031,Outpatient Surgical Group 2,5445.73,3539.72,12162.28,18056.43,50
CPT,67036,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67036,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67036,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67039,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67039,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67039,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,67040,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67040,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67040,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,67041,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67041,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67041,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67042,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67042,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67042,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67043,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67043,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67043,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67101,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67101,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67101,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67105,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,67105,Outpatient Surgery Group 4 Global Rate,5445.73,3539.72,26623.0,28144.0,2
CPT,67105,Outpatient Surgical Group 1,5445.73,3539.72,9088.3,13492.72,50
CPT,67107,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67107,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67107,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67108,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67108,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,67108,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,67110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67110,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67110,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67113,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,67113,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,67113,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,67115,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67115,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67115,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67121,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67121,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67121,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67141,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67141,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67141,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67145,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67145,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,67145,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67208,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67208,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67208,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67210,HB ARG/KRYP DESTRUCTION RETINA,5445.73,3539.72,683.11,785.58,8
CPT,67210,OUTPATIENT SURGERY CPT GROUP 1,5445.73,3539.72,6417.0,7038.0,2
CPT,67210,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,67210,Outpatient Surgical Group 1,5445.73,3539.72,9088.3,13492.72,50
CPT,67218,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67218,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67218,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67220,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67220,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,67220,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67221,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,67221,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67221,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67225,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67225,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67225,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67227,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67227,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67227,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67228,OUTPATIENT SURGERY CPT GROUP 1,5445.73,3539.72,6417.0,7038.0,2
CPT,67228,Outpatient Grouper - 1,5445.73,3539.72,10495.38,11385.92,24
CPT,67228,Outpatient Surgical Group 1,5445.73,3539.72,9088.3,13492.72,50
CPT,67229,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,67229,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67229,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,67250,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67250,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67250,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67255,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67255,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67255,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67299,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,67299,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67311,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67311,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67311,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67312,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67312,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67312,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67314,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67314,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67314,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67316,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67316,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67316,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67318,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67318,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67318,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67320,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67320,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67320,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67331,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67331,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67331,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67332,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67332,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67332,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67334,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67334,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67334,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67335,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67335,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67335,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67340,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67340,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67340,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67343,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67343,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67343,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67345,HB CHEMODENRV EXTRCLR MUSCLE,1594.35,1036.33,372.22,428.06,8
CPT,67345,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67345,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67345,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,67346,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67346,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67399,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67399,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67400,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67400,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67400,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67405,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67405,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67405,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67412,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67412,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67412,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67413,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67413,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67413,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67414,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67414,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67414,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,67415,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67415,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67415,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67420,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67420,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67420,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67430,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67430,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67430,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67440,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67440,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67440,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67445,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67445,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,67445,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,67450,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67450,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67450,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67500,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67500,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,67505,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67505,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67505,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,67515,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67515,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67515,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,67516,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67516,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,67550,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67550,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67550,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67560,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67560,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67560,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67570,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67570,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67570,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,67599,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67599,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67700,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67700,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67700,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,67710,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67710,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,67710,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67715,OUTPATIENT SURGERY CPT GROUP 1,9460.09,6149.06,6417.0,7038.0,2
CPT,67715,Outpatient Grouper - 3,9460.09,6149.06,14341.63,15558.59,24
CPT,67715,Outpatient Surgical Group 1,9460.09,6149.06,9088.3,13492.72,50
CPT,67800,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67800,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,67801,Outpatient Grouper - 2,4132.95,2686.42,13036.88,14143.2,24
CPT,67801,Outpatient Surgical Group 1,4132.95,2686.42,9088.3,13492.72,50
CPT,67805,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67805,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67805,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,67808,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67808,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67808,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67810,HB BIOPSY EYELID & LID MARGIN,1594.35,1036.33,372.22,428.06,8
CPT,67810,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67810,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,67820,HB EPILATION BY FORCEPS,1074.29,698.29,160.5,184.58,8
CPT,67820,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,67820,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,67820,Outpatient Surgical Group 1,1074.29,698.29,9088.3,13492.72,50
CPT,67825,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67825,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67825,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,67830,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,67830,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67830,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67835,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67835,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67835,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67840,HB EXC EYELID LESION WO CLOSE/SIMP REPAIR,4132.95,2686.42,1206.01,1386.92,8
CPT,67840,OUTPATIENT SURGERY CPT GROUP 1,4132.95,2686.42,6417.0,7038.0,2
CPT,67840,Outpatient Grouper - 2,4132.95,2686.42,13036.88,14143.2,24
CPT,67840,Outpatient Surgical Group 1,4132.95,2686.42,9088.3,13492.72,50
CPT,67850,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67850,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,67850,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67875,OUTPATIENT SURGERY CPT GROUP 1,4132.95,2686.42,6417.0,7038.0,2
CPT,67875,Outpatient Grouper - 2,4132.95,2686.42,13036.88,14143.2,24
CPT,67875,Outpatient Surgical Group 1,4132.95,2686.42,9088.3,13492.72,50
CPT,67880,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67880,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67880,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67882,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67882,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67882,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67900,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67900,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67901,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67901,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67901,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67902,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67902,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67902,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67903,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67903,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67903,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67904,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67904,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67904,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67906,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67906,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,67906,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,67908,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67908,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67908,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67909,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67909,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67909,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67911,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67911,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67911,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67912,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67912,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67912,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67914,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67914,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67914,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67915,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67915,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67915,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,67916,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67916,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67916,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67917,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67917,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67917,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67921,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67921,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67921,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67922,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67922,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67922,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67923,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67923,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67923,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67924,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67924,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,67924,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,67930,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,67930,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67930,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67935,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67935,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67935,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67938,HB REMOVE EMBEDDED FB EYELID,1594.35,1036.33,372.22,428.06,8
CPT,67938,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,67938,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,67938,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,67950,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67950,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,67950,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,67961,Outpatient Grouper - 3,9460.09,6149.06,14341.63,15558.59,24
CPT,67961,Outpatient Surgery Group 3 Global Rate,9460.09,6149.06,22055.0,22787.0,2
CPT,67961,Outpatient Surgical Group 3,9460.09,6149.06,13899.75,20635.92,50
CPT,67966,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67966,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67966,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67971,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67971,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67971,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67973,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67973,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67973,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67974,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,67974,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67974,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67975,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,67975,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,67975,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,67999,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,67999,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68020,OUTPATIENT SURGERY CPT GROUP 1,4132.95,2686.42,6417.0,7038.0,2
CPT,68020,Outpatient Grouper - 2,4132.95,2686.42,13036.88,14143.2,24
CPT,68020,Outpatient Surgical Group 2,4132.95,2686.42,12162.28,18056.43,50
CPT,68040,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68040,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68040,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,68100,Outpatient Grouper - 1,9460.09,6149.06,10495.38,11385.92,24
CPT,68100,Outpatient Surgical Group 1,9460.09,6149.06,9088.3,13492.72,50
CPT,68110,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68115,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68115,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68115,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68130,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68130,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68130,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68135,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68135,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68135,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68200,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68200,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68200,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,68320,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68320,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68320,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68325,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68325,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68325,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68326,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68326,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68326,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68328,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68328,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68328,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68330,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68330,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68330,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68335,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68335,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68335,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68340,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68340,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68340,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68360,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68360,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68360,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68362,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68362,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68362,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68371,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68371,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68371,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68399,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68399,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68400,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68400,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,68400,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,68420,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68420,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,68420,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68440,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68440,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68440,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,68500,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68500,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68500,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,68505,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68505,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68505,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,68510,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68510,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68510,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68520,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68520,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68520,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,68525,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68525,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68525,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68530,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68530,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68530,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68540,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68540,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68540,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,68550,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68550,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68550,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,68700,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68700,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68700,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68705,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68705,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68705,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68720,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68720,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68720,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68745,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68745,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,68745,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68750,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,68750,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,68750,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68760,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68760,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68760,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,68761,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68761,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68761,Outpatient Surgical Group 0,1594.35,1036.33,2806.68,4166.87,50
CPT,68770,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68770,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,68770,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,68801,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68801,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68801,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68810,HB NASOLACR DUCT PROBING W/WO IRRIGATION,1594.35,1036.33,372.22,428.06,8
CPT,68810,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68810,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68810,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,68811,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68811,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68811,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68815,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68815,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,68815,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,68816,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68816,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68816,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,68840,HB LACRIMAL CANALICULI PROBING,1594.35,1036.33,372.22,428.06,8
CPT,68840,OUTPATIENT SURGERY CPT GROUP 1,1594.35,1036.33,6417.0,7038.0,2
CPT,68840,Outpatient Grouper - 0,1594.35,1036.33,9059.94,9827.82,24
CPT,68840,Outpatient Surgical Group 1,1594.35,1036.33,9088.3,13492.72,50
CPT,68841,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,68841,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,68850,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,68850,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68899,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,68899,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69000,OUTPATIENT SURGERY CPT GROUP 1,5952.47,3869.11,6417.0,7038.0,2
CPT,69000,Outpatient Grouper - 1,5952.47,3869.11,10495.38,11385.92,24
CPT,69000,Outpatient Surgical Group 0,5952.47,3869.11,2806.68,4166.87,50
CPT,69005,OUTPATIENT SURGERY CPT GROUP 1,11474.0,7458.1,6417.0,7038.0,2
CPT,69005,Outpatient Grouper - 2,11474.0,7458.1,13036.88,14143.2,24
CPT,69005,Outpatient Surgical Group 1,11474.0,7458.1,9088.3,13492.72,50
CPT,69020,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69020,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
CPT,69020,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69090,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,69090,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69100,OUTPATIENT SURGERY CPT GROUP 1,1962.39,1275.55,6417.0,7038.0,2
CPT,69100,Outpatient Grouper - 0,1962.39,1275.55,9059.94,9827.82,24
CPT,69100,Outpatient Surgical Group 1,1962.39,1275.55,9088.3,13492.72,50
CPT,69105,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69105,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69105,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69110,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69110,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69110,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69120,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69120,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69140,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69140,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69140,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69145,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69145,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69145,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69150,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69150,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69150,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69155,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,69155,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,69155,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69200,HB PEDS ENT-REMOVE-FB-EXTAUDITCAN,1074.29,698.29,160.5,184.58,8
CPT,69200,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,69200,Outpatient Grouper - 0,1074.29,698.29,9059.94,9827.82,24
CPT,69200,Outpatient Surgical Group 0,1074.29,698.29,2806.68,4166.87,50
CPT,69205,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69205,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69205,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69209,HB REMOVE IMPACTED EAR WAX UNI,1192.76,775.29,73.96,14761.0,10
CPT,69209,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,69209,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,69210,"HB RMVL IMPACTED CERUMEN, REQ. INSTRMNT, UNILATERAL",1037.19,674.17,73.96,85.06,8
CPT,69210,OUTPATIENT SURGERY CPT GROUP 1,1037.19,674.17,6417.0,7038.0,2
CPT,69210,Outpatient Grouper - 0,1037.19,674.17,9059.94,9827.82,24
CPT,69210,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,69220,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69220,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69220,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69222,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69222,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69222,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69300,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69300,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69300,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69310,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69310,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69310,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69320,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69320,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,69320,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69399,Outpatient Grouper - 0,2070.32,1345.71,9059.94,9827.82,24
CPT,69399,Outpatient Surgical Group 1,2070.32,1345.71,9088.3,13492.72,50
CPT,69420,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69420,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69420,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69421,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69421,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69421,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69424,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69424,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,69424,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69433,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69433,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69433,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69436,Outpatient Grouper - 2,6393.69,4155.9,13036.88,14143.2,24
CPT,69436,Outpatient Surgery Group 2 Global Rate,6393.69,4155.9,14322.0,15354.0,2
CPT,69436,Outpatient Surgical Group 3,6393.69,4155.9,13899.75,20635.92,50
CPT,69440,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69440,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69440,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69450,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69450,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69450,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69501,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69501,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69501,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69502,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69502,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69502,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69505,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69505,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69505,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69511,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69511,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69511,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69530,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69530,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69530,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69535,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,69535,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69535,Outpatient Surgical Group 6,7503.89,4877.53,22453.45,33334.94,50
CPT,69540,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69540,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69540,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69550,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69550,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69550,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69552,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69552,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69552,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69554,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,69554,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69554,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69601,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69601,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69601,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69602,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69602,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69602,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69603,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69603,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69603,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69604,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69604,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69604,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69605,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69610,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69610,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69610,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,69620,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69620,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69620,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69631,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69631,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69631,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69632,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69632,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69632,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69633,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69633,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69633,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69635,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69635,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69635,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69636,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69636,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69636,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69637,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69637,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69637,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69641,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69641,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69641,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69642,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69642,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69642,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69643,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69643,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69643,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69644,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69644,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69644,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69645,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69645,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69645,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69646,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69646,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69646,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69650,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69650,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,69650,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69660,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69660,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69660,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69661,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69661,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69661,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69662,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69662,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,69662,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69666,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69666,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,69666,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,69667,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69667,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
CPT,69667,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,69670,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69670,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69670,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69676,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,69676,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69676,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69700,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69700,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69700,Outpatient Surgical Group 3,7503.89,4877.53,13899.75,20635.92,50
CPT,69705,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69705,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69705,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69706,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69706,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,69706,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69710,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69710,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69710,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,69711,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69711,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69711,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69714,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
CPT,69714,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,69714,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,69715,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,69716,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,69716,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,69716,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69717,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69717,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69717,Outpatient Surgical Group 9,7503.89,4877.53,36513.58,54208.97,50
CPT,69718,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69719,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,69719,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69719,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69720,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69720,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69720,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69725,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69725,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69725,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69726,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,69726,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69726,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69727,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,69727,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69727,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69728,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
CPT,69728,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,69728,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,69729,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,69729,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,69729,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69730,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,69730,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
CPT,69730,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69740,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69740,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69740,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69745,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69745,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69745,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69799,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69799,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69801,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,69801,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
CPT,69801,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,69805,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69805,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69805,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69806,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69806,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69806,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69905,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69905,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69905,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69910,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69910,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69910,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69915,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69915,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69915,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69930,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
CPT,69930,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69930,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69949,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69949,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,69950,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,69950,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69950,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69955,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69955,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,69955,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69960,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69960,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69960,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69970,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
CPT,69970,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
CPT,69970,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,69979,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,69979,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,69990,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,69990,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,70010,"MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,96.09,96.09,2
CPT,70010,"MYELOGRAPHY, POSTERIOR FOSSA; SUPERVISION AND INTERPRETATION ONLY",,,1083.06,1724.89,2
CPT,70010,PET Scan,,,4155.27,4200.53,2
CPT,70015,"CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,280.07,280.07,2
CPT,70015,"CISTERNOGRAPHY, POSITIVE CONTRAST; SUPERVISION AND INTERPRETATION ONLY",,,339.78,541.13,2
CPT,70015,PET Scan,,,4155.27,4200.53,2
CPT,70030,PET Scan,,,4155.27,4200.53,2
CPT,70030,"RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY",,,59.58,169.11,4
CPT,70100,HB XR MANDIBLE 1-3VW,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,70100,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70100,"RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS",1344.46,873.9,74.56,207.59,4
CPT,70110,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,70110,"RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS",1760.68,1144.44,78.72,247.39,4
CPT,70120,HB XR MASTOIDS 1-3VW,1546.13,1004.9849999999999,132.41,14761.0,10
CPT,70120,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70120,"RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE",1344.46,873.9,74.56,247.39,4
CPT,70130,PET Scan,,,4155.27,4200.53,2
CPT,70130,"RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE",,,115.33,314.25,4
CPT,70134,PET Scan,,,4155.27,4200.53,2
CPT,70134,"RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE",,,111.17,294.96,4
CPT,70140,HB XR FACIAL BONES 1-2VW,1764.855,1147.155,109.64,14761.0,10
CPT,70140,PET Scan,1534.65,997.52,4155.27,4200.53,2
CPT,70140,"RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS",1534.65,997.52,56.25,246.36,4
CPT,70150,HB XR FACIAL BONES 3VW/MORE,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,70150,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,70150,"RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS",1760.68,1144.44,86.21,313.22,4
CPT,70160,HB XR NASAL BONES 3VW/MORE,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,70160,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70160,"RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS",1344.46,873.9,74.56,207.69,4
CPT,70170,"DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,85.75,85.75,2
CPT,70170,"DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT; SUPERVISION AND INTERPRETATION ONLY",,,235.42,374.92,2
CPT,70170,PET Scan,,,4155.27,4200.53,2
CPT,70190,PET Scan,,,4155.27,4200.53,2
CPT,70190,RADIOLOGIC EXAMINATION; OPTIC FORAMINA,,,67.07,247.39,4
CPT,70200,HB XR ORBITS 4VW/MORE,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,70200,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,70200,"RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS",1760.68,1144.44,86.21,314.34,4
CPT,70210,HB XR SINUSES 1-2VW,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,70210,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70210,"RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS",1344.46,873.9,59.58,246.27,4
CPT,70211,PET Scan,,,4155.27,4200.53,2
CPT,70219,PET Scan,,,4155.27,4200.53,2
CPT,70220,HB XR SINUSES 3VW/MORE,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,70220,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,70220,"RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS",1760.68,1144.44,67.9,313.22,4
CPT,70240,PET Scan,,,4155.27,4200.53,2
CPT,70240,"RADIOLOGIC EXAMINATION, SELLA TURCICA",,,59.58,169.11,4
CPT,70250,HB XR SKULL 1-3VW,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,70250,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,70250,"RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS,",1760.68,1144.44,155.34,247.39,2
CPT,70250,"RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO",1760.68,1144.44,67.9,67.9,2
CPT,70260,HB XR SKULL 4VW/MORE,2112.81,1373.33,132.41,152.28,8
CPT,70260,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,70260,"RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS,",2112.81,1373.33,224.42,357.41,2
CPT,70260,"RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO",2112.81,1373.33,77.89,77.89,2
CPT,70300,PET Scan,,,4155.27,4200.53,2
CPT,70300,"RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW",,,19.64,95.23,4
CPT,70310,PET Scan,,,4155.27,4200.53,2
CPT,70310,"RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH",,,78.72,169.11,4
CPT,70320,PET Scan,,,4155.27,4200.53,2
CPT,70320,"RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH",,,104.51,313.12,4
CPT,70328,HB XR TMJ UNILATERAL,1257.07,817.1,109.64,126.08,8
CPT,70328,PET Scan,1257.07,817.1,4155.27,4200.53,2
CPT,70328,"RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL",1257.07,817.1,64.57,196.26,4
CPT,70330,HB XR TMJ BILAT,1344.46,873.9,109.64,126.08,8
CPT,70330,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70330,"RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL",1344.46,873.9,103.68,332.5,4
CPT,70332,PET Scan,,,4155.27,4200.53,2
CPT,70332,"TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,146.95,146.95,2
CPT,70332,TEMPOROMANDIBULAR JOINT ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY,,,525.16,836.37,2
CPT,70336,HB MRI TMJ BILATERAL,7574.37,4923.34,300.99,14761.0,10
CPT,70336,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT",6586.41,4281.17,517.71,517.71,2
CPT,70336,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINTS",6586.41,4281.17,2453.75,3907.85,2
CPT,70336,MRI,6586.41,4281.17,2387.94,2411.35,2
CPT,70336,MRI/MRA,6586.41,4281.17,3089.09,3116.45,2
CPT,70336,PET Scan,6586.41,4281.17,4155.27,4200.53,2
CPT,70350,"CEPHALOGRAM, ORTHODONTIC",,,19.64,149.73,4
CPT,70350,PET Scan,,,4155.27,4200.53,2
CPT,70355,ORTHOPANTOGRAM,,,20.48,226.88,4
CPT,70355,PET Scan,,,4155.27,4200.53,2
CPT,70360,HB XR NECK SOFT TISSUE,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,70360,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,70360,"RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE",1344.46,873.9,57.08,169.11,4
CPT,70370,PET Scan,,,4155.27,4200.53,2
CPT,70370,"RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQUE",,,217.67,518.47,4
CPT,70371,COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING,,,168.58,824.85,4
CPT,70371,PET Scan,,,4155.27,4200.53,2
CPT,70380,PET Scan,,,4155.27,4200.53,2
CPT,70380,"RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS",,,73.73,265.46,4
CPT,70390,PET Scan,2775.46,1804.05,4155.27,4200.53,2
CPT,70390,"SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2775.46,1804.05,250.12,250.12,2
CPT,70390,SIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY,2775.46,1804.05,444.08,707.24,2
CPT,70400,PET Scan,,,4155.27,4200.53,2
CPT,70401,PET Scan,,,4155.27,4200.53,2
CPT,70402,PET Scan,,,4155.27,4200.53,2
CPT,70409,PET Scan,,,4155.27,4200.53,2
CPT,70441,PET Scan,,,4155.27,4200.53,2
CPT,70442,PET Scan,,,4155.27,4200.53,2
CPT,70450,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,70450,"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; W/O CONTRAST MATERIAL",6671.63,4336.56,1170.61,1864.31,2
CPT,70450,"COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,173.57,173.57,2
CPT,70450,CT SCAN,6671.63,4336.56,1139.21,1150.38,2
CPT,70450,HB CT HEAD/BRAIN WO CONT,7672.360000000001,4987.035,132.41,14761.0,10
CPT,70450,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,70460,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,70460,"COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,248.45,2236.52,4
CPT,70460,CT SCAN,8051.27,5233.33,1366.65,1380.05,2
CPT,70460,HB CT HEAD/BRAIN W CONT,9258.985,6018.344999999999,221.67,14761.0,10
CPT,70460,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,70470,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,70470,"COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,1751.97,2790.2,2
CPT,70470,"COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,298.89,298.89,2
CPT,70470,CT SCAN,8432.03,5480.82,1704.98,1721.7,2
CPT,70470,HB CT HEAD/BRAIN WO/W CONT,9696.835,6302.945,221.67,14761.0,10
CPT,70470,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,70480,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,70480,"COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; W/O CONTRAST MATERIAL",6671.63,4336.56,1176.31,1873.4,2
CPT,70480,"COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,257.61,257.61,2
CPT,70480,CT SCAN,6671.63,4336.56,1144.76,1155.98,2
CPT,70480,HB CT ORBITS/SELLA/EAR WO CONT,7672.360000000001,4987.035,132.41,14761.0,10
CPT,70480,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,70481,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,70481,"COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST MATERI",8432.03,5480.82,1407.79,2242.04,2
CPT,70481,"COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST MATERIAL(S)",8432.03,5480.82,333.83,333.83,2
CPT,70481,CT SCAN,8432.03,5480.82,1370.03,1383.46,2
CPT,70481,HB CT ORBITS/SELLA/EAR W CONT,9696.835,6302.945,221.67,14761.0,10
CPT,70481,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,70482,CAT Scan,10118.4,6576.96,2808.07,2839.65,2
CPT,70482,"COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MAT",10118.4,6576.96,1754.85,2794.78,2
CPT,70482,"COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",10118.4,6576.96,396.24,396.24,2
CPT,70482,CT SCAN,10118.4,6576.96,1707.79,1724.53,2
CPT,70482,HB CT ORBIT/SELLA/EAR WO/W CON,11636.17,7563.51,221.67,14761.0,10
CPT,70482,PET Scan,10118.4,6576.96,4155.27,4200.53,2
CPT,70486,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,70486,"COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,1174.14,1869.93,2
CPT,70486,"COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,230.15,230.15,2
CPT,70486,CT SCAN,6671.63,4336.56,1142.64,1153.85,2
CPT,70486,HB CT MAXILLOFACIAL WO CONT,7672.360000000001,4987.035,132.41,14761.0,10
CPT,70486,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,70487,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,70487,"COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,259.27,2241.01,4
CPT,70487,HB CT MAXILLOFACIAL W CONT,9258.985,6018.344999999999,221.67,14761.0,10
CPT,70487,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,70488,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,70488,"COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,1754.15,2793.66,2
CPT,70488,"COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,328.01,328.01,2
CPT,70488,CT SCAN,8432.03,5480.82,1707.1,1723.84,2
CPT,70488,HB CT MAXILLOFACIAL WO/W CONT,8432.03,5480.82,221.67,254.92,8
CPT,70488,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,70490,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,70490,"COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; W/O CONTRAST MATERIAL",6671.63,4336.56,1176.31,1873.4,2
CPT,70490,"COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,235.98,235.98,2
CPT,70490,CT SCAN,6671.63,4336.56,1144.76,1155.98,2
CPT,70490,HB CT NECK SFT TISS WO CONT,7672.360000000001,4987.035,132.41,14761.0,10
CPT,70490,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,70491,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,70491,"COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,313.87,2242.04,4
CPT,70491,CT SCAN,8051.27,5233.33,1370.03,1383.46,2
CPT,70491,HB CT NECK SFT TISS W CONT,9258.985,6018.344999999999,221.67,14761.0,10
CPT,70491,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,70492,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,70492,"COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,1754.85,2794.78,2
CPT,70492,"COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,383.76,383.76,2
CPT,70492,CT SCAN,8432.03,5480.82,1707.79,1724.53,2
CPT,70492,HB CT NECK SFT TISS WO/W CONT,8432.03,5480.82,221.67,254.92,8
CPT,70492,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,70496,CAT Scan,7452.6,4844.19,2808.07,2839.65,2
CPT,70496,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",7452.6,4844.19,507.08,507.08,2
CPT,70496,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY,HEAD W/O CONTRAST,FOLLOWED BY CONTRAST, INCLUDING IMAGE POST PROCESSING",7452.6,4844.19,1824.17,2905.18,2
CPT,70496,CT SCAN,7452.6,4844.19,1775.25,1792.65,2
CPT,70496,HB CT ANGIO HEAD W 3D,8570.39,5570.754999999999,221.67,14761.0,10
CPT,70496,PET Scan,7452.6,4844.19,4155.27,4200.53,2
CPT,70498,CAT Scan,7452.6,4844.19,2808.07,2839.65,2
CPT,70498,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",7452.6,4844.19,506.25,506.25,2
CPT,70498,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY,NECK W/O CONTRAST,FOLLOWED BY CONTRAST, INCLUDING IMAGE POST PROCESSING",7452.6,4844.19,1824.17,2905.18,2
CPT,70498,CT SCAN,7452.6,4844.19,1775.25,1792.65,2
CPT,70498,HB CT ANGIO NECK W 3D,8570.39,5570.754999999999,221.67,14761.0,10
CPT,70498,PET Scan,7452.6,4844.19,4155.27,4200.53,2
CPT,70521,PET Scan,,,4155.27,4200.53,2
CPT,70522,PET Scan,,,4155.27,4200.53,2
CPT,70540,HB MRI ORBITS/FACE/NECK WO CONT,9621.474999999999,6253.955,300.99,14761.0,10
CPT,70540,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE AND/OR NECK; WITHOUT CONTRAST MATERIAL(S)",8366.99,5438.54,2765.83,4404.87,2
CPT,70540,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK",8366.99,5438.54,430.34,430.34,2
CPT,70540,MRI,8366.99,5438.54,2691.65,2718.04,2
CPT,70540,MRI/MRA,8366.99,5438.54,3089.09,3116.45,2
CPT,70540,PET Scan,8366.99,5438.54,4155.27,4200.53,2
CPT,70542,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK; WITH CONTRAST MATERIAL(S)",13131.3,8535.34,508.56,508.56,2
CPT,70542,"MAGNETIC RESONANCE IMAGING, ORBIT, FACE AND NECK; WITH CONTRAST MATERIALS",13131.3,8535.34,3371.54,5369.52,2
CPT,70542,MRI,13131.3,8535.34,3281.11,3313.28,2
CPT,70542,PET Scan,13131.3,8535.34,4155.27,4200.53,2
CPT,70543,HB MRI ORBITS/FCE/NCK WO/W CON,15861.46,10309.95,444.69,14761.0,10
CPT,70543,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",13792.6,8965.19,630.22,630.22,2
CPT,70543,"MAGNETIC RESONANCE IMAGING, ORBIT, FACE AND NECK; W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST,FURTHER SEQUENCES",13792.6,8965.19,6241.09,9939.57,2
CPT,70543,MRI,13792.6,8965.19,6073.69,6133.24,2
CPT,70543,MRI/MRA,13792.6,8965.19,3089.09,3116.45,2
CPT,70543,PET Scan,13792.6,8965.19,4155.27,4200.53,2
CPT,70544,HB MR ANGIO HEAD WO CONT W 3D,8800.064999999999,5720.045,300.99,14761.0,20
CPT,70544,"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; W/O CONTRAST MATERIALS",7651.66,4973.58,2844.38,4529.97,2
CPT,70544,"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S)",7651.66,4973.58,417.03,417.03,2
CPT,70544,MRI,7651.66,4973.58,2768.09,2795.23,2
CPT,70544,MRI/MRA,7651.66,4973.58,3089.09,3116.45,2
CPT,70544,PET Scan,7651.66,4973.58,4155.27,4200.53,2
CPT,70545,"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CONTRAST MATERIAL(S)",,,448.84,448.84,2
CPT,70545,MAGNETIC RESONANCE ANGIOGRAPHY; HEAD; W/CONTRAST MATERIALS,,,2844.38,4529.97,2
CPT,70545,MRI,,,2768.09,2795.23,2
CPT,70545,PET Scan,,,4155.27,4200.53,2
CPT,70546,HB MR ANGIO HEAD WO/W CONT W 3D,13532.765,8796.295,444.69,14761.0,20
CPT,70546,"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; W/O CONTRAST MATERIALSFOLLOWED BY CONTRAST MATERIALS AND FURTHER SEQUENCES",11767.6,7648.94,5592.99,8907.41,2
CPT,70546,"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",11767.6,7648.94,680.97,680.97,2
CPT,70546,MRI,11767.6,7648.94,5442.98,5496.34,2
CPT,70546,MRI/MRA,11767.6,7648.94,3089.09,3116.45,2
CPT,70546,PET Scan,11767.6,7648.94,4155.27,4200.53,2
CPT,70547,HB MR ANGIO NECK WO CONT W 3D,8173.385,5312.700000000001,300.99,14761.0,12
CPT,70547,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; W/O CONTRAST MATERIALS",7107.0,4619.55,2844.38,4529.97,2
CPT,70547,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S)",7107.0,4619.55,417.87,417.87,2
CPT,70547,MRI,7107.0,4619.55,2768.09,2795.23,2
CPT,70547,MRI/MRA,7107.0,4619.55,3089.09,3116.45,2
CPT,70547,PET Scan,7107.0,4619.55,4155.27,4200.53,2
CPT,70548,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; W/CONTRAST MATERIALS",7912.54,5143.15,2844.38,4529.97,2
CPT,70548,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITH CONTRAST MATERIAL(S)",7912.54,5143.15,461.32,461.32,2
CPT,70548,MRI,7912.54,5143.15,2768.09,2795.23,2
CPT,70548,PET Scan,7912.54,5143.15,4155.27,4200.53,2
CPT,70549,HB MR ANGIO NECK WO/W CONT W 3D,13532.765,8796.295,444.69,14761.0,20
CPT,70549,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; W/O CONTRAST MATERIALSFOLLOWED BY CONTRAST MATERIALS AND FURTHER SEQUENCES",11767.6,7648.94,5592.99,8907.41,2
CPT,70549,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",11767.6,7648.94,684.31,684.31,2
CPT,70549,MRI,11767.6,7648.94,5442.98,5496.34,2
CPT,70549,MRI/MRA,11767.6,7648.94,3089.09,3116.45,2
CPT,70549,PET Scan,11767.6,7648.94,4155.27,4200.53,2
CPT,70551,HB MRI HEAD/BRAIN WO CONT,9334.415,6067.37,300.99,14761.0,10
CPT,70551,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL",5450.1,3542.57,333.0,4404.87,4
CPT,70551,MRI,5450.1,3542.57,2691.65,2718.04,2
CPT,70551,MRI/MRA,5450.1,3542.57,3089.09,3116.45,2
CPT,70551,PET Scan,5450.1,3542.57,4155.27,4200.53,2
CPT,70552,HB MRI HEAD/BRAIN W CONT,14711.005000000001,9562.154999999999,444.69,14761.0,10
CPT,70552,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST MATERIAL(S)",12792.2,8314.93,492.1,5276.35,4
CPT,70552,MRI,12792.2,8314.93,3224.18,3255.79,2
CPT,70552,MRI/MRA,12792.2,8314.93,3089.09,3116.45,2
CPT,70552,PET Scan,12792.2,8314.93,4155.27,4200.53,2
CPT,70553,HB MRI HEAD/PITUITARY WO/W CNT,17730.32,11524.705,444.69,14761.0,10
CPT,70553,"MAGNETIC RESONANCE (EG, PROTON) IMAGING BRAIN;W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQ",15417.1,10021.11,5446.89,8674.72,2
CPT,70553,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",15417.1,10021.11,557.83,557.83,2
CPT,70553,MRI,15417.1,10021.11,5300.79,5352.76,2
CPT,70553,MRI/MRA,15417.1,10021.11,3089.09,3116.45,2
CPT,70553,PET Scan,15417.1,10021.11,4155.27,4200.53,2
CPT,70554,"MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTIONAL MRI; INCLUDING TEST SELECTION AND ADMINISTATION OF REPETITIVE BODY PART MOVEMENT AND/OR VISUAL STIMULATION, NOT REQUIRING PHYSICIAN OR PSYHOLOGIST ADMINIS",,,736.72,736.72,2
CPT,70554,MRI,,,3167.19,3198.24,2
CPT,70554,"MRI, BRAIN, FUNCTIONAL MRI; INCL TEST SELECTION AND ADMINISTRATION REPETITIVE BODY PART MOVEMENT AND/OR VISUAL STIMULATI",,,3167.19,5183.09,2
CPT,70554,PET Scan,,,4155.27,4200.53,2
CPT,70555,HB MRI BRAIN FUNCT W MD ASST,11692.315,7600.005,300.99,14761.0,10
CPT,70555,"MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTIONAL MRI; REQUIRING PHYSICIAN OR PSYHOLOGIST ADMINISTRATION OF ENTIRE NEUROFUNCTIONAL TESTING",10167.2,6608.68,1409.92,1409.92,2
CPT,70555,MRI,10167.2,6608.68,3868.45,3906.38,2
CPT,70555,"MRI, BRAIN, FUNCTIONAL MRI; REQG PHYS OR PSYCHOLOGIST ADMIN ENTIRE NEUROFUNCTIONAL TEST ï",10167.2,6608.68,3868.45,6330.7,2
CPT,70555,MRI/MRA,10167.2,6608.68,3089.09,3116.45,2
CPT,70555,PET Scan,10167.2,6608.68,4155.27,4200.53,2
CPT,70557,HB MRI HEAD/BRAIN DURING OPEN INTRACRANIAL PROC,6868.93,4464.8,13270.0,14761.0,2
CPT,70557,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM ANDSKULL BASE), DURING OPEN INTRACRANIAL PROCEDURE (EG, TO ASSESS FOR RESIDUAL TUMOR OR RESIDUAL VASCULAR MALFORMATION); WITHOUT CO",5283.6,3434.34,3128.72,3128.72,2
CPT,70557,"MAGNETIC RESONANCE IMAGING, BRAIN, DURING OPEN INTRACRANIAL PROCEDURE; WITHOUT CONTRAST MATERIAL",5283.6,3434.34,2765.83,4404.87,2
CPT,70557,MRI,5283.6,3434.34,2691.65,2718.04,2
CPT,70557,MRI/MRA,5283.6,3434.34,3089.09,3116.45,2
CPT,70557,PET Scan,5283.6,3434.34,4155.27,4200.53,2
CPT,70558,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM ANDSKULL BASE), DURING OPEN INTRACRANIAL PROCEDURE (EG, TO ASSESS FOR RESIDUAL TUMOR OR RESIDUAL VASCULAR MALFORMATION); WITH CONTR",,,3254.59,3254.59,2
CPT,70558,"MAGNETIC RESONANCE IMAGING, BRAIN, DURING OPEN INTRACRANIAL PROCEDURE; WITH CONTRAST MATERIAL",,,3313.04,5276.35,2
CPT,70558,MRI,,,3224.18,3224.18,1
CPT,70558,PET Scan,,,4155.27,4200.53,2
CPT,70559,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM ANDSKULL BASE), DURING OPEN INTRACRANIAL PROCEDURE (EG, TO ASSESS FOR RESIDUAL TUMOR OR RESIDUAL VASCULAR MALFORMATION); WITHOUT CO",,,3122.39,3122.39,2
CPT,70559,"MAGNETIC RESONANCE IMAGING, BRAIN, DURING OPEN INTRACRANIAL PROCEDURE; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAS",,,5446.89,8674.72,2
CPT,70559,MRI,,,5300.79,5352.76,2
CPT,70559,PET Scan,,,4155.27,4200.53,2
CPT,70581,PET Scan,,,4155.27,4200.53,2
CPT,70582,PET Scan,,,4155.27,4200.53,2
CPT,70583,PET Scan,,,4155.27,4200.53,2
CPT,70589,PET Scan,,,4155.27,4200.53,2
CPT,70700,PET Scan,,,4155.27,4200.53,2
CPT,70701,PET Scan,,,4155.27,4200.53,2
CPT,70702,PET Scan,,,4155.27,4200.53,2
CPT,70703,PET Scan,,,4155.27,4200.53,2
CPT,70704,PET Scan,,,4155.27,4200.53,2
CPT,70705,PET Scan,,,4155.27,4200.53,2
CPT,70706,PET Scan,,,4155.27,4200.53,2
CPT,70707,PET Scan,,,4155.27,4200.53,2
CPT,70709,PET Scan,,,4155.27,4200.53,2
CPT,70710,PET Scan,,,4155.27,4200.53,2
CPT,70711,PET Scan,,,4155.27,4200.53,2
CPT,70712,PET Scan,,,4155.27,4200.53,2
CPT,70713,PET Scan,,,4155.27,4200.53,2
CPT,70714,PET Scan,,,4155.27,4200.53,2
CPT,70715,PET Scan,,,4155.27,4200.53,2
CPT,70719,PET Scan,,,4155.27,4200.53,2
CPT,70720,PET Scan,,,4155.27,4200.53,2
CPT,70721,PET Scan,,,4155.27,4200.53,2
CPT,70722,PET Scan,,,4155.27,4200.53,2
CPT,70723,PET Scan,,,4155.27,4200.53,2
CPT,70724,PET Scan,,,4155.27,4200.53,2
CPT,70725,PET Scan,,,4155.27,4200.53,2
CPT,70900,PET Scan,,,4155.27,4200.53,2
CPT,70901,PET Scan,,,4155.27,4200.53,2
CPT,70909,PET Scan,,,4155.27,4200.53,2
CPT,71045,HB XR CHEST 1VW FRONTAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,71045,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,71045,"Radiologic examination, chest; single view",1344.46,873.9,42.94,42.94,2
CPT,71045,X-ray exam chest 1 view,1344.46,873.9,113.3,180.44,2
CPT,71046,HB XR EXAM CHEST 2 VIEWS,1590.4299999999998,1033.78,109.64,14761.0,10
CPT,71046,PET Scan,1382.99,898.94,4155.27,4200.53,2
CPT,71046,"Radiologic examination, chest; 2 views",1382.99,898.94,57.92,57.92,2
CPT,71046,X-ray exam chest 2 views,1382.99,898.94,209.43,333.53,2
CPT,71047,HB XR EXAM CHEST 3 VIEWS,1685.56,1095.615,109.64,14761.0,10
CPT,71047,PET Scan,1465.71,952.71,4155.27,4200.53,2
CPT,71047,"Radiologic examination, chest; 3 views",1465.71,952.71,72.89,72.89,2
CPT,71047,X-ray exam chest 3 views,1465.71,952.71,266.99,425.21,2
CPT,71048,HB XR EXAM CHEST 4+ VIEWS,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,71048,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,71048,"Radiologic examination, chest; 4 or more views",1760.68,1144.44,78.72,78.72,2
CPT,71048,X-ray exam chest 4+ views,1760.68,1144.44,274.69,437.47,2
CPT,71100,HB XR RIBS 2-3VW UNILAT,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,71100,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,71100,"RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS",1344.46,873.9,65.4,228.1,4
CPT,71101,HB XR RIBS 2-3VW UNI & CHEST,1685.56,1095.615,132.41,14761.0,10
CPT,71101,PET Scan,1465.71,952.71,4155.27,4200.53,2
CPT,71101,"RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS",1465.71,952.71,73.73,267.9,4
CPT,71102,PET Scan,,,4155.27,4200.53,2
CPT,71103,PET Scan,,,4155.27,4200.53,2
CPT,71104,PET Scan,,,4155.27,4200.53,2
CPT,71105,PET Scan,,,4155.27,4200.53,2
CPT,71106,PET Scan,,,4155.27,4200.53,2
CPT,71107,PET Scan,,,4155.27,4200.53,2
CPT,71108,PET Scan,,,4155.27,4200.53,2
CPT,71109,PET Scan,,,4155.27,4200.53,2
CPT,71110,HB XR RIBS 3VW BILAT,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,71110,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,71110,"RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS",1760.68,1144.44,75.39,314.34,4
CPT,71111,HB XR RIBS 3VW BILAT & CHEST,2429.7349999999997,1579.33,132.41,14761.0,10
CPT,71111,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,71111,"RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS",2112.81,1373.33,92.87,356.29,4
CPT,71112,PET Scan,,,4155.27,4200.53,2
CPT,71113,PET Scan,,,4155.27,4200.53,2
CPT,71114,PET Scan,,,4155.27,4200.53,2
CPT,71115,PET Scan,,,4155.27,4200.53,2
CPT,71116,PET Scan,,,4155.27,4200.53,2
CPT,71117,PET Scan,,,4155.27,4200.53,2
CPT,71118,PET Scan,,,4155.27,4200.53,2
CPT,71119,PET Scan,,,4155.27,4200.53,2
CPT,71120,HB XR STERNUM 2VW/MORE,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,71120,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,71120,"RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS",1344.46,873.9,60.42,258.72,4
CPT,71121,PET Scan,,,4155.27,4200.53,2
CPT,71122,PET Scan,,,4155.27,4200.53,2
CPT,71123,PET Scan,,,4155.27,4200.53,2
CPT,71124,PET Scan,,,4155.27,4200.53,2
CPT,71125,PET Scan,,,4155.27,4200.53,2
CPT,71126,PET Scan,,,4155.27,4200.53,2
CPT,71127,PET Scan,,,4155.27,4200.53,2
CPT,71128,PET Scan,,,4155.27,4200.53,2
CPT,71129,PET Scan,,,4155.27,4200.53,2
CPT,71130,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,71130,"RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS",1344.46,873.9,77.06,278.01,4
CPT,71131,PET Scan,,,4155.27,4200.53,2
CPT,71132,PET Scan,,,4155.27,4200.53,2
CPT,71133,PET Scan,,,4155.27,4200.53,2
CPT,71134,PET Scan,,,4155.27,4200.53,2
CPT,71135,PET Scan,,,4155.27,4200.53,2
CPT,71136,PET Scan,,,4155.27,4200.53,2
CPT,71137,PET Scan,,,4155.27,4200.53,2
CPT,71138,PET Scan,,,4155.27,4200.53,2
CPT,71139,PET Scan,,,4155.27,4200.53,2
CPT,71140,PET Scan,,,4155.27,4200.53,2
CPT,71141,PET Scan,,,4155.27,4200.53,2
CPT,71142,PET Scan,,,4155.27,4200.53,2
CPT,71143,PET Scan,,,4155.27,4200.53,2
CPT,71144,PET Scan,,,4155.27,4200.53,2
CPT,71145,PET Scan,,,4155.27,4200.53,2
CPT,71146,PET Scan,,,4155.27,4200.53,2
CPT,71147,PET Scan,,,4155.27,4200.53,2
CPT,71148,PET Scan,,,4155.27,4200.53,2
CPT,71149,PET Scan,,,4155.27,4200.53,2
CPT,71150,PET Scan,,,4155.27,4200.53,2
CPT,71151,PET Scan,,,4155.27,4200.53,2
CPT,71152,PET Scan,,,4155.27,4200.53,2
CPT,71153,PET Scan,,,4155.27,4200.53,2
CPT,71154,PET Scan,,,4155.27,4200.53,2
CPT,71155,PET Scan,,,4155.27,4200.53,2
CPT,71156,PET Scan,,,4155.27,4200.53,2
CPT,71157,PET Scan,,,4155.27,4200.53,2
CPT,71158,PET Scan,,,4155.27,4200.53,2
CPT,71159,PET Scan,,,4155.27,4200.53,2
CPT,71160,PET Scan,,,4155.27,4200.53,2
CPT,71161,PET Scan,,,4155.27,4200.53,2
CPT,71162,PET Scan,,,4155.27,4200.53,2
CPT,71163,PET Scan,,,4155.27,4200.53,2
CPT,71164,PET Scan,,,4155.27,4200.53,2
CPT,71165,PET Scan,,,4155.27,4200.53,2
CPT,71166,PET Scan,,,4155.27,4200.53,2
CPT,71167,PET Scan,,,4155.27,4200.53,2
CPT,71168,PET Scan,,,4155.27,4200.53,2
CPT,71169,PET Scan,,,4155.27,4200.53,2
CPT,71170,PET Scan,,,4155.27,4200.53,2
CPT,71171,PET Scan,,,4155.27,4200.53,2
CPT,71172,PET Scan,,,4155.27,4200.53,2
CPT,71173,PET Scan,,,4155.27,4200.53,2
CPT,71174,PET Scan,,,4155.27,4200.53,2
CPT,71175,PET Scan,,,4155.27,4200.53,2
CPT,71176,PET Scan,,,4155.27,4200.53,2
CPT,71177,PET Scan,,,4155.27,4200.53,2
CPT,71178,PET Scan,,,4155.27,4200.53,2
CPT,71179,PET Scan,,,4155.27,4200.53,2
CPT,71180,PET Scan,,,4155.27,4200.53,2
CPT,71181,PET Scan,,,4155.27,4200.53,2
CPT,71182,PET Scan,,,4155.27,4200.53,2
CPT,71183,PET Scan,,,4155.27,4200.53,2
CPT,71184,PET Scan,,,4155.27,4200.53,2
CPT,71185,PET Scan,,,4155.27,4200.53,2
CPT,71186,PET Scan,,,4155.27,4200.53,2
CPT,71187,PET Scan,,,4155.27,4200.53,2
CPT,71188,PET Scan,,,4155.27,4200.53,2
CPT,71189,PET Scan,,,4155.27,4200.53,2
CPT,71190,PET Scan,,,4155.27,4200.53,2
CPT,71191,PET Scan,,,4155.27,4200.53,2
CPT,71192,PET Scan,,,4155.27,4200.53,2
CPT,71193,PET Scan,,,4155.27,4200.53,2
CPT,71194,PET Scan,,,4155.27,4200.53,2
CPT,71195,PET Scan,,,4155.27,4200.53,2
CPT,71196,PET Scan,,,4155.27,4200.53,2
CPT,71197,PET Scan,,,4155.27,4200.53,2
CPT,71198,PET Scan,,,4155.27,4200.53,2
CPT,71199,PET Scan,,,4155.27,4200.53,2
CPT,71210,PET Scan,,,4155.27,4200.53,2
CPT,71211,PET Scan,,,4155.27,4200.53,2
CPT,71212,PET Scan,,,4155.27,4200.53,2
CPT,71213,PET Scan,,,4155.27,4200.53,2
CPT,71214,PET Scan,,,4155.27,4200.53,2
CPT,71215,PET Scan,,,4155.27,4200.53,2
CPT,71216,PET Scan,,,4155.27,4200.53,2
CPT,71217,PET Scan,,,4155.27,4200.53,2
CPT,71218,PET Scan,,,4155.27,4200.53,2
CPT,71219,PET Scan,,,4155.27,4200.53,2
CPT,71220,PET Scan,,,4155.27,4200.53,2
CPT,71221,PET Scan,,,4155.27,4200.53,2
CPT,71222,PET Scan,,,4155.27,4200.53,2
CPT,71223,PET Scan,,,4155.27,4200.53,2
CPT,71224,PET Scan,,,4155.27,4200.53,2
CPT,71225,PET Scan,,,4155.27,4200.53,2
CPT,71226,PET Scan,,,4155.27,4200.53,2
CPT,71227,PET Scan,,,4155.27,4200.53,2
CPT,71228,PET Scan,,,4155.27,4200.53,2
CPT,71229,PET Scan,,,4155.27,4200.53,2
CPT,71230,PET Scan,,,4155.27,4200.53,2
CPT,71231,PET Scan,,,4155.27,4200.53,2
CPT,71232,PET Scan,,,4155.27,4200.53,2
CPT,71233,PET Scan,,,4155.27,4200.53,2
CPT,71234,PET Scan,,,4155.27,4200.53,2
CPT,71235,PET Scan,,,4155.27,4200.53,2
CPT,71236,PET Scan,,,4155.27,4200.53,2
CPT,71237,PET Scan,,,4155.27,4200.53,2
CPT,71238,PET Scan,,,4155.27,4200.53,2
CPT,71239,PET Scan,,,4155.27,4200.53,2
CPT,71250,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,71250,"COMPUTED TOMOGRAPHY, THORAX; W/O CONTRAST MATERIAL",6671.63,4336.56,1464.88,2332.97,2
CPT,71250,"COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,216.01,216.01,2
CPT,71250,CT SCAN,6671.63,4336.56,1425.59,1439.56,2
CPT,71250,HB CT CHEST WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,71250,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,71260,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,71260,"COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,293.06,2790.2,4
CPT,71260,CT SCAN,8051.27,5233.33,1704.98,1721.7,2
CPT,71260,HB CT CHEST W CONTRAST,9258.985,6018.344999999999,221.67,14761.0,10
CPT,71260,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,71270,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,71270,"COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,361.29,3477.87,4
CPT,71270,CT SCAN,8432.03,5480.82,2125.19,2146.03,2
CPT,71270,HB CT CHEST WO/W CONTRAST,9696.835,6302.945,221.67,14761.0,10
CPT,71270,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,71271,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,71271,CT SCAN,6671.63,4336.56,642.39,648.68,2
CPT,71271,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)",6671.63,4336.56,227.65,1051.26,4
CPT,71271,HB CT THORAX LOW LUNG CNCR SCRN W/O CONT,6671.63,4336.56,132.41,152.28,8
CPT,71271,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,71275,CAT Scan,7452.6,4844.19,2808.07,2839.65,2
CPT,71275,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",7452.6,4844.19,512.9,512.9,2
CPT,71275,"CT ANGIOGRAPHY, CHEST (NONCORONARY), W/O CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, IN",7452.6,4844.19,2231.15,3553.34,2
CPT,71275,CT SCAN,7452.6,4844.19,2171.31,2192.6,2
CPT,71275,HB CT ANGIO CHEST W 3D,8570.39,5570.754999999999,221.67,14761.0,10
CPT,71275,PET Scan,7452.6,4844.19,4155.27,4200.53,2
CPT,71280,PET Scan,,,4155.27,4200.53,2
CPT,71281,PET Scan,,,4155.27,4200.53,2
CPT,71282,PET Scan,,,4155.27,4200.53,2
CPT,71283,PET Scan,,,4155.27,4200.53,2
CPT,71284,PET Scan,,,4155.27,4200.53,2
CPT,71285,PET Scan,,,4155.27,4200.53,2
CPT,71286,PET Scan,,,4155.27,4200.53,2
CPT,71287,PET Scan,,,4155.27,4200.53,2
CPT,71288,PET Scan,,,4155.27,4200.53,2
CPT,71289,PET Scan,,,4155.27,4200.53,2
CPT,71290,PET Scan,,,4155.27,4200.53,2
CPT,71291,PET Scan,,,4155.27,4200.53,2
CPT,71292,PET Scan,,,4155.27,4200.53,2
CPT,71293,PET Scan,,,4155.27,4200.53,2
CPT,71294,PET Scan,,,4155.27,4200.53,2
CPT,71295,PET Scan,,,4155.27,4200.53,2
CPT,71296,PET Scan,,,4155.27,4200.53,2
CPT,71297,PET Scan,,,4155.27,4200.53,2
CPT,71298,PET Scan,,,4155.27,4200.53,2
CPT,71299,PET Scan,,,4155.27,4200.53,2
CPT,71430,PET Scan,,,4155.27,4200.53,2
CPT,71431,PET Scan,,,4155.27,4200.53,2
CPT,71432,PET Scan,,,4155.27,4200.53,2
CPT,71433,PET Scan,,,4155.27,4200.53,2
CPT,71481,PET Scan,,,4155.27,4200.53,2
CPT,71489,PET Scan,,,4155.27,4200.53,2
CPT,71500,PET Scan,,,4155.27,4200.53,2
CPT,71504,PET Scan,,,4155.27,4200.53,2
CPT,71509,PET Scan,,,4155.27,4200.53,2
CPT,71510,PET Scan,,,4155.27,4200.53,2
CPT,71511,PET Scan,,,4155.27,4200.53,2
CPT,71512,PET Scan,,,4155.27,4200.53,2
CPT,71513,PET Scan,,,4155.27,4200.53,2
CPT,71514,PET Scan,,,4155.27,4200.53,2
CPT,71515,PET Scan,,,4155.27,4200.53,2
CPT,71516,PET Scan,,,4155.27,4200.53,2
CPT,71517,PET Scan,,,4155.27,4200.53,2
CPT,71518,PET Scan,,,4155.27,4200.53,2
CPT,71520,PET Scan,,,4155.27,4200.53,2
CPT,71521,PET Scan,,,4155.27,4200.53,2
CPT,71522,PET Scan,,,4155.27,4200.53,2
CPT,71523,PET Scan,,,4155.27,4200.53,2
CPT,71524,PET Scan,,,4155.27,4200.53,2
CPT,71525,PET Scan,,,4155.27,4200.53,2
CPT,71526,PET Scan,,,4155.27,4200.53,2
CPT,71527,PET Scan,,,4155.27,4200.53,2
CPT,71528,PET Scan,,,4155.27,4200.53,2
CPT,71530,PET Scan,,,4155.27,4200.53,2
CPT,71531,PET Scan,,,4155.27,4200.53,2
CPT,71532,PET Scan,,,4155.27,4200.53,2
CPT,71533,PET Scan,,,4155.27,4200.53,2
CPT,71534,PET Scan,,,4155.27,4200.53,2
CPT,71535,PET Scan,,,4155.27,4200.53,2
CPT,71536,PET Scan,,,4155.27,4200.53,2
CPT,71537,PET Scan,,,4155.27,4200.53,2
CPT,71538,PET Scan,,,4155.27,4200.53,2
CPT,71550,HB MRI CHEST WO CONTRAST,6695.629999999999,4352.16,300.99,14761.0,10
CPT,71550,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY)",5822.28,3784.48,2767.25,4407.12,2
CPT,71550,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY) W/O CONTRAST MATERIAL(S)",5822.28,3784.48,710.93,710.93,2
CPT,71550,MRI,5822.28,3784.48,2693.02,2719.43,2
CPT,71550,MRI/MRA,5822.28,3784.48,3089.09,3116.45,2
CPT,71550,PET Scan,5822.28,3784.48,4155.27,4200.53,2
CPT,71551,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY); WITH CONTRAST MATERIAL(S)",,,772.5,772.5,2
CPT,71551,"MAGNETIC RESONANCE IMAGING, CHEST, WITH CONTRAST MATERIALS",,,3379.24,5381.79,2
CPT,71551,MRI,,,3288.6,3320.85,2
CPT,71551,PET Scan,,,4155.27,4200.53,2
CPT,71552,HB MRI CHEST WO/W CONTRAST,15036.349999999999,9773.630000000001,444.69,14761.0,10
CPT,71552,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY); WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",13075.1,8498.82,967.2,967.2,2
CPT,71552,"MAGNETIC RESONANCE IMAGING,CHEST,W/O CONTRAST MATERIALS FOLLOWED BY CONTRAST AND FURTHER SEQUENCES",13075.1,8498.82,6214.4,9897.06,2
CPT,71552,MRI,13075.1,8498.82,6047.71,6107.01,2
CPT,71552,MRI/MRA,13075.1,8498.82,3089.09,3116.45,2
CPT,71552,PET Scan,13075.1,8498.82,4155.27,4200.53,2
CPT,71555,HB MR ANGIO CHEST WO CONT W 3D,10878.279999999999,7070.88,13270.0,14761.0,4
CPT,71555,"MAGNETIC RESONANCE ANGIOGRAPHY, CHEST (EXCLUDING MYOCARDIUM), WITH OR WITHOUT CONTRAST MATERIAL(S)",9460.25,6149.16,656.02,656.02,2
CPT,71555,"MAGNETIC RESONANCE ANGIOGRAPHY, CHEST, WITH OR WITHOUT CONTRAST MATERIAL",9460.25,6149.16,2770.13,4411.71,2
CPT,71555,MRI,9460.25,6149.16,2695.83,2722.26,2
CPT,71555,MRI/MRA,9460.25,6149.16,3089.09,3116.45,2
CPT,71555,PET Scan,9460.25,6149.16,4155.27,4200.53,2
CPT,71580,PET Scan,,,4155.27,4200.53,2
CPT,71589,PET Scan,,,4155.27,4200.53,2
CPT,71590,PET Scan,,,4155.27,4200.53,2
CPT,71591,PET Scan,,,4155.27,4200.53,2
CPT,71592,PET Scan,,,4155.27,4200.53,2
CPT,71593,PET Scan,,,4155.27,4200.53,2
CPT,71594,PET Scan,,,4155.27,4200.53,2
CPT,71595,PET Scan,,,4155.27,4200.53,2
CPT,71596,PET Scan,,,4155.27,4200.53,2
CPT,71597,PET Scan,,,4155.27,4200.53,2
CPT,71598,PET Scan,,,4155.27,4200.53,2
CPT,71600,PET Scan,,,4155.27,4200.53,2
CPT,71601,PET Scan,,,4155.27,4200.53,2
CPT,71602,PET Scan,,,4155.27,4200.53,2
CPT,71603,PET Scan,,,4155.27,4200.53,2
CPT,71604,PET Scan,,,4155.27,4200.53,2
CPT,71605,PET Scan,,,4155.27,4200.53,2
CPT,71606,PET Scan,,,4155.27,4200.53,2
CPT,71607,PET Scan,,,4155.27,4200.53,2
CPT,71608,PET Scan,,,4155.27,4200.53,2
CPT,71609,PET Scan,,,4155.27,4200.53,2
CPT,71610,PET Scan,,,4155.27,4200.53,2
CPT,71611,PET Scan,,,4155.27,4200.53,2
CPT,71612,PET Scan,,,4155.27,4200.53,2
CPT,71613,PET Scan,,,4155.27,4200.53,2
CPT,71614,PET Scan,,,4155.27,4200.53,2
CPT,71615,PET Scan,,,4155.27,4200.53,2
CPT,71616,PET Scan,,,4155.27,4200.53,2
CPT,71617,PET Scan,,,4155.27,4200.53,2
CPT,71618,PET Scan,,,4155.27,4200.53,2
CPT,71619,PET Scan,,,4155.27,4200.53,2
CPT,71620,PET Scan,,,4155.27,4200.53,2
CPT,71621,PET Scan,,,4155.27,4200.53,2
CPT,71622,PET Scan,,,4155.27,4200.53,2
CPT,71623,PET Scan,,,4155.27,4200.53,2
CPT,71624,PET Scan,,,4155.27,4200.53,2
CPT,71625,PET Scan,,,4155.27,4200.53,2
CPT,71626,PET Scan,,,4155.27,4200.53,2
CPT,71627,PET Scan,,,4155.27,4200.53,2
CPT,71628,PET Scan,,,4155.27,4200.53,2
CPT,71629,PET Scan,,,4155.27,4200.53,2
CPT,71630,PET Scan,,,4155.27,4200.53,2
CPT,71631,PET Scan,,,4155.27,4200.53,2
CPT,71632,PET Scan,,,4155.27,4200.53,2
CPT,71633,PET Scan,,,4155.27,4200.53,2
CPT,71634,PET Scan,,,4155.27,4200.53,2
CPT,71635,PET Scan,,,4155.27,4200.53,2
CPT,71636,PET Scan,,,4155.27,4200.53,2
CPT,71637,PET Scan,,,4155.27,4200.53,2
CPT,71638,PET Scan,,,4155.27,4200.53,2
CPT,71639,PET Scan,,,4155.27,4200.53,2
CPT,71640,PET Scan,,,4155.27,4200.53,2
CPT,71641,PET Scan,,,4155.27,4200.53,2
CPT,71642,PET Scan,,,4155.27,4200.53,2
CPT,71643,PET Scan,,,4155.27,4200.53,2
CPT,71644,PET Scan,,,4155.27,4200.53,2
CPT,71645,PET Scan,,,4155.27,4200.53,2
CPT,71646,PET Scan,,,4155.27,4200.53,2
CPT,71647,PET Scan,,,4155.27,4200.53,2
CPT,71648,PET Scan,,,4155.27,4200.53,2
CPT,71649,PET Scan,,,4155.27,4200.53,2
CPT,71650,PET Scan,,,4155.27,4200.53,2
CPT,71651,PET Scan,,,4155.27,4200.53,2
CPT,71652,PET Scan,,,4155.27,4200.53,2
CPT,71653,PET Scan,,,4155.27,4200.53,2
CPT,71654,PET Scan,,,4155.27,4200.53,2
CPT,71655,PET Scan,,,4155.27,4200.53,2
CPT,71656,PET Scan,,,4155.27,4200.53,2
CPT,71657,PET Scan,,,4155.27,4200.53,2
CPT,71658,PET Scan,,,4155.27,4200.53,2
CPT,71659,PET Scan,,,4155.27,4200.53,2
CPT,71660,PET Scan,,,4155.27,4200.53,2
CPT,71661,PET Scan,,,4155.27,4200.53,2
CPT,71662,PET Scan,,,4155.27,4200.53,2
CPT,71663,PET Scan,,,4155.27,4200.53,2
CPT,71664,PET Scan,,,4155.27,4200.53,2
CPT,71665,PET Scan,,,4155.27,4200.53,2
CPT,71666,PET Scan,,,4155.27,4200.53,2
CPT,71667,PET Scan,,,4155.27,4200.53,2
CPT,71668,PET Scan,,,4155.27,4200.53,2
CPT,71680,PET Scan,,,4155.27,4200.53,2
CPT,71681,PET Scan,,,4155.27,4200.53,2
CPT,71682,PET Scan,,,4155.27,4200.53,2
CPT,71683,PET Scan,,,4155.27,4200.53,2
CPT,71684,PET Scan,,,4155.27,4200.53,2
CPT,71685,PET Scan,,,4155.27,4200.53,2
CPT,71686,PET Scan,,,4155.27,4200.53,2
CPT,71687,PET Scan,,,4155.27,4200.53,2
CPT,71688,PET Scan,,,4155.27,4200.53,2
CPT,71689,PET Scan,,,4155.27,4200.53,2
CPT,71690,PET Scan,,,4155.27,4200.53,2
CPT,71691,PET Scan,,,4155.27,4200.53,2
CPT,71692,PET Scan,,,4155.27,4200.53,2
CPT,71693,PET Scan,,,4155.27,4200.53,2
CPT,71694,PET Scan,,,4155.27,4200.53,2
CPT,71695,PET Scan,,,4155.27,4200.53,2
CPT,71696,PET Scan,,,4155.27,4200.53,2
CPT,71697,PET Scan,,,4155.27,4200.53,2
CPT,71698,PET Scan,,,4155.27,4200.53,2
CPT,71699,PET Scan,,,4155.27,4200.53,2
CPT,71740,PET Scan,,,4155.27,4200.53,2
CPT,71741,PET Scan,,,4155.27,4200.53,2
CPT,71742,PET Scan,,,4155.27,4200.53,2
CPT,71743,PET Scan,,,4155.27,4200.53,2
CPT,71749,PET Scan,,,4155.27,4200.53,2
CPT,71781,PET Scan,,,4155.27,4200.53,2
CPT,71782,PET Scan,,,4155.27,4200.53,2
CPT,71783,PET Scan,,,4155.27,4200.53,2
CPT,71784,PET Scan,,,4155.27,4200.53,2
CPT,71785,PET Scan,,,4155.27,4200.53,2
CPT,71789,PET Scan,,,4155.27,4200.53,2
CPT,71800,PET Scan,,,4155.27,4200.53,2
CPT,71801,PET Scan,,,4155.27,4200.53,2
CPT,71802,PET Scan,,,4155.27,4200.53,2
CPT,71803,PET Scan,,,4155.27,4200.53,2
CPT,71804,PET Scan,,,4155.27,4200.53,2
CPT,71805,PET Scan,,,4155.27,4200.53,2
CPT,71807,PET Scan,,,4155.27,4200.53,2
CPT,71808,PET Scan,,,4155.27,4200.53,2
CPT,71809,PET Scan,,,4155.27,4200.53,2
CPT,71810,PET Scan,,,4155.27,4200.53,2
CPT,71811,PET Scan,,,4155.27,4200.53,2
CPT,71812,PET Scan,,,4155.27,4200.53,2
CPT,71813,PET Scan,,,4155.27,4200.53,2
CPT,71814,PET Scan,,,4155.27,4200.53,2
CPT,71815,PET Scan,,,4155.27,4200.53,2
CPT,71817,PET Scan,,,4155.27,4200.53,2
CPT,71818,PET Scan,,,4155.27,4200.53,2
CPT,71819,PET Scan,,,4155.27,4200.53,2
CPT,71820,PET Scan,,,4155.27,4200.53,2
CPT,71821,PET Scan,,,4155.27,4200.53,2
CPT,71822,PET Scan,,,4155.27,4200.53,2
CPT,71823,PET Scan,,,4155.27,4200.53,2
CPT,71824,PET Scan,,,4155.27,4200.53,2
CPT,71825,PET Scan,,,4155.27,4200.53,2
CPT,71826,PET Scan,,,4155.27,4200.53,2
CPT,71827,PET Scan,,,4155.27,4200.53,2
CPT,71828,PET Scan,,,4155.27,4200.53,2
CPT,71829,PET Scan,,,4155.27,4200.53,2
CPT,71830,PET Scan,,,4155.27,4200.53,2
CPT,71831,PET Scan,,,4155.27,4200.53,2
CPT,71832,PET Scan,,,4155.27,4200.53,2
CPT,71833,PET Scan,,,4155.27,4200.53,2
CPT,71834,PET Scan,,,4155.27,4200.53,2
CPT,71835,PET Scan,,,4155.27,4200.53,2
CPT,71836,PET Scan,,,4155.27,4200.53,2
CPT,71837,PET Scan,,,4155.27,4200.53,2
CPT,71838,PET Scan,,,4155.27,4200.53,2
CPT,71839,PET Scan,,,4155.27,4200.53,2
CPT,71840,PET Scan,,,4155.27,4200.53,2
CPT,71841,PET Scan,,,4155.27,4200.53,2
CPT,71842,PET Scan,,,4155.27,4200.53,2
CPT,71843,PET Scan,,,4155.27,4200.53,2
CPT,71844,PET Scan,,,4155.27,4200.53,2
CPT,71845,PET Scan,,,4155.27,4200.53,2
CPT,71846,PET Scan,,,4155.27,4200.53,2
CPT,71847,PET Scan,,,4155.27,4200.53,2
CPT,71848,PET Scan,,,4155.27,4200.53,2
CPT,71849,PET Scan,,,4155.27,4200.53,2
CPT,71850,PET Scan,,,4155.27,4200.53,2
CPT,71851,PET Scan,,,4155.27,4200.53,2
CPT,71852,PET Scan,,,4155.27,4200.53,2
CPT,71853,PET Scan,,,4155.27,4200.53,2
CPT,71854,PET Scan,,,4155.27,4200.53,2
CPT,71855,PET Scan,,,4155.27,4200.53,2
CPT,71856,PET Scan,,,4155.27,4200.53,2
CPT,71857,PET Scan,,,4155.27,4200.53,2
CPT,71858,PET Scan,,,4155.27,4200.53,2
CPT,71859,PET Scan,,,4155.27,4200.53,2
CPT,71860,PET Scan,,,4155.27,4200.53,2
CPT,71865,PET Scan,,,4155.27,4200.53,2
CPT,71870,PET Scan,,,4155.27,4200.53,2
CPT,71871,PET Scan,,,4155.27,4200.53,2
CPT,71872,PET Scan,,,4155.27,4200.53,2
CPT,71873,PET Scan,,,4155.27,4200.53,2
CPT,71874,PET Scan,,,4155.27,4200.53,2
CPT,71875,PET Scan,,,4155.27,4200.53,2
CPT,71876,PET Scan,,,4155.27,4200.53,2
CPT,71877,PET Scan,,,4155.27,4200.53,2
CPT,71878,PET Scan,,,4155.27,4200.53,2
CPT,71879,PET Scan,,,4155.27,4200.53,2
CPT,71880,PET Scan,,,4155.27,4200.53,2
CPT,71881,PET Scan,,,4155.27,4200.53,2
CPT,71882,PET Scan,,,4155.27,4200.53,2
CPT,71883,PET Scan,,,4155.27,4200.53,2
CPT,71884,PET Scan,,,4155.27,4200.53,2
CPT,71885,PET Scan,,,4155.27,4200.53,2
CPT,71886,PET Scan,,,4155.27,4200.53,2
CPT,71887,PET Scan,,,4155.27,4200.53,2
CPT,71888,PET Scan,,,4155.27,4200.53,2
CPT,71889,PET Scan,,,4155.27,4200.53,2
CPT,71890,PET Scan,,,4155.27,4200.53,2
CPT,71891,PET Scan,,,4155.27,4200.53,2
CPT,71892,PET Scan,,,4155.27,4200.53,2
CPT,71893,PET Scan,,,4155.27,4200.53,2
CPT,71894,PET Scan,,,4155.27,4200.53,2
CPT,71895,PET Scan,,,4155.27,4200.53,2
CPT,71897,PET Scan,,,4155.27,4200.53,2
CPT,71898,PET Scan,,,4155.27,4200.53,2
CPT,71899,PET Scan,,,4155.27,4200.53,2
CPT,71900,PET Scan,,,4155.27,4200.53,2
CPT,71901,PET Scan,,,4155.27,4200.53,2
CPT,71902,PET Scan,,,4155.27,4200.53,2
CPT,71903,PET Scan,,,4155.27,4200.53,2
CPT,71904,PET Scan,,,4155.27,4200.53,2
CPT,71905,PET Scan,,,4155.27,4200.53,2
CPT,71906,PET Scan,,,4155.27,4200.53,2
CPT,71907,PET Scan,,,4155.27,4200.53,2
CPT,71908,PET Scan,,,4155.27,4200.53,2
CPT,71909,PET Scan,,,4155.27,4200.53,2
CPT,71910,PET Scan,,,4155.27,4200.53,2
CPT,71911,PET Scan,,,4155.27,4200.53,2
CPT,71912,PET Scan,,,4155.27,4200.53,2
CPT,71913,PET Scan,,,4155.27,4200.53,2
CPT,71914,PET Scan,,,4155.27,4200.53,2
CPT,71915,PET Scan,,,4155.27,4200.53,2
CPT,71916,PET Scan,,,4155.27,4200.53,2
CPT,71917,PET Scan,,,4155.27,4200.53,2
CPT,71918,PET Scan,,,4155.27,4200.53,2
CPT,71919,PET Scan,,,4155.27,4200.53,2
CPT,71920,PET Scan,,,4155.27,4200.53,2
CPT,71921,PET Scan,,,4155.27,4200.53,2
CPT,71922,PET Scan,,,4155.27,4200.53,2
CPT,71923,PET Scan,,,4155.27,4200.53,2
CPT,71924,PET Scan,,,4155.27,4200.53,2
CPT,71925,PET Scan,,,4155.27,4200.53,2
CPT,71926,PET Scan,,,4155.27,4200.53,2
CPT,71927,PET Scan,,,4155.27,4200.53,2
CPT,71928,PET Scan,,,4155.27,4200.53,2
CPT,71929,PET Scan,,,4155.27,4200.53,2
CPT,71930,PET Scan,,,4155.27,4200.53,2
CPT,71931,PET Scan,,,4155.27,4200.53,2
CPT,71932,PET Scan,,,4155.27,4200.53,2
CPT,71933,PET Scan,,,4155.27,4200.53,2
CPT,71934,PET Scan,,,4155.27,4200.53,2
CPT,71935,PET Scan,,,4155.27,4200.53,2
CPT,71936,PET Scan,,,4155.27,4200.53,2
CPT,71937,PET Scan,,,4155.27,4200.53,2
CPT,71938,PET Scan,,,4155.27,4200.53,2
CPT,71939,PET Scan,,,4155.27,4200.53,2
CPT,71940,PET Scan,,,4155.27,4200.53,2
CPT,71941,PET Scan,,,4155.27,4200.53,2
CPT,71942,PET Scan,,,4155.27,4200.53,2
CPT,71943,PET Scan,,,4155.27,4200.53,2
CPT,71944,PET Scan,,,4155.27,4200.53,2
CPT,71945,PET Scan,,,4155.27,4200.53,2
CPT,71946,PET Scan,,,4155.27,4200.53,2
CPT,71947,PET Scan,,,4155.27,4200.53,2
CPT,71948,PET Scan,,,4155.27,4200.53,2
CPT,71949,PET Scan,,,4155.27,4200.53,2
CPT,71950,PET Scan,,,4155.27,4200.53,2
CPT,71951,PET Scan,,,4155.27,4200.53,2
CPT,71952,PET Scan,,,4155.27,4200.53,2
CPT,71953,PET Scan,,,4155.27,4200.53,2
CPT,71954,PET Scan,,,4155.27,4200.53,2
CPT,71955,PET Scan,,,4155.27,4200.53,2
CPT,71956,PET Scan,,,4155.27,4200.53,2
CPT,71957,PET Scan,,,4155.27,4200.53,2
CPT,71958,PET Scan,,,4155.27,4200.53,2
CPT,71959,PET Scan,,,4155.27,4200.53,2
CPT,71960,PET Scan,,,4155.27,4200.53,2
CPT,71961,PET Scan,,,4155.27,4200.53,2
CPT,71962,PET Scan,,,4155.27,4200.53,2
CPT,71963,PET Scan,,,4155.27,4200.53,2
CPT,71964,PET Scan,,,4155.27,4200.53,2
CPT,71965,PET Scan,,,4155.27,4200.53,2
CPT,71966,PET Scan,,,4155.27,4200.53,2
CPT,71967,PET Scan,,,4155.27,4200.53,2
CPT,71968,PET Scan,,,4155.27,4200.53,2
CPT,71969,PET Scan,,,4155.27,4200.53,2
CPT,71980,PET Scan,,,4155.27,4200.53,2
CPT,71981,PET Scan,,,4155.27,4200.53,2
CPT,71982,PET Scan,,,4155.27,4200.53,2
CPT,71983,PET Scan,,,4155.27,4200.53,2
CPT,71984,PET Scan,,,4155.27,4200.53,2
CPT,71985,PET Scan,,,4155.27,4200.53,2
CPT,71986,PET Scan,,,4155.27,4200.53,2
CPT,71987,PET Scan,,,4155.27,4200.53,2
CPT,71988,PET Scan,,,4155.27,4200.53,2
CPT,71989,PET Scan,,,4155.27,4200.53,2
CPT,71990,PET Scan,,,4155.27,4200.53,2
CPT,71991,PET Scan,,,4155.27,4200.53,2
CPT,71992,PET Scan,,,4155.27,4200.53,2
CPT,71993,PET Scan,,,4155.27,4200.53,2
CPT,71994,PET Scan,,,4155.27,4200.53,2
CPT,71995,PET Scan,,,4155.27,4200.53,2
CPT,71996,PET Scan,,,4155.27,4200.53,2
CPT,71997,PET Scan,,,4155.27,4200.53,2
CPT,71998,PET Scan,,,4155.27,4200.53,2
CPT,71999,PET Scan,,,4155.27,4200.53,2
CPT,72020,HB XR C-SPINE 1 VW,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,72020,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,72020,"RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL",1344.46,873.9,42.11,169.11,4
CPT,72040,HB XR C-SPINE 2-3VW,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,72040,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72040,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 3 VIEWS OR LESS",1760.68,1144.44,150.4,239.52,2
CPT,72040,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL",1760.68,1144.44,72.06,72.06,2
CPT,72050,HB XR C-SPINE 4-5VW,2429.74,1579.335,132.41,14761.0,10
CPT,72050,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,72050,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS",2112.81,1373.33,224.42,357.41,2
CPT,72050,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS",2112.81,1373.33,100.36,100.36,2
CPT,72052,HB XR C-SPINE 6VW/MORE,2535.39,1648.0,132.41,152.28,8
CPT,72052,PET Scan,2535.39,1648.0,4155.27,4200.53,2
CPT,72052,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 6 OR MORE VIEWS",2535.39,1648.0,282.86,450.49,2
CPT,72052,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES",2535.39,1648.0,119.49,119.49,2
CPT,72070,HB XR T-SPINE 2VW,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,72070,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72070,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL",1760.68,1144.44,57.92,57.92,2
CPT,72070,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, TWO VIEWS",1760.68,1144.44,162.45,258.72,2
CPT,72072,HB XR T-SPINE 3VW,2429.74,1579.335,132.41,14761.0,10
CPT,72072,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,72072,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL, INCLUDING SWIMMER'S VIEW OF THE CERVICOTHORACIC JUNCTION",2112.81,1373.33,71.24,71.24,2
CPT,72072,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, THREE VIEWS",2112.81,1373.33,184.62,294.02,2
CPT,72074,HB XR T-SPINE 4VW/MORE,2915.6949999999997,1895.2,132.41,14761.0,10
CPT,72074,PET Scan,2535.39,1648.0,4155.27,4200.53,2
CPT,72074,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING OBLIQUES, MINIMUM OF FOUR VIEWS",2535.39,1648.0,81.21,81.21,2
CPT,72074,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, MINIMUM OF FOUR VIEWS",2535.39,1648.0,228.01,363.12,2
CPT,72080,HB XR T/L-SPINE MIN 2VW,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,72080,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,72080,"RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR AND LATERAL",1344.46,873.9,61.25,61.25,2
CPT,72080,"RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, TWO VIEWS",1344.46,873.9,167.45,266.68,2
CPT,72081,HB X-RAY EXAM ENTIRE SPI 1 VW,1165.54,757.5999999999999,109.64,14761.0,10
CPT,72081,PET Scan,1013.51,658.78,4155.27,4200.53,2
CPT,72081,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view",1013.51,658.78,75.39,75.39,2
CPT,72081,X-ray exam entire spi 1 vw,1013.51,658.78,263.52,419.68,2
CPT,72082,HB X-RAY EXAM ENTIRE SPI 2/3 VW,1930.205,1254.635,132.41,14761.0,10
CPT,72082,PET Scan,1678.44,1090.99,4155.27,4200.53,2
CPT,72082,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views",1678.44,1090.99,137.8,137.8,2
CPT,72082,X-ray exam entire spi 2/3 vw,1678.44,1090.99,481.59,766.98,2
CPT,72083,HB X-RAY EXAM ENTIRE SPI 4/5 VW,2848.96,1851.82,132.41,152.28,8
CPT,72083,PET Scan,2848.96,1851.82,4155.27,4200.53,2
CPT,72083,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views",2848.96,1851.82,154.44,154.44,2
CPT,72083,X-ray exam entire spi 4/5 vw,2848.96,1851.82,522.75,832.53,2
CPT,72084,PET Scan,3434.25,2232.26,4155.27,4200.53,2
CPT,72084,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views",3434.25,2232.26,197.38,197.38,2
CPT,72084,X-ray exam entire spi 6/> vw,3434.25,2232.26,627.52,999.39,2
CPT,72089,PET Scan,,,4155.27,4200.53,2
CPT,72100,HB XR L-SPINE 2-3VW,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,72100,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72100,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL",1760.68,1144.44,72.89,72.89,2
CPT,72100,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; TWO OR THREE VIEWS",1760.68,1144.44,167.45,266.68,2
CPT,72110,HB XR L-SPINE 4-5VW,2429.74,1579.335,132.41,14761.0,10
CPT,72110,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,72110,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS",2112.81,1373.33,97.02,97.02,2
CPT,72110,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF FOUR VIEWS",2112.81,1373.33,228.71,364.25,2
CPT,72114,HB XR L-SPINE 6VW W BENDING,2915.6949999999997,1895.2,132.41,14761.0,10
CPT,72114,PET Scan,2535.39,1648.0,4155.27,4200.53,2
CPT,72114,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS",2535.39,1648.0,117.82,470.9,4
CPT,72120,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72120,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS",1760.68,1144.44,74.56,355.17,4
CPT,72125,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,72125,"COMPUTED TOMOGRAPHY, CERVICAL SPINE; W/O CONTRAST MATERIAL",6671.63,4336.56,1464.88,2332.97,2
CPT,72125,"COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,217.67,217.67,2
CPT,72125,CT SCAN,6671.63,4336.56,1425.59,1439.56,2
CPT,72125,HB CT C-SPINE WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,72125,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,72126,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,72126,"COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL",8051.27,5233.33,292.23,2789.17,4
CPT,72126,CT SCAN,8051.27,5233.33,1704.35,1721.06,2
CPT,72126,HB CT C-SPINE W CONTRAST,9258.985,6018.344999999999,444.69,14761.0,10
CPT,72126,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,72127,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,72127,"COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,2182.29,3475.52,2
CPT,72127,"COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,361.29,361.29,2
CPT,72127,CT SCAN,8432.03,5480.82,2123.76,2144.58,2
CPT,72127,HB CT C-SPINE WO/W CONTRAST,9696.835,6302.945,221.67,14761.0,10
CPT,72127,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,72128,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,72128,"COMPUTED TOMOGRAPHY, THORACIC SPINE; W/O CONTRAST MATERIAL",6671.63,4336.56,1464.88,2332.97,2
CPT,72128,"COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,217.67,217.67,2
CPT,72128,CT SCAN,6671.63,4336.56,1425.59,1439.56,2
CPT,72128,HB CT T-SPINE WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,72128,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,72129,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,72129,"COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL",8051.27,5233.33,294.73,2789.17,4
CPT,72129,CT SCAN,8051.27,5233.33,1704.35,1721.06,2
CPT,72129,HB CT T-SPINE W CONTRAST,9258.985,6018.344999999999,221.67,14761.0,10
CPT,72129,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,72130,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,72130,"COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,2182.29,3475.52,2
CPT,72130,"COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,365.45,365.45,2
CPT,72130,CT SCAN,8432.03,5480.82,2123.76,2144.58,2
CPT,72130,HB CT T-SPINE WO/W CONTRAST,10961.64,7125.07,13270.0,14761.0,2
CPT,72130,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,72131,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,72131,"COMPUTED TOMOGRAPHY, LUMBAR SPINE; W/O CONTRAST MATERIAL",6671.63,4336.56,1464.88,2332.97,2
CPT,72131,"COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,216.01,216.01,2
CPT,72131,CT SCAN,6671.63,4336.56,1425.59,1439.56,2
CPT,72131,HB CT L-SPINE WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,72131,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,72132,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,72132,"COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL",8051.27,5233.33,293.06,2789.17,4
CPT,72132,CT SCAN,8051.27,5233.33,1704.35,1721.06,2
CPT,72132,HB CT L-SPINE W CONTRAST,9258.985,6018.344999999999,444.69,14761.0,10
CPT,72132,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,72133,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,72133,"COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,2182.29,3475.52,2
CPT,72133,"COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,362.12,362.12,2
CPT,72133,CT SCAN,8432.03,5480.82,2123.76,2144.58,2
CPT,72133,HB CT L-SPINE WO/W CONTRAST,9696.835,6302.945,221.67,14761.0,10
CPT,72133,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,72141,HB MRI C-SPINE WO CONTRAST,9099.41,5914.615,300.99,14761.0,10
CPT,72141,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL",7912.54,5143.15,318.86,4407.12,4
CPT,72141,MRI,7912.54,5143.15,2693.02,2719.43,2
CPT,72141,MRI/MRA,7912.54,5143.15,3089.09,3116.45,2
CPT,72141,PET Scan,7912.54,5143.15,4155.27,4200.53,2
CPT,72142,HB MRI C-SPINE W CONTRAST,11566.119999999999,7517.98,444.69,14761.0,10
CPT,72142,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S)",10057.9,6537.64,504.4,5288.81,4
CPT,72142,MRI,10057.9,6537.64,3231.79,3263.47,2
CPT,72142,MRI/MRA,10057.9,6537.64,3089.09,3116.45,2
CPT,72142,PET Scan,10057.9,6537.64,4155.27,4200.53,2
CPT,72146,HB MRI T-SPINE WO CONTRAST,7426.425,4827.18,300.99,14761.0,10
CPT,72146,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL",6457.75,4197.54,318.86,4888.13,4
CPT,72146,MRI,6457.75,4197.54,2986.95,3016.24,2
CPT,72146,MRI/MRA,6457.75,4197.54,3089.09,3116.45,2
CPT,72146,PET Scan,6457.75,4197.54,4155.27,4200.53,2
CPT,72147,HB MRI T-SPINE W CONTRAST,9099.41,5914.615,444.69,14761.0,10
CPT,72147,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S)",7912.54,5143.15,499.4,5288.81,4
CPT,72147,MRI,7912.54,5143.15,3231.79,3263.47,2
CPT,72147,MRI/MRA,7912.54,5143.15,3089.09,3116.45,2
CPT,72147,PET Scan,7912.54,5143.15,4155.27,4200.53,2
CPT,72148,HB MRI L-SPINE WO CONTRAST,9099.41,5914.615,300.99,14761.0,10
CPT,72148,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL",7912.54,5143.15,320.52,4883.64,4
CPT,72148,MRI,7912.54,5143.15,2984.2,3013.46,2
CPT,72148,MRI/MRA,7912.54,5143.15,3089.09,3116.45,2
CPT,72148,PET Scan,7912.54,5143.15,4155.27,4200.53,2
CPT,72149,HB MRI L-SPINE W CONTRAST,12326.265,8012.075000000001,444.69,14761.0,10
CPT,72149,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S)",10718.5,6967.03,492.75,5285.43,4
CPT,72149,MRI,10718.5,6967.03,3229.73,3261.39,2
CPT,72149,MRI/MRA,10718.5,6967.03,3089.09,3116.45,2
CPT,72149,PET Scan,10718.5,6967.03,4155.27,4200.53,2
CPT,72156,HB MRI C-SPINE WO/W CONT,17087.125,11106.63,444.69,14761.0,10
CPT,72156,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; CERVICAL",14858.4,9657.96,562.0,562.0,2
CPT,72156,"MAGNETIC RESONANCE(EG, PROTON)IMAGING,SPINAL CANAL AND CONTENTS, W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATERIA",14858.4,9657.96,5444.77,8671.35,2
CPT,72156,MRI,14858.4,9657.96,5298.73,5350.68,2
CPT,72156,MRI/MRA,14858.4,9657.96,3089.09,3116.45,2
CPT,72156,PET Scan,14858.4,9657.96,4155.27,4200.53,2
CPT,72157,HB MRI T-SPINE WO/W CONT,17087.125,11106.63,444.69,14761.0,10
CPT,72157,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; THORACIC",14858.4,9657.96,563.66,563.66,2
CPT,72157,"MAGNETIC RESONANCE IMAGING,SPINAL CANAL AND CONTENTS,W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATERIAL(S);THORACIC",14858.4,9657.96,5444.77,8671.35,2
CPT,72157,MRI,14858.4,9657.96,5298.73,5350.68,2
CPT,72157,MRI/MRA,14858.4,9657.96,3089.09,3116.45,2
CPT,72157,PET Scan,14858.4,9657.96,4155.27,4200.53,2
CPT,72158,HB MRI L-SPINE WO/W CONT,14549.78,9457.355,444.69,14761.0,10
CPT,72158,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; LUMBAR",12652.2,8223.93,560.33,560.33,2
CPT,72158,"MAGNETIC RESONANCE IMAGING,SPINAL CANAL AND CONTENTS, W/O CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S);LUMBAR",12652.2,8223.93,5446.89,8674.72,2
CPT,72158,MRI,12652.2,8223.93,5300.79,5352.76,2
CPT,72158,MRI/MRA,12652.2,8223.93,3089.09,3116.45,2
CPT,72158,PET Scan,12652.2,8223.93,4155.27,4200.53,2
CPT,72159,HB MR ANGIO SPINE WO/W CONT,12610.28,8196.68,13270.0,14761.0,2
CPT,72159,"MAGNETIC RESONANCE ANGIOGRAPHY, SPINAL CANAL AND CONTENTS, WITH OR WITHOUT CONTRAST MATERIAL(S)",9701.27,6305.83,686.81,686.81,2
CPT,72159,"MAGNETIC RESONANCE ANGIOGRAPHY,SPINAL CANAL AND CONTENTS, WITH OR WITHOUT CONTRAST MATERIAL(S)",9701.27,6305.83,3072.92,4893.94,2
CPT,72159,MRI,9701.27,6305.83,2990.5,3019.82,2
CPT,72159,MRI/MRA,9701.27,6305.83,3089.09,3116.45,2
CPT,72159,PET Scan,9701.27,6305.83,4155.27,4200.53,2
CPT,72170,HB XR PELVIS 1-2VW,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,72170,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72170,"RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY",1760.68,1144.44,48.76,48.76,2
CPT,72170,"RADIOLOGIC EXAMINATION, PELVIS; ONE OR TWO VIEWS",1760.68,1144.44,130.41,207.69,2
CPT,72190,HB XR PELVIS 3VW/MORE,2429.74,1579.335,132.41,14761.0,10
CPT,72190,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,72190,"RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS",2112.81,1373.33,75.39,266.68,4
CPT,72191,CAT Scan,5733.3,3726.65,2808.07,2839.65,2
CPT,72191,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",5733.3,3726.65,579.47,579.47,2
CPT,72191,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY,PELVIS, W/O CONTRAST FOLLOWBY CONTRAST,AND FURTHER SEQUENCES,INCLUDE IMAGE POST PROCESS",5733.3,3726.65,2144.67,3415.6,2
CPT,72191,CT SCAN,5733.3,3726.65,2087.14,2107.6,2
CPT,72191,HB CT ANGIO PELVIS W 3D,6592.950000000001,4285.42,221.67,14761.0,10
CPT,72191,PET Scan,5733.3,3726.65,4155.27,4200.53,2
CPT,72192,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,72192,"COMPUTED TOMOGRAPHY, PELVIS; W/O CONTRAST MATERIAL RIAL",6671.63,4336.56,1464.11,2331.75,2
CPT,72192,"COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,215.18,215.18,2
CPT,72192,CT SCAN,6671.63,4336.56,1424.84,1438.81,2
CPT,72192,HB CT PELVIS WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,72192,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,72193,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,72193,"COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,461.13,2694.97,4
CPT,72193,CT SCAN,8051.27,5233.33,1646.79,1662.94,2
CPT,72193,HB CT PELVIS W CONTRAST,9258.985,6018.344999999999,221.67,14761.0,10
CPT,72193,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,72194,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,72194,"COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,516.05,3336.01,4
CPT,72194,CT SCAN,8432.03,5480.82,2038.51,2058.49,2
CPT,72194,HB CT PELVIS WO/W CONTRAST,9696.835,6302.945,221.67,14761.0,10
CPT,72194,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,72195,HB MRI PELVIS WO CONTRAST,7541.209999999999,4901.79,300.99,14761.0,10
CPT,72195,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S)",6557.95,4262.67,423.69,423.69,2
CPT,72195,"MAGNETIC RESONANCE IMAGING, PELVIS; W/O CONTRAST MATERIALS",6557.95,4262.67,2821.57,4493.64,2
CPT,72195,MRI,6557.95,4262.67,2745.89,2772.81,2
CPT,72195,MRI/MRA,6557.95,4262.67,3089.09,3116.45,2
CPT,72195,PET Scan,6557.95,4262.67,4155.27,4200.53,2
CPT,72196,HB MRI PELVIS W CONTRAST,8425.375,5476.495,444.69,14761.0,10
CPT,72196,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS WITH CONTRAST MATERIAL",7326.41,4762.17,2767.25,4407.12,2
CPT,72196,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS WITH CONTRAST MATERIAL(S)",7326.41,4762.17,495.25,495.25,2
CPT,72196,MRI,7326.41,4762.17,2693.02,2719.43,2
CPT,72196,MRI/MRA,7326.41,4762.17,3089.09,3116.45,2
CPT,72196,PET Scan,7326.41,4762.17,4155.27,4200.53,2
CPT,72197,HB MRI PELVIS WO/W CONT,15128.51,9833.529999999999,444.69,14761.0,10
CPT,72197,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",13155.2,8550.88,620.24,620.24,2
CPT,72197,"MAGNETIC RESONANCE IMAGING, PELVIS;W/O CONTRAST,FOLLOWED BY CONTRAST, AND FURTHER SEQUENCES",13155.2,8550.88,6252.5,9957.73,2
CPT,72197,MRI,13155.2,8550.88,6084.79,6144.45,2
CPT,72197,MRI/MRA,13155.2,8550.88,3089.09,3116.45,2
CPT,72197,PET Scan,13155.2,8550.88,4155.27,4200.53,2
CPT,72198,HB MR ANGIO PELVIS WO CONT W 3D,10352.029999999999,6728.8150000000005,13270.0,14761.0,2
CPT,72198,HB MR ANGIO PELVIS WO/W CONT W 3D,10352.029999999999,6728.8150000000005,13270.0,14761.0,4
CPT,72198,"MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUT CONTRAST MATERIAL(S)",9002.05,5851.33,667.66,667.66,2
CPT,72198,"MAGNETIC RESONANCE ANGIOGRAPHY,PELVIS, WITH OR WITHOUT CONTRAST MATERIAL (S)",9002.05,5851.33,2770.77,4412.74,2
CPT,72198,MRI,9002.05,5851.33,2696.46,2722.89,2
CPT,72198,MRI/MRA,9002.05,5851.33,3089.09,3116.45,2
CPT,72198,PET Scan,9002.05,5851.33,4155.27,4200.53,2
CPT,72200,HB XR SACROILIAC JNT 2VW/LESS,1546.13,1004.9849999999999,132.41,14761.0,10
CPT,72200,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,72200,"RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS",1344.46,873.9,62.08,207.69,4
CPT,72202,HB XR SACROILIAC JNT 3VW/MORE,1760.68,1144.44,132.41,152.28,8
CPT,72202,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,72202,"RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS",1760.68,1144.44,71.24,246.36,4
CPT,72210,PET Scan,,,4155.27,4200.53,2
CPT,72211,PET Scan,,,4155.27,4200.53,2
CPT,72220,HB XR SACRUM/COCCYX 2VW/MORE,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,72220,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,72220,"RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS",1344.46,873.9,60.42,226.98,4
CPT,72230,PET Scan,,,4155.27,4200.53,2
CPT,72231,PET Scan,,,4155.27,4200.53,2
CPT,72232,PET Scan,,,4155.27,4200.53,2
CPT,72239,PET Scan,,,4155.27,4200.53,2
CPT,72240,"MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13069.6,8495.24,176.9,176.9,2
CPT,72240,"MYELOGRAPHY, CERVICAL; SUPERVISION AND INTERPRETATION ONLY",13069.6,8495.24,1180.02,1879.29,2
CPT,72240,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,72251,PET Scan,,,4155.27,4200.53,2
CPT,72252,PET Scan,,,4155.27,4200.53,2
CPT,72255,"MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13069.6,8495.24,184.39,184.39,2
CPT,72255,"MYELOGRAPHY, THORACIC; SUPERVISION AND INTERPRETATION ONLY",13069.6,8495.24,1077.12,1715.43,2
CPT,72255,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,72265,"MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13069.6,8495.24,175.24,175.24,2
CPT,72265,"MYELOGRAPHY, LUMBOSACRAL; SUPERVISION AND INTERPRETATION ONLY",13069.6,8495.24,1013.27,1613.74,2
CPT,72265,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,72270,"MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13069.6,8495.24,247.62,247.62,2
CPT,72270,"MYELOGRAPHY, TWO OR MORE REGIONS (EG, LUMBAR/THORACIC, CERVICAL/THORACIC, LUMBAR/CERVICAL, LUMBAR/THORACIC/CERVICAL), SU",13069.6,8495.24,1516.26,2414.8,2
CPT,72270,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,72271,PET Scan,,,4155.27,4200.53,2
CPT,72272,PET Scan,,,4155.27,4200.53,2
CPT,72273,PET Scan,,,4155.27,4200.53,2
CPT,72275,"EPIDUROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,532.86,848.63,2
CPT,72275,PET Scan,,,4155.27,4200.53,2
CPT,72280,PET Scan,,,4155.27,4200.53,2
CPT,72281,PET Scan,,,4155.27,4200.53,2
CPT,72282,PET Scan,,,4155.27,4200.53,2
CPT,72283,PET Scan,,,4155.27,4200.53,2
CPT,72285,"DISKOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13722.6,8919.69,183.56,183.56,2
CPT,72285,"DISKOGRAPHY, CERVICAL; SUPERVISION AND INTERPRETATION ONLY",13722.6,8919.69,2083.28,3317.84,2
CPT,72285,PET Scan,13722.6,8919.69,4155.27,4200.53,2
CPT,72290,PET Scan,,,4155.27,4200.53,2
CPT,72291,PET Scan,,,4155.27,4200.53,2
CPT,72292,PET Scan,,,4155.27,4200.53,2
CPT,72293,PET Scan,,,4155.27,4200.53,2
CPT,72295,"DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13722.6,8919.69,178.56,178.56,2
CPT,72295,"DISKOGRAPHY, LUMBAR; SUPERVISION AND INTERPRETATION ONLY",13722.6,8919.69,1950.99,3107.16,2
CPT,72295,HB DISCOGRAM LUMBAR S&I,13722.6,8919.69,2431.57,2796.3,8
CPT,72295,PET Scan,13722.6,8919.69,4155.27,4200.53,2
CPT,72400,PET Scan,,,4155.27,4200.53,2
CPT,72401,PET Scan,,,4155.27,4200.53,2
CPT,72402,PET Scan,,,4155.27,4200.53,2
CPT,72403,PET Scan,,,4155.27,4200.53,2
CPT,72409,PET Scan,,,4155.27,4200.53,2
CPT,72470,PET Scan,,,4155.27,4200.53,2
CPT,72471,PET Scan,,,4155.27,4200.53,2
CPT,72479,PET Scan,,,4155.27,4200.53,2
CPT,72610,PET Scan,,,4155.27,4200.53,2
CPT,72611,PET Scan,,,4155.27,4200.53,2
CPT,72612,PET Scan,,,4155.27,4200.53,2
CPT,72613,PET Scan,,,4155.27,4200.53,2
CPT,72619,PET Scan,,,4155.27,4200.53,2
CPT,72630,PET Scan,,,4155.27,4200.53,2
CPT,72631,PET Scan,,,4155.27,4200.53,2
CPT,72632,PET Scan,,,4155.27,4200.53,2
CPT,72633,PET Scan,,,4155.27,4200.53,2
CPT,72639,PET Scan,,,4155.27,4200.53,2
CPT,72660,PET Scan,,,4155.27,4200.53,2
CPT,72661,PET Scan,,,4155.27,4200.53,2
CPT,72662,PET Scan,,,4155.27,4200.53,2
CPT,72663,PET Scan,,,4155.27,4200.53,2
CPT,72664,PET Scan,,,4155.27,4200.53,2
CPT,72665,PET Scan,,,4155.27,4200.53,2
CPT,72669,PET Scan,,,4155.27,4200.53,2
CPT,72670,PET Scan,,,4155.27,4200.53,2
CPT,72671,PET Scan,,,4155.27,4200.53,2
CPT,72672,PET Scan,,,4155.27,4200.53,2
CPT,72673,PET Scan,,,4155.27,4200.53,2
CPT,72679,PET Scan,,,4155.27,4200.53,2
CPT,72690,PET Scan,,,4155.27,4200.53,2
CPT,72691,PET Scan,,,4155.27,4200.53,2
CPT,72700,PET Scan,,,4155.27,4200.53,2
CPT,72701,PET Scan,,,4155.27,4200.53,2
CPT,72702,PET Scan,,,4155.27,4200.53,2
CPT,72703,PET Scan,,,4155.27,4200.53,2
CPT,72704,PET Scan,,,4155.27,4200.53,2
CPT,72705,PET Scan,,,4155.27,4200.53,2
CPT,72706,PET Scan,,,4155.27,4200.53,2
CPT,72709,PET Scan,,,4155.27,4200.53,2
CPT,72740,PET Scan,,,4155.27,4200.53,2
CPT,72741,PET Scan,,,4155.27,4200.53,2
CPT,72742,PET Scan,,,4155.27,4200.53,2
CPT,72743,PET Scan,,,4155.27,4200.53,2
CPT,72749,PET Scan,,,4155.27,4200.53,2
CPT,72750,PET Scan,,,4155.27,4200.53,2
CPT,72751,PET Scan,,,4155.27,4200.53,2
CPT,72759,PET Scan,,,4155.27,4200.53,2
CPT,72760,PET Scan,,,4155.27,4200.53,2
CPT,72761,PET Scan,,,4155.27,4200.53,2
CPT,72762,PET Scan,,,4155.27,4200.53,2
CPT,72763,PET Scan,,,4155.27,4200.53,2
CPT,72764,PET Scan,,,4155.27,4200.53,2
CPT,72765,PET Scan,,,4155.27,4200.53,2
CPT,72766,PET Scan,,,4155.27,4200.53,2
CPT,72767,PET Scan,,,4155.27,4200.53,2
CPT,72768,PET Scan,,,4155.27,4200.53,2
CPT,72769,PET Scan,,,4155.27,4200.53,2
CPT,72781,PET Scan,,,4155.27,4200.53,2
CPT,72782,PET Scan,,,4155.27,4200.53,2
CPT,72783,PET Scan,,,4155.27,4200.53,2
CPT,72789,PET Scan,,,4155.27,4200.53,2
CPT,72810,PET Scan,,,4155.27,4200.53,2
CPT,72811,PET Scan,,,4155.27,4200.53,2
CPT,72812,PET Scan,,,4155.27,4200.53,2
CPT,72813,PET Scan,,,4155.27,4200.53,2
CPT,72819,PET Scan,,,4155.27,4200.53,2
CPT,72871,PET Scan,,,4155.27,4200.53,2
CPT,72879,PET Scan,,,4155.27,4200.53,2
CPT,72881,PET Scan,,,4155.27,4200.53,2
CPT,72882,PET Scan,,,4155.27,4200.53,2
CPT,72883,PET Scan,,,4155.27,4200.53,2
CPT,72884,PET Scan,,,4155.27,4200.53,2
CPT,72885,PET Scan,,,4155.27,4200.53,2
CPT,72886,PET Scan,,,4155.27,4200.53,2
CPT,72887,PET Scan,,,4155.27,4200.53,2
CPT,72888,PET Scan,,,4155.27,4200.53,2
CPT,72889,PET Scan,,,4155.27,4200.53,2
CPT,72930,PET Scan,,,4155.27,4200.53,2
CPT,72931,PET Scan,,,4155.27,4200.53,2
CPT,72939,PET Scan,,,4155.27,4200.53,2
CPT,72971,PET Scan,,,4155.27,4200.53,2
CPT,72972,PET Scan,,,4155.27,4200.53,2
CPT,72973,PET Scan,,,4155.27,4200.53,2
CPT,72979,PET Scan,,,4155.27,4200.53,2
CPT,72981,PET Scan,,,4155.27,4200.53,2
CPT,72982,PET Scan,,,4155.27,4200.53,2
CPT,72989,PET Scan,,,4155.27,4200.53,2
CPT,72990,PET Scan,,,4155.27,4200.53,2
CPT,72991,PET Scan,,,4155.27,4200.53,2
CPT,72992,PET Scan,,,4155.27,4200.53,2
CPT,72999,PET Scan,,,4155.27,4200.53,2
CPT,73000,HB XR CLAVICLE UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73000,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73000,"RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE",1344.46,873.9,60.42,207.69,4
CPT,73001,PET Scan,,,4155.27,4200.53,2
CPT,73002,PET Scan,,,4155.27,4200.53,2
CPT,73003,PET Scan,,,4155.27,4200.53,2
CPT,73004,PET Scan,,,4155.27,4200.53,2
CPT,73005,PET Scan,,,4155.27,4200.53,2
CPT,73006,PET Scan,,,4155.27,4200.53,2
CPT,73007,PET Scan,,,4155.27,4200.53,2
CPT,73008,PET Scan,,,4155.27,4200.53,2
CPT,73009,PET Scan,,,4155.27,4200.53,2
CPT,73010,HB XR SCAPULA UNILATERAL,1546.13,1004.9849999999999,132.41,14761.0,10
CPT,73010,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73010,"RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE",1344.46,873.9,37.12,207.69,4
CPT,73011,PET Scan,,,4155.27,4200.53,2
CPT,73012,PET Scan,,,4155.27,4200.53,2
CPT,73013,PET Scan,,,4155.27,4200.53,2
CPT,73014,PET Scan,,,4155.27,4200.53,2
CPT,73015,PET Scan,,,4155.27,4200.53,2
CPT,73016,PET Scan,,,4155.27,4200.53,2
CPT,73017,PET Scan,,,4155.27,4200.53,2
CPT,73018,PET Scan,,,4155.27,4200.53,2
CPT,73019,PET Scan,,,4155.27,4200.53,2
CPT,73020,HB XR SHOULDER 1VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73020,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73020,"RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW",1344.46,873.9,35.45,188.4,4
CPT,73021,PET Scan,,,4155.27,4200.53,2
CPT,73022,PET Scan,,,4155.27,4200.53,2
CPT,73023,PET Scan,,,4155.27,4200.53,2
CPT,73024,PET Scan,,,4155.27,4200.53,2
CPT,73025,PET Scan,,,4155.27,4200.53,2
CPT,73026,PET Scan,,,4155.27,4200.53,2
CPT,73027,PET Scan,,,4155.27,4200.53,2
CPT,73028,PET Scan,,,4155.27,4200.53,2
CPT,73029,PET Scan,,,4155.27,4200.53,2
CPT,73030,HB XR SHOULDER 2VW/MORE UNILT,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73030,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73030,"RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS",1760.68,1144.44,63.75,226.98,4
CPT,73031,PET Scan,,,4155.27,4200.53,2
CPT,73032,PET Scan,,,4155.27,4200.53,2
CPT,73033,PET Scan,,,4155.27,4200.53,2
CPT,73034,PET Scan,,,4155.27,4200.53,2
CPT,73035,PET Scan,,,4155.27,4200.53,2
CPT,73036,PET Scan,,,4155.27,4200.53,2
CPT,73037,PET Scan,,,4155.27,4200.53,2
CPT,73038,PET Scan,,,4155.27,4200.53,2
CPT,73039,PET Scan,,,4155.27,4200.53,2
CPT,73040,HB ARTHROGRAM SHOULDER S&I UNI,3834.59,2492.48,444.69,511.4,8
CPT,73040,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73040,"RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISIONAND INTERPRETATION",3834.59,2492.48,262.61,262.61,2
CPT,73040,"RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,522.51,832.15,2
CPT,73050,HB XR AC JNTS WO/W WEIGHTS BIL,1760.68,1144.44,109.64,126.08,8
CPT,73050,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73050,"RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION",1760.68,1144.44,48.76,266.68,4
CPT,73060,HB XR HUMERUS 2VW/MORE UNILAT,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73060,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73060,"RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS",1344.46,873.9,60.42,226.98,4
CPT,73070,HB XR ELBOW 2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73070,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73070,"RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,52.93,52.93,2
CPT,73070,"RADIOLOGIC EXAMINATION, ELBOW; TWO VIEWS",1344.46,873.9,130.41,207.69,2
CPT,73071,PET Scan,,,4155.27,4200.53,2
CPT,73072,PET Scan,,,4155.27,4200.53,2
CPT,73073,PET Scan,,,4155.27,4200.53,2
CPT,73074,PET Scan,,,4155.27,4200.53,2
CPT,73075,PET Scan,,,4155.27,4200.53,2
CPT,73076,PET Scan,,,4155.27,4200.53,2
CPT,73077,PET Scan,,,4155.27,4200.53,2
CPT,73078,PET Scan,,,4155.27,4200.53,2
CPT,73079,PET Scan,,,4155.27,4200.53,2
CPT,73080,HB XR ELBOW 3VW/MORE UNILAT,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73080,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73080,"RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS",1760.68,1144.44,60.42,226.98,4
CPT,73081,PET Scan,,,4155.27,4200.53,2
CPT,73082,PET Scan,,,4155.27,4200.53,2
CPT,73083,PET Scan,,,4155.27,4200.53,2
CPT,73084,PET Scan,,,4155.27,4200.53,2
CPT,73085,HB ARTHROGRAM ELBOW S&I UNILAT,3834.59,2492.48,444.69,511.4,8
CPT,73085,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73085,"RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3834.59,2492.48,211.84,211.84,2
CPT,73085,"RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,522.51,832.15,2
CPT,73086,PET Scan,,,4155.27,4200.53,2
CPT,73087,PET Scan,,,4155.27,4200.53,2
CPT,73088,PET Scan,,,4155.27,4200.53,2
CPT,73089,PET Scan,,,4155.27,4200.53,2
CPT,73090,HB XR FOREARM 2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73090,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73090,"RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,53.76,53.76,2
CPT,73090,"RADIOLOGIC EXAMINATION; FOREARM, TWO VIEWS",1344.46,873.9,130.41,207.69,2
CPT,73091,PET Scan,,,4155.27,4200.53,2
CPT,73092,HB XR EXT UPP INFANT 2VW UNI,2288.88,1487.77,13270.0,14761.0,2
CPT,73092,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73092,"RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS",1760.68,1144.44,59.58,196.26,4
CPT,73093,PET Scan,,,4155.27,4200.53,2
CPT,73094,PET Scan,,,4155.27,4200.53,2
CPT,73095,PET Scan,,,4155.27,4200.53,2
CPT,73096,PET Scan,,,4155.27,4200.53,2
CPT,73097,PET Scan,,,4155.27,4200.53,2
CPT,73098,PET Scan,,,4155.27,4200.53,2
CPT,73099,PET Scan,,,4155.27,4200.53,2
CPT,73100,HB XR WRIST 2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73100,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73100,"RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,64.57,64.57,2
CPT,73100,"RADIOLOGIC EXAMINATION, WRIST; TWO VIEWS",1344.46,873.9,123.23,196.26,2
CPT,73110,HB XR WRIST 3VW/MORE UNILAT,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73110,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73110,"RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS",1760.68,1144.44,81.21,211.06,4
CPT,73115,HB ARTHROGRAM WRIST S&I UNILAT,3834.59,2492.48,444.69,511.4,8
CPT,73115,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73115,"RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3834.59,2492.48,271.75,271.75,2
CPT,73115,"RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,392.4,624.93,2
CPT,73120,HB XR HAND 2VW UNILATERAL,1546.13,1004.9849999999999,132.41,14761.0,10
CPT,73120,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73120,"RADIOLOGIC EXAMINATION, HAND; TWO VIEWS",1344.46,873.9,57.92,196.26,4
CPT,73130,HB XR HAND 3VW/MORE UNILATERAL,1685.56,1095.615,109.64,14761.0,10
CPT,73130,PET Scan,1465.71,952.71,4155.27,4200.53,2
CPT,73130,"RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS",1465.71,952.71,71.24,211.06,4
CPT,73140,HB XR FINGERS 2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73140,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73140,"RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS",1344.46,873.9,77.89,167.89,4
CPT,73200,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,73200,"COMPUTED TOMOGRAPHY, UPPER EXTREMITY; W/O CONTRAST MATERIAL",6671.63,4336.56,1231.87,1961.88,2
CPT,73200,"COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,301.7,301.7,2
CPT,73200,CT SCAN,6671.63,4336.56,1198.83,1210.59,2
CPT,73200,HB CT EXT UPP WO CONTRAST UNI,7672.360000000001,4987.035,132.41,14761.0,10
CPT,73200,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,73201,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,73201,"COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,385.42,2332.97,4
CPT,73201,CT SCAN,8051.27,5233.33,1425.59,1439.56,2
CPT,73201,HB CT EXT UPP W CONTRAST UNI,9258.985,6018.344999999999,444.69,14761.0,10
CPT,73201,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,73202,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,73202,"COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,1838.23,2927.56,2
CPT,73202,"COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,504.4,504.4,2
CPT,73202,CT SCAN,8432.03,5480.82,1788.92,1806.46,2
CPT,73202,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,73206,CAT Scan,4359.6,2833.74,2808.07,2839.65,2
CPT,73206,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, UPPER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",4359.6,2833.74,559.5,559.5,2
CPT,73206,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY,UPPER EXTREMITY,WITHOUT CONTRAST,FOLLOWED CONTRAST,FURTHER SEQUENCES, IMAGE POST",4359.6,2833.74,1882.62,2998.26,2
CPT,73206,CT SCAN,4359.6,2833.74,1832.12,1850.08,2
CPT,73206,HB CT ANGIO EXT UPPER UNILAT W 3D,5013.54,3258.8,221.67,14761.0,10
CPT,73206,PET Scan,4359.6,2833.74,4155.27,4200.53,2
CPT,73218,HB MRI EXT UPP WO CONT UNI,6804.025,4422.62,300.99,14761.0,10
CPT,73218,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S)",5916.55,3845.76,633.56,633.56,2
CPT,73218,"MAGNETIC RESONANCE IMAGING, UPPER EXTREMITY,OTHER THAN JOINTW/O CONTRAST MATERIALS",5916.55,3845.76,2812.05,4478.47,2
CPT,73218,MRI,5916.55,3845.76,2736.62,2763.45,2
CPT,73218,MRI/MRA,5916.55,3845.76,3089.09,3116.45,2
CPT,73218,PET Scan,5916.55,3845.76,4155.27,4200.53,2
CPT,73219,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITH CONTRAST MATERIAL(S)",7326.41,4762.17,675.99,675.99,2
CPT,73219,"MAGNETIC RESONANCE IMAGING, UPPER EXTREMITY,OTHER THAN JOINTWITH CONTRAST MATERIALS",7326.41,4762.17,3389.18,5397.61,2
CPT,73219,MRI,7326.41,4762.17,3298.27,3330.61,2
CPT,73219,PET Scan,7326.41,4762.17,4155.27,4200.53,2
CPT,73220,HB MRI EXT UPP WO/W CONT UNI,10629.89,6909.425,444.69,14761.0,10
CPT,73220,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT WITHOUT CONTRAST MATERIALS(S) FOLLOWED BY CONTRAST MATERIALS AND FUTHER SEQUENCES",9244.13,6008.68,818.26,818.26,2
CPT,73220,"MAGNETIC RESONANCE IMAGING,UPPER EXTREMITY,OTHER THAN JOINT W/O THEN FOLLOWED WITH CONTRAST MATERIALS,FURTHER SEQUENCES",9244.13,6008.68,2765.83,4404.87,2
CPT,73220,MRI,9244.13,6008.68,2691.65,2718.04,2
CPT,73220,MRI/MRA,9244.13,6008.68,3089.09,3116.45,2
CPT,73220,PET Scan,9244.13,6008.68,4155.27,4200.53,2
CPT,73221,HB MRI EXT UPP JT WO CONT UNI,7579.47,4926.655,300.99,14761.0,10
CPT,73221,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY",6590.76,4283.99,2755.78,4388.86,2
CPT,73221,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIALS",6590.76,4283.99,364.62,364.62,2
CPT,73221,MRI,6590.76,4283.99,2681.86,2708.16,2
CPT,73221,MRI/MRA,6590.76,4283.99,3089.09,3116.45,2
CPT,73221,PET Scan,6590.76,4283.99,4155.27,4200.53,2
CPT,73222,HB MRI EXT UPP JT W CONT UNI,13069.6,8495.24,983.77,1131.34,8
CPT,73222,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITH CONTRAST MATERIALS",13069.6,8495.24,625.88,625.88,2
CPT,73222,"MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; WITH CONTRAST MATERIALS",13069.6,8495.24,3371.54,5369.52,2
CPT,73222,MRI,13069.6,8495.24,3281.11,3313.28,2
CPT,73222,MRI/MRA,13069.6,8495.24,3089.09,3116.45,2
CPT,73222,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,73223,HB MRI EXT UPP JT WO/W CNT UNI,15100.955,9815.619999999999,444.69,14761.0,10
CPT,73223,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIALS, FOLLOWED BY CONTRAST MATERIALS AND FURTHER SEQUENCES",13131.3,8535.34,757.52,757.52,2
CPT,73223,"MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; W/O CONTRAST,FOLLOWED CONTRAST,AND FURTHER SEQUENCES",13131.3,8535.34,6241.09,9939.57,2
CPT,73223,MRI,13131.3,8535.34,6073.69,6133.24,2
CPT,73223,MRI/MRA,13131.3,8535.34,3089.09,3116.45,2
CPT,73223,PET Scan,13131.3,8535.34,4155.27,4200.53,2
CPT,73225,HB MR ANGIO EXT UPP WO/W CN UN,8853.69,5754.9,,,0
CPT,73225,"MAGNETIC RESONANCE ANGIOGRAPHY, UPPER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S)",8853.69,5754.9,686.81,686.81,2
CPT,73225,"MAGNETIC RESONANCE ANGIOGRAPHY,UPPER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S)",8853.69,5754.9,2769.36,4410.49,2
CPT,73225,MRI,8853.69,5754.9,2695.08,2721.51,2
CPT,73225,MRI/MRA,8853.69,5754.9,3089.09,3116.45,2
CPT,73225,PET Scan,8853.69,5754.9,4155.27,4200.53,2
CPT,73300,PET Scan,,,4155.27,4200.53,2
CPT,73301,PET Scan,,,4155.27,4200.53,2
CPT,73302,PET Scan,,,4155.27,4200.53,2
CPT,73303,PET Scan,,,4155.27,4200.53,2
CPT,73309,PET Scan,,,4155.27,4200.53,2
CPT,73310,PET Scan,,,4155.27,4200.53,2
CPT,73311,PET Scan,,,4155.27,4200.53,2
CPT,73312,PET Scan,,,4155.27,4200.53,2
CPT,73313,PET Scan,,,4155.27,4200.53,2
CPT,73314,PET Scan,,,4155.27,4200.53,2
CPT,73315,PET Scan,,,4155.27,4200.53,2
CPT,73316,PET Scan,,,4155.27,4200.53,2
CPT,73319,PET Scan,,,4155.27,4200.53,2
CPT,73320,PET Scan,,,4155.27,4200.53,2
CPT,73321,PET Scan,,,4155.27,4200.53,2
CPT,73322,PET Scan,,,4155.27,4200.53,2
CPT,73329,PET Scan,,,4155.27,4200.53,2
CPT,73340,PET Scan,,,4155.27,4200.53,2
CPT,73341,PET Scan,,,4155.27,4200.53,2
CPT,73342,PET Scan,,,4155.27,4200.53,2
CPT,73343,PET Scan,,,4155.27,4200.53,2
CPT,73344,PET Scan,,,4155.27,4200.53,2
CPT,73345,PET Scan,,,4155.27,4200.53,2
CPT,73349,PET Scan,,,4155.27,4200.53,2
CPT,73381,PET Scan,,,4155.27,4200.53,2
CPT,73382,PET Scan,,,4155.27,4200.53,2
CPT,73390,PET Scan,,,4155.27,4200.53,2
CPT,73391,PET Scan,,,4155.27,4200.53,2
CPT,73392,PET Scan,,,4155.27,4200.53,2
CPT,73393,PET Scan,,,4155.27,4200.53,2
CPT,73394,PET Scan,,,4155.27,4200.53,2
CPT,73395,PET Scan,,,4155.27,4200.53,2
CPT,73396,PET Scan,,,4155.27,4200.53,2
CPT,73397,PET Scan,,,4155.27,4200.53,2
CPT,73398,PET Scan,,,4155.27,4200.53,2
CPT,73399,PET Scan,,,4155.27,4200.53,2
CPT,73501,HB X-RAY EXAM HIP UNI 1 VIEW,3888.0649999999996,2527.24,109.64,14761.0,10
CPT,73501,PET Scan,3380.93,2197.6,4155.27,4200.53,2
CPT,73501,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view",3380.93,2197.6,59.58,59.58,2
CPT,73501,X-ray exam hip uni 1 view,3380.93,2197.6,211.19,336.34,2
CPT,73502,HB X-RAY EXAM HIP UNI 2-3 VIEWS,5401.515,3510.985,109.64,14761.0,10
CPT,73502,PET Scan,4696.97,3053.03,4155.27,4200.53,2
CPT,73502,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views",4696.97,3053.03,90.37,90.37,2
CPT,73502,X-ray exam hip uni 2-3 views,4696.97,3053.03,312.44,497.59,2
CPT,73503,HB X-RAY EXAM HIP UNI 4/> VIEWS,6458.33,4197.91,132.41,152.28,8
CPT,73503,PET Scan,6458.33,4197.91,4155.27,4200.53,2
CPT,73503,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views",6458.33,4197.91,115.33,115.33,2
CPT,73503,X-ray exam hip uni 4/> views,6458.33,4197.91,387.17,616.6,2
CPT,73521,HB X-RAY EXAM HIPS BI 2 VIEWS,6751.889999999999,4388.73,132.41,14761.0,10
CPT,73521,PET Scan,5871.21,3816.29,4155.27,4200.53,2
CPT,73521,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views",5871.21,3816.29,76.23,76.23,2
CPT,73521,X-ray exam hips bi 2 views,5871.21,3816.29,293.56,467.53,2
CPT,73522,HB X-RAY EXAM HIPS BI 3-4 VIEWS,9452.645,6144.22,132.41,14761.0,10
CPT,73522,PET Scan,8219.69,5342.8,4155.27,4200.53,2
CPT,73522,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views",8219.69,5342.8,98.69,98.69,2
CPT,73522,X-ray exam hips bi 3-4 views,8219.69,5342.8,350.24,557.8,2
CPT,73523,HB X-RAY EXAM HIPS BI 5/> VIEWS,15492.1,10069.86,132.41,152.28,8
CPT,73523,PET Scan,15492.1,10069.86,4155.27,4200.53,2
CPT,73523,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views",15492.1,10069.86,117.0,117.0,2
CPT,73523,X-ray exam hips bi 5/> views,15492.1,10069.86,421.5,671.28,2
CPT,73525,HB ARTHROGRAM HIP S&I UNILAT,3834.59,2492.48,444.69,511.4,8
CPT,73525,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73525,"RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3834.59,2492.48,257.61,257.61,2
CPT,73525,"RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,522.51,832.15,2
CPT,73551,HB X-RAY EXAM OF FEMUR 1,1391.52,904.49,109.64,14761.0,10
CPT,73551,PET Scan,1210.01,786.51,4155.27,4200.53,2
CPT,73551,"Radiologic examination, femur; 1 view",1210.01,786.51,52.93,52.93,2
CPT,73551,X-ray exam of femur 1,1210.01,786.51,200.02,318.55,2
CPT,73552,HB X-RAY EXAM OF FEMUR 2/>,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73552,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73552,"Radiologic examination, femur; minimum 2 views",1344.46,873.9,67.07,67.07,2
CPT,73552,X-ray exam of femur 2/>,1344.46,873.9,237.77,378.67,2
CPT,73560,HB XR KNEE 1-2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73560,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73560,"RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,65.4,207.69,4
CPT,73562,HB XR KNEE 3VW UNILATERAL,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73562,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73562,"RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS",1760.68,1144.44,78.72,226.88,4
CPT,73564,HB XR KNEE 4VW/MORE UNILATERAL,2429.74,1579.335,132.41,14761.0,10
CPT,73564,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,73564,"RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEWS",2112.81,1373.33,88.7,88.7,2
CPT,73564,"RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND/OR TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEWS",2112.81,1373.33,155.34,247.39,2
CPT,73565,HB XR KNEE 1VW STANDING BILAT,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73565,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73565,"RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR",1344.46,873.9,78.72,196.36,4
CPT,73580,HB ARTHROGRAM KNEE S&I UNILAT,3834.59,2492.48,444.69,511.4,8
CPT,73580,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73580,"RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION ANDINTERPRETATION",3834.59,2492.48,244.3,244.3,2
CPT,73580,"RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,654.74,1042.74,2
CPT,73590,HB XR TIBIA/FIBULA 2VW UNILAT,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73590,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73590,"RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,59.58,59.58,2
CPT,73590,"RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, TWO VIEWS",1344.46,873.9,130.41,207.69,2
CPT,73592,HB XR EXT LOW 2VW UNILAT INFNT,1760.68,1144.44,109.64,126.08,8
CPT,73592,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73592,"RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS",1760.68,1144.44,59.58,196.26,4
CPT,73600,HB XR ANKLE 2VW UNILATERAL,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73600,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73600,"RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS",1760.68,1144.44,61.25,61.25,2
CPT,73600,"RADIOLOGIC EXAMINATION, ANKLE; TWO VIEWS",1760.68,1144.44,123.23,196.26,2
CPT,73601,PET Scan,,,4155.27,4200.53,2
CPT,73602,PET Scan,,,4155.27,4200.53,2
CPT,73603,PET Scan,,,4155.27,4200.53,2
CPT,73604,PET Scan,,,4155.27,4200.53,2
CPT,73605,PET Scan,,,4155.27,4200.53,2
CPT,73606,PET Scan,,,4155.27,4200.53,2
CPT,73607,PET Scan,,,4155.27,4200.53,2
CPT,73609,PET Scan,,,4155.27,4200.53,2
CPT,73610,HB XR ANKLE 3VW/MORE UNILAT,2429.74,1579.335,109.64,14761.0,10
CPT,73610,PET Scan,2112.81,1373.33,4155.27,4200.53,2
CPT,73610,"RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS",2112.81,1373.33,71.24,211.06,4
CPT,73615,HB ARTHROGRAM ANKLE S&I UNILAT,3834.59,2492.48,444.69,511.4,8
CPT,73615,PET Scan,3834.59,2492.48,4155.27,4200.53,2
CPT,73615,"RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3834.59,2492.48,256.77,256.77,2
CPT,73615,"RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY; SUPERVISION AND INTERPRETATION ONLY",3834.59,2492.48,522.51,832.15,2
CPT,73620,HB XR FOOT 2VW UNILATERAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73620,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73620,"RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS",1344.46,873.9,52.09,52.09,2
CPT,73620,"RADIOLOGIC EXAMINATION, FOOT; TWO VIEWS",1344.46,873.9,123.23,196.26,2
CPT,73621,PET Scan,,,4155.27,4200.53,2
CPT,73622,PET Scan,,,4155.27,4200.53,2
CPT,73629,PET Scan,,,4155.27,4200.53,2
CPT,73630,HB XR FOOT 3VW/MORE UNILAT,2024.7800000000002,1316.105,109.64,14761.0,10
CPT,73630,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,73630,"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS",1760.68,1144.44,65.4,211.06,4
CPT,73631,PET Scan,,,4155.27,4200.53,2
CPT,73632,PET Scan,,,4155.27,4200.53,2
CPT,73639,PET Scan,,,4155.27,4200.53,2
CPT,73641,PET Scan,,,4155.27,4200.53,2
CPT,73642,PET Scan,,,4155.27,4200.53,2
CPT,73650,HB XR CALCANEUS 2VW/MORE UNI,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73650,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73650,"RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS",1344.46,873.9,52.09,188.4,4
CPT,73660,HB XR TOES 2VWS/MORE UNILAT,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,73660,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,73660,"RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS",1344.46,873.9,57.08,167.89,4
CPT,73670,PET Scan,,,4155.27,4200.53,2
CPT,73671,PET Scan,,,4155.27,4200.53,2
CPT,73672,PET Scan,,,4155.27,4200.53,2
CPT,73673,PET Scan,,,4155.27,4200.53,2
CPT,73674,PET Scan,,,4155.27,4200.53,2
CPT,73675,PET Scan,,,4155.27,4200.53,2
CPT,73676,PET Scan,,,4155.27,4200.53,2
CPT,73679,PET Scan,,,4155.27,4200.53,2
CPT,73681,PET Scan,,,4155.27,4200.53,2
CPT,73689,PET Scan,,,4155.27,4200.53,2
CPT,73700,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,73700,"COMPUTED TOMOGRAPHY, LOWER EXTREMITY; W/O CONTRAST MATERIAL",6671.63,4336.56,1231.87,1961.88,2
CPT,73700,"COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,216.83,216.83,2
CPT,73700,CT SCAN,6671.63,4336.56,1198.83,1210.59,2
CPT,73700,HB CT LOW EXT WO CONT UNILAT,7672.360000000001,4987.035,132.41,14761.0,10
CPT,73700,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,73701,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,73701,"COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,293.89,2332.97,4
CPT,73701,CT SCAN,8051.27,5233.33,1425.59,1439.56,2
CPT,73701,HB CT EXT LOW W CONT UNILAT,9258.985,6018.344999999999,221.67,14761.0,10
CPT,73701,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,73702,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,73702,"COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH",8432.03,5480.82,1838.23,2927.56,2
CPT,73702,"COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,362.12,362.12,2
CPT,73702,CT SCAN,8432.03,5480.82,1788.92,1806.46,2
CPT,73702,HB CT LOW EXT WO/W CONT UNILAT,10961.64,7125.07,13270.0,14761.0,2
CPT,73702,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,73706,CAT Scan,4630.82,3010.03,2808.07,2839.65,2
CPT,73706,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",4630.82,3010.03,616.08,616.08,2
CPT,73706,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY,LOWER EXTREMITY,W/O CONTRASFOLLOW CONTRAST,FURTHER SECTIONS,INCLUDING IMAGE POST PROCES",4630.82,3010.03,1882.62,2998.26,2
CPT,73706,CT SCAN,4630.82,3010.03,1832.12,1850.08,2
CPT,73706,HB CT ANGIO EXT LOW WO/W CN UN 3D,5325.4349999999995,3461.53,221.67,14761.0,10
CPT,73706,PET Scan,4630.82,3010.03,4155.27,4200.53,2
CPT,73710,PET Scan,,,4155.27,4200.53,2
CPT,73711,PET Scan,,,4155.27,4200.53,2
CPT,73712,PET Scan,,,4155.27,4200.53,2
CPT,73718,HB MRI EXT LOW WO CONT UNI,7579.47,4926.655,300.99,14761.0,10
CPT,73718,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S)",6590.76,4283.99,422.86,422.86,2
CPT,73718,"MAGNETIC RESONANCE IMAGING, LOWER EXTREMITY;OTHER THAN JOINTW/O CONTRAST MATERIALS",6590.76,4283.99,2812.05,4478.47,2
CPT,73718,MRI,6590.76,4283.99,2736.62,2763.45,2
CPT,73718,MRI/MRA,6590.76,4283.99,3089.09,3116.45,2
CPT,73718,PET Scan,6590.76,4283.99,4155.27,4200.53,2
CPT,73719,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITH CONTRAST MATERIAL(S)",,,492.75,492.75,2
CPT,73719,"MAGNETIC RESONANCE IMAGING,LOWER EXTREMITY,OTHER THAN JOINT WITH CONTRAST MATERIALS",,,3371.54,5369.52,2
CPT,73719,MRI,,,3281.11,3313.28,2
CPT,73719,PET Scan,,,4155.27,4200.53,2
CPT,73720,HB MRI EXT LOW WO/W CONT UNILAT,13609.205,8845.985,444.69,14761.0,10
CPT,73720,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCE",11834.1,7692.17,626.07,626.07,2
CPT,73720,"MAGNETIC RESONANCE IMAGING,LOWER EXTREMITY,OTHER THAN JOINT W/O THEN WITH CONTRAST MATERIALS AND FURTHER SEQUENCES",11834.1,7692.17,2765.83,4404.87,2
CPT,73720,MRI,11834.1,7692.17,2691.65,2718.04,2
CPT,73720,MRI/MRA,11834.1,7692.17,3089.09,3116.45,2
CPT,73720,PET Scan,11834.1,7692.17,4155.27,4200.53,2
CPT,73721,HB MRI EXT LOW JT WO CONT UNI,8819.755000000001,5732.84,300.99,14761.0,10
CPT,73721,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL",7669.16,4984.95,364.62,364.62,2
CPT,73721,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIALS",7669.16,4984.95,2755.78,4388.86,2
CPT,73721,MRI,7669.16,4984.95,2681.86,2708.16,2
CPT,73721,MRI/MRA,7669.16,4984.95,3089.09,3116.45,2
CPT,73721,PET Scan,7669.16,4984.95,4155.27,4200.53,2
CPT,73722,HB MRI EXT LOW JT W CONT UNI,13069.6,8495.24,983.77,1131.34,8
CPT,73722,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)",13069.6,8495.24,626.71,626.71,2
CPT,73722,"MAGNETIC RESONANCE IMAGING,ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIALS",13069.6,8495.24,3371.54,5369.52,2
CPT,73722,MRI,13069.6,8495.24,3281.11,3313.28,2
CPT,73722,MRI/MRA,13069.6,8495.24,3089.09,3116.45,2
CPT,73722,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,73723,HB MRI EXT LOW JT WO/W CNT UNI,15100.955,9815.619999999999,444.69,14761.0,10
CPT,73723,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",13131.3,8535.34,755.03,755.03,2
CPT,73723,"MAGNETIC RESONANCE IMAGING, ANY JOINT OF LOWER EXTREMITY W/O CONTRAST, FOLLOWED CONTRAST AND FURTHER SEQUENCES",13131.3,8535.34,6241.09,9939.57,2
CPT,73723,MRI,13131.3,8535.34,6073.69,6133.24,2
CPT,73723,MRI/MRA,13131.3,8535.34,3089.09,3116.45,2
CPT,73723,PET Scan,13131.3,8535.34,4155.27,4200.53,2
CPT,73725,HB MR ANGIO EXT LOW WO CONT W 3D,10910.27,7091.675,13270.0,14761.0,2
CPT,73725,"MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S)",9486.86,6166.46,660.18,4412.83,4
CPT,73725,MRI,9486.86,6166.46,2696.51,2722.95,2
CPT,73725,MRI/MRA,9486.86,6166.46,3089.09,3116.45,2
CPT,73725,PET Scan,9486.86,6166.46,4155.27,4200.53,2
CPT,73729,PET Scan,,,4155.27,4200.53,2
CPT,73730,PET Scan,,,4155.27,4200.53,2
CPT,73731,PET Scan,,,4155.27,4200.53,2
CPT,73732,PET Scan,,,4155.27,4200.53,2
CPT,73733,PET Scan,,,4155.27,4200.53,2
CPT,73734,PET Scan,,,4155.27,4200.53,2
CPT,73739,PET Scan,,,4155.27,4200.53,2
CPT,73740,PET Scan,,,4155.27,4200.53,2
CPT,73741,PET Scan,,,4155.27,4200.53,2
CPT,73742,PET Scan,,,4155.27,4200.53,2
CPT,73743,PET Scan,,,4155.27,4200.53,2
CPT,73810,PET Scan,,,4155.27,4200.53,2
CPT,73811,PET Scan,,,4155.27,4200.53,2
CPT,73812,PET Scan,,,4155.27,4200.53,2
CPT,73819,PET Scan,,,4155.27,4200.53,2
CPT,74018,HB XR ABDOMEN 1VW FRONTAL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,74018,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,74018,"Radiologic examination, abdomen; 1 view",1344.46,873.9,52.93,52.93,2
CPT,74018,X-ray exam abdomen 1 view,1344.46,873.9,176.86,281.66,2
CPT,74019,HB XR EXAM ABDOMEN 2 VIEWS,1685.56,1095.615,132.41,14761.0,10
CPT,74019,PET Scan,1465.71,952.71,4155.27,4200.53,2
CPT,74019,"Radiologic examination, abdomen; 2 views",1465.71,952.71,64.57,64.57,2
CPT,74019,X-ray exam abdomen 2 views,1465.71,952.71,212.01,337.66,2
CPT,74021,HB XR EXAM ABDOMEN 3+ VIEWS,2024.79,1316.115,132.41,14761.0,10
CPT,74021,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,74021,"Radiologic examination, abdomen; 3 or more views",1760.68,1144.44,75.39,75.39,2
CPT,74021,X-ray exam abdomen 3+ views,1760.68,1144.44,247.23,393.74,2
CPT,74022,HB XR ABDOMEN+CHEST 2+ VIEWS,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,74022,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,74022,"RADIOLOGIC EXAM, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCSUPINE, ERECT, AND/OR DECUBITUS VIEWS, SINGLE VIEW CHEST",1760.68,1144.44,185.26,295.05,2
CPT,74022,"RADIOLOGIC EXAMINATION, ABDOMEN;COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/OR DECUBITUSVIEWS, UPRIGHT PA CHEST",1760.68,1144.44,86.21,86.21,2
CPT,74100,PET Scan,,,4155.27,4200.53,2
CPT,74101,PET Scan,,,4155.27,4200.53,2
CPT,74102,PET Scan,,,4155.27,4200.53,2
CPT,74103,PET Scan,,,4155.27,4200.53,2
CPT,74150,CAT Scan,6671.63,4336.56,2808.07,2839.65,2
CPT,74150,"COMPUTED TOMOGRAPHY, ABDOMEN; W/O CONTRAST MATERIAL",6671.63,4336.56,1404.97,2237.55,2
CPT,74150,"COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL",6671.63,4336.56,212.68,212.68,2
CPT,74150,CT SCAN,6671.63,4336.56,1367.28,1380.69,2
CPT,74150,HB CT ABDOMEN WO CONTRAST,7672.360000000001,4987.035,132.41,14761.0,10
CPT,74150,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,74160,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,74160,"COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S)",8051.27,5233.33,458.64,2698.34,4
CPT,74160,CT SCAN,8051.27,5233.33,1648.85,1665.02,2
CPT,74160,HB CT ABDOMEN W CONTRAST,9258.985,6018.344999999999,221.67,14761.0,10
CPT,74160,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,74170,CAT Scan,8432.03,5480.82,2808.07,2839.65,2
CPT,74170,"COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIO",8432.03,5480.82,2097.51,3340.5,2
CPT,74170,"COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",8432.03,5480.82,518.55,518.55,2
CPT,74170,CT SCAN,8432.03,5480.82,2041.25,2061.27,2
CPT,74170,HB CT ABDOMEN WO/W CONTRAST,9696.835,6302.945,221.67,14761.0,10
CPT,74170,PET Scan,8432.03,5480.82,4155.27,4200.53,2
CPT,74174,CAT Scan,17010.4,11056.76,2808.07,2839.65,2
CPT,74174,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S)INCLUDING NONCONTRAST IMAGES,IF PERFORMED",17010.4,11056.76,3399.29,5413.72,2
CPT,74174,CT ANGIO ABD&PELV W/O&W/DYE,17010.4,11056.76,728.4,728.4,2
CPT,74174,CT SCAN,17010.4,11056.76,3308.12,3340.55,2
CPT,74174,HB CT ANGIO ABD & PEL WO/W CON,19561.980000000003,12715.285,444.69,14761.0,10
CPT,74174,PET Scan,17010.4,11056.76,4155.27,4200.53,2
CPT,74175,CAT Scan,8964.1,5826.67,2808.07,2839.65,2
CPT,74175,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, W/O CONTRAST FOLLOW CONTRAST, AND FURTHER SECTIONS,IMAGE POST PROCESSING",8964.1,5826.67,2144.67,3415.6,2
CPT,74175,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, WITHOUT CONTRAST MATERIAL(S),FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING",8964.1,5826.67,581.13,581.13,2
CPT,74175,CT SCAN,8964.1,5826.67,2087.14,2107.6,2
CPT,74175,HB CT ANGIO ABDOMEN WO/W CONT W 3D,10308.310000000001,6700.405000000001,221.67,14761.0,10
CPT,74175,PET Scan,8964.1,5826.67,4155.27,4200.53,2
CPT,74176,CAT Scan,13166.0,8557.9,2808.07,2839.65,2
CPT,74176,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL",13166.0,8557.9,266.44,1503.81,4
CPT,74176,CT SCAN,13166.0,8557.9,918.92,927.93,2
CPT,74176,HB CT ABD & PELVIS WO CONTRAST,15140.88,9841.57,300.99,14761.0,10
CPT,74176,PET Scan,13166.0,8557.9,4155.27,4200.53,2
CPT,74177,CAT Scan,17057.9,11087.64,2808.07,2839.65,2
CPT,74177,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)",17057.9,11087.64,576.79,2869.51,4
CPT,74177,CT SCAN,17057.9,11087.64,1753.45,1770.64,2
CPT,74177,HB CT ABD & PELVIS W CONTRAST,19616.605000000003,12750.795,444.69,14761.0,10
CPT,74177,PET Scan,17057.9,11087.64,4155.27,4200.53,2
CPT,74178,CAT Scan,20510.2,13331.63,2808.07,2839.65,2
CPT,74178,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY CONTRAST MAT",20510.2,13331.63,2382.08,3793.7,2
CPT,74178,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS IN ONE OR BOTH BODY REGIONS",20510.2,13331.63,650.84,650.84,2
CPT,74178,CT SCAN,20510.2,13331.63,2318.19,2340.92,2
CPT,74178,HB CT ABD & PELVIS WO/W CONT,23586.684999999998,15331.345000000001,444.69,14761.0,10
CPT,74178,PET Scan,20510.2,13331.63,4155.27,4200.53,2
CPT,74181,HB MRI ABDOMEN WO CONT MRCP,9099.41,5914.615,300.99,14761.0,10
CPT,74181,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S)",7912.54,5143.15,337.16,337.16,2
CPT,74181,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIALS",7912.54,5143.15,2767.25,4407.12,2
CPT,74181,MRI,7912.54,5143.15,2693.02,2719.43,2
CPT,74181,MRI/MRA,7912.54,5143.15,3089.09,3116.45,2
CPT,74181,PET Scan,7912.54,5143.15,4155.27,4200.53,2
CPT,74182,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITH CONTRAST MATERIAL(S)",,,585.29,585.29,2
CPT,74182,"MAGNETIC RESONANCE IMGAING, ABDOMEN; WITH CONTRAST MATERIALS",,,3379.24,5381.79,2
CPT,74182,MRI,,,3288.6,3320.85,2
CPT,74182,PET Scan,,,4155.27,4200.53,2
CPT,74183,HB MRI ABDOMEN WO/W CONT MRCP,15460.385,10049.25,444.69,14761.0,18
CPT,74183,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",13444.0,8738.6,623.57,623.57,2
CPT,74183,"MAGNETIC RESONANCE IMAGING, ABDOMEN ; W/O CONTRAST FOLLOWED CONTRAST, AND FURTHER SEQUENCES",13444.0,8738.6,6252.5,9957.73,2
CPT,74183,MRI,13444.0,8738.6,6084.79,6144.45,2
CPT,74183,MRI/MRA,13444.0,8738.6,3089.09,3116.45,2
CPT,74183,PET Scan,13444.0,8738.6,4155.27,4200.53,2
CPT,74185,HB MR ANGIO ABDOMEN WO CONT W 3D,9137.84,5939.595,13270.0,14761.0,4
CPT,74185,HB MRI ABDOMEN WO/W CONT MRCP,13444.0,8738.6,444.69,511.4,8
CPT,74185,"MAGNETIC RESONANCE ANGIOGRAPHY, ABDOMEN, WITH OR WITHOUT CONTRAST MATERIAL(S)",7946.11,5164.97,666.0,666.0,2
CPT,74185,"MAGNETIC RESONANCE ANGIOGRAPHY,ABDOMEN, WITH OR WITHOUT CONTRAST MATERIAL(S)",7946.11,5164.97,2770.77,4412.74,2
CPT,74185,MRI,7946.11,5164.97,2696.46,2722.89,2
CPT,74185,MRI/MRA,7946.11,5164.97,3089.09,3116.45,2
CPT,74185,PET Scan,7946.11,5164.97,4155.27,4200.53,2
CPT,74190,"PERITONEOGRAM (EG, AFTER INJECTION OF AIR OR CONTRAST), RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,80.76,80.76,2
CPT,74190,"PERITONEOGRAM, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,323.84,515.75,2
CPT,74190,PET Scan,,,4155.27,4200.53,2
CPT,74191,PET Scan,,,4155.27,4200.53,2
CPT,74192,PET Scan,,,4155.27,4200.53,2
CPT,74193,PET Scan,,,4155.27,4200.53,2
CPT,74210,PET Scan,,,4155.27,4200.53,2
CPT,74210,RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS,,,172.74,433.45,4
CPT,74220,HB XR ESOPHAGRAM SINGLE CONT STUDY,3009.5299999999997,1956.195,221.67,14761.0,10
CPT,74220,PET Scan,2616.99,1701.04,4155.27,4200.53,2
CPT,74220,RADIOLOGIC EXAMINATION; ESOPHAGUS,2616.99,1701.04,176.9,442.53,4
CPT,74221,HB XR ESOPHAGRAM DOUBLE CONT STUDY,3573.5649999999996,2322.815,221.67,14761.0,10
CPT,74221,PET Scan,3107.43,2019.83,4155.27,4200.53,2
CPT,74221,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study",3107.43,2019.83,196.87,809.3,4
CPT,74230,HB XR SWALLOW CINE VIDEO CONT STUDY,3009.5299999999997,1956.195,221.67,14761.0,10
CPT,74230,PET Scan,2616.99,1701.04,4155.27,4200.53,2
CPT,74230,"SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO",2616.99,1701.04,254.28,519.69,4
CPT,74235,PET Scan,5449.85,3542.4,4155.27,4200.53,2
CPT,74235,"REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER UNDER FLUOROSCOPIC GUIDANCE",5449.85,3542.4,657.68,1047.42,2
CPT,74240,HB XR UPPER GI SINGLE CONT STUDY,5533.73,3596.9249999999997,221.67,14761.0,10
CPT,74240,PET Scan,4720.18,3068.12,4155.27,4200.53,2
CPT,74240,"RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB",4720.18,3068.12,216.01,583.26,4
CPT,74246,HB XR UPPER GI DOUBLE CONT,6150.21,3997.64,221.67,14761.0,10
CPT,74246,PET Scan,5348.01,3476.21,4155.27,4200.53,2
CPT,74246,"RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFERVESCENT",5348.01,3476.21,413.21,658.08,2
CPT,74246,"RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH OR WITHOUT DELAYED FILMS, WITHOUT",5348.01,3476.21,247.62,247.62,2
CPT,74248,HB XR SMALL INTESTINE F-THRU STUDY,3830.33,2489.715,13270.0,14761.0,2
CPT,74248,PET Scan,3333.29,2166.64,4155.27,4200.53,2
CPT,74248,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination)",3333.29,2166.64,327.08,520.9,2
CPT,74250,HB XR SMALL INTESTINE SINGLE CONT,3009.5299999999997,1956.195,221.67,14761.0,10
CPT,74250,PET Scan,2616.99,1701.04,4155.27,4200.53,2
CPT,74250,"RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS",2616.99,1701.04,325.61,518.56,2
CPT,74250,"RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS;",2616.99,1701.04,214.34,214.34,2
CPT,74251,PET Scan,3024.59,1965.98,4155.27,4200.53,2
CPT,74251,"RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS; VIA ENTEROCLYSIS TUBE",3024.59,1965.98,795.94,795.94,2
CPT,74251,"RADIOLOGIC EXAMINATION,COLON;VIA ENTEROCLYSIS TUBE",3024.59,1965.98,327.78,522.03,2
CPT,74253,PET Scan,,,4155.27,4200.53,2
CPT,74259,PET Scan,,,4155.27,4200.53,2
CPT,74261,CAT Scan,16568.5,10769.52,2808.07,2839.65,2
CPT,74261,"COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING IMAGE POSTPROCESSING; WITHOUT CONTRAST MATERIAL",16568.5,10769.52,1349.4,2149.06,2
CPT,74261,CT SCAN,16568.5,10769.52,1313.21,1326.09,2
CPT,74261,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material",16568.5,10769.52,802.45,802.45,2
CPT,74261,HB CT COLONOGRAPHY DIAG WO CNT,19053.515,12384.78,132.41,14761.0,10
CPT,74261,PET Scan,16568.5,10769.52,4155.27,4200.53,2
CPT,74262,CAT Scan,17360.0,11284.0,2808.07,2839.65,2
CPT,74262,"COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING IMAGE POSTPROCESSING; WITH CONTRAST MATERIAL(S) INCLUDING",17360.0,11284.0,2053.3,3270.08,2
CPT,74262,CT SCAN,17360.0,11284.0,1998.22,2017.82,2
CPT,74262,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed",17360.0,11284.0,928.09,928.09,2
CPT,74262,PET Scan,17360.0,11284.0,4155.27,4200.53,2
CPT,74263,CAT Scan,9532.66,6196.23,2808.07,2839.65,2
CPT,74263,"COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, SCREENING, INCLUDING IMAGE POSTPROCESSING",9532.66,6196.23,4080.84,6499.16,2
CPT,74263,CT SCAN,9532.66,6196.23,3971.39,4010.32,2
CPT,74263,"Computed tomographic (CT) colonography, screening, including image postprocessing",9532.66,6196.23,1443.13,1443.13,2
CPT,74263,HB CT COLONOGRAPHY SCREENING,10962.57,7125.67,300.99,14761.0,10
CPT,74263,PET Scan,9532.66,6196.23,4155.27,4200.53,2
CPT,74270,HB XR COLON POUCH-O-GRAM,4248.325,2761.41,221.67,14761.0,10
CPT,74270,PET Scan,3693.4,2400.71,4155.27,4200.53,2
CPT,74270,"RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA, WITH OR WITHOUT KUB",3693.4,2400.71,266.76,266.76,2
CPT,74270,"RADIOLOGIC EXAMINATION, COLON; CONTRAST (EG, BARIUM) ENEMA, WITH OR WITHOUT KUB",3693.4,2400.71,413.98,659.3,2
CPT,74280,HB XR COLON ENEMA W CONT & AIR,5075.51,3299.08,221.67,14761.0,10
CPT,74280,PET Scan,4412.59,2868.18,4155.27,4200.53,2
CPT,74280,"RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT GLUCAGON",4412.59,2868.18,411.21,769.32,4
CPT,74283,"BARIUM ENEMA, THERAPEUTIC, FOR REDUCTION OF INTUSSUSCEPTION",2604.36,1692.83,394.06,877.1,4
CPT,74283,HB XR COLON ENEMA THERAPEUTIC,2996.49,1947.715,221.67,14761.0,10
CPT,74283,PET Scan,2604.36,1692.83,4155.27,4200.53,2
CPT,74290,"CHOLECYSTOGRAPHY, ORAL CONTRAST;",,,179.39,295.05,4
CPT,74290,PET Scan,,,4155.27,4200.53,2
CPT,74300,"CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY;INTRAOPERTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3484.12,2264.68,,,0
CPT,74300,HB CHOLANGIOGRAM INTRAOP,4008.2999999999997,2605.395,13270.0,14761.0,2
CPT,74300,PET Scan,3484.12,2264.68,4155.27,4200.53,2
CPT,74301,CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET DURING SURGERY,,,170.98,272.3,2
CPT,74301,PET Scan,,,4155.27,4200.53,2
CPT,74303,PET Scan,,,4155.27,4200.53,2
CPT,74306,PET Scan,,,4155.27,4200.53,2
CPT,74310,PET Scan,,,4155.27,4200.53,2
CPT,74311,PET Scan,,,4155.27,4200.53,2
CPT,74312,PET Scan,,,4155.27,4200.53,2
CPT,74320,PET Scan,,,4155.27,4200.53,2
CPT,74321,PET Scan,,,4155.27,4200.53,2
CPT,74322,PET Scan,,,4155.27,4200.53,2
CPT,74328,"ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2161.73,1405.12,782.68,1246.5,2
CPT,74328,HB ENDO CATH- BILE DUCT S&I,2161.73,1405.12,13270.0,14761.0,2
CPT,74328,PET Scan,2161.73,1405.12,4155.27,4200.53,2
CPT,74329,"ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2161.73,1405.12,782.68,1246.5,2
CPT,74329,HB ENDO CATH- PANCR DUCT S&I,2161.73,1405.12,13270.0,14761.0,2
CPT,74329,PET Scan,2161.73,1405.12,4155.27,4200.53,2
CPT,74330,"COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND INTERPRET",2768.14,1799.29,782.68,1246.5,2
CPT,74330,HB ENDO CATH-BIL- PANCR DUCT S&I,2768.14,1799.29,13270.0,14761.0,2
CPT,74330,PET Scan,2768.14,1799.29,4155.27,4200.53,2
CPT,74331,PET Scan,,,4155.27,4200.53,2
CPT,74332,PET Scan,,,4155.27,4200.53,2
CPT,74333,PET Scan,,,4155.27,4200.53,2
CPT,74334,PET Scan,,,4155.27,4200.53,2
CPT,74335,PET Scan,,,4155.27,4200.53,2
CPT,74336,PET Scan,,,4155.27,4200.53,2
CPT,74337,PET Scan,,,4155.27,4200.53,2
CPT,74339,PET Scan,,,4155.27,4200.53,2
CPT,74340,"INTRODUCTION OF LONG GASTROINTESTINAL TUBE,WITH MULTIPLE FLUOROSCOPIES AND FILMS, RADIOLOGICAL SUPERVISION AND INTER",2911.61,1892.55,654.74,1042.74,2
CPT,74340,PET Scan,2911.61,1892.55,4155.27,4200.53,2
CPT,74341,PET Scan,,,4155.27,4200.53,2
CPT,74342,PET Scan,,,4155.27,4200.53,2
CPT,74343,PET Scan,,,4155.27,4200.53,2
CPT,74344,PET Scan,,,4155.27,4200.53,2
CPT,74345,PET Scan,,,4155.27,4200.53,2
CPT,74346,PET Scan,,,4155.27,4200.53,2
CPT,74347,PET Scan,,,4155.27,4200.53,2
CPT,74348,PET Scan,,,4155.27,4200.53,2
CPT,74349,PET Scan,,,4155.27,4200.53,2
CPT,74351,PET Scan,,,4155.27,4200.53,2
CPT,74352,PET Scan,,,4155.27,4200.53,2
CPT,74353,PET Scan,,,4155.27,4200.53,2
CPT,74354,PET Scan,,,4155.27,4200.53,2
CPT,74355,PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE; RADIOLOGIC GUIDANCE ONLY,,,654.86,1042.93,2
CPT,74355,PET Scan,,,4155.27,4200.53,2
CPT,74356,PET Scan,,,4155.27,4200.53,2
CPT,74357,PET Scan,,,4155.27,4200.53,2
CPT,74358,PET Scan,,,4155.27,4200.53,2
CPT,74359,PET Scan,,,4155.27,4200.53,2
CPT,74360,"INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS OR BILIARY TREE); RADIOLOGIC GUIDANCE ONLY",2161.73,1405.12,782.62,1246.4,2
CPT,74360,PET Scan,2161.73,1405.12,4155.27,4200.53,2
CPT,74361,PET Scan,,,4155.27,4200.53,2
CPT,74362,PET Scan,,,4155.27,4200.53,2
CPT,74363,PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE WITH OR WITHOUT PLACEMENT OF STENT,14114.7,9174.56,1516.21,2414.71,2
CPT,74363,PET Scan,14114.7,9174.56,4155.27,4200.53,2
CPT,74364,PET Scan,,,4155.27,4200.53,2
CPT,74365,PET Scan,,,4155.27,4200.53,2
CPT,74366,PET Scan,,,4155.27,4200.53,2
CPT,74369,PET Scan,,,4155.27,4200.53,2
CPT,74400,HB UROGRAM IVP,5087.33,3306.76,221.67,254.92,8
CPT,74400,PET Scan,5087.33,3306.76,4155.27,4200.53,2
CPT,74400,"UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY;",5087.33,3306.76,282.25,282.25,2
CPT,74400,"UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB;",5087.33,3306.76,420.33,669.41,2
CPT,74401,PET Scan,,,4155.27,4200.53,2
CPT,74402,PET Scan,,,4155.27,4200.53,2
CPT,74403,PET Scan,,,4155.27,4200.53,2
CPT,74404,PET Scan,,,4155.27,4200.53,2
CPT,74405,PET Scan,,,4155.27,4200.53,2
CPT,74409,PET Scan,,,4155.27,4200.53,2
CPT,74410,PET Scan,,,4155.27,4200.53,2
CPT,74410,"UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;",,,296.39,773.82,4
CPT,74415,PET Scan,4288.29,2787.39,4155.27,4200.53,2
CPT,74415,"UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY",4288.29,2787.39,330.5,838.52,4
CPT,74420,PET Scan,3107.43,2019.83,4155.27,4200.53,2
CPT,74420,"UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB",3107.43,2019.83,131.97,915.68,4
CPT,74421,PET Scan,,,4155.27,4200.53,2
CPT,74422,PET Scan,,,4155.27,4200.53,2
CPT,74423,PET Scan,,,4155.27,4200.53,2
CPT,74424,PET Scan,,,4155.27,4200.53,2
CPT,74425,HB UROGRAM ANTEGRADE S&I,4107.58,2669.93,13270.0,14761.0,2
CPT,74425,PET Scan,3159.68,2053.79,4155.27,4200.53,2
CPT,74425,"UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION",3159.68,2053.79,283.4,283.4,2
CPT,74425,"UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM); SUPERVISION AND INTERPRETATION ONLY",3159.68,2053.79,323.78,515.66,2
CPT,74429,PET Scan,,,4155.27,4200.53,2
CPT,74430,"CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2613.22,1698.59,65.4,65.4,2
CPT,74430,"CYSTOGRAPHY, MINIMUM OF THREE VIEWS; SUPERVISION AND INTERPRETATION ONLY",2613.22,1698.59,262.28,417.71,2
CPT,74430,HB CYSTOGRAM 3VW/MORE S&I,3005.35,1953.475,444.69,14761.0,10
CPT,74430,PET Scan,2613.22,1698.59,4155.27,4200.53,2
CPT,74440,PET Scan,2962.45,1925.59,4155.27,4200.53,2
CPT,74440,"VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISIONAND INTERPRETATION",2962.45,1925.59,199.37,199.37,2
CPT,74440,"VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",2962.45,1925.59,282.16,449.36,2
CPT,74441,PET Scan,,,4155.27,4200.53,2
CPT,74442,PET Scan,,,4155.27,4200.53,2
CPT,74443,PET Scan,,,4155.27,4200.53,2
CPT,74445,"CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2042.04,1327.33,96.23,96.23,2
CPT,74445,CORPORA CAVERNOSOGRAPHY; SUPERVISION AND INTERPRETATION ONLY,2042.04,1327.33,283.57,451.61,2
CPT,74445,PET Scan,2042.04,1327.33,4155.27,4200.53,2
CPT,74446,PET Scan,,,4155.27,4200.53,2
CPT,74447,PET Scan,,,4155.27,4200.53,2
CPT,74449,PET Scan,,,4155.27,4200.53,2
CPT,74450,HB URETHROCYSTOGRAM RETRO S&I,3341.26,2171.82,300.99,14761.0,10
CPT,74450,PET Scan,3341.26,2171.82,4155.27,4200.53,2
CPT,74450,"URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",3341.26,2171.82,128.04,128.04,2
CPT,74450,"URETHROCYSTOGRAPHY, RETROGRADE; SUPERVISION AND INTERPRETATION ONLY",3341.26,2171.82,363.06,578.21,2
CPT,74455,HB URETHROCYSTOGRAM VOID S&I,5213.115,3388.525,300.99,14761.0,10
CPT,74455,PET Scan,4533.92,2947.05,4155.27,4200.53,2
CPT,74455,"URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION",4533.92,2947.05,223.5,223.5,2
CPT,74455,"URETHROCYSTOGRAPHY, VOIDING; SUPERVISION AND INTERPRETATION ONLY",4533.92,2947.05,394.28,627.93,2
CPT,74470,PET Scan,8021.33,5213.86,4155.27,4200.53,2
CPT,74470,"RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8021.33,5213.86,108.4,108.4,2
CPT,74470,"RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION; SUPERVISION AND INTERPRETAT",8021.33,5213.86,312.91,498.34,2
CPT,74481,PET Scan,,,4155.27,4200.53,2
CPT,74482,PET Scan,,,4155.27,4200.53,2
CPT,74483,PET Scan,,,4155.27,4200.53,2
CPT,74484,PET Scan,,,4155.27,4200.53,2
CPT,74485,DILATION OF NEPHROSTOMY OR URETERS WITH FLUOROSCOPIC MONITORING AND RADIOGRAPHY; SUPERVISION AND INTERPRETATIO,12855.0,8355.75,786.85,1253.14,2
CPT,74485,"DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION",12855.0,8355.75,201.03,201.03,2
CPT,74485,PET Scan,12855.0,8355.75,4155.27,4200.53,2
CPT,74489,PET Scan,,,4155.27,4200.53,2
CPT,74510,PET Scan,,,4155.27,4200.53,2
CPT,74511,PET Scan,,,4155.27,4200.53,2
CPT,74512,PET Scan,,,4155.27,4200.53,2
CPT,74519,PET Scan,,,4155.27,4200.53,2
CPT,74560,PET Scan,,,4155.27,4200.53,2
CPT,74561,PET Scan,,,4155.27,4200.53,2
CPT,74569,PET Scan,,,4155.27,4200.53,2
CPT,74600,PET Scan,,,4155.27,4200.53,2
CPT,74601,PET Scan,,,4155.27,4200.53,2
CPT,74602,PET Scan,,,4155.27,4200.53,2
CPT,74609,PET Scan,,,4155.27,4200.53,2
CPT,74681,PET Scan,,,4155.27,4200.53,2
CPT,74682,PET Scan,,,4155.27,4200.53,2
CPT,74683,PET Scan,,,4155.27,4200.53,2
CPT,74684,PET Scan,,,4155.27,4200.53,2
CPT,74685,PET Scan,,,4155.27,4200.53,2
CPT,74686,PET Scan,,,4155.27,4200.53,2
CPT,74687,PET Scan,,,4155.27,4200.53,2
CPT,74689,PET Scan,,,4155.27,4200.53,2
CPT,74710,"PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION",,,59.58,418.65,4
CPT,74710,PET Scan,,,4155.27,4200.53,2
CPT,74711,PET Scan,,,4155.27,4200.53,2
CPT,74712,HB MRI FETAL SNGL/1ST GESTATION,10892.0,7079.8,300.99,346.13,8
CPT,74712,MRI,10892.0,7079.8,5086.62,5136.5,2
CPT,74712,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation",10892.0,7079.8,710.93,710.93,2
CPT,74712,Mri fetal sngl/1st gestation,10892.0,7079.8,5086.62,8324.24,2
CPT,74712,PET Scan,10892.0,7079.8,4155.27,4200.53,2
CPT,74713,MRI,13302.1,8646.36,2179.49,2200.86,2
CPT,74713,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)",13302.1,8646.36,298.38,298.38,2
CPT,74713,Mri fetal ea addl gestation,13302.1,8646.36,2179.49,3566.73,2
CPT,74713,PET Scan,13302.1,8646.36,4155.27,4200.53,2
CPT,74720,PET Scan,,,4155.27,4200.53,2
CPT,74721,PET Scan,,,4155.27,4200.53,2
CPT,74722,PET Scan,,,4155.27,4200.53,2
CPT,74729,PET Scan,,,4155.27,4200.53,2
CPT,74731,PET Scan,,,4155.27,4200.53,2
CPT,74732,PET Scan,,,4155.27,4200.53,2
CPT,74739,PET Scan,,,4155.27,4200.53,2
CPT,74740,HB HYSTEROSALPINGOGRAM S&I,2775.46,1804.05,300.99,346.13,8
CPT,74740,"HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2775.46,1804.05,194.37,194.37,2
CPT,74740,HYSTEROSALPINGOGRAPHY; SUPERVISION AND INTERPRETATION ONLY,2775.46,1804.05,323.84,515.75,2
CPT,74740,PET Scan,2775.46,1804.05,4155.27,4200.53,2
CPT,74741,PET Scan,,,4155.27,4200.53,2
CPT,74742,PET Scan,,,4155.27,4200.53,2
CPT,74742,"TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICASUPERVISION AND INTERPRETATION",,,782.74,1246.59,2
CPT,74749,PET Scan,,,4155.27,4200.53,2
CPT,74760,PET Scan,,,4155.27,4200.53,2
CPT,74761,PET Scan,,,4155.27,4200.53,2
CPT,74762,PET Scan,,,4155.27,4200.53,2
CPT,74763,PET Scan,,,4155.27,4200.53,2
CPT,74764,PET Scan,,,4155.27,4200.53,2
CPT,74769,PET Scan,,,4155.27,4200.53,2
CPT,74775,HB VAGINOGRAM/PERINEOGRAM,2770.0950000000003,1800.56,300.99,14761.0,10
CPT,74775,"PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES)",2409.03,1565.87,128.87,581.11,4
CPT,74775,PET Scan,2409.03,1565.87,4155.27,4200.53,2
CPT,74781,PET Scan,,,4155.27,4200.53,2
CPT,74782,PET Scan,,,4155.27,4200.53,2
CPT,74783,PET Scan,,,4155.27,4200.53,2
CPT,74789,PET Scan,,,4155.27,4200.53,2
CPT,74860,PET Scan,,,4155.27,4200.53,2
CPT,74861,PET Scan,,,4155.27,4200.53,2
CPT,74869,PET Scan,,,4155.27,4200.53,2
CPT,74900,PET Scan,,,4155.27,4200.53,2
CPT,74901,PET Scan,,,4155.27,4200.53,2
CPT,74902,PET Scan,,,4155.27,4200.53,2
CPT,74903,PET Scan,,,4155.27,4200.53,2
CPT,74904,PET Scan,,,4155.27,4200.53,2
CPT,74910,PET Scan,,,4155.27,4200.53,2
CPT,74911,PET Scan,,,4155.27,4200.53,2
CPT,74912,PET Scan,,,4155.27,4200.53,2
CPT,74913,PET Scan,,,4155.27,4200.53,2
CPT,74914,PET Scan,,,4155.27,4200.53,2
CPT,74920,PET Scan,,,4155.27,4200.53,2
CPT,74921,PET Scan,,,4155.27,4200.53,2
CPT,74922,PET Scan,,,4155.27,4200.53,2
CPT,74923,PET Scan,,,4155.27,4200.53,2
CPT,74924,PET Scan,,,4155.27,4200.53,2
CPT,74925,PET Scan,,,4155.27,4200.53,2
CPT,75010,PET Scan,,,4155.27,4200.53,2
CPT,75011,PET Scan,,,4155.27,4200.53,2
CPT,75012,PET Scan,,,4155.27,4200.53,2
CPT,75013,PET Scan,,,4155.27,4200.53,2
CPT,75015,PET Scan,,,4155.27,4200.53,2
CPT,75016,PET Scan,,,4155.27,4200.53,2
CPT,75019,PET Scan,,,4155.27,4200.53,2
CPT,75021,PET Scan,,,4155.27,4200.53,2
CPT,75022,PET Scan,,,4155.27,4200.53,2
CPT,75023,PET Scan,,,4155.27,4200.53,2
CPT,75024,PET Scan,,,4155.27,4200.53,2
CPT,75025,PET Scan,,,4155.27,4200.53,2
CPT,75026,PET Scan,,,4155.27,4200.53,2
CPT,75027,PET Scan,,,4155.27,4200.53,2
CPT,75029,PET Scan,,,4155.27,4200.53,2
CPT,75160,PET Scan,,,4155.27,4200.53,2
CPT,75161,PET Scan,,,4155.27,4200.53,2
CPT,75162,PET Scan,,,4155.27,4200.53,2
CPT,75169,PET Scan,,,4155.27,4200.53,2
CPT,75210,PET Scan,,,4155.27,4200.53,2
CPT,75211,PET Scan,,,4155.27,4200.53,2
CPT,75219,PET Scan,,,4155.27,4200.53,2
CPT,75231,PET Scan,,,4155.27,4200.53,2
CPT,75232,PET Scan,,,4155.27,4200.53,2
CPT,75233,PET Scan,,,4155.27,4200.53,2
CPT,75234,PET Scan,,,4155.27,4200.53,2
CPT,75235,PET Scan,,,4155.27,4200.53,2
CPT,75236,PET Scan,,,4155.27,4200.53,2
CPT,75239,PET Scan,,,4155.27,4200.53,2
CPT,75240,PET Scan,,,4155.27,4200.53,2
CPT,75241,PET Scan,,,4155.27,4200.53,2
CPT,75242,PET Scan,,,4155.27,4200.53,2
CPT,75243,PET Scan,,,4155.27,4200.53,2
CPT,75244,PET Scan,,,4155.27,4200.53,2
CPT,75245,PET Scan,,,4155.27,4200.53,2
CPT,75246,PET Scan,,,4155.27,4200.53,2
CPT,75247,PET Scan,,,4155.27,4200.53,2
CPT,75249,PET Scan,,,4155.27,4200.53,2
CPT,75251,PET Scan,,,4155.27,4200.53,2
CPT,75252,PET Scan,,,4155.27,4200.53,2
CPT,75261,PET Scan,,,4155.27,4200.53,2
CPT,75262,PET Scan,,,4155.27,4200.53,2
CPT,75263,PET Scan,,,4155.27,4200.53,2
CPT,75264,PET Scan,,,4155.27,4200.53,2
CPT,75265,PET Scan,,,4155.27,4200.53,2
CPT,75269,PET Scan,,,4155.27,4200.53,2
CPT,75281,PET Scan,,,4155.27,4200.53,2
CPT,75289,PET Scan,,,4155.27,4200.53,2
CPT,75310,PET Scan,,,4155.27,4200.53,2
CPT,75311,PET Scan,,,4155.27,4200.53,2
CPT,75312,PET Scan,,,4155.27,4200.53,2
CPT,75313,PET Scan,,,4155.27,4200.53,2
CPT,75314,PET Scan,,,4155.27,4200.53,2
CPT,75315,PET Scan,,,4155.27,4200.53,2
CPT,75316,PET Scan,,,4155.27,4200.53,2
CPT,75317,PET Scan,,,4155.27,4200.53,2
CPT,75319,PET Scan,,,4155.27,4200.53,2
CPT,75320,PET Scan,,,4155.27,4200.53,2
CPT,75321,PET Scan,,,4155.27,4200.53,2
CPT,75322,PET Scan,,,4155.27,4200.53,2
CPT,75323,PET Scan,,,4155.27,4200.53,2
CPT,75329,PET Scan,,,4155.27,4200.53,2
CPT,75430,PET Scan,,,4155.27,4200.53,2
CPT,75431,PET Scan,,,4155.27,4200.53,2
CPT,75432,PET Scan,,,4155.27,4200.53,2
CPT,75433,PET Scan,,,4155.27,4200.53,2
CPT,75435,PET Scan,,,4155.27,4200.53,2
CPT,75440,PET Scan,,,4155.27,4200.53,2
CPT,75441,PET Scan,,,4155.27,4200.53,2
CPT,75442,PET Scan,,,4155.27,4200.53,2
CPT,75443,PET Scan,,,4155.27,4200.53,2
CPT,75444,PET Scan,,,4155.27,4200.53,2
CPT,75450,PET Scan,,,4155.27,4200.53,2
CPT,75451,PET Scan,,,4155.27,4200.53,2
CPT,75452,PET Scan,,,4155.27,4200.53,2
CPT,75453,PET Scan,,,4155.27,4200.53,2
CPT,75459,PET Scan,,,4155.27,4200.53,2
CPT,75460,PET Scan,,,4155.27,4200.53,2
CPT,75461,PET Scan,,,4155.27,4200.53,2
CPT,75462,PET Scan,,,4155.27,4200.53,2
CPT,75469,PET Scan,,,4155.27,4200.53,2
CPT,75470,PET Scan,,,4155.27,4200.53,2
CPT,75471,PET Scan,,,4155.27,4200.53,2
CPT,75479,PET Scan,,,4155.27,4200.53,2
CPT,75481,PET Scan,,,4155.27,4200.53,2
CPT,75482,PET Scan,,,4155.27,4200.53,2
CPT,75489,PET Scan,,,4155.27,4200.53,2
CPT,75500,PET Scan,,,4155.27,4200.53,2
CPT,75501,PET Scan,,,4155.27,4200.53,2
CPT,75502,PET Scan,,,4155.27,4200.53,2
CPT,75510,PET Scan,,,4155.27,4200.53,2
CPT,75511,PET Scan,,,4155.27,4200.53,2
CPT,75512,PET Scan,,,4155.27,4200.53,2
CPT,75513,PET Scan,,,4155.27,4200.53,2
CPT,75514,PET Scan,,,4155.27,4200.53,2
CPT,75520,PET Scan,,,4155.27,4200.53,2
CPT,75521,PET Scan,,,4155.27,4200.53,2
CPT,75522,PET Scan,,,4155.27,4200.53,2
CPT,75523,PET Scan,,,4155.27,4200.53,2
CPT,75524,PET Scan,,,4155.27,4200.53,2
CPT,75525,PET Scan,,,4155.27,4200.53,2
CPT,75526,PET Scan,,,4155.27,4200.53,2
CPT,75527,PET Scan,,,4155.27,4200.53,2
CPT,75528,PET Scan,,,4155.27,4200.53,2
CPT,75529,PET Scan,,,4155.27,4200.53,2
CPT,75530,PET Scan,,,4155.27,4200.53,2
CPT,75531,PET Scan,,,4155.27,4200.53,2
CPT,75532,PET Scan,,,4155.27,4200.53,2
CPT,75533,PET Scan,,,4155.27,4200.53,2
CPT,75534,PET Scan,,,4155.27,4200.53,2
CPT,75535,PET Scan,,,4155.27,4200.53,2
CPT,75536,PET Scan,,,4155.27,4200.53,2
CPT,75537,PET Scan,,,4155.27,4200.53,2
CPT,75538,PET Scan,,,4155.27,4200.53,2
CPT,75539,PET Scan,,,4155.27,4200.53,2
CPT,75550,PET Scan,,,4155.27,4200.53,2
CPT,75551,PET Scan,,,4155.27,4200.53,2
CPT,75552,PET Scan,,,4155.27,4200.53,2
CPT,75553,PET Scan,,,4155.27,4200.53,2
CPT,75554,PET Scan,,,4155.27,4200.53,2
CPT,75555,PET Scan,,,4155.27,4200.53,2
CPT,75556,PET Scan,,,4155.27,4200.53,2
CPT,75557,CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION W/O CONTRAST MATERIAL;,11720.3,7618.19,2504.31,3988.37,2
CPT,75557,CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL;,11720.3,7618.19,449.49,449.49,2
CPT,75557,HB MRI HEART WO CONTRAST,13479.009999999998,8761.355,300.99,14761.0,10
CPT,75557,MRI,11720.3,7618.19,2437.14,2461.04,2
CPT,75557,MRI/MRA,11720.3,7618.19,3089.09,3116.45,2
CPT,75557,PET Scan,11720.3,7618.19,4155.27,4200.53,2
CPT,75558,PET Scan,,,4155.27,4200.53,2
CPT,75559,CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION W/O CONTRAST MATERIAL;WITH STRESS IMAGING,,,3886.41,6189.5,2
CPT,75559,CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL; WITH STRESS IMAGING,,,631.7,631.7,2
CPT,75559,MRI,,,3782.17,3819.25,2
CPT,75559,PET Scan,,,4155.27,4200.53,2
CPT,75560,PET Scan,,,4155.27,4200.53,2
CPT,75561,"CARDIAC MAGNET RESONANCE IMAGING FOR MORPHOLOGY AND FUNCITON W/O CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL (S)",12494.7,8121.56,3656.23,5822.91,2
CPT,75561,"CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES;",12494.7,8121.56,644.18,644.18,2
CPT,75561,HB MRI HEART WO/W CONTRAST,14369.32,9340.06,444.69,14761.0,10
CPT,75561,MRI,12494.7,8121.56,3558.16,3593.04,2
CPT,75561,MRI/MRA,12494.7,8121.56,3089.09,3116.45,2
CPT,75561,PET Scan,12494.7,8121.56,4155.27,4200.53,2
CPT,75562,PET Scan,,,4155.27,4200.53,2
CPT,75563,"CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION W/O CONTRAST MATERIAL(S),FOLLOWED BY CONTRAST MATERIAL(S",13069.6,8495.24,4569.72,7277.75,2
CPT,75563,"CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; WITH STRESS IMAGING",13069.6,8495.24,756.69,756.69,2
CPT,75563,HB MRI HEART WO/W CONT W STRES,15030.04,9769.525,983.77,14761.0,10
CPT,75563,MRI,13069.6,8495.24,4447.15,4490.76,2
CPT,75563,MRI/MRA,13069.6,8495.24,3089.09,3116.45,2
CPT,75563,PET Scan,13069.6,8495.24,4155.27,4200.53,2
CPT,75564,PET Scan,,,4155.27,4200.53,2
CPT,75565,CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),6059.54,3938.7,545.09,868.11,2
CPT,75565,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure),6059.54,3938.7,89.02,89.02,2
CPT,75565,HB MRI HEART FLOW/VELOCITY,6966.05,4527.93,13270.0,14761.0,2
CPT,75565,MRI,6059.54,3938.7,530.47,535.67,2
CPT,75565,MRI/MRA,6059.54,3938.7,3089.09,3116.45,2
CPT,75565,PET Scan,6059.54,3938.7,4155.27,4200.53,2
CPT,75566,PET Scan,,,4155.27,4200.53,2
CPT,75567,PET Scan,,,4155.27,4200.53,2
CPT,75569,PET Scan,,,4155.27,4200.53,2
CPT,75571,CAT Scan,7505.1,4878.32,2808.07,2839.65,2
CPT,75571,"COMPUTED TOMOGRAPHY, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM",7505.1,4878.32,310.73,494.87,2
CPT,75571,CT SCAN,7505.1,4878.32,302.4,305.36,2
CPT,75571,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium",7505.1,4878.32,187.71,187.71,2
CPT,75571,HB CT HEART WO CONTRAST,8630.880000000001,5610.075,109.64,14761.0,10
CPT,75571,PET Scan,7505.1,4878.32,4155.27,4200.53,2
CPT,75572,CAT Scan,9006.13,5853.98,2808.07,2839.65,2
CPT,75572,"COMPUTED TOMOGRAPHY, HEART, W/CONTRAST MATERIAL, FOR EVAL OF CARDIAC STRUCTURE & MORPHOLOGY (INCLUDING 3D IMAGE POSTPROC",9006.13,5853.98,1229.23,1957.67,2
CPT,75572,CT SCAN,9006.13,5853.98,1196.26,1207.99,2
CPT,75572,"Computed tomography, heart, with contrast material. for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",9006.13,5853.98,379.78,379.78,2
CPT,75572,HB CT HEART W CONT,10357.06,6732.084999999999,444.69,14761.0,10
CPT,75572,PET Scan,9006.13,5853.98,4155.27,4200.53,2
CPT,75573,CAT Scan,8051.27,5233.33,2808.07,2839.65,2
CPT,75573,CT SCAN,8051.27,5233.33,1694.97,1711.59,2
CPT,75573,"CT, HEART, W/CONTRAST MATL, FOR EVAL OF CARDIAC STRUCT & MORPHOLOGY IN THE SETTING OF CONGENITAL HEART DISEASE",8051.27,5233.33,1741.68,2773.81,2
CPT,75573,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV c",8051.27,5233.33,479.63,479.63,2
CPT,75573,"HB CT HEART W CONT, CONGEN DZ",8051.27,5233.33,444.69,511.4,8
CPT,75573,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,75574,CAT Scan,5782.4,3758.56,2808.07,2839.65,2
CPT,75574,"CT ANGIOGRAPHY, HEART, CORONARY ARTERIES AND BYPASS GRAFTS (WHEN PRESENT), WITH CONTRAST MATERIAL, INCLUDING 3D IMAGE PO",5782.4,3758.56,1861.04,2963.89,2
CPT,75574,CT SCAN,5782.4,3758.56,1811.12,1828.88,2
CPT,75574,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",5782.4,3758.56,545.35,545.35,2
CPT,75574,HB CT ANGIO HEART W 3D,6649.754999999999,4322.34,444.69,14761.0,10
CPT,75574,PET Scan,5782.4,3758.56,4155.27,4200.53,2
CPT,75600,"AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,402.06,402.06,2
CPT,75600,"AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",,,3148.35,5014.07,2
CPT,75600,PET Scan,,,4155.27,4200.53,2
CPT,75605,"AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",24975.0,16233.75,169.09,169.09,2
CPT,75605,"AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",24975.0,16233.75,3131.13,4986.64,2
CPT,75605,HB ANGIOGRAM AORTA THORACIC S&I,24975.0,16233.75,13270.0,14761.0,2
CPT,75605,PET Scan,24975.0,16233.75,4155.27,4200.53,2
CPT,75610,PET Scan,,,4155.27,4200.53,2
CPT,75611,PET Scan,,,4155.27,4200.53,2
CPT,75612,PET Scan,,,4155.27,4200.53,2
CPT,75613,PET Scan,,,4155.27,4200.53,2
CPT,75614,PET Scan,,,4155.27,4200.53,2
CPT,75615,PET Scan,,,4155.27,4200.53,2
CPT,75616,PET Scan,,,4155.27,4200.53,2
CPT,75617,PET Scan,,,4155.27,4200.53,2
CPT,75619,PET Scan,,,4155.27,4200.53,2
CPT,75625,"AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13829.7,8989.31,149.44,149.44,2
CPT,75625,"AORTOGRAPHY, ABDOMINAL, TRANSLUMBAR, BY SERIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",13829.7,8989.31,3131.13,4986.64,2
CPT,75625,HB ANGIOGRAM AORTA ABDOMEN S&I,13829.7,8989.31,3919.23,14761.0,10
CPT,75625,PET Scan,13829.7,8989.31,4155.27,4200.53,2
CPT,75630,"AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",16123.3,10480.15,160.26,160.26,2
CPT,75630,"AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY; SUPERVISION AND INTERPRE",16123.3,10480.15,3263.3,5197.13,2
CPT,75630,HB AORTOGRAPHY ABD+ILIOFEM BILAT,18541.775,12052.154999999999,3919.23,14761.0,10
CPT,75630,PET Scan,16123.3,10480.15,4155.27,4200.53,2
CPT,75635,CAT Scan,4512.37,2933.04,2808.07,2839.65,2
CPT,75635,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA AND BILATERAL ILIOFEMORAL LOWER EXTREMITY RUNOFF, RADIOLOGICAL SUPERVISION AND INTERPRETATION, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATE",4512.37,2933.04,780.82,780.82,2
CPT,75635,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA,BILATERAL ILIOFEMOAL LOWER EXTREMITY RUNOFF,SUPV,INTERP W/O CONTRAST",4512.37,2933.04,2144.67,3415.6,2
CPT,75635,CT SCAN,4512.37,2933.04,2087.14,2107.6,2
CPT,75635,HB CT ANGIO ABDOMINAL RUNOFF W 3D,5189.225,3372.995,221.67,14761.0,10
CPT,75635,PET Scan,4512.37,2933.04,4155.27,4200.53,2
CPT,75650,PET Scan,,,4155.27,4200.53,2
CPT,75651,PET Scan,,,4155.27,4200.53,2
CPT,75652,PET Scan,,,4155.27,4200.53,2
CPT,75653,PET Scan,,,4155.27,4200.53,2
CPT,75654,PET Scan,,,4155.27,4200.53,2
CPT,75655,PET Scan,,,4155.27,4200.53,2
CPT,75656,PET Scan,,,4155.27,4200.53,2
CPT,75659,PET Scan,,,4155.27,4200.53,2
CPT,75670,PET Scan,,,4155.27,4200.53,2
CPT,75671,PET Scan,,,4155.27,4200.53,2
CPT,75672,PET Scan,,,4155.27,4200.53,2
CPT,75673,PET Scan,,,4155.27,4200.53,2
CPT,75679,PET Scan,,,4155.27,4200.53,2
CPT,75681,PET Scan,,,4155.27,4200.53,2
CPT,75682,PET Scan,,,4155.27,4200.53,2
CPT,75683,PET Scan,,,4155.27,4200.53,2
CPT,75689,PET Scan,,,4155.27,4200.53,2
CPT,75705,"ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",24975.0,16233.75,331.52,331.52,2
CPT,75705,"ANGIOGRAPHY, SPINAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",24975.0,16233.75,3148.35,5014.07,2
CPT,75705,HB ANGIO SPINAL,28721.25,18668.815000000002,6731.11,14761.0,10
CPT,75705,PET Scan,24975.0,16233.75,4155.27,4200.53,2
CPT,75710,"ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",18106.1,11768.97,171.58,171.58,2
CPT,75710,"ANGIOGRAPHY, EXTREMITY, UNILATERAL; SUPERVISION AND INTERPRETATION ONLY",18106.1,11768.97,3131.13,4986.64,2
CPT,75710,HB ANGIO EXTREMITY UNI S&I,18106.1,11768.97,3919.23,14761.0,10
CPT,75710,PET Scan,18106.1,11768.97,4155.27,4200.53,2
CPT,75716,"ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",19929.2,12953.98,178.24,178.24,2
CPT,75716,"ANGIOGRAPHY, EXTREMITY, BILATERAL; SUPERVISION AND INTERPRETATION ONLY",19929.2,12953.98,3148.35,5014.07,2
CPT,75716,HB ANGIO EXTREMITY BILAT,22918.555,14897.06,3919.23,14761.0,10
CPT,75716,PET Scan,19929.2,12953.98,4155.27,4200.53,2
CPT,75726,"ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION",24975.0,16233.75,193.21,193.21,2
CPT,75726,"ANGIOGRAPHY, VISCERAL; SELECTIVE OR SUPRASELECTIVE, SUPERVISION AND INTERPRETATION ONLY",24975.0,16233.75,3131.13,4986.64,2
CPT,75726,HB ANGIOGRAM VISCERAL S&I,24975.0,16233.75,6731.11,14761.0,10
CPT,75726,PET Scan,24975.0,16233.75,4155.27,4200.53,2
CPT,75731,"ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,245.82,245.82,2
CPT,75731,"ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",8165.3,5307.45,3131.13,4986.64,2
CPT,75731,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75732,PET Scan,,,4155.27,4200.53,2
CPT,75733,"ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION ANDINTERPRETATION",10312.3,6702.99,269.95,269.95,2
CPT,75733,"ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",10312.3,6702.99,3148.35,5014.07,2
CPT,75733,PET Scan,10312.3,6702.99,4155.27,4200.53,2
CPT,75736,"ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",24975.0,16233.75,225.85,225.85,2
CPT,75736,"ANGIOGRAPHY, PELVIC; SELECTIVE OR SUPRASELECTIVE, SUPERVISION AND INTERPRETATION ONLY",24975.0,16233.75,3148.41,5014.17,2
CPT,75736,HB ANGIOGRAM PELVIC S&I,24975.0,16233.75,6731.11,14761.0,10
CPT,75736,PET Scan,24975.0,16233.75,4155.27,4200.53,2
CPT,75739,PET Scan,,,4155.27,4200.53,2
CPT,75741,"ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",15741.2,10231.78,176.58,176.58,2
CPT,75741,"ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",15741.2,10231.78,3131.07,4986.54,2
CPT,75741,HB ANGIO PULMONARY UNILAT,18102.34,11766.52,3919.23,14761.0,10
CPT,75741,PET Scan,15741.2,10231.78,4155.27,4200.53,2
CPT,75743,"ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",19929.2,12953.98,179.9,179.9,2
CPT,75743,"ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",19929.2,12953.98,3148.35,5014.07,2
CPT,75743,HB ANGIO PULMONARY BILAT,25907.91,16840.14,13270.0,14761.0,2
CPT,75743,PET Scan,19929.2,12953.98,4155.27,4200.53,2
CPT,75746,"ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,204.87,204.87,2
CPT,75746,"ANGIOGRAPHY, PULMONARY; BY NONSELECTIVE CATHETER OR VENOUS INJECTION, SUPERVISION AND INTERPRETATION ONLY",8165.3,5307.45,3148.41,5014.17,2
CPT,75746,HB ANGIO PULM NON SELECT CATH,10614.89,6899.68,13270.0,14761.0,2
CPT,75746,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75756,"ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",14909.4,9691.11,265.79,265.79,2
CPT,75756,"ANGIOGRAPHY, INTERNAL MAMMARY; SUPERVISION AND INTERPRETATION ONLY",14909.4,9691.11,3131.13,4986.64,2
CPT,75756,HB ANGIO INTERNAL MAMMARY,17145.825,11144.785,3919.23,14761.0,10
CPT,75756,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75774,"ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION; SUPERVISION AND INTERPRETATIO",20000.4,13000.26,3131.01,4986.45,2
CPT,75774,HB ANGIOGRAM EA ADDL VESSEL S&I,20000.4,13000.26,13270.0,14761.0,2
CPT,75774,PET Scan,20000.4,13000.26,4155.27,4200.53,2
CPT,75801,"LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,498.34,498.34,2
CPT,75801,"LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL; SUPERVISION AND INTERPRETATION ONLY",,,1353.99,2156.37,2
CPT,75801,PET Scan,,,4155.27,4200.53,2
CPT,75803,"LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,480.68,480.68,2
CPT,75803,"LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL; SUPERVISION AND INTERPRETATION ONLY",,,1353.99,2156.37,2
CPT,75803,PET Scan,,,4155.27,4200.53,2
CPT,75805,HB LYMPHANGIOGRAM PELVIC/ABD; UNILAT,10614.89,6899.68,13270.0,14761.0,2
CPT,75805,"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISIONAND INTERPRETATION",8165.3,5307.45,531.81,531.81,2
CPT,75805,"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL; SUPERVISION AND INTERPRETATION ONLY",8165.3,5307.45,1524.26,2427.54,2
CPT,75805,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75807,HB LYMPHANGIOGRAM PELVIC/ABD; BILAT,19382.25,12598.46,13270.0,14761.0,2
CPT,75807,"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",14909.4,9691.11,509.16,509.16,2
CPT,75807,"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL; SUPERVISION AND INTERPRETATION ONLY",14909.4,9691.11,1516.21,2414.71,2
CPT,75807,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75809,HB SHUNTOGRAM NON-VAS SHUNT S&I,1760.68,1144.44,13270.0,14761.0,2
CPT,75809,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,75809,"SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULARSHUNT (EG, LEVEEN SHUNT, VENTRICULOPERITONEAL SHUNT), RADIOLOGICAL SUPERVISION AND INTERPRETATION",1760.68,1144.44,147.78,147.78,2
CPT,75809,"SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLINGNONVASCULAR SHUNT,RADIOLOGICAL SUPERVISION AND INTERPRETATIO",1760.68,1144.44,196.2,312.47,2
CPT,75810,HB SPLENOPORTOGRAPHY,10614.89,6899.68,13270.0,14761.0,2
CPT,75810,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75810,"SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,943.9,943.9,2
CPT,75810,SPLENOPORTOGRAPHY; SUPERVISION AND INTERPRETATION ONLY,8165.3,5307.45,3131.13,4986.64,2
CPT,75820,HB VENOGRAM EXTREMITY UNI S&I,5255.94,3416.36,1934.32,14761.0,10
CPT,75820,PET Scan,5255.94,3416.36,4155.27,4200.53,2
CPT,75820,"VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",5255.94,3416.36,150.27,150.27,2
CPT,75820,"VENOGRAPHY, EXTREMITY, UNILATERAL; SUPERVISION AND INTERPRETATION ONLY",5255.94,3416.36,235.42,374.92,2
CPT,75822,HB VENOGRAPHY EXTREMITY BILAT,9390.095,6103.5650000000005,1934.32,14761.0,10
CPT,75822,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75822,"VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,162.76,162.76,2
CPT,75822,"VENOGRAPHY, EXTREMITY, BILATERAL; SUPERVISION AND INTERPRETATION ONLY",8165.3,5307.45,368.0,586.07,2
CPT,75825,HB VENOGRAM VENA CAVA INF S&I,14909.4,9691.11,3919.23,14761.0,10
CPT,75825,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75825,"VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",14909.4,9691.11,153.61,153.61,2
CPT,75825,"VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",14909.4,9691.11,3131.13,4986.64,2
CPT,75827,HB VENOGRAPHY SUPERIOR CAVAL,6646.0599999999995,4319.94,1934.32,14761.0,10
CPT,75827,PET Scan,5779.18,3756.47,4155.27,4200.53,2
CPT,75827,"VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",5779.18,3756.47,165.25,165.25,2
CPT,75827,"VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY; SUPERVISION AND INTERPRETATION ONLY",5779.18,3756.47,3131.13,4986.64,2
CPT,75831,HB VENOGRAPHY RENAL UNILAT,15254.075,9915.150000000001,3919.23,14761.0,10
CPT,75831,PET Scan,13264.4,8621.86,4155.27,4200.53,2
CPT,75831,"VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",13264.4,8621.86,171.58,171.58,2
CPT,75831,"VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",13264.4,8621.86,3146.94,5011.83,2
CPT,75832,PET Scan,,,4155.27,4200.53,2
CPT,75833,PET Scan,15424.8,10026.12,4155.27,4200.53,2
CPT,75833,"VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",15424.8,10026.12,194.05,194.05,2
CPT,75833,"VENOGRAPHY, RENAL, BILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",15424.8,10026.12,3148.41,5014.17,2
CPT,75839,PET Scan,,,4155.27,4200.53,2
CPT,75840,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75840,"VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION ANDINTERPRETATION",14909.4,9691.11,187.39,187.39,2
CPT,75840,"VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",14909.4,9691.11,3148.41,5014.17,2
CPT,75842,PET Scan,,,4155.27,4200.53,2
CPT,75842,"VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,219.84,219.84,2
CPT,75842,"VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE; SUPERVISION AND INTERPRETATION ONLY",,,3148.41,5014.17,2
CPT,75860,HB VENOGRAM JUGULAR S&I,14909.4,9691.11,3919.23,14761.0,10
CPT,75860,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75860,"VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION",14909.4,9691.11,181.57,181.57,2
CPT,75860,"VENOGRAPHY,VENOUS SINUS (EG, PETROSAL AND INFERIOR SAGITTAL) OR JUGULAR, CATHETER; SUPERVISION AND INTRPRETATION",14909.4,9691.11,3148.41,5014.17,2
CPT,75870,HB VENOGRAM SUP SAG SINUS S&I,8165.3,5307.45,13270.0,14761.0,2
CPT,75870,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75870,"VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,244.81,244.81,2
CPT,75870,"VENOGRAPHY, SUPERIOR SAGITTAL SINUS; SUPERVISION AND INTERPRETATION ONLY",8165.3,5307.45,3148.41,5014.17,2
CPT,75872,PET Scan,,,4155.27,4200.53,2
CPT,75872,"VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,187.39,187.39,2
CPT,75872,"VENOGRAPHY, EPIDURAL; SUPERVISION AND INTERPRETATION ONLY",,,3148.41,5014.17,2
CPT,75880,PET Scan,,,4155.27,4200.53,2
CPT,75880,"VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,186.56,186.56,2
CPT,75880,"VENOGRAPHY, ORBITAL; SUPERVISION AND INTERPRETATION ONLY",,,235.42,374.92,2
CPT,75881,PET Scan,,,4155.27,4200.53,2
CPT,75885,HB PERC TRANSHEP PORT W HEMODYNAMIC S&I,17145.825,11144.785,3919.23,14761.0,10
CPT,75885,"PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",14909.4,9691.11,179.9,179.9,2
CPT,75885,PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION; SUPERVISION AND INTERPRETATION ONLY,14909.4,9691.11,3148.35,5014.07,2
CPT,75885,PET Scan,14909.4,9691.11,4155.27,4200.53,2
CPT,75887,HB PERC TRANSHEP PORT W/O HEMODYNAMIC S&I,10614.89,6899.68,13270.0,14761.0,2
CPT,75887,"PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",8165.3,5307.45,182.4,182.4,2
CPT,75887,PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION; SUPERVISION AND INTERPRETATION ONLY,8165.3,5307.45,3148.35,5014.07,2
CPT,75887,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75889,HB VENOGRAM HEPATIC W HDM,29794.09,19366.16,3919.23,14761.0,10
CPT,75889,"HEPATIC VENOGRAPHY WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION; SUPERVISION AND INTERPRETATION ONLY",25907.9,16840.14,3148.41,5014.17,2
CPT,75889,"HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",25907.9,16840.14,180.74,180.74,2
CPT,75889,PET Scan,25907.9,16840.14,4155.27,4200.53,2
CPT,75891,HB VENOGRAM HEPATIC WO HEMO S&I,22350.0,14527.5,13270.0,14761.0,2
CPT,75891,"HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION",22350.0,14527.5,181.57,181.57,2
CPT,75891,"HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION; SUPERVISION AND INTERPRETATION ONLY",22350.0,14527.5,3148.41,5014.17,2
CPT,75891,PET Scan,22350.0,14527.5,4155.27,4200.53,2
CPT,75893,HB VENOUS SAMPLE W/WO ANGIO,28721.25,18668.815000000002,6731.11,14761.0,10
CPT,75893,PET Scan,24975.0,16233.75,4155.27,4200.53,2
CPT,75893,VENOUS SAMPLING BY CATHETER,24975.0,16233.75,196.55,196.55,2
CPT,75893,"VENOUS SAMPLING THROUGH CATHETER WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN)",24975.0,16233.75,3131.01,4986.45,2
CPT,75894,HB TRANSCATH EMBOLIZATION S&I,23303.0,15146.95,13270.0,14761.0,2
CPT,75894,PET Scan,23303.0,15146.95,4155.27,4200.53,2
CPT,75894,"TRANSCATHETER THERAPY, EMBOLIZATION (EG, PARTICULATE OR LIQUID), INCLUDING ANGIOGRAPHY; SUPERVISION AND INTERPRETATIO",23303.0,15146.95,5996.97,9550.79,2
CPT,75898,"ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION",8165.3,5307.45,107.57,107.57,2
CPT,75898,"ANGIOGRAPHY THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION, OTHER THA",8165.3,5307.45,225.13,358.54,2
CPT,75898,"HB ANGIO THRU EXIST CATH, NON THROMBOLYSIS",9390.095,6103.5650000000005,3919.23,14761.0,10
CPT,75898,PET Scan,8165.3,5307.45,4155.27,4200.53,2
CPT,75901,HB CATH REMOVAL OBS MAT S&I,2768.14,1799.29,13270.0,14761.0,2
CPT,75901,"MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS, RADIO",2768.14,1799.29,456.9,727.65,2
CPT,75901,PET Scan,2768.14,1799.29,4155.27,4200.53,2
CPT,75902,"MECHANICAL REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL FROMCENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN,RAD SUP & INTER",3811.46,2477.45,456.9,727.65,2
CPT,75902,PET Scan,3811.46,2477.45,4155.27,4200.53,2
CPT,75956,PET Scan,,,4155.27,4200.53,2
CPT,75956,RADIOLOGICAL SUPERVISION AND INTERPRETATION FOR ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA; INVOLVING COVERAGE OF,,,3463.79,5516.44,2
CPT,75957,HB REPAIR DECEND AORTA WO SUBCLAV S&I,8201.63,5331.06,13270.0,14761.0,2
CPT,75957,PET Scan,,,4155.27,4200.53,2
CPT,75957,RADIOLOGICAL SUPERVISION AND INTERPRETATION FOR ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA; NOT INVOLVING COVERAG,,,2967.5,4726.05,2
CPT,75958,PET Scan,,,4155.27,4200.53,2
CPT,75958,RADIOLOGICAL SUPERVISION AND INTERPRETATION FOR THE PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR,,,1978.51,3150.98,2
CPT,75959,PET Scan,,,4155.27,4200.53,2
CPT,75959,RADIOLOGICAL SUPERVISION AND INTERPRETATION FOR THE PLACEMENT OF DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF,,,1732.22,2758.73,2
CPT,75970,HB BIOPSY TRANSCATHETER S&I,12072.9,7847.39,13270.0,14761.0,2
CPT,75970,PET Scan,12072.9,7847.39,4155.27,4200.53,2
CPT,75970,TRANSCATHETER BIOPSY; SUPERVISION AND INTERPRETATION ONLY,12072.9,7847.39,2868.43,4568.27,2
CPT,75981,PET Scan,,,4155.27,4200.53,2
CPT,75982,PET Scan,,,4155.27,4200.53,2
CPT,75983,PET Scan,,,4155.27,4200.53,2
CPT,75984,"CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT); SUPERVISION",4851.06,3153.19,488.23,777.56,2
CPT,75984,HB XCHANGE DRAINAGE CATH S&I,4851.06,3153.19,13270.0,14761.0,2
CPT,75984,PET Scan,4851.06,3153.19,4155.27,4200.53,2
CPT,75989,CAT Scan,5284.77,3435.1,2808.07,2839.65,2
CPT,75989,HB XR DRAINAGE S&I,6076.215,3949.54,13270.0,14761.0,2
CPT,75989,PET Scan,5284.77,3435.1,4155.27,4200.53,2
CPT,75989,"RADIOLOGICAL GUIDANCE (IE FLUOROSCOPY, ULTRASOUND, CT)W/PLCTOF CATHETER, RAD SUPV & INTERP; FOR PERCUTANEOUS DRAINAGE",5284.77,3435.1,782.68,1246.5,2
CPT,76000,"FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034",1.0,0.65,69.57,69.57,2
CPT,76000,"FLUOROSCOPY UP TO 1 HOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL TIME, OTHER THAN 71023 OR 71034 (EG CARDI",1.0,0.65,284.27,452.73,2
CPT,76000,HB XR FLUOROSCOPY 1HR/LESS,1.0,0.65,300.99,14761.0,10
CPT,76000,PET Scan,1.0,0.65,4155.27,4200.53,2
CPT,76010,HB XR NOSE TO RECTUM FB CHILD,1244.89,809.18,109.64,126.08,8
CPT,76010,PET Scan,1244.89,809.18,4155.27,4200.53,2
CPT,76010,"RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM VIEW,CHILD",1244.89,809.18,137.99,219.77,2
CPT,76010,"RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM, CHILD",1244.89,809.18,52.93,52.93,2
CPT,76061,PET Scan,,,4155.27,4200.53,2
CPT,76062,PET Scan,,,4155.27,4200.53,2
CPT,76063,PET Scan,,,4155.27,4200.53,2
CPT,76064,PET Scan,,,4155.27,4200.53,2
CPT,76070,PET Scan,,,4155.27,4200.53,2
CPT,76071,PET Scan,,,4155.27,4200.53,2
CPT,76072,PET Scan,,,4155.27,4200.53,2
CPT,76073,PET Scan,,,4155.27,4200.53,2
CPT,76074,PET Scan,,,4155.27,4200.53,2
CPT,76075,PET Scan,,,4155.27,4200.53,2
CPT,76076,PET Scan,,,4155.27,4200.53,2
CPT,76077,PET Scan,,,4155.27,4200.53,2
CPT,76078,PET Scan,,,4155.27,4200.53,2
CPT,76079,PET Scan,,,4155.27,4200.53,2
CPT,76080,HB IMG ABSCESS/FISTULA S&I,3191.7799999999997,2074.655,682.74,14761.0,10
CPT,76080,PET Scan,2775.46,1804.05,4155.27,4200.53,2
CPT,76080,"RADIOLOGIC EXAMINATION, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2775.46,1804.05,87.87,87.87,2
CPT,76080,"RADIOLOGIC EXAMINATION, FISTULA OR SINUS TRACT STUDY; SUPERVISION AND INTERPRETATION ONLY",2775.46,1804.05,262.34,417.81,2
CPT,76098,HB PATHOLOGY TISSUE XRAY,3191.775,2074.655,682.74,14761.0,10
CPT,76098,PET Scan,2775.46,1804.05,4155.27,4200.53,2
CPT,76098,"RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN",2775.46,1804.05,106.24,169.2,2
CPT,76098,"RADIOLOGICAL EXAMINATION, SURGICAL SPECIMEN",2775.46,1804.05,67.07,67.07,2
CPT,76100,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,76100,"RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY",1760.68,1144.44,154.44,500.4,4
CPT,76101,PET Scan,,,4155.27,4200.53,2
CPT,76101,"RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER THAN WITH U",,,355.47,566.13,2
CPT,76102,PET Scan,,,4155.27,4200.53,2
CPT,76102,"RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER THAN WITH U",,,433.2,689.92,2
CPT,76120,"CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED",,,245.13,419.77,4
CPT,76120,PET Scan,,,4155.27,4200.53,2
CPT,76125,CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION,,,196.61,313.12,2
CPT,76125,PET Scan,,,4155.27,4200.53,2
CPT,76140,"CONSULTATION ON X-RAY EXAMINATION MADE ELSEWHERE, WRITTEN REPORT",,,142.52,226.98,2
CPT,76140,PET Scan,,,4155.27,4200.53,2
CPT,76145,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report",,,1180.16,1180.16,2
CPT,76376,"3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMAGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER",1.0,0.65,842.41,1341.63,2
CPT,76376,CAT Scan,1.0,0.65,2808.07,2839.65,2
CPT,76376,HB RECON 3D TECH WORKSTATN,1.0,0.65,13270.0,14761.0,6
CPT,76376,PET Scan,1.0,0.65,4155.27,4200.53,2
CPT,76377,"3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMAGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER",1.0,0.65,888.22,1414.57,2
CPT,76377,CAT Scan,1.0,0.65,2808.07,2839.65,2
CPT,76377,HB RECON 3D INDPNDNT WRKSTN,1.0,0.65,13270.0,14761.0,4
CPT,76377,PET Scan,1.0,0.65,4155.27,4200.53,2
CPT,76380,CAT Scan,4612.05,2997.83,2808.07,2839.65,2
CPT,76380,"COMPUTED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY",4612.05,2997.83,796.55,1268.59,2
CPT,76380,"COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY",4612.05,2997.83,226.82,226.82,2
CPT,76380,HB CT LIMITED/FOLLOW-UP SCAN,5303.860000000001,3447.51,109.64,14761.0,10
CPT,76380,PET Scan,4612.05,2997.83,4155.27,4200.53,2
CPT,76381,PET Scan,,,4155.27,4200.53,2
CPT,76382,PET Scan,,,4155.27,4200.53,2
CPT,76383,PET Scan,,,4155.27,4200.53,2
CPT,76384,PET Scan,,,4155.27,4200.53,2
CPT,76389,PET Scan,,,4155.27,4200.53,2
CPT,76390,HB MRI SPECTROSCOPY,3598.59,2339.085,109.64,14761.0,10
CPT,76390,MAGNETIC RESONANCE SPECTROSCOPY,3129.21,2033.99,749.0,4459.65,4
CPT,76390,MRI,3129.21,2033.99,2725.12,2751.84,2
CPT,76390,MRI/MRA,3129.21,2033.99,3089.09,3116.45,2
CPT,76390,PET Scan,3129.21,2033.99,4155.27,4200.53,2
CPT,76391,HB MR ELASTOGRAPHY,13110.0,8521.5,300.99,346.13,8
CPT,76391,"Magnetic resonance (eg, vibration) elastography",13110.0,8521.5,396.24,396.24,2
CPT,76391,Mr elastography,13110.0,8521.5,1787.19,2846.28,2
CPT,76391,PET Scan,13110.0,8521.5,4155.27,4200.53,2
CPT,76400,PET Scan,,,4155.27,4200.53,2
CPT,76401,PET Scan,,,4155.27,4200.53,2
CPT,76402,PET Scan,,,4155.27,4200.53,2
CPT,76403,PET Scan,,,4155.27,4200.53,2
CPT,76404,PET Scan,,,4155.27,4200.53,2
CPT,76405,PET Scan,,,4155.27,4200.53,2
CPT,76406,PET Scan,,,4155.27,4200.53,2
CPT,76407,PET Scan,,,4155.27,4200.53,2
CPT,76408,PET Scan,,,4155.27,4200.53,2
CPT,76409,PET Scan,,,4155.27,4200.53,2
CPT,76410,PET Scan,,,4155.27,4200.53,2
CPT,76411,PET Scan,,,4155.27,4200.53,2
CPT,76412,PET Scan,,,4155.27,4200.53,2
CPT,76413,PET Scan,,,4155.27,4200.53,2
CPT,76414,PET Scan,,,4155.27,4200.53,2
CPT,76415,PET Scan,,,4155.27,4200.53,2
CPT,76416,PET Scan,,,4155.27,4200.53,2
CPT,76417,PET Scan,,,4155.27,4200.53,2
CPT,76418,PET Scan,,,4155.27,4200.53,2
CPT,76419,PET Scan,,,4155.27,4200.53,2
CPT,76420,PET Scan,,,4155.27,4200.53,2
CPT,76421,PET Scan,,,4155.27,4200.53,2
CPT,76422,PET Scan,,,4155.27,4200.53,2
CPT,76423,PET Scan,,,4155.27,4200.53,2
CPT,76424,PET Scan,,,4155.27,4200.53,2
CPT,76425,PET Scan,,,4155.27,4200.53,2
CPT,76426,PET Scan,,,4155.27,4200.53,2
CPT,76427,PET Scan,,,4155.27,4200.53,2
CPT,76428,PET Scan,,,4155.27,4200.53,2
CPT,76429,PET Scan,,,4155.27,4200.53,2
CPT,76490,PET Scan,,,4155.27,4200.53,2
CPT,76491,PET Scan,,,4155.27,4200.53,2
CPT,76492,PET Scan,,,4155.27,4200.53,2
CPT,76493,PET Scan,,,4155.27,4200.53,2
CPT,76494,PET Scan,,,4155.27,4200.53,2
CPT,76495,PET Scan,,,4155.27,4200.53,2
CPT,76496,HB UL PROC ART/VEN STRUCTURE,964.45,626.89,109.64,14761.0,10
CPT,76496,PET Scan,841.94,547.26,4155.27,4200.53,2
CPT,76496,UNLISTED FLUOROSCOPIC PROCEDURE,841.94,547.26,106.53,106.53,2
CPT,76497,CAT Scan,1371.34,891.37,2808.07,2839.65,2
CPT,76497,HB UL PROC CT BONE SURVEY SKULL-THIGH,1782.75,1158.79,13270.0,14761.0,2
CPT,76497,PET Scan,1371.34,891.37,4155.27,4200.53,2
CPT,76497,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,1371.34,891.37,213.16,213.16,2
CPT,76498,HB MRI UL PROC MYELOMA BNE SVY,6718.57,4367.07,109.64,126.08,8
CPT,76498,MRI/MRA,6718.57,4367.07,3089.09,3116.45,2
CPT,76498,PET Scan,6718.57,4367.07,4155.27,4200.53,2
CPT,76498,UNLISTED MAGNETIC RESONANCE PROCEDURE,6718.57,4367.07,186.39,186.39,2
CPT,76499,HB UL PROC DXA FAT COMP ASSMT,1778.0500000000002,1155.73,109.64,14761.0,10
CPT,76499,PET Scan,1546.13,1004.98,4155.27,4200.53,2
CPT,76499,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,1546.13,1004.98,212.09,212.09,2
CPT,76500,PET Scan,,,4155.27,4200.53,2
CPT,76501,PET Scan,,,4155.27,4200.53,2
CPT,76502,PET Scan,,,4155.27,4200.53,2
CPT,76503,PET Scan,,,4155.27,4200.53,2
CPT,76504,PET Scan,,,4155.27,4200.53,2
CPT,76505,PET Scan,,,4155.27,4200.53,2
CPT,76506,"ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTRICULAR S",1943.37,1263.19,306.38,487.94,2
CPT,76506,"ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTRICULAR SIZE, DELINEATION OF CEREBRAL CONTENTS AND DETECTION OF FLUID MASSES OR OTHER INTRA",1943.37,1263.19,208.52,208.52,2
CPT,76506,HB US BRAIN W DOPPLER,2234.87,1452.665,132.41,14761.0,10
CPT,76506,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76507,PET Scan,,,4155.27,4200.53,2
CPT,76508,PET Scan,,,4155.27,4200.53,2
CPT,76509,PET Scan,,,4155.27,4200.53,2
CPT,76510,"OPHTHALMIC ULTRASOUND, DIAGNOSTIC; B-SCAN AND QUANTITATIVE A-SCAN PERFORMED DURING THE SAME PATIENT ENCOUNTER",1074.29,698.29,75.39,75.39,2
CPT,76510,"OPHTHALMIC ULTRASOUND, DIAGNOSTIC; B-SCAN AND QUANTITATIVE ASCAN PERFORMED DURING THE SAME PATIENT ENCOUNTER",1074.29,698.29,523.33,833.46,2
CPT,76510,PET Scan,1074.29,698.29,4155.27,4200.53,2
CPT,76511,"OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION",,,53.76,53.76,2
CPT,76511,PET Scan,,,4155.27,4200.53,2
CPT,76511,QUANTITATIVE A-SCAN ONLY,,,317.79,506.11,2
CPT,76512,B-SCAN (WITH OR WITHOUT SUPERIMPOSED NON-QUANTITATIVE A-SCAN),1165.55,757.61,383.28,610.42,2
CPT,76512,HB US OPHTH DX B-SCAN W/WO NON QUAN A-SCAN,1340.38,871.25,132.41,14761.0,10
CPT,76512,"OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN)",1165.55,757.61,43.77,43.77,2
CPT,76512,PET Scan,1165.55,757.61,4155.27,4200.53,2
CPT,76513,"OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; IMMERSION (WATER BATH) B-SCAN",,,107.01,610.51,4
CPT,76513,PET Scan,,,4155.27,4200.53,2
CPT,76514,"OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERA",486.73,316.37,16.52,26.31,2
CPT,76514,"OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL (DETERMINATION OF CORNEAL THICKNESS)",486.73,316.37,8.83,8.83,2
CPT,76514,PET Scan,486.73,316.37,4155.27,4200.53,2
CPT,76515,PET Scan,,,4155.27,4200.53,2
CPT,76516,"OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;",,,60.42,499.27,4
CPT,76516,PET Scan,,,4155.27,4200.53,2
CPT,76517,PET Scan,,,4155.27,4200.53,2
CPT,76518,PET Scan,,,4155.27,4200.53,2
CPT,76519,"OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATION",1165.55,757.61,92.87,499.27,4
CPT,76519,PET Scan,1165.55,757.61,4155.27,4200.53,2
CPT,76520,PET Scan,,,4155.27,4200.53,2
CPT,76521,PET Scan,,,4155.27,4200.53,2
CPT,76522,PET Scan,,,4155.27,4200.53,2
CPT,76523,PET Scan,,,4155.27,4200.53,2
CPT,76524,PET Scan,,,4155.27,4200.53,2
CPT,76525,PET Scan,,,4155.27,4200.53,2
CPT,76526,PET Scan,,,4155.27,4200.53,2
CPT,76527,PET Scan,,,4155.27,4200.53,2
CPT,76528,PET Scan,,,4155.27,4200.53,2
CPT,76529,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,,,134.46,545.06,4
CPT,76529,PET Scan,,,4155.27,4200.53,2
CPT,76536,"ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION",3053.85,1985.0,211.01,211.01,2
CPT,76536,HB US HEAD/NECK SOFT TISSUE,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76536,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76536,"ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE DOCUMENTATION",3053.85,1985.0,355.53,566.22,2
CPT,76604,"ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION",3053.85,1985.0,72.89,72.89,2
CPT,76604,HB US CHEST,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76604,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76604,"ULTRASOUND, CHEST (INCLUDES MEDIASTINUM), REAL TIME WITH IMAGE DOCUMENTATION",3053.85,1985.0,326.31,519.69,2
CPT,76621,PET Scan,,,4155.27,4200.53,2
CPT,76622,PET Scan,,,4155.27,4200.53,2
CPT,76641,HB US BREAST COMPLETE UNILATERAL,2234.875,1452.67,132.41,14761.0,10
CPT,76641,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76641,Ultrasound breast complete,1943.37,1263.19,636.93,1014.37,2
CPT,76641,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete",1943.37,1263.19,171.9,171.9,2
CPT,76642,HB US BREAST LIMITED UNILATERAL,1628.12,1058.275,109.64,14761.0,10
CPT,76642,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76642,Ultrasound breast limited,1415.76,920.24,487.59,776.53,2
CPT,76642,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited",1415.76,920.24,131.97,131.97,2
CPT,76700,"ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION;COMPLETE",3609.09,2345.91,196.87,196.87,2
CPT,76700,HB US ABDOMEN COMPLETE,4150.4400000000005,2697.785,132.41,14761.0,10
CPT,76700,PET Scan,3609.09,2345.91,4155.27,4200.53,2
CPT,76700,"ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE",3609.09,2345.91,493.76,786.36,2
CPT,76705,"ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLO",3053.85,1985.0,355.53,566.22,2
CPT,76705,"ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION;LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP)",3053.85,1985.0,150.27,150.27,2
CPT,76705,HB US ABDOMEN LIMITED,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76705,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76706,HB VAS SCREENING ABDOMEN,1415.76,920.24,132.41,152.28,8
CPT,76706,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76706,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm",1415.76,920.24,651.51,1037.59,2
CPT,76706,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)",1415.76,920.24,201.86,201.86,2
CPT,76711,PET Scan,,,4155.27,4200.53,2
CPT,76719,PET Scan,,,4155.27,4200.53,2
CPT,76770,"ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",3053.85,1985.0,185.22,185.22,2
CPT,76770,HB US RETROPERITONEUM COMPLETE,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76770,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76770,"ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",3053.85,1985.0,493.76,786.36,2
CPT,76775,"ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED",1943.37,1263.19,78.72,566.13,4
CPT,76775,HB US RETROPERITONEUM LIMITED,2234.87,1452.665,132.41,14761.0,10
CPT,76775,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76776,HB US TRANSPLANTED KIDNEY,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76776,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76776,"ULTRASOUND, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER WITH IMAGE DOCUMENTATION",3053.85,1985.0,281.42,281.42,2
CPT,76776,"ULTRASOUND, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER WITH IMAGE DOCUMENTATION ï",3053.85,1985.0,468.07,745.44,2
CPT,76800,"ECHOGRAPHY, SPINAL CANAL AND CONTENTS",1415.76,920.24,240.96,573.06,4
CPT,76800,HB US SPINAL CANAL,1628.125,1058.28,132.41,14761.0,10
CPT,76800,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76801,HB US OB < 14 WKS SINGLE FETUS,2234.875,1452.67,132.41,14761.0,10
CPT,76801,"OB ULTRASOUND < 14 WKS, SINGLE FETUS",1943.37,1263.19,177.74,177.74,2
CPT,76801,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76801,"ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL,FIRST TRI(<14WKS 0DAYS),TRANSABDOMINAL;SNGL/FIRST GEST",1943.37,1263.19,274.16,436.63,2
CPT,76802,"HB OB US < 14 WKS, ADD'L FETUS",856.45,556.69,,,0
CPT,76802,PET Scan,856.45,556.69,4155.27,4200.53,2
CPT,76802,"ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL,FIRST TRI(<14WKS 0DAYS),TRANSABDOMINAL:EACH ADD GESTAT",856.45,556.69,193.67,308.44,2
CPT,76805,"ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MATERNAL EVALUATION)",2913.5,1893.78,221.51,221.51,2
CPT,76805,HB ULTRASOUND OB >14 WEEKS,3350.52,2177.84,132.41,14761.0,20
CPT,76805,PET Scan,2913.5,1893.78,4155.27,4200.53,2
CPT,76805,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, FETAL & MATERNAL EVAL, AFTER 1ST TRIMESTER, SINGLE/FIRST GESTATION",2913.5,1893.78,512.22,815.77,2
CPT,76810,HB US OB > 14 WKS ADD'L GEST,4409.3,2866.045,13270.0,14761.0,2
CPT,76810,PET Scan,3834.17,2492.21,4155.27,4200.53,2
CPT,76810,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, FETAL & MATERNAL EVAL, AFTER 1ST TRIMESTER, EACH ADDTL GESTATION",3834.17,2492.21,678.26,1080.2,2
CPT,76811,HB U/S OB W/ DETAIL FETAL EXAM,5387.3,3501.745,300.99,14761.0,10
CPT,76811,HB US OB > 14 WKS ADD'L GEST,3834.17,2492.21,,,0
CPT,76811,"OB ULTRASOUND, DETAILED, SNGL FETUS",4684.6,3044.99,214.2,214.2,2
CPT,76811,PET Scan,4684.6,3044.99,4155.27,4200.53,2
CPT,76811,"ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL PLS DET FETAL ANATOMIC EXM,TRANSAB APPR;SINGLE OR FRST",4684.6,3044.99,929.9,1480.96,2
CPT,76812,"HB U/S OB, ADDL GESTATION",4912.925,3193.4049999999997,13270.0,14761.0,2
CPT,76812,PET Scan,4272.1,2776.87,4155.27,4200.53,2
CPT,76812,"ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL PLS DET FETAL ANATOMIC EXM,TRANSAB APPR; ECH ADD GESTAT",4272.1,2776.87,323.2,514.72,2
CPT,76813,"HB OB U/S NUCHAL MEAS, 1 GEST",1943.37,1263.19,132.41,152.28,8
CPT,76813,"OB ULTRASOUND NUCHAL MEASUREMENT, FIRST GESTATION",1943.37,1263.19,152.77,152.77,2
CPT,76813,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76813,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOCUMENTATION, 1ST TRIMESTER FETAL NUCHAL TRANSLUCENCY MEASUREMENT, TRANS",1943.37,1263.19,442.61,704.9,2
CPT,76814,"HB U/S OB NUCHAL, ADDL GESTATION",897.57,583.42,,,0
CPT,76814,PET Scan,897.57,583.42,4155.27,4200.53,2
CPT,76814,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOCUMENTATION, 1ST TRIMESTER FETAL NUCHAL TRANSLUCENCY MEASUREMENT, TRANS",897.57,583.42,228.95,364.62,2
CPT,76815,"ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (GESTATIONAL AGE, HEART BEAT, PLACENTAL LOCATION, FETAL POSITION, OR EMERGENCY IN THE DELIVERY",1943.37,1263.19,126.14,126.14,2
CPT,76815,HB US PREG UTERUS LMTD,2234.875,1452.67,132.41,14761.0,18
CPT,76815,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76815,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, LIMITED;ONE OR MORE FETUSES; (EG, FETAL HEARTBEAT, PLACENTAL LOCATIO",1943.37,1263.19,339.84,541.22,2
CPT,76816,"ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT",1415.76,920.24,173.57,173.57,2
CPT,76816,HB US OB FU/EVAL PER FETUS,1628.125,1058.28,132.41,14761.0,10
CPT,76816,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76816,"ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, FOLLOWUPPER FETUS; (EG, RE-EVAL OF SIZE, ORGAN SYSTEMS), TRANSAB APP",1415.76,920.24,240.06,382.32,2
CPT,76817,HB US PELVIS OB TRANSVAGINAL,2234.87,1452.665,132.41,14761.0,10
CPT,76817,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76817,"TRANSVAGINAL ULTRASOUND, OBSTETRIC",1943.37,1263.19,142.79,142.79,2
CPT,76817,"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL",1943.37,1263.19,391.22,623.06,2
CPT,76818,FETAL BIOPHYSICAL PROFILE,3609.09,2345.91,165.76,165.76,2
CPT,76818,FETAL BIOPHYSICAL PROFILE;WITH NON-STRESS TESTING,3609.09,2345.91,348.42,554.89,2
CPT,76818,HB FETAL BIOPHYS PROF W NONSTRESS,4150.46,2697.8,132.41,14761.0,10
CPT,76818,PET Scan,3609.09,2345.91,4155.27,4200.53,2
CPT,76819,FETAL BIOPHYSICAL PROFILE; WITHOUT STRESS OR NON-STRESS TESTING,3053.85,1985.0,119.49,654.05,4
CPT,76819,HB FETAL BIOPH PROFILE W/O NST,3511.935,2282.755,132.41,14761.0,10
CPT,76819,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76820,"DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY",1415.76,920.24,52.93,636.64,4
CPT,76820,HB UMBILICAL ARTERY DOPPLER,1628.125,1058.28,132.41,14761.0,10
CPT,76820,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76821,"DOPPLER VELOCIMETRY, FETAL; MIDDLE CEREBRAL ARTERY",1415.76,920.24,138.63,636.73,4
CPT,76821,HB FETAL MID CEREBRAL ARTERY DPLR,1628.125,1058.28,132.41,14761.0,10
CPT,76821,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76825,"ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING;",2864.56,1861.96,458.82,458.82,2
CPT,76825,"ECHOCARDIOGRAPHY, FETAL, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING",2864.56,1861.96,480.18,764.73,2
CPT,76825,HB FETAL ECHO COMPLETE,3294.245,2141.255,682.74,14761.0,18
CPT,76825,PET Scan,2864.56,1861.96,4155.27,4200.53,2
CPT,76826,"ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; FOLLOW-UP OR REPEAT STUDY",1790.49,1163.82,294.73,294.73,2
CPT,76826,FOLLOW-UP OR REPEAT STUDY,1790.49,1163.82,152.46,242.8,2
CPT,76826,HB FETAL ECHO FOLLOW UP,2059.07,1338.395,300.99,14761.0,18
CPT,76826,PET Scan,1790.49,1163.82,4155.27,4200.53,2
CPT,76827,"DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; COMPLETE",1415.76,920.24,105.34,105.34,2
CPT,76827,"DOPPLER ECHOCARDIOGRAPHY, FETAL, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; COMPLETE",1415.76,920.24,208.02,331.29,2
CPT,76827,HB FETAL ECHO COMPLETE DOPPLER,1628.125,1058.28,132.41,14761.0,18
CPT,76827,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76828,"DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; FOLLOW-UP OR REPEAT STUDY",1415.76,920.24,57.08,57.08,2
CPT,76828,FOLLOW-UP OR REPEAT STUDY,1415.76,920.24,243.65,388.03,2
CPT,76828,HB FETAL ECHO FOLLOW UP DOPPLER,1628.125,1058.28,132.41,14761.0,18
CPT,76828,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76830,"ECHOGRAPHY, TRANSVAGINAL",1943.37,1263.19,217.67,610.42,4
CPT,76830,HB US PELVIS TRANSVAGINAL,2234.87,1452.665,132.41,14761.0,10
CPT,76830,PET Scan,1943.37,1263.19,4155.27,4200.53,2
CPT,76831,HB US PELVIS HYSTEROSONOGRAM,4684.6,3044.99,300.99,346.13,8
CPT,76831,"HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER",4684.6,3044.99,206.02,206.02,2
CPT,76831,PET Scan,4684.6,3044.99,4155.27,4200.53,2
CPT,76831,"SALINE INFUSION SONOHYSTEROGRAPHY (SIS), INCLUDING COLOR FLOW DOPPLER, WHEN PERFORMED",4684.6,3044.99,381.7,607.89,2
CPT,76856,"ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",3053.85,1985.0,182.73,182.73,2
CPT,76856,HB US PELVIS TRANSABDOMEN COM,3511.935,2282.755,132.41,14761.0,10
CPT,76856,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76856,"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",3053.85,1985.0,383.28,610.42,2
CPT,76857,"ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, F",1544.15,1003.7,263.58,419.77,2
CPT,76857,"ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES)",1544.15,1003.7,62.92,62.92,2
CPT,76857,HB US PELVIS LIMITED,1775.77,1154.25,132.41,14761.0,10
CPT,76857,PET Scan,1544.15,1003.7,4155.27,4200.53,2
CPT,76870,"ECHOGRAPHY, SCROTUM AND CONTENTS",3053.85,1985.0,176.9,546.93,4
CPT,76870,HB US SCROTUM & TESTICLE(S),3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76870,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76871,PET Scan,,,4155.27,4200.53,2
CPT,76872,"ECHOGRAPHY, TRANSRECTAL",3053.85,1985.0,422.02,422.02,2
CPT,76872,HB US TRANSRECTAL,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76872,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76872,"ULTRASOUND, TRANSRECTAL",3053.85,1985.0,340.54,542.35,2
CPT,76873,"ECHOGRAPHY, TRANSRECTAL; PROSTATE VOLUME STUDY FOR BRACHYTHERAPHY TREATMENT PLANNING",,,522.86,832.71,2
CPT,76873,"ECHOGRAPHY, TRANSRECTAL; PROSTATE VOLUME STUDY FOR BRACHYTHERAPY TREATMENT PLANNING (SEPARATE PROCEDURE)",,,246.46,246.46,2
CPT,76873,PET Scan,,,4155.27,4200.53,2
CPT,76881,HB US COMPLETE JOINT,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,76881,PET Scan,3053.85,1985.0,4155.27,4200.53,2
CPT,76881,"ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; COMPLETE",3053.85,1985.0,27.13,982.91,4
CPT,76882,HB US LTD JOINT/NON-VASC EXT,1628.125,1058.28,132.41,14761.0,10
CPT,76882,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76882,"ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC",1415.76,920.24,22.98,114.8,4
CPT,76883,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity",,,36.29,161.34,4
CPT,76885,"ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC(EG, REQUIRING MANIPULATION)",,,254.78,254.78,2
CPT,76885,PET Scan,,,4155.27,4200.53,2
CPT,76885,"ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC (REQUIRING PHYSICIAN OR OTHER QUALIFIED HEALTH CA",,,381.76,607.99,2
CPT,76886,"ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; LIMITED, STATIC (EG, NOT REQUIRING MANIPULATION)",1415.76,920.24,178.56,178.56,2
CPT,76886,HB US INFANT HIPS; LIMITED/STATIC,1628.125,1058.28,109.64,14761.0,10
CPT,76886,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76886,"ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION ; LIMITED, STATIC (NOT REQUIRING PHYSICIAN OR OTHER QUALIF",1415.76,920.24,354.83,565.1,2
CPT,76932,PET Scan,,,4155.27,4200.53,2
CPT,76932,ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY; IMAGING RADIOLOGICAL SUPERVISION AND INTERPRETATION,,,380.11,605.36,2
CPT,76936,PET Scan,3969.24,2580.01,4155.27,4200.53,2
CPT,76936,ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEDUOANEURYSM OR ARTERIOVENOUS FISTULAE,3969.24,2580.01,897.68,1429.65,2
CPT,76936,"ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDOANEURYSM OR ARTERIOVENOUS FISTULAE (INCLUDES DIAGNOSTIC ULTRASOUND EVALUATION, COMPRESSION OF LESION AND IMAGING)",3969.24,2580.01,414.72,414.72,2
CPT,76937,HB U/S GUID VASCULAR ACCESS,2596.8199999999997,1687.935,13270.0,14761.0,2
CPT,76937,HB VASCULAR ACCESS GUIDANCE,2215.88,1440.32,,,0
CPT,76937,PET Scan,2257.64,1467.47,4155.27,4200.53,2
CPT,76937,"ULTRASOUND GUIDANCE FOR VASCULAR ACCESS REQUIRING ULTRASOUNDEVALUATION OF POTENTIAL ACCESS SITES, DOCUMENTATION OF SELEC",2257.64,1467.47,111.95,178.28,2
CPT,76940,PET Scan,2070.54,1345.85,4155.27,4200.53,2
CPT,76940,"ULTRASOUND GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION",2070.54,1345.85,423.27,674.09,2
CPT,76941,PET Scan,1555.4,1011.01,4155.27,4200.53,2
CPT,76941,"ULTRASONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION OR CORDOCENTESIS, IMAGING RADIOLOGICAL(S)AND(I)",1555.4,1011.01,380.34,605.74,2
CPT,76942,HB US PLACEMENT NEEDLE S&I,4381.73,2848.125,13270.0,14761.0,4
CPT,76942,PET Scan,3809.62,2476.25,4155.27,4200.53,2
CPT,76942,"ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT(EG,BIOPSY,ASPIRATION,INJECTION,LOCALIZATION DEVICE)RADIOLOGICAL IMAGING(S)AND(I",3809.62,2476.25,380.11,605.36,2
CPT,76945,HB PRENATAL CVS GUIDANCE,1133.98,737.09,,,0
CPT,76945,PET Scan,1133.98,737.09,4155.27,4200.53,2
CPT,76945,"ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING,IMAGING RADIOLOGICAL SUPERVISION AND INTERPRETATION",1133.98,737.09,380.4,605.83,2
CPT,76946,HB US GUIDE FOR AMNIOCENTESIS,1867.14,1213.64,,,0
CPT,76946,PET Scan,1867.14,1213.64,4155.27,4200.53,2
CPT,76946,ULTRASONIC GUIDANCE FOR AMNIOCENTESIS; IMAGING RADIOLOGICAL SUPERVISION AND INTERPRETATION,1867.14,1213.64,380.11,605.36,2
CPT,76948,PET Scan,,,4155.27,4200.53,2
CPT,76948,ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA; IMAGING RADIOLOGICAL SUPERVISION AND INTERPRETATION,,,380.11,605.36,2
CPT,76965,PET Scan,,,4155.27,4200.53,2
CPT,76965,ULTRASONIC GUIDANCE FOR INTERSTITAL RADIOELEMENT APPLICATION,,,1391.74,2216.48,2
CPT,76970,PET Scan,,,4155.27,4200.53,2
CPT,76975,"GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, RADILOGICAL SUPERVISION AND INTERPRETATION",,,380.05,605.27,2
CPT,76975,"GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,141.86,141.86,2
CPT,76975,PET Scan,,,4155.27,4200.53,2
CPT,76977,PET Scan,,,4155.27,4200.53,2
CPT,76977,"ULTRASOUND BONE DENSITY MEASUREMENT AND INTERPRERATION, PERIPHERAL SITE(S) ANY METHOD",,,208.78,332.5,2
CPT,76977,"ULTRASOUND BONE DENSITY MEASUREMENT AND INTERPRETATION, PERIPHERAL SITE(S), ANY METHOD",,,10.49,10.49,2
CPT,76978,HB US TRGT DYN MBUBB 1ST LES,9258.985,6018.344999999999,221.67,14761.0,10
CPT,76978,PET Scan,8051.27,5233.33,4155.27,4200.53,2
CPT,76978,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion",8051.27,5233.33,447.82,447.82,2
CPT,76978,Us trgt dyn mbubb 1st les,8051.27,5233.33,2420.71,3855.22,2
CPT,76979,PET Scan,3902.88,2536.87,4155.27,4200.53,2
CPT,76979,Us trgt dyn mbubb ea addl,3902.88,2536.87,1767.44,2814.82,2
CPT,76981,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,76981,"Ultrasound, elastography; parenchyma (eg, organ)",6671.63,4336.56,189.38,189.38,2
CPT,76981,Use parenchyma,6671.63,4336.56,769.16,1224.96,2
CPT,76982,PET Scan,6671.63,4336.56,4155.27,4200.53,2
CPT,76982,"Ultrasound, elastography; first target lesion",6671.63,4336.56,162.76,162.76,2
CPT,76982,Use 1st target lesion,6671.63,4336.56,656.68,1045.83,2
CPT,76983,PET Scan,2274.79,1478.61,4155.27,4200.53,2
CPT,76983,Use ea addl target lesion,2274.79,1478.61,334.78,533.17,2
CPT,76998,HB US INTRAOPERATIVE GUIDANCE,2500.26,1625.17,13270.0,14761.0,2
CPT,76998,PET Scan,2174.12,1413.18,4155.27,4200.53,2
CPT,76998,"ULTRASONIC GUIDANCE, INTRAOPERATIVE ï",2174.12,1413.18,567.08,903.13,2
CPT,76999,HB US UL PROC,1628.12,1058.275,109.64,14761.0,10
CPT,76999,PET Scan,1415.76,920.24,4155.27,4200.53,2
CPT,76999,UNLISTED ULTRASOUND PROCEDURE,1415.76,920.24,212.09,212.09,2
CPT,76999,"UNLISTED ULTRASOUND PROCEDURE (EG DIAGNOSTIC,INTERVENTIONAL)",1415.76,920.24,,,0
CPT,77001,FLUORO GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT/REMOVAL AND CATHETER MANIP AND RADIOGRAPHIC DOCUMENTATION OF,1942.47,1262.61,331.72,528.3,2
CPT,77001,HB FLUORO GUIDANCE CENTRAL VENOUS DEV PLCMT,2233.69,1451.9,13270.0,14761.0,2
CPT,77001,PET Scan,1942.47,1262.61,4155.27,4200.53,2
CPT,77002,"FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY,ASPIRATION,INJECTION,LOCALIZATION DEVICE) ï",2846.91,1850.49,420.38,669.5,2
CPT,77002,HB FLUORO GUIDANCE NEEDLE PLCMT,3273.95,2128.065,13270.0,14761.0,2
CPT,77002,PET Scan,2846.91,1850.49,4155.27,4200.53,2
CPT,77003,FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE OR PARASPINOUS DIAGNOSTIC OR THERAPEUTIC INJE,2387.85,1552.1,321.14,511.45,2
CPT,77003,HB FLUORO GUIDANCE NEEDLE/CATH SPINE,2745.8450000000003,1784.8,13270.0,14761.0,2
CPT,77003,PET Scan,2387.85,1552.1,4155.27,4200.53,2
CPT,77010,PET Scan,,,4155.27,4200.53,2
CPT,77011,CAT Scan,,,2808.07,2839.65,2
CPT,77011,COMPUTED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION ï,,,2062.88,3285.35,2
CPT,77011,PET Scan,,,4155.27,4200.53,2
CPT,77012,CAT Scan,6938.2,4509.83,2808.07,2839.65,2
CPT,77012,"COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION,INJECTION,LOCALIZATION DEVICE), RADIOLOGICAL S",6938.2,4509.83,2051.42,3267.09,2
CPT,77012,HB CT GUIDANCE S&I,7978.93,5186.305,13270.0,14761.0,2
CPT,77012,PET Scan,6938.2,4509.83,4155.27,4200.53,2
CPT,77013,CAT Scan,5958.24,3872.86,2808.07,2839.65,2
CPT,77013,"COMPUTERIZED TOMOGRAPHY GUIDANCE FOR, AND MONITORING OF , PARENCHYMAL TISSUE ABLATION. ï",5958.24,3872.86,2154.43,3431.14,2
CPT,77013,HB CT GUIDANCE FOR ABLATION,6852.09,4453.86,13270.0,14761.0,2
CPT,77013,PET Scan,5958.24,3872.86,4155.27,4200.53,2
CPT,77014,CAT Scan,,,2808.07,2839.65,2
CPT,77014,COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS. ï,,,677.55,1079.07,2
CPT,77014,PET Scan,,,4155.27,4200.53,2
CPT,77014,RADIATION THERAPY SERVICES,,,635.34,1021.22,2
CPT,77015,PET Scan,,,4155.27,4200.53,2
CPT,77016,PET Scan,,,4155.27,4200.53,2
CPT,77017,PET Scan,,,4155.27,4200.53,2
CPT,77018,PET Scan,,,4155.27,4200.53,2
CPT,77021,MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT RADIOLOGICAL SUPERVISION AND INTERPRETATION ï,7165.17,4657.36,2838.68,4520.89,2
CPT,77021,MRI,7165.17,4657.36,2762.54,2789.63,2
CPT,77021,PET Scan,7165.17,4657.36,4155.27,4200.53,2
CPT,77022,"MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF , PARENCHYMAL TISSUE ABLATION. ï",53539.4,34800.61,2838.45,4520.51,2
CPT,77022,MRI,53539.4,34800.61,2762.31,2789.4,2
CPT,77022,PET Scan,53539.4,34800.61,4155.27,4200.53,2
CPT,77046,HB MRI BREAST WO CONT UNILAT,4774.18,3103.22,300.99,346.13,8
CPT,77046,MRI,4774.18,3103.22,1527.89,1542.87,2
CPT,77046,"Magnetic resonance imaging, breast, without contrast material; unilateral",4774.18,3103.22,381.26,381.26,2
CPT,77046,Mri breast c- unilateral,4774.18,3103.22,1527.89,2500.39,2
CPT,77046,PET Scan,4774.18,3103.22,4155.27,4200.53,2
CPT,77047,HB MRI BREAST WO CONT BILAT,6215.76,4040.24,300.99,346.13,8
CPT,77047,MRI,6215.76,4040.24,1518.74,1533.63,2
CPT,77047,"Magnetic resonance imaging, breast, without contrast material; bilateral",6215.76,4040.24,382.93,382.93,2
CPT,77047,Mri breast c- bilateral,6215.76,4040.24,1518.74,2485.41,2
CPT,77047,PET Scan,6215.76,4040.24,4155.27,4200.53,2
CPT,77048,MRI,5810.77,3777.0,2516.16,2540.83,2
CPT,77048,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",5810.77,3777.0,628.56,628.56,2
CPT,77048,Mri breast c-+ w/cad uni,5810.77,3777.0,2516.16,4117.69,2
CPT,77048,PET Scan,5810.77,3777.0,4155.27,4200.53,2
CPT,77049,"HB MRI BREAST CA, W & W/O BILAT",7500.04,4875.03,444.69,14761.0,10
CPT,77049,"HB MRI BREAST W CAD, W & W/O BILAT",7500.04,4875.03,,,0
CPT,77049,MRI,6414.28,4169.28,2503.63,2528.18,2
CPT,77049,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",6414.28,4169.28,623.57,623.57,2
CPT,77049,Mri breast c-+ w/cad bi,6414.28,4169.28,2503.63,4097.18,2
CPT,77049,PET Scan,6414.28,4169.28,4155.27,4200.53,2
CPT,77053,"MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION",4658.67,3028.14,90.37,1047.42,4
CPT,77053,PET Scan,4658.67,3028.14,4155.27,4200.53,2
CPT,77054,"MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION",2775.46,1804.05,119.49,1457.55,4
CPT,77054,PET Scan,2775.46,1804.05,4155.27,4200.53,2
CPT,77061,Digital breast tomosynthesis; unilateral,1067.41,693.82,217.67,687.67,4
CPT,77061,HB MAMMO TOMOSYNTHESIS UNILAT,1227.5300000000002,797.895,13270.0,14761.0,2
CPT,77061,PET Scan,1067.41,693.82,4155.27,4200.53,2
CPT,77062,Digital breast tomosynthesis; bilateral,1406.93,914.5,277.58,906.41,4
CPT,77062,HB MAMMO TOMOSYNTHESIS BILAT,1617.97,1051.6799999999998,13270.0,14761.0,2
CPT,77062,PET Scan,1406.93,914.5,4155.27,4200.53,2
CPT,77063,Breast tomosynthesis bi,766.6,498.29,273.81,436.07,2
CPT,77063,HB MAMMO TOMOSYNTHESIS SCREEN BILAT,881.585,573.03,13270.0,14761.0,2
CPT,77063,PET Scan,766.6,498.29,4155.27,4200.53,2
CPT,77063,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)",766.6,498.29,59.91,59.91,2
CPT,77065,"Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral",1632.86,1061.36,217.67,1097.8,4
CPT,77065,HB MAMMO DIAG DIGITAL UNILAT INCL CAD,1877.795,1220.565,13270.0,14761.0,2
CPT,77065,PET Scan,1632.86,1061.36,4155.27,4200.53,2
CPT,77066,"Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral",2090.35,1358.73,277.58,1405.4,4
CPT,77066,HB MAMMO DIAG DIGITAL BILAT INCL CAD,2403.91,1562.545,13270.0,14761.0,2
CPT,77066,PET Scan,2090.35,1358.73,4155.27,4200.53,2
CPT,77067,HB MAMMO SCREENING BILATERAL INCL CAD,2084.525,1354.94,13270.0,14761.0,2
CPT,77067,PET Scan,1812.63,1178.21,4155.27,4200.53,2
CPT,77067,"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed",1812.63,1178.21,230.15,1160.63,4
CPT,77071,"MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL FOR JOINT RADIOGRAPHY, I",,,115.65,184.18,2
CPT,77071,PET Scan,,,4155.27,4200.53,2
CPT,77071,"RADIOLOGIC EXAMINATION, STRESS VIEW(S), ANY JOINT, STRESS APPLIED BY A PHYSICIAN (INCLUDES COMPARISON VIEWS)",,,212.09,212.09,2
CPT,77072,BONE AGE STUDIES,1760.68,1144.44,42.11,42.11,2
CPT,77072,BONE AGE STUDIES ï,1760.68,1144.44,130.41,207.69,2
CPT,77072,HB XR BONE SURVEY AGE,2024.79,1316.115,132.41,14761.0,10
CPT,77072,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,77073,"BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)",1760.68,1144.44,79.55,79.55,2
CPT,77073,"BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM) ï",1760.68,1144.44,197.37,314.34,2
CPT,77073,HB XR BONE SURVEY LENGTH,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,77073,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,77074,HB XR BONE SURVEY OSSEOUS LTD,2024.79,1316.115,132.41,14761.0,10
CPT,77074,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,77074,"RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES)",1760.68,1144.44,110.33,110.33,2
CPT,77074,"RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES) ï",1760.68,1144.44,250.06,398.24,2
CPT,77075,HB XR BONE SURVEY COMPLETE,5353.72,3479.92,132.41,14761.0,10
CPT,77075,PET Scan,4655.26,3025.92,4155.27,4200.53,2
CPT,77075,"RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON)",4655.26,3025.92,183.24,183.24,2
CPT,77075,"RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) ï",4655.26,3025.92,360.53,574.18,2
CPT,77076,HB XR BONE SURVEY CHILD,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,77076,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,77076,"RADIOLOGIC EXAMINATION ,OSSESUS SURVEY, INFANT ï",1760.68,1144.44,185.26,295.05,2
CPT,77076,"RADIOLOGIC EXAMINATION OSSEOUS SURVEY, INFANT",1760.68,1144.44,184.89,184.89,2
CPT,77077,"JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS (SPECIFY) ï",,,277.87,442.53,2
CPT,77077,"JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY)",,,76.23,76.23,2
CPT,77077,PET Scan,,,4155.27,4200.53,2
CPT,77078,CAT Scan,,,2808.07,2839.65,2
CPT,77078,"COMPUTED TOMOGRAPHY , BONE MINERAL DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE) ï",,,718.83,1144.81,2
CPT,77078,"COMPUTERIZED TOMOGRAPHY, BONE DENSITY STUDY",,,232.64,232.64,2
CPT,77078,CT SCAN,,,699.55,706.41,2
CPT,77078,PET Scan,,,4155.27,4200.53,2
CPT,77080,"DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY",1760.68,1144.44,71.24,71.24,2
CPT,77080,"DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON",1760.68,1144.44,713.18,1135.82,2
CPT,77080,HB DXA BONE DEN AXIAL SKEL WO VFA,2024.7800000000002,1316.105,132.41,14761.0,10
CPT,77080,PET Scan,1760.68,1144.44,4155.27,4200.53,2
CPT,77081,"DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL)",1344.46,873.9,53.76,53.76,2
CPT,77081,"DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) ï",1344.46,873.9,379.11,603.77,2
CPT,77081,HB DXA BONE DEN PERIPH SKEL,1546.13,1004.9849999999999,109.64,14761.0,10
CPT,77081,PET Scan,1344.46,873.9,4155.27,4200.53,2
CPT,77082,PET Scan,,,4155.27,4200.53,2
CPT,77083,PET Scan,,,4155.27,4200.53,2
CPT,77084,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY",7500.04,4875.03,639.38,639.38,2
CPT,77084,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY ï",7500.04,4875.03,2767.3,4407.21,2
CPT,77084,MRI,7500.04,4875.03,2693.08,2719.48,2
CPT,77084,PET Scan,7500.04,4875.03,4155.27,4200.53,2
CPT,77085,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment",,,92.87,92.87,2
CPT,77085,Dxa bone density study,,,533.09,849.01,2
CPT,77085,PET Scan,,,4155.27,4200.53,2
CPT,77086,Fracture assessment via dxa,,,346.77,552.27,2
CPT,77086,PET Scan,,,4155.27,4200.53,2
CPT,77086,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA),,,62.08,62.08,2
CPT,77087,PET Scan,,,4155.27,4200.53,2
CPT,77088,PET Scan,,,4155.27,4200.53,2
CPT,77089,PET Scan,,,4155.27,4200.53,2
CPT,77089,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual X-ray absorptiometry (DXA) or other imaging data on gray-scale variogram, calculation, with interpretation a",,,272.1,433.35,2
CPT,77090,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere",,,15.46,212.09,4
CPT,77091,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only",,,192.26,306.19,4
CPT,77092,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional",,,64.38,102.53,2
CPT,77181,PET Scan,,,4155.27,4200.53,2
CPT,77182,PET Scan,,,4155.27,4200.53,2
CPT,77183,PET Scan,,,4155.27,4200.53,2
CPT,77189,PET Scan,,,4155.27,4200.53,2
CPT,77210,PET Scan,,,4155.27,4200.53,2
CPT,77211,PET Scan,,,4155.27,4200.53,2
CPT,77212,PET Scan,,,4155.27,4200.53,2
CPT,77213,PET Scan,,,4155.27,4200.53,2
CPT,77214,PET Scan,,,4155.27,4200.53,2
CPT,77261,GLOBAL RADIATION THERAPY,,,498.76,751.74,2
CPT,77261,PET Scan,,,4155.27,4200.53,2
CPT,77261,THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE,,,498.76,794.32,2
CPT,77262,GLOBAL RADIATION THERAPY,,,758.1,1142.63,2
CPT,77262,PET Scan,,,4155.27,4200.53,2
CPT,77262,THERAPEUTIC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE,,,758.1,1207.36,2
CPT,77263,GLOBAL RADIATION THERAPY,,,1126.45,1697.81,2
CPT,77263,PET Scan,,,4155.27,4200.53,2
CPT,77263,THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX,,,1126.45,1793.99,2
CPT,77280,HB RT SIMULATION SIMPLE,10047.5,6530.88,165.32,14761.0,10
CPT,77280,PET Scan,10047.5,6530.88,4155.27,4200.53,2
CPT,77280,RADIATION THERAPY SERVICES,10047.5,6530.88,708.78,1139.26,2
CPT,77280,THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE,10047.5,6530.88,577.11,1203.8,4
CPT,77285,PET Scan,,,4155.27,4200.53,2
CPT,77285,RADIATION THERAPY SERVICES,,,1138.42,1829.85,2
CPT,77285,THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE,,,957.86,1933.51,4
CPT,77290,HB RT SIMULATION COMPLEX,14637.6,9514.44,455.83,14761.0,10
CPT,77290,PET Scan,14637.6,9514.44,4155.27,4200.53,2
CPT,77290,RADIATION THERAPY SERVICES,14637.6,9514.44,1324.82,2129.47,2
CPT,77290,THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX,14637.6,9514.44,922.08,2250.1,4
CPT,77293,HB RESPIRATOR MOTION MGMT SIM,7806.95,5074.52,13270.0,14761.0,2
CPT,77293,PET Scan,7806.95,5074.52,4155.27,4200.53,2
CPT,77293,RADIATION THERAPY SERVICES,7806.95,5074.52,2319.79,3728.74,2
CPT,77293,RESPIRATORY MOTION MANAGEMENT SIMULATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),7806.95,5074.52,767.51,3939.96,4
CPT,77295,HB RT 3-D SIMULATION,17529.8,11394.37,1703.74,14761.0,10
CPT,77295,PET Scan,17529.8,11394.37,4155.27,4200.53,2
CPT,77295,RADIATION THERAPY SERVICES,17529.8,11394.37,5716.2,9187.99,2
CPT,77295,THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; BY THREE-DIMENSIONAL RECONSTRUCTION OF TUMOR VOLUME,17529.8,11394.37,6095.98,9708.47,2
CPT,77295,THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; BY THREE-DIMENSIONAL RECONSTRUCTION OF TUMOR VOLUME IN PREPARATION FOR TREATMENT WITH NON-COPLANAR THERAPY BEAMS,17529.8,11394.37,629.26,629.26,2
CPT,77299,PET Scan,,,4155.27,4200.53,2
CPT,77299,"UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY CLINICAL TREATMENT PLANNING",,,325.61,325.61,2
CPT,77300,"BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TISSUE INHOM",2778.93,1806.3,337.01,536.73,2
CPT,77300,"BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TISSUE INHOMOGENEITY FACTORS, AS REQUIRED DURING COURSE OF TREATMENT, ONLY WHEN PRESCRIBED B",2778.93,1806.3,82.05,82.05,2
CPT,77300,HB RT DOSIMETRY BASIC,2778.93,1806.3,165.32,14761.0,10
CPT,77300,PET Scan,2778.93,1806.3,4155.27,4200.53,2
CPT,77300,RADIATION THERAPY SERVICES,2778.93,1806.3,316.02,507.95,2
CPT,77301,HB RT IMRT TX PLANNING,17529.8,11394.37,1703.74,14761.0,10
CPT,77301,INTENSITY MODULATED RADIOTHERAPY DOSE PLAN,17529.8,11394.37,3521.98,3521.98,2
CPT,77301,"INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE VOLUMEHISTOGRAMS FOR TARGET CRITICAL STRUCTURE PARTIAL TOLERANCE",17529.8,11394.37,6652.01,10594.0,2
CPT,77301,PET Scan,17529.8,11394.37,4155.27,4200.53,2
CPT,77301,RADIATION THERAPY SERVICES,17529.8,11394.37,6237.58,10026.04,2
CPT,77306,PET Scan,2788.5,1812.53,4155.27,4200.53,2
CPT,77306,"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)",2788.5,1812.53,184.07,184.07,2
CPT,77306,Telethx isodose plan simple,2788.5,1812.53,653.27,1040.4,2
CPT,77307,HB TELETHX ISODOSE PLAN CPLX,13045.5,8479.58,455.83,14761.0,10
CPT,77307,PET Scan,13045.5,8479.58,4155.27,4200.53,2
CPT,77307,RADIATION THERAPY SERVICES,13045.5,8479.58,1122.05,1803.53,2
CPT,77307,"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)",13045.5,8479.58,332.35,332.35,2
CPT,77307,Telethx isodose plan cplx,13045.5,8479.58,1196.6,1905.7,2
CPT,77316,"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)",14611.9,9497.74,423.88,423.88,2
CPT,77316,Brachytx isodose plan simple,14611.9,9497.74,1017.21,1620.01,2
CPT,77316,HB BRACHYTX ISODOSE PLAN SIMPLE,14611.9,9497.74,455.83,524.2,8
CPT,77316,PET Scan,14611.9,9497.74,4155.27,4200.53,2
CPT,77316,RADIATION THERAPY SERVICES,14611.9,9497.74,953.84,1533.16,2
CPT,77317,"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)",16514.9,10734.69,558.85,558.85,2
CPT,77317,Brachytx isodose intermed,16514.9,10734.69,1326.24,2112.17,2
CPT,77317,HB BRACHYTX ISODOSE INTERMED,16514.9,10734.69,455.83,14761.0,10
CPT,77317,PET Scan,16514.9,10734.69,4155.27,4200.53,2
CPT,77317,RADIATION THERAPY SERVICES,16514.9,10734.69,1243.61,1998.93,2
CPT,77318,"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)",18417.9,11971.64,755.4,755.4,2
CPT,77318,Brachytx isodose complex,18417.9,11971.64,1800.07,2866.79,2
CPT,77318,HB BRACHYTX ISODOSE COMPLEX,18417.9,11971.64,455.83,14761.0,10
CPT,77318,PET Scan,18417.9,11971.64,4155.27,4200.53,2
CPT,77318,RADIATION THERAPY SERVICES,18417.9,11971.64,1687.92,2713.1,2
CPT,77321,PET Scan,,,4155.27,4200.53,2
CPT,77321,RADIATION THERAPY SERVICES,,,1077.61,1732.11,2
CPT,77321,"SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY",,,108.68,1830.23,4
CPT,77331,PET Scan,2770.07,1800.55,4155.27,4200.53,2
CPT,77331,RADIATION THERAPY SERVICES,2770.07,1800.55,120.9,194.34,2
CPT,77331,"SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYSICIAN",2770.07,1800.55,47.11,205.35,4
CPT,77332,HB RT TX DEVICE SIMPLE,5327.07,3462.6,165.32,14761.0,10
CPT,77332,PET Scan,5327.07,3462.6,4155.27,4200.53,2
CPT,77332,RADIATION THERAPY SERVICES,5327.07,3462.6,314.69,505.83,2
CPT,77332,"TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS)",5327.07,3462.6,35.45,534.48,4
CPT,77333,PET Scan,,,4155.27,4200.53,2
CPT,77333,RADIATION THERAPY SERVICES,,,447.62,719.48,2
CPT,77333,"TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS)",,,244.3,760.24,4
CPT,77334,HB RT TX DEVICE COMPLEX - MASKS,5327.07,3462.6,455.83,14761.0,10
CPT,77334,PET Scan,5327.07,3462.6,4155.27,4200.53,2
CPT,77334,RADIATION THERAPY SERVICES,5327.07,3462.6,760.93,1223.09,2
CPT,77334,"TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, MOL",5327.07,3462.6,811.49,1292.38,2
CPT,77334,"TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, MOLDS OR CASTS)",5327.07,3462.6,161.09,161.09,2
CPT,77336,CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING QUALITY A,2478.08,1610.75,656.92,1046.21,2
CPT,77336,CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING QUALITY ASSURANCE REPORTED PER WEEK OF THERAPY,2478.08,1610.75,325.61,325.61,2
CPT,77336,GLOBAL RADIATION THERAPY,2478.08,1610.75,656.92,990.12,2
CPT,77336,HB RT CONTINUING PHYSICS CNSLT,2478.08,1610.75,165.32,14761.0,10
CPT,77336,PET Scan,2478.08,1610.75,4155.27,4200.53,2
CPT,77338,HB DESIGN MLC FOR IMRT,5360.57,3484.37,455.83,14761.0,10
CPT,77338,"MULTI-LEAF COLLIMATOR (MLC) DEVICE(S) FOR INTENSITY MODULATED RADIATION THERAPY (IMRT), DESIGN AND CONSTRUCTION PER IMRT",5360.57,3484.37,2290.24,3647.44,2
CPT,77338,"Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT),design and construction per IMRT plan",5360.57,3484.37,593.15,593.15,2
CPT,77338,PET Scan,5360.57,3484.37,4155.27,4200.53,2
CPT,77338,RADIATION THERAPY SERVICES,5360.57,3484.37,2147.56,3451.9,2
CPT,77370,GLOBAL RADIATION THERAPY,9393.72,6105.92,790.85,1191.99,2
CPT,77370,HB RT PHYSICS CONSL-IMG FUSION,9393.72,6105.92,165.32,14761.0,10
CPT,77370,PET Scan,9393.72,6105.92,4155.27,4200.53,2
CPT,77370,SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION,9393.72,6105.92,325.61,1259.51,4
CPT,77371,GLOBAL RADIATION THERAPY,,,7288.35,10985.14,2
CPT,77371,Gamma Knife,,,24420.0,24420.0,1
CPT,77371,PET Scan,,,4155.27,4200.53,2
CPT,77371,"RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY (SRS), COMPLETE COURSE OF TREATMENT OF CEREBRAL LESION(S) CONSISTING OF 1 SESSION; MULTI-SOURCE COBALT 60 BASED",,,2760.84,2760.84,2
CPT,77371,"RADIATION TX DELIVERY, STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF TX OF CEREBRAL LESION(S) CONSISTING OF 1 SESSION; M",,,7288.35,11607.43,2
CPT,77371,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",10318.6,6707.09,64417.25,69885.3,3
CPT,77372,Cyber Knife,102573.0,66672.45,29000.0,29000.0,1
CPT,77372,GLOBAL RADIATION THERAPY,102573.0,66672.45,5530.79,8336.11,2
CPT,77372,HB SRS LINEAR BASED 1 SESSION,102573.0,66672.45,9518.83,14761.0,10
CPT,77372,PET Scan,102573.0,66672.45,4155.27,4200.53,2
CPT,77372,"RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY (SRS), COMPLETE COURSE OF TREATMENT OF CEREBRAL LESION(S) CONSISTING OF 1 SESSION; LINEAR ACCELERATOR BASED",102573.0,66672.45,2401.77,2401.77,2
CPT,77372,"RADIATION TX DELIVERY, STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF TX OF CEREBRAL LESION(S) CONSISTING OF 1 SESSION; L",102573.0,66672.45,5530.79,8808.34,2
CPT,77372,Stereotactic Radiosurgery,102573.0,66672.45,54913.12,86027.67,5
CPT,77372,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",102573.0,66672.45,64417.25,69885.3,3
CPT,77373,GLOBAL RADIATION THERAPY,27427.7,17828.01,10318.4,15552.11,2
CPT,77373,Gamma Knife,27427.7,17828.01,24420.0,24420.0,1
CPT,77373,HB SBRT DELIVERY PER FRACTION,27427.7,17828.01,2186.44,14761.0,10
CPT,77373,PET Scan,27427.7,17828.01,4155.27,4200.53,2
CPT,77373,"STEREOTACTIC BODY RADIATION THERAPY, TREATMENT DELIVERY, PER FRACTION TO 1 OR MORE LESIONS, INCLUDING IMAGE GUIDANCE, ENTIRE COURSE NOT TO EXCEED 5 FRACTIONS",27427.7,17828.01,2494.5,2494.5,2
CPT,77373,"STEREOTACTIC BODY RADIATION TX, TX DELIVERY, PER FRACTION TO 1 OR MORE LESIONS, ENTIRE COURSE NOT TO EXCEED 5 FRACTIONS.",27427.7,17828.01,10318.4,16433.11,2
CPT,77373,"Stereotactic Radiosurgery, fractionated, entire course not to exceed 5 fractions",27427.7,17828.01,,,0
CPT,77385,GLOBAL RADIATION THERAPY,13168.8,8559.72,3566.68,5375.77,2
CPT,77385,HB NTSTY MODUL RAD TX DLVR SMPL,13168.8,8559.72,720.3,14761.0,10
CPT,77385,"Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; simple",13168.8,8559.72,1397.53,5680.3,4
CPT,77385,PET Scan,13168.8,8559.72,4155.27,4200.53,2
CPT,77386,GLOBAL RADIATION THERAPY,13168.8,8559.72,4280.86,6452.2,2
CPT,77386,HB NTSTY MODUL RAD TX DLVR CPLX,13168.8,8559.72,720.3,14761.0,10
CPT,77386,"Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex",13168.8,8559.72,1397.53,6817.71,4
CPT,77386,PET Scan,13168.8,8559.72,4155.27,4200.53,2
CPT,77387,"Guidance for localization of target volume for delivery of radiation treatment delivery, includes intrafraction tracking, when performed",14966.9,9728.49,252.62,682.15,4
CPT,77387,HB GUIDANCE FOR RADIAJ TX DLVR,14966.9,9728.49,,,0
CPT,77387,PET Scan,14966.9,9728.49,4155.27,4200.53,2
CPT,77387,RADIATION THERAPY SERVICES,14966.9,9728.49,401.64,645.57,2
CPT,77399,PET Scan,,,4155.27,4200.53,2
CPT,77399,"UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY AND TREATMENT DEVICES",,,325.61,325.61,2
CPT,77401,GLOBAL RADIATION THERAPY,1649.15,1071.95,391.16,589.57,2
CPT,77401,PET Scan,1649.15,1071.95,4155.27,4200.53,2
CPT,77401,"RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHO VOLTAGE",1649.15,1071.95,102.01,622.97,4
CPT,77402,GLOBAL RADIATION THERAPY,1649.15,1071.95,391.87,590.63,2
CPT,77402,PET Scan,1649.15,1071.95,4155.27,4200.53,2
CPT,77402,"RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR NO BLOCKS; UP TO 5 MEV",1649.15,1071.95,298.78,298.78,2
CPT,77402,"RADIATION TREATMENT DELIVERY,SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS,SIMPLE OR NO BLOCK,UP TO 5MEV",1649.15,1071.95,391.87,624.09,2
CPT,77407,PET Scan,1978.99,1286.34,4155.27,4200.53,2
CPT,77407,"RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, USE OF M",1978.99,1286.34,505.87,805.65,2
CPT,77407,"RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, USE OF MULTIPLE BLOCKS; UP TO 5 MEV",1978.99,1286.34,641.87,641.87,2
CPT,77412,GLOBAL RADIATION THERAPY,3386.14,2200.99,523.69,789.31,2
CPT,77412,HB RAD TREATMNT DELVRY COMPLX,3386.14,2200.99,327.46,14761.0,10
CPT,77412,PET Scan,3386.14,2200.99,4155.27,4200.53,2
CPT,77412,"RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIO",3386.14,2200.99,523.69,834.02,2
CPT,77412,"RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, ELECTRON OR NEUTRONS); UP TO ",3386.14,2200.99,641.87,641.87,2
CPT,77417,HB RT PORT IMAGES,698.91,454.29,13270.0,14761.0,2
CPT,77417,PET Scan,698.91,454.29,4155.27,4200.53,2
CPT,77417,THERAPEUTIC RADIOLOGY PORT FILM(S),698.91,454.29,144.64,230.35,2
CPT,77423,GLOBAL RADIATION THERAPY,,,570.43,859.76,2
CPT,77423,HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY; ONE OR MORE ISOCENTER(S) WITH COPLANAR OR NON-COPLANAR GEOMETRY WITH,,,570.43,908.47,2
CPT,77423,"NEUTRON BEAM TX, COMPLEX",,,217.85,217.85,2
CPT,77423,PET Scan,,,4155.27,4200.53,2
CPT,77424,GLOBAL RADIATION THERAPY,102573.0,66672.45,,,0
CPT,77424,"INTRAOPERATIVE RADIATION TREATMENT DELIVERY, X-RAY, SINGLE TREATMENT SESSION.",102573.0,66672.45,,,0
CPT,77424,IO RAD TX DELIVERY BY X-RAY,102573.0,66672.45,18774.45,18774.45,2
CPT,77424,PET Scan,102573.0,66672.45,4155.27,4200.53,2
CPT,77425,GLOBAL RADIATION THERAPY,102573.0,66672.45,881.34,1328.37,2
CPT,77425,"INTRAOPERATIVE RADIATION TREATMENT DELIVERY, ELECTRONS, SINGLE TREATMENT SESSION",102573.0,66672.45,881.34,1403.62,2
CPT,77425,IO RAD TX DELIVER BY ELCTRNS,102573.0,66672.45,18774.45,18774.45,2
CPT,77425,PET Scan,102573.0,66672.45,4155.27,4200.53,2
CPT,77427,GLOBAL RADIATION THERAPY,,,1179.43,1777.66,2
CPT,77427,PET Scan,,,4155.27,4200.53,2
CPT,77427,"RADIATION TREATMENT MANAGEMENT, FIVE TREATMENTS",,,1179.43,1878.36,2
CPT,77430,PET Scan,,,4155.27,4200.53,2
CPT,77431,GLOBAL RADIATION THERAPY,,,527.21,794.63,2
CPT,77431,PET Scan,,,4155.27,4200.53,2
CPT,77431,RADIATION THERAPY MANAGEMENT WITH COMPLETE COURSE OF THERAPY CONSISTING OF ONE OR TWO FRACTIONS ONLY,,,494.37,839.64,2
CPT,77432,GLOBAL RADIATION THERAPY,,,2590.57,3904.55,2
CPT,77432,PET Scan,,,4155.27,4200.53,2
CPT,77432,STEREOTACTIC RADIATION TREATMENT MANAGEMENT OF CERBRAL LESION(S),,,2590.57,4125.74,2
CPT,77435,GLOBAL RADIATION THERAPY,,,3765.29,5675.12,2
CPT,77435,PET Scan,,,4155.27,4200.53,2
CPT,77435,"STEREOTACTIC BODY RADIATION TX, TX MANAGEMENT, PER TX COURSE, TO ONE OR MORE LESIONS, ENTIRE COURSE NOT TO EXCEED 5 FRAC",,,3765.29,5996.61,2
CPT,77439,PET Scan,,,4155.27,4200.53,2
CPT,77469,GLOBAL RADIATION THERAPY,,,1922.83,2898.13,2
CPT,77469,INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT,,,1922.83,3062.3,2
CPT,77469,PET Scan,,,4155.27,4200.53,2
CPT,77470,HB RT SPECIAL TX PROCEDURE HD,9896.5,6432.73,720.3,14761.0,10
CPT,77470,PET Scan,9896.5,6432.73,4155.27,4200.53,2
CPT,77470,RADIATION THERAPY SERVICES,9896.5,6432.73,2274.25,3655.54,2
CPT,77470,"SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY IRRADIATION, PER ORAL, VAGINAL CONE IRRADIATION)",9896.5,6432.73,80.06,80.06,2
CPT,77470,"SPECIAL TREATMENT PROCEDURE(EG,TOTAL BODY IRRADIATION,HEMIBODY IRRADIATION,PER ORAL VAGINAL ENDOCAVITARY,INTRAOPERATIVE",9896.5,6432.73,2425.35,3862.62,2
CPT,77499,PET Scan,,,4155.27,4200.53,2
CPT,77520,PET Scan,,,4155.27,4200.53,2
CPT,77520,"PROTON BEAM DELIVERY TO A SINGLE TREATMENT AREA, SINGLE PORT, CUSTOM BLOCK, WITH OR WITHOUT COMPENSATION, WITH TREATMENT SET-UP AND VERIFICATION IMAGES",,,2174.03,2174.03,2
CPT,77520,"PROTON TREATMENT DELIVERY;SIMPLE,WITHOUT COMPENSATION",,,911.97,1452.4,2
CPT,77520,RADIATION THERAPY SERVICES,,,855.15,1374.54,2
CPT,77522,GLOBAL RADIATION THERAPY,,,841.24,1267.93,2
CPT,77522,PET Scan,,,4155.27,4200.53,2
CPT,77522,PROTON TREATMENT DELIVERY; SIMPLE WITH COMPENSATION,,,841.24,1339.76,2
CPT,77522,"PROTON TREATMENT DELIVERY; SIMPLE, WITH COMPENSATION",,,2179.02,2179.02,2
CPT,77523,PET Scan,,,4155.27,4200.53,2
CPT,77523,"PROTON BEAM DELIVERY TO ONE OR TWO TREATMENT AREAS, TWO OR MORE PORTS, TWO OR MORE CUSTOM BLOCKS, AND TWO OR MORE COMPENSATORS, WITH TREATMENT SET-UP AND VERIFICATION IMAGES",,,2531.01,2531.01,2
CPT,77523,"PROTON TREATMENT DELIVERY; SIMPLE,WITHOUT COMPENSATION, INTERMEDIATE",,,1139.98,1815.53,2
CPT,77523,RADIATION THERAPY SERVICES,,,1068.95,1718.2,2
CPT,77525,GLOBAL RADIATION THERAPY,,,1184.6,1785.46,2
CPT,77525,PET Scan,,,4155.27,4200.53,2
CPT,77525,PROTON TREATMENT DELIVERY; COMPLEX,,,1184.6,2800.45,4
CPT,77581,PET Scan,,,4155.27,4200.53,2
CPT,77589,PET Scan,,,4155.27,4200.53,2
CPT,77600,"HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS)",,,654.04,1140.45,4
CPT,77600,PET Scan,,,4155.27,4200.53,2
CPT,77600,RADIATION THERAPY SERVICES,,,613.29,985.78,2
CPT,77605,"HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM)",,,1017.45,2148.04,4
CPT,77605,PET Scan,,,4155.27,4200.53,2
CPT,77605,RADIATION THERAPY SERVICES,,,954.06,1533.52,2
CPT,77610,HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS,,,763.75,1547.32,4
CPT,77610,PET Scan,,,4155.27,4200.53,2
CPT,77610,RADIATION THERAPY SERVICES,,,716.16,1151.13,2
CPT,77615,HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS,,,1017.45,2447.3,4
CPT,77615,PET Scan,,,4155.27,4200.53,2
CPT,77615,RADIATION THERAPY SERVICES,,,954.06,1533.52,2
CPT,77620,HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S),,,761.45,1387.57,4
CPT,77620,PET Scan,,,4155.27,4200.53,2
CPT,77620,RADIATION THERAPY SERVICES,,,714.01,1147.68,2
CPT,77750,INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION,,,321.53,321.53,2
CPT,77750,INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION (INCLUDES THREE MONTHS FOLLOW-UP CARE),,,333.07,530.45,2
CPT,77750,PET Scan,,,4155.27,4200.53,2
CPT,77750,RADIATION THERAPY SERVICES,,,312.32,502.02,2
CPT,77751,PET Scan,,,4155.27,4200.53,2
CPT,77752,PET Scan,,,4155.27,4200.53,2
CPT,77753,PET Scan,,,4155.27,4200.53,2
CPT,77761,INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE,,,535.23,535.23,2
CPT,77761,INTRACAVITARY RADIOELEMENT RADIATION SOURCE APPLICATION; SIMPLE,,,642.63,1023.45,2
CPT,77761,PET Scan,,,4155.27,4200.53,2
CPT,77761,RADIATION THERAPY SERVICES,,,602.59,968.58,2
CPT,77762,INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE,,,613.3,1469.45,4
CPT,77762,PET Scan,,,4155.27,4200.53,2
CPT,77762,RADIATION THERAPY SERVICES,,,865.19,1390.67,2
CPT,77763,INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX,,,794.87,1832.57,4
CPT,77763,PET Scan,,,4155.27,4200.53,2
CPT,77763,RADIATION THERAPY SERVICES,,,1078.99,1734.32,2
CPT,77767,Hdr rdncl skn surf brachytx,,,1532.26,2440.27,2
CPT,77767,PET Scan,,,4155.27,4200.53,2
CPT,77767,RADIATION THERAPY SERVICES,,,1436.8,2309.45,2
CPT,77767,"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel",,,481.28,481.28,2
CPT,77768,Hdr rdncl skn surf brachytx,,,2517.72,4009.72,2
CPT,77768,PET Scan,,,4155.27,4200.53,2
CPT,77768,RADIATION THERAPY SERVICES,,,2360.86,3794.76,2
CPT,77768,"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions",,,719.95,719.95,2
CPT,77770,HB HDR RDNCL NTRSTL/ICAV BRCHTX 1 CHNL,20280.0,13182.0,863.92,993.51,8
CPT,77770,Hdr rdncl ntrstl/icav brchtx,20280.0,13182.0,1982.04,3156.6,2
CPT,77770,PET Scan,20280.0,13182.0,4155.27,4200.53,2
CPT,77770,RADIATION THERAPY SERVICES,20280.0,13182.0,1858.55,2987.37,2
CPT,77770,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel",20280.0,13182.0,606.09,606.09,2
CPT,77771,HB HDR RDNCL NTRSTL/ICAV BRCHTX 2-12 CHNLS,20280.0,13182.0,863.92,14761.0,10
CPT,77771,Hdr rdncl ntrstl/icav brchtx,20280.0,13182.0,3609.6,5748.66,2
CPT,77771,PET Scan,20280.0,13182.0,4155.27,4200.53,2
CPT,77771,RADIATION THERAPY SERVICES,20280.0,13182.0,3384.72,5440.46,2
CPT,77771,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels",20280.0,13182.0,996.87,996.87,2
CPT,77772,HB HDR RDNCL NTRSTL/ICAV BRCHTX >12 CHNLS,20280.0,13182.0,863.92,14761.0,10
CPT,77772,Hdr rdncl ntrstl/icav brchtx,20280.0,13182.0,5695.53,9070.71,2
CPT,77772,PET Scan,20280.0,13182.0,4155.27,4200.53,2
CPT,77772,RADIATION THERAPY SERVICES,20280.0,13182.0,5340.69,8584.42,2
CPT,77772,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels",20280.0,13182.0,1523.79,1523.79,2
CPT,77778,INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX,,,1123.57,2096.91,4
CPT,77778,PET Scan,,,4155.27,4200.53,2
CPT,77778,RADIATION THERAPY SERVICES,,,1234.63,1984.49,2
CPT,77789,PET Scan,,,4155.27,4200.53,2
CPT,77789,RADIATION THERAPY SERVICES,,,90.91,146.13,2
CPT,77789,SURFACE APPLICATION OF RADIOELEMENT,,,178.24,178.24,2
CPT,77789,SURFACE APPLICATION OF RADIOELEMENT RADIATION SOURCE,,,96.95,154.41,2
CPT,77790,HB NM RAD DOSE HANDLING/LOADING,5001.81,3251.18,,,0
CPT,77790,PET Scan,5001.81,3251.18,4155.27,4200.53,2
CPT,77790,RADIATION THERAPY SERVICES,5001.81,3251.18,120.9,194.34,2
CPT,77790,"SUPERVISION, HANDLING, LOADING OF RADIOELEMENT",5001.81,3251.18,128.94,205.35,2
CPT,77799,PET Scan,,,4155.27,4200.53,2
CPT,77799,"UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY",,,298.78,298.78,2
CPT,77931,PET Scan,,,4155.27,4200.53,2
CPT,77932,PET Scan,,,4155.27,4200.53,2
CPT,77933,PET Scan,,,4155.27,4200.53,2
CPT,77934,PET Scan,,,4155.27,4200.53,2
CPT,77981,PET Scan,,,4155.27,4200.53,2
CPT,77982,PET Scan,,,4155.27,4200.53,2
CPT,77983,PET Scan,,,4155.27,4200.53,2
CPT,77984,PET Scan,,,4155.27,4200.53,2
CPT,77985,PET Scan,,,4155.27,4200.53,2
CPT,77989,PET Scan,,,4155.27,4200.53,2
CPT,78001,PET Scan,,,4155.27,4200.53,2
CPT,78002,PET Scan,,,4155.27,4200.53,2
CPT,78003,PET Scan,,,4155.27,4200.53,2
CPT,78009,PET Scan,,,4155.27,4200.53,2
CPT,78012,HB NM THYROID UPTAKE SINGLE/MULT,6279.86,4081.91,500.35,575.41,8
CPT,78012,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78012,"THYROID UPTAKE, SINGLE OR MULTIPLE QUANTATIVE MEASUREMENTS (INCL STIMULATION, SUPPRESSION OR DISCHARGE, WHEN PERFORMED)",6279.86,4081.91,548.5,873.54,2
CPT,78012,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)",6279.86,4081.91,178.43,178.43,2
CPT,78013,HB NM THYROID IMG W VAS FL ONLY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78013,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78013,"THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED);",6279.86,4081.91,1115.05,1775.83,2
CPT,78013,"Thyroid imaging (including vascular flow, when performed);",6279.86,4081.91,399.75,399.75,2
CPT,78014,HB NM THYROID IMG W VAS & UPTKE,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78014,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78014,"THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED); WITH SINGLE OR MULTIPLE UPTAKES QUATITATIVE MEASUREMENTS (IN",6279.86,4081.91,1624.98,2587.94,2
CPT,78014,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)",6279.86,4081.91,495.44,495.44,2
CPT,78015,HB NM THYROID METS SCAN LTD,6279.86,4081.91,500.35,575.41,8
CPT,78015,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78015,"THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY)",6279.86,4081.91,457.16,956.6,4
CPT,78016,PET Scan,,,4155.27,4200.53,2
CPT,78016,"THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY)",,,560.52,1323.09,4
CPT,78018,HB NM THYRD METS SCAN WHO BODY,7877.34,5120.27,670.25,770.78,8
CPT,78018,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78018,THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY,7877.34,5120.27,626.07,1883.6,4
CPT,78020,PET Scan,,,4155.27,4200.53,2
CPT,78020,THYROID CARCINOMA METASTASES UPTAKE,,,177.27,282.32,2
CPT,78031,PET Scan,,,4155.27,4200.53,2
CPT,78032,PET Scan,,,4155.27,4200.53,2
CPT,78033,PET Scan,,,4155.27,4200.53,2
CPT,78039,PET Scan,,,4155.27,4200.53,2
CPT,78050,PET Scan,,,4155.27,4200.53,2
CPT,78051,PET Scan,,,4155.27,4200.53,2
CPT,78052,PET Scan,,,4155.27,4200.53,2
CPT,78053,PET Scan,,,4155.27,4200.53,2
CPT,78054,PET Scan,,,4155.27,4200.53,2
CPT,78055,PET Scan,,,4155.27,4200.53,2
CPT,78056,PET Scan,,,4155.27,4200.53,2
CPT,78057,PET Scan,,,4155.27,4200.53,2
CPT,78058,PET Scan,,,4155.27,4200.53,2
CPT,78059,PET Scan,,,4155.27,4200.53,2
CPT,78060,PET Scan,,,4155.27,4200.53,2
CPT,78061,PET Scan,,,4155.27,4200.53,2
CPT,78062,PET Scan,,,4155.27,4200.53,2
CPT,78063,PET Scan,,,4155.27,4200.53,2
CPT,78064,PET Scan,,,4155.27,4200.53,2
CPT,78065,PET Scan,,,4155.27,4200.53,2
CPT,78066,PET Scan,,,4155.27,4200.53,2
CPT,78070,HB NM PARATHYROID SCAN,6279.86,4081.91,500.35,575.41,8
CPT,78070,PARATHYROID IMAGING,6279.86,4081.91,587.78,587.78,2
CPT,78070,"PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION, WHEN PERFORMED)",6279.86,4081.91,452.43,720.54,2
CPT,78070,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78071,"PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION, WHEN PERFORMED); WITH TOMOGRAPHIC (SPECT)",6279.86,4081.91,2268.78,3613.26,2
CPT,78071,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78071,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT)",6279.86,4081.91,674.32,674.32,2
CPT,78072,HB NM PARATHYRD SCAN W SPECT/CT,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78072,PARATHYROID PLANAR IMAGING;WITH TOMOGRAPHIC(SPECT) &CONCURR ENTLY ACQUIRED COMPUTED TOMOGRAPHIC(CT) FOR ANATOMICAL LOCAL,7877.34,5120.27,2398.37,3819.64,2
CPT,78072,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78072,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (CT) for anatomical localization",7877.34,5120.27,832.41,832.41,2
CPT,78075,"ADRENAL IMAGING, CORTEX AND/OR MEDULLA",,,944.59,2160.3,4
CPT,78075,PET Scan,,,4155.27,4200.53,2
CPT,78079,PET Scan,,,4155.27,4200.53,2
CPT,78091,PET Scan,,,4155.27,4200.53,2
CPT,78092,PET Scan,,,4155.27,4200.53,2
CPT,78093,PET Scan,,,4155.27,4200.53,2
CPT,78094,PET Scan,,,4155.27,4200.53,2
CPT,78095,PET Scan,,,4155.27,4200.53,2
CPT,78096,PET Scan,,,4155.27,4200.53,2
CPT,78097,PET Scan,,,4155.27,4200.53,2
CPT,78099,PET Scan,,,4155.27,4200.53,2
CPT,78099,"UNLISTED ENDOCRINE PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",,,948.86,948.86,2
CPT,78102,BONE MARROW IMAGING; LIMITED AREA,,,341.51,812.21,4
CPT,78102,PET Scan,,,4155.27,4200.53,2
CPT,78103,BONE MARROW IMAGING; MULTIPLE AREAS,6279.86,4081.91,359.81,1261.1,4
CPT,78103,HB NM BONE MARROW SCAN MULT,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78103,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78104,BONE MARROW IMAGING; WHOLE BODY,,,491.27,1621.98,4
CPT,78104,PET Scan,,,4155.27,4200.53,2
CPT,78110,PET Scan,,,4155.27,4200.53,2
CPT,78110,"PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE SAMPLING",,,150.97,374.45,4
CPT,78111,PET Scan,,,4155.27,4200.53,2
CPT,78111,"PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS",,,158.46,897.6,4
CPT,78120,PET Scan,,,4155.27,4200.53,2
CPT,78120,RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING,,,150.97,681.96,4
CPT,78121,PET Scan,,,4155.27,4200.53,2
CPT,78121,RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS,,,158.46,1011.0,4
CPT,78122,PET Scan,,,4155.27,4200.53,2
CPT,78122,"WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONUCLIDE V",,,1151.79,1834.35,2
CPT,78122,"WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONUCLIDE VOLUME-DILUTION TECHNIQUE)",,,194.24,194.24,2
CPT,78130,PET Scan,,,4155.27,4200.53,2
CPT,78130,RED CELL SURVIVAL STUDY;,,,245.17,1135.63,4
CPT,78135,PET Scan,,,4155.27,4200.53,2
CPT,78140,"LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC)",,,210.04,210.04,2
CPT,78140,"LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, EG, SPLENIC AND/OR HEPATIC",,,984.05,1567.2,2
CPT,78140,PET Scan,,,4155.27,4200.53,2
CPT,78185,PET Scan,,,4155.27,4200.53,2
CPT,78185,"SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW",,,353.15,353.15,2
CPT,78185,SPLEEN IMAGING ONLY;,,,585.66,932.72,2
CPT,78191,PET Scan,,,4155.27,4200.53,2
CPT,78191,PLATELET SURVIVAL STUDY,,,245.17,2919.23,4
CPT,78192,PET Scan,,,4155.27,4200.53,2
CPT,78193,PET Scan,,,4155.27,4200.53,2
CPT,78194,PET Scan,,,4155.27,4200.53,2
CPT,78195,HB NM LYMPHATICS/NODES SCAN,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78195,LYMPHATICS AND LYMPH GLANDS IMAGING,7877.34,5120.27,682.64,1621.98,4
CPT,78195,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78199,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78199,"UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",6279.86,4081.91,948.86,948.86,2
CPT,78201,HB NM LIVER SCAN STATIC ONLY,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78201,LIVER IMAGING; STATIC ONLY,7877.34,5120.27,394.76,933.94,4
CPT,78201,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78202,LIVER IMAGING; WITH VASCULAR FLOW,,,428.03,1135.82,4
CPT,78202,PET Scan,,,4155.27,4200.53,2
CPT,78215,LIVER AND SPLEEN IMAGING; STATIC ONLY,6279.86,4081.91,401.41,1155.2,4
CPT,78215,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78216,HB NM LIVER/SPLEEN SCAN VAS/FL,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78216,LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW,6279.86,4081.91,253.31,1373.0,4
CPT,78216,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78226,HB NM HEPATOBILIARY WO PHARM,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78226,HEPATOBILIARY SYSTEM IMAGING,6279.86,4081.91,667.66,667.66,2
CPT,78226,"HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT;",6279.86,4081.91,2180.35,3472.43,2
CPT,78226,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78226,RADIATION THERAPY SERVICES,6279.86,4081.91,2044.52,3286.27,2
CPT,78227,HB NM HEPATOBILIARY W PHARM,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78227,HEPATOBIL SYST IMAGE W/DRUG,7877.34,5120.27,907.98,907.98,2
CPT,78227,"HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; WITH PHARMACOLOGIC INTERVENTION,INCLUDING QUANTITATIVE",7877.34,5120.27,2180.35,3472.43,2
CPT,78227,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78227,RADIATION THERAPY SERVICES,7877.34,5120.27,2044.52,3286.27,2
CPT,78230,PET Scan,,,4155.27,4200.53,2
CPT,78230,SALIVARY GLAND IMAGING;,,,360.64,867.08,4
CPT,78231,PET Scan,,,4155.27,4200.53,2
CPT,78231,SALIVARY GLAND IMAGING; WITH SERIAL IMAGES,,,205.06,1261.29,4
CPT,78232,PET Scan,,,4155.27,4200.53,2
CPT,78232,SALIVARY GLAND FUNCTION STUDY,,,205.88,1406.8,4
CPT,78258,ESOPHAGEAL MOTILITY,,,415.56,1147.62,4
CPT,78258,PET Scan,,,4155.27,4200.53,2
CPT,78261,GASTRIC MUCOSA IMAGING,,,399.75,1633.97,4
CPT,78261,PET Scan,,,4155.27,4200.53,2
CPT,78262,GASTROESOPHAGEAL REFLUX STUDY,,,492.1,1692.68,4
CPT,78262,PET Scan,,,4155.27,4200.53,2
CPT,78264,GASTRIC EMPTYING STUDY,6279.86,4081.91,674.32,1430.87,4
CPT,78264,HB NM GASTRIC EMPTYING STUDY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78264,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78265,Gastric emptying imag study,6279.86,4081.91,3048.23,4854.61,2
CPT,78265,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit",6279.86,4081.91,793.48,793.48,2
CPT,78265,HB NM GASTRIC EMPTYNG IMG W/SM BWL,6279.86,4081.91,500.35,575.41,8
CPT,78265,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78266,Gastric emptying imag study,,,3649.11,5811.58,2
CPT,78266,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days",,,909.65,909.65,2
CPT,78266,PET Scan,,,4155.27,4200.53,2
CPT,78267,PET Scan,,,4155.27,4200.53,2
CPT,78267,"UREA BREATH TEST, C-14 (ISOTOPIC); ACQUISITION FOR ANALYSIS",,,68.32,108.81,2
CPT,78267,"UREA BREATH TEST, C-14; ACQUISITION FOR ANALYSIS",,,27.45,27.45,2
CPT,78268,PET Scan,,,4155.27,4200.53,2
CPT,78268,"UREA BREATH TEST, C-14; ANALYSIS",,,232.14,889.74,4
CPT,78278,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,6279.86,4081.91,693.46,1939.88,4
CPT,78278,HB NM ACUTE GI BLEED STUDY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78278,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78282,GASTROINTESTINAL PROTEIN LOSS,,,110.06,1112.03,4
CPT,78282,PET Scan,,,4155.27,4200.53,2
CPT,78290,"BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL'S LOCALIZATION, VOLVULUS)",6279.86,4081.91,685.97,1210.35,4
CPT,78290,HB NM INTESTINE SCAN,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78290,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78291,HB NM PERITONEAL SHUNT PATENCY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78291,"PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT)",6279.86,4081.91,507.91,1218.5,4
CPT,78291,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78299,PET Scan,,,4155.27,4200.53,2
CPT,78299,"UNLISTED GASTROINTESTINAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",,,948.86,948.86,2
CPT,78300,BONE AND/OR JOINT IMAGING; LIMITED AREA,6279.86,4081.91,453.83,969.14,4
CPT,78300,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78305,BONE AND/OR JOINT IMAGING; MULTIPLE AREAS,6279.86,4081.91,544.52,1379.74,4
CPT,78305,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78306,BONE AND/OR JOINT IMAGING; WHOLE BODY,6279.86,4081.91,586.13,1659.06,4
CPT,78306,HB NM BONE/JNT SCAN WHOLE BODY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78306,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78315,BONE AND/OR JOINT IMAGING; THREE PHASE STUDY,6279.86,4081.91,685.14,1754.2,4
CPT,78315,HB NM BONE/JNT SCAN 3-PHASE,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78315,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78321,PET Scan,,,4155.27,4200.53,2
CPT,78322,PET Scan,,,4155.27,4200.53,2
CPT,78340,PET Scan,,,4155.27,4200.53,2
CPT,78341,PET Scan,,,4155.27,4200.53,2
CPT,78342,PET Scan,,,4155.27,4200.53,2
CPT,78343,PET Scan,,,4155.27,4200.53,2
CPT,78350,BONE DENSITY (BONE MINERAL CONTENT) STUDY; SINGLE PHOTON ABSORPTIOMETRY,,,52.09,301.79,4
CPT,78350,PET Scan,,,4155.27,4200.53,2
CPT,78351,BONE DENSITY (BONE MINERAL CONTENT) STUDY; DUAL PHOTON ABSORPTIOMETRY,,,22.57,556.02,4
CPT,78351,PET Scan,,,4155.27,4200.53,2
CPT,78399,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78399,"UNLISTED MUSCULOSKELETAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",6279.86,4081.91,948.86,948.86,2
CPT,78414,"DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR WIT",,,284.98,453.86,2
CPT,78414,"DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR WITHOUT PHARMACOLOGIC INTERVENTION OR EXERCISE, SINGLE OR MULTIPLE DETERMINATIONS",,,118.38,118.38,2
CPT,78414,PET Scan,,,4155.27,4200.53,2
CPT,78428,CARDIAC SHUNT DETECTION,6279.86,4081.91,347.33,898.63,4
CPT,78428,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78429,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently a",19474.8,12658.62,532.21,940.8,4
CPT,78429,PET Scan,19474.8,12658.62,4155.27,4200.53,2
CPT,78430,HB PET CARDIAC PERF SNGL CNCRNT CT,22396.14,14557.490000000002,1816.22,14761.0,20
CPT,78430,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or",19474.8,12658.62,504.76,1121.81,4
CPT,78430,PET Scan,19474.8,12658.62,4155.27,4200.53,2
CPT,78431,HB PET CARDIAC PERF MULT CNCRNT CT,11611.225,7547.299999999999,2802.3,14761.0,20
CPT,78431,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercis",10096.7,6562.86,587.13,1311.79,4
CPT,78431,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78432,"Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radi",10096.7,6562.86,624.93,1396.38,4
CPT,78432,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78433,HB PET CARD PERF/META DUAL RAD CNCRNT CT,11611.225,7547.299999999999,2428.74,14761.0,12
CPT,78433,"Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radi",10096.7,6562.86,683.32,1524.53,4
CPT,78433,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78434,"Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (List separately in addition to code for primary procedure)",12330.9,8015.09,198.32,315.84,2
CPT,78434,HB PET AQMBF REST AND PHARM STRESS,14180.494999999999,9217.325,13270.0,14761.0,4
CPT,78434,PET Scan,12330.9,8015.09,4155.27,4200.53,2
CPT,78440,PET Scan,,,4155.27,4200.53,2
CPT,78441,PET Scan,,,4155.27,4200.53,2
CPT,78442,PET Scan,,,4155.27,4200.53,2
CPT,78443,PET Scan,,,4155.27,4200.53,2
CPT,78444,PET Scan,,,4155.27,4200.53,2
CPT,78445,PET Scan,,,4155.27,4200.53,2
CPT,78445,"VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)",,,428.87,735.33,4
CPT,78449,PET Scan,,,4155.27,4200.53,2
CPT,78451,HB NM HEART SPECT SNGL RST/STR,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78451,"MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); SINGLE STUDY, AT REST OR STRESS (EXERCISE OR PHARMACOLOGIC)",10096.7,6562.86,1074.71,1711.59,2
CPT,78451,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",10096.7,6562.86,627.72,627.72,2
CPT,78451,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78452,HB NM HEART SPECT MULT RST/STR,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78452,"MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE OR PHARMACOLOGIC) A",10096.7,6562.86,3103.14,4942.07,2
CPT,78452,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",10096.7,6562.86,902.16,902.16,2
CPT,78452,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78453,"MYOCARDIAL PERFUSION IMAGING; SINGLE STUDY, AT REST OR STRESS (EXERCISE OR PHARMACOLOGIC)",10096.7,6562.86,1002.63,1596.79,2
CPT,78453,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",10096.7,6562.86,563.66,563.66,2
CPT,78453,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78454,"MYOCARDIAL PERFUSION IMAGING, PLANAR, MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE OR PHARMACOLOGIC) AND/OR REDISTR",10096.7,6562.86,842.94,1342.47,2
CPT,78454,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",10096.7,6562.86,853.07,853.07,2
CPT,78454,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78456,"ACUTE VENOUS THROMBOSIS IMAGING, PEPTIDE",,,607.76,1579.38,4
CPT,78456,PET Scan,,,4155.27,4200.53,2
CPT,78457,PET Scan,,,4155.27,4200.53,2
CPT,78457,"VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); UNILATERAL",,,663.33,1056.41,2
CPT,78457,"VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL",,,300.74,300.74,2
CPT,78458,PET Scan,,,4155.27,4200.53,2
CPT,78458,"VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL",,,379.78,1588.55,4
CPT,78459,MYCARDIAL IMAGING POSITRON EMISSION ROMOGRAPHY(PET) METAOLIC EVALUATON,10096.7,6562.86,5879.5,9363.7,2
CPT,78459,"MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION",10096.7,6562.86,852.65,852.65,2
CPT,78459,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78460,PET Scan,,,4155.27,4200.53,2
CPT,78461,PET Scan,,,4155.27,4200.53,2
CPT,78466,"MYOCARDIAL IMAGING, INFARCT AVID, AT REST; QUALITATIVE",,,655.45,1043.87,2
CPT,78466,"MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE",,,350.65,350.65,2
CPT,78466,PET Scan,,,4155.27,4200.53,2
CPT,78468,"MYOCARDIAL IMAGING, INFARCT AVID, AT REST; WITH FIRST PASS TECHNIQUE",,,908.38,1446.69,2
CPT,78468,"MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE",,,363.97,363.97,2
CPT,78468,PET Scan,,,4155.27,4200.53,2
CPT,78469,"MYOCARDIAL IMAGING, INFARCT AVID, AT REST; WITH EMISSION COMPUTED TOMOGRAPHY",7877.34,5120.27,1294.55,2061.7,2
CPT,78469,"MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTITATION",7877.34,5120.27,411.4,411.4,2
CPT,78469,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78472,"CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, AT REST; WALL MOTION STUDY PLUS REGIONAL EJECTION FRACTION",6279.86,4081.91,1201.24,1913.1,2
CPT,78472,"CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT REST OR WITH STRESS, WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT ADDITIONAL QUANTITATIVE PROCESSING",6279.86,4081.91,416.39,416.39,2
CPT,78472,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78473,"CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, AT REST;WALL MULTIPLE STUDIES,WALL MOTION STUDY PLUS EJECTION FRACTION,",,,2006.32,3195.27,2
CPT,78473,"CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, RESTING AND STRESS (WITH EXERCISE AND/OR PHARMACOLOGIC), WITH OR WITHOUT ADDITIONAL QUANTIFIC",,,503.76,503.76,2
CPT,78473,PET Scan,,,4155.27,4200.53,2
CPT,78481,"CARDIAC BLOOD POOL IMAGING, FIRST PASS TECHNIQUE, AT REST; WALL MOTION STUDY WITH EJECTION FRACTION",7877.34,5120.27,1296.02,2064.04,2
CPT,78481,"CARDIAC BLOOD POOL IMAGING, FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR WITH STRESS, WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT QUANTITATIVE PROCESSING",7877.34,5120.27,300.74,300.74,2
CPT,78481,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78483,"CARDIAC BLOOD POOL IMAGING, FIRST PASS TECHNIQUE; MULTIPLE STUDIES, RESTING AND WITH STRESS (EXERCISE AND/OR PHARMACOLOGIC), WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT ADDITIONAL QUANTI",,,389.76,389.76,2
CPT,78483,"CARDIAC BLOOD POOL IMAGING,FIRST PASS TECHNIQUE, AT REST; MULTIPLE STUDIES,RESTING AND WITH STRESS,W/WO ADD QUANTIFICA",,,1876.38,2988.33,2
CPT,78483,PET Scan,,,4155.27,4200.53,2
CPT,78491,"MYCOCARDIAL IMAGING, POSITION EMISSION TOMOGRAPHY (PET) PERFUSION; SIGNLE STUDY AT REST OR STRESS",14227.7,9248.01,3647.88,5809.61,2
CPT,78491,"MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION;SINGLE STUDY AT REST OR STRESS",14227.7,9248.01,890.78,890.78,2
CPT,78491,PET Scan,14227.7,9248.01,4155.27,4200.53,2
CPT,78492,"MYCOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) PERFUSION; MULTIPLE STUDIES AT REST AND/OR STRESS",34829.0,22638.85,4274.87,6808.16,2
CPT,78492,"MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION; MULTIPLE STUDIES AT REST AND/OR STRESS",34829.0,22638.85,1062.27,1062.27,2
CPT,78492,PET Scan,34829.0,22638.85,4155.27,4200.53,2
CPT,78494,"CARDIA BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, AT REST,WALL MOTION STUDY PLUS EJECTIN FRACTION,W/WO QUANTI PRO",6279.86,4081.91,1386.92,2208.8,2
CPT,78494,"CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, AT REST, WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT QUANTITATIVE PROCESSING",6279.86,4081.91,395.59,395.59,2
CPT,78494,HB NM CARDIAC MUGA WM/EF SPECT,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78494,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78496,"CARDIAC BLOOD POOL IMAGING,GATED EQUILIBRIUM,SINGLE STUDY AT REST WITH RIGHT VENTRICULAR EJECTION FRACTION BY 1ST PASS",,,423.21,674.0,2
CPT,78496,PET Scan,,,4155.27,4200.53,2
CPT,78499,PET Scan,,,4155.27,4200.53,2
CPT,78499,"UNLISTED CARDIOVASCULAR PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",,,948.86,948.86,2
CPT,78550,PET Scan,,,4155.27,4200.53,2
CPT,78551,PET Scan,,,4155.27,4200.53,2
CPT,78552,PET Scan,,,4155.27,4200.53,2
CPT,78559,PET Scan,,,4155.27,4200.53,2
CPT,78579,HB NM LUNG VENT WO PERFUSION,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78579,LUNG VENTILATION IMAGING,6279.86,4081.91,381.44,381.44,2
CPT,78579,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78579,"PULMONARY VENTILATION IMAGING (EG, AEROSOL OR GAS)",6279.86,4081.91,1124.51,1790.9,2
CPT,78579,RADIATION THERAPY SERVICES,6279.86,4081.91,1054.45,1694.89,2
CPT,78580,HB NM LUNG PERFUSION SCAN,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78580,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78580,"PULMONARY PERFUSION IMAGING, PARTICULATE",6279.86,4081.91,463.82,463.82,2
CPT,78580,PULMONARY PERFUSION IMAGING; PARTICULATE,6279.86,4081.91,767.33,1222.06,2
CPT,78582,HB NM LUNG VENT W PERFUSION,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78582,LUNG VENTILAT&PERFUS IMAGING,7877.34,5120.27,646.87,646.87,2
CPT,78582,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78582,"PULMONARY VENTILATION (EG, AEROSOL OR GAS) AND PERFUSION IMAGING",7877.34,5120.27,2020.69,3218.15,2
CPT,78582,RADIATION THERAPY SERVICES,7877.34,5120.27,1894.8,3045.62,2
CPT,78597,HB NM LUNG VENT W DIFFERENTIAL,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78597,LUNG PERFUSION DIFFERENTIAL,6279.86,4081.91,383.1,383.1,2
CPT,78597,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78597,"QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING WHEN PERFORMED.",6279.86,4081.91,1206.06,1920.78,2
CPT,78597,RADIATION THERAPY SERVICES,6279.86,4081.91,1130.92,1817.8,2
CPT,78598,LUNG PERF&VENTILAT DIFFERENTIAL,,,604.43,604.43,2
CPT,78598,PET Scan,,,4155.27,4200.53,2
CPT,78598,"QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION AND VENTILATION (EG, AEROSOL OR GAS), INCLUDING IMAGING WHEN PERFORMED",,,1954.59,3112.89,2
CPT,78598,RADIATION THERAPY SERVICES,,,1832.82,2946.0,2
CPT,78599,PET Scan,,,4155.27,4200.53,2
CPT,78599,"UNLISTED RESPIRATORY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",,,948.86,948.86,2
CPT,78600,"BRAIN IMAGING, LIMITED PROCEDURE; STATIC",,,372.29,1134.69,4
CPT,78600,PET Scan,,,4155.27,4200.53,2
CPT,78601,"BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW",6279.86,4081.91,445.51,1336.67,4
CPT,78601,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78602,PET Scan,,,4155.27,4200.53,2
CPT,78603,PET Scan,,,4155.27,4200.53,2
CPT,78604,PET Scan,,,4155.27,4200.53,2
CPT,78605,"BRAIN IMAGING, COMPLETE STUDY; STATIC",,,406.4,1336.67,4
CPT,78605,PET Scan,,,4155.27,4200.53,2
CPT,78606,"BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW",,,683.47,1523.94,4
CPT,78606,PET Scan,,,4155.27,4200.53,2
CPT,78607,PET Scan,,,4155.27,4200.53,2
CPT,78608,"BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); METABOLIC EVALUATION",17580.5,11427.33,1220.45,1220.45,2
CPT,78608,"BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY(PET); METABOLIC EVALUATION",17580.5,11427.33,5343.58,8510.2,2
CPT,78608,HB NM PET BRAIN METABOLIC EVAL,20217.57,13141.425,1816.22,14761.0,10
CPT,78608,PET Scan,17580.5,11427.33,4155.27,4200.53,2
CPT,78609,"BRAIN IMAGING,POSITRON EMISSION TOMOGRAPHY (PET); PERFUSION EVALUATION",,,6127.32,9758.38,2
CPT,78609,PET Scan,,,4155.27,4200.53,2
CPT,78610,"BRAIN IMAGING, VASCULAR FLOW ONLY",,,343.42,546.93,4
CPT,78610,PET Scan,,,4155.27,4200.53,2
CPT,78630,"CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY",7877.34,5120.27,701.78,1983.42,4
CPT,78630,HB NM CSF FLOW/CISTERNOGRAM,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78630,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78631,PET Scan,,,4155.27,4200.53,2
CPT,78635,"CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY",,,632.69,1007.63,4
CPT,78635,PET Scan,,,4155.27,4200.53,2
CPT,78639,PET Scan,,,4155.27,4200.53,2
CPT,78645,"CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION",7877.34,5120.27,682.64,1353.71,4
CPT,78645,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78650,"CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CSF LEAKAGE DETECTION AND LOCALIZATION",10096.7,6562.86,1144.92,1823.39,2
CPT,78650,CSF LEAKAGE DETECTION AND LOCALIZATION,10096.7,6562.86,567.82,567.82,2
CPT,78650,HB NM CSF LEAK SCAN,10096.7,6562.86,1625.57,1869.4,8
CPT,78650,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78651,PET Scan,,,4155.27,4200.53,2
CPT,78652,PET Scan,,,4155.27,4200.53,2
CPT,78659,PET Scan,,,4155.27,4200.53,2
CPT,78660,PET Scan,,,4155.27,4200.53,2
CPT,78660,RADIONUCLIDE DACRYOCYSTOGRAPHY,,,304.89,844.32,4
CPT,78699,PET Scan,,,4155.27,4200.53,2
CPT,78699,"UNLISTED NERVOUS SYSTEM PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",,,948.86,948.86,2
CPT,78700,KIDNEY IMAGING; MORPHOLOGY;,6279.86,4081.91,710.36,1131.32,2
CPT,78700,KIDNEY IMAGING; STATIC ONLY,6279.86,4081.91,347.33,347.33,2
CPT,78700,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78701,KIDNEY IMAGING M0RPHOLOGY; WITH VASCULAR FLOW,,,467.14,467.14,2
CPT,78701,KIDNEY IMAGING; WITH VASCULAR FLOW,,,877.75,1397.91,2
CPT,78701,PET Scan,,,4155.27,4200.53,2
CPT,78702,PET Scan,,,4155.27,4200.53,2
CPT,78703,PET Scan,,,4155.27,4200.53,2
CPT,78704,PET Scan,,,4155.27,4200.53,2
CPT,78707,HB NM KIDNEY SCAN FLOW/FUNCT W/O PHARM,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78707,"KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION, SINGLE STUDY WITHOUT PHARMACOLOGICAL INTERVENTION",7877.34,5120.27,1108.64,1765.62,2
CPT,78707,KIDNEY IMAGING; WITH VASCULAR FLOW AND FUNCTION STUDY,7877.34,5120.27,433.87,433.87,2
CPT,78707,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78708,HB NM KIDNEY SCAN FLOW/FUNCT PHARM,9058.935000000001,5888.305,670.25,14761.0,10
CPT,78708,"KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY, WITH PHARMACOLOGICAL INTERVENTION (EG, ANGIOTENSIN CONVERTING ENZYME INHIBITOR AND/OR DIURETIC)",7877.34,5120.27,294.08,294.08,2
CPT,78708,"KIDNEY IMAGING; W/VASCULAR FLOW AND FUNCTION, SINGLE STUDY, W/PHARM INTERVENTION (EG, ANGIOTENSIN CONVERTING ENZYME INHI",7877.34,5120.27,1117.4,1779.57,2
CPT,78708,PET Scan,7877.34,5120.27,4155.27,4200.53,2
CPT,78709,"KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; MULTIPLE STUDIES, WITH AND WITHOUT PHARMACOLOGICAL INTERVENTION (EG, ANGIOTENSIN CONVERTING ENZYME INHIBITOR AND/OR DIURETIC)",,,696.97,696.97,2
CPT,78709,"KIDNEY IMAGING; W/VASCULAR FLOW AND FUNCTION, SINGLE STUDY, W/WO PHARM INTERVENTION (EG, ANGIOTENSIN CONVERTING ENZYME I",,,1117.4,1779.57,2
CPT,78709,PET Scan,,,4155.27,4200.53,2
CPT,78720,PET Scan,,,4155.27,4200.53,2
CPT,78721,PET Scan,,,4155.27,4200.53,2
CPT,78722,PET Scan,,,4155.27,4200.53,2
CPT,78723,PET Scan,,,4155.27,4200.53,2
CPT,78724,PET Scan,,,4155.27,4200.53,2
CPT,78725,HB NM KIDNEY FUNCTION STUDY,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78725,KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION,6279.86,4081.91,236.66,659.3,4
CPT,78725,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78729,PET Scan,,,4155.27,4200.53,2
CPT,78730,PET Scan,,,4155.27,4200.53,2
CPT,78730,URINARY BLADDER RESIDUAL STUDY,,,151.94,649.0,4
CPT,78740,PET Scan,,,4155.27,4200.53,2
CPT,78740,URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM),,,442.19,844.32,4
CPT,78760,PET Scan,,,4155.27,4200.53,2
CPT,78761,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78761,TESTICULAR IMAGING WITH VASCULAR FLOW,6279.86,4081.91,793.67,1264.01,2
CPT,78761,TESTICULAR IMAGING; WITH VASCULAR FLOW,6279.86,4081.91,413.06,413.06,2
CPT,78762,PET Scan,,,4155.27,4200.53,2
CPT,78763,PET Scan,,,4155.27,4200.53,2
CPT,78791,PET Scan,,,4155.27,4200.53,2
CPT,78799,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78799,"UNLISTED GENITOURINARY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",6279.86,4081.91,948.86,948.86,2
CPT,78800,HB NM TUMOR SCAN PLANAR SINGLE,7221.83,4694.1900000000005,500.35,14761.0,10
CPT,78800,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78800,RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA,6279.86,4081.91,510.41,510.41,2
CPT,78800,RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRIBUTION OF RADIOPHARMACEUTICAL AGENT(S); LIMITED AREA,6279.86,4081.91,840.71,1338.92,2
CPT,78801,PET Scan,,,4155.27,4200.53,2
CPT,78801,RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS,,,551.18,1670.2,4
CPT,78802,HB NM TUMOR SCAN WHOLE BODY,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78802,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78802,RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY,10096.7,6562.86,626.07,626.07,2
CPT,78802,"WHOLE BODY, SINGLE DAY IMAGING",10096.7,6562.86,1368.69,2179.78,2
CPT,78803,HB NM TUMOR SPECT SINGLE AREA,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78803,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78803,TUMOR LOCALIZATION (SPECT),10096.7,6562.86,760.02,2363.59,4
CPT,78804,HB NM TUMOR SCAN 2DAYS/MORE,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78804,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78804,"RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRIBUTION OF RADIOPHARMACEUTICAL AGENT(S); WHOLE BODY, REQUIRING TWO OR MORE DAYS IMAGING",10096.7,6562.86,1382.76,1382.76,2
CPT,78804,"RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRIBUTION OFRADIOPHARMACEUTICAL AGENT(S); WHOLE BODY, REQUIRING TWO OR M",10096.7,6562.86,1084.36,1726.95,2
CPT,78808,HB INJ LOC NON-IMG PROBE - INTRAVENOUS,8163.8,5306.47,13270.0,14761.0,2
CPT,78808,"INJECTION PROCEDURE FOR RADIOPHARMACEUTICAL LOCALIZATION BY NON-IMAGING PROBE STUDY, INTRAVENOUS (EG PARATHYROID ADENOMA)",,,948.86,948.86,2
CPT,78808,"INJECTION PROCEDURE FOR RADIOPHARMACEUTICAL LOCALIZATION BY NON-IMAGING PROBE STUDY, INTRAVENOUS (EG, PARATHYROID ADENOM",,,433.5,690.39,2
CPT,78808,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,78808,PET Scan,,,4155.27,4200.53,2
CPT,78811,HB NM PET LIMITED AREA,10096.7,6562.86,1625.57,1869.4,8
CPT,78811,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78811,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); LIMITED AREA (EG, CHEST, HEAD/NECK)",10096.7,6562.86,1244.26,1244.26,2
CPT,78811,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY; LIMITED AREA",10096.7,6562.86,5144.56,8193.24,2
CPT,78812,HB NM PET SKULL-THIGH,14565.085,9467.305,1816.22,14761.0,10
CPT,78812,PET Scan,12665.3,8232.44,4155.27,4200.53,2
CPT,78812,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); SKULL BASE TO MID-THIGH",12665.3,8232.44,1597.41,1597.41,2
CPT,78812,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY; SKULL BASE TO MID-THIGH",12665.3,8232.44,5661.96,9017.24,2
CPT,78813,HB NM PET WHOLE BODY,14670.2,9535.63,1816.22,2088.65,8
CPT,78813,PET Scan,14670.2,9535.63,4155.27,4200.53,2
CPT,78813,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); WHOLE BODY",14670.2,9535.63,1609.57,1609.57,2
CPT,78813,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY; WHOLE BODY",14670.2,9535.63,6849.62,10908.71,2
CPT,78814,HB NM PET/CT LIMITED AREA,22361.125,14534.735,1816.22,14761.0,10
CPT,78814,PET Scan,19371.7,12591.61,4155.27,4200.53,2
CPT,78814,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LIMITED AREA (EG, CHEST, HEAD/NECK)",19371.7,12591.61,1812.87,1812.87,2
CPT,78814,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY WITH CONCURRENT ACQUIRED COMPUTED TOMOGRAPHY FOR ATTENUATION CORRECTION AND",19371.7,12591.61,5732.51,9129.61,2
CPT,78815,HB NM PET/CT SKULL-THIGH,22396.14,14557.490000000002,1816.22,14761.0,20
CPT,78815,PET Scan,19474.8,12658.62,4155.27,4200.53,2
CPT,78815,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL BASE TO MID-THIGH",19474.8,12658.62,2010.33,2010.33,2
CPT,78815,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY WITH CONCURRENT ACQUIRED COMPUTED TOMOGRAPHY FOR ATTENUATION CORRECTION AND",19474.8,12658.62,6249.91,9953.61,2
CPT,78816,HB NM PET/CT WHOLE BODY,18753.505,12189.779999999999,1816.22,14761.0,18
CPT,78816,PET Scan,16307.4,10599.81,4155.27,4200.53,2
CPT,78816,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHOLE BODY",16307.4,10599.81,2022.49,2022.49,2
CPT,78816,"TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY WITH CONCURRENT ACQUIRED COMPUTED TOMOGRAPHY FOR ATTENUATION CORRECTION AND",16307.4,10599.81,7437.57,11845.08,2
CPT,78820,PET Scan,,,4155.27,4200.53,2
CPT,78821,PET Scan,,,4155.27,4200.53,2
CPT,78829,PET Scan,,,4155.27,4200.53,2
CPT,78830,CAT Scan,10096.7,6562.86,2808.07,2839.65,2
CPT,78830,HB TUMOR SPECT CNCRNT CT SINGLE AREA,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78830,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78830,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",10096.7,6562.86,945.75,5849.78,4
CPT,78831,CAT Scan,10096.7,6562.86,2808.07,2839.65,2
CPT,78831,HB TUMOR SPECT MIN 2 AREAS,11611.225,7547.299999999999,1625.57,14761.0,10
CPT,78831,PET Scan,10096.7,6562.86,4155.27,4200.53,2
CPT,78831,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",10096.7,6562.86,1435.36,8679.68,4
CPT,78832,CAT Scan,19474.8,12658.62,2808.07,2839.65,2
CPT,78832,HB TUMOR SPECT CNCRNT CT MIN 2 AREAS,22396.14,14557.490000000002,1816.22,14761.0,10
CPT,78832,PET Scan,19474.8,12658.62,4155.27,4200.53,2
CPT,78832,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",19474.8,12658.62,1865.53,11467.26,4
CPT,78833,PET Scan,,,4155.27,4200.53,2
CPT,78834,PET Scan,,,4155.27,4200.53,2
CPT,78835,PET Scan,7669.41,4985.12,4155.27,4200.53,2
CPT,78835,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure),7669.41,4985.12,705.6,1123.74,2
CPT,78836,PET Scan,,,4155.27,4200.53,2
CPT,78837,PET Scan,,,4155.27,4200.53,2
CPT,78838,PET Scan,,,4155.27,4200.53,2
CPT,78839,PET Scan,,,4155.27,4200.53,2
CPT,78841,PET Scan,,,4155.27,4200.53,2
CPT,78842,PET Scan,,,4155.27,4200.53,2
CPT,78843,PET Scan,,,4155.27,4200.53,2
CPT,78861,PET Scan,,,4155.27,4200.53,2
CPT,78862,PET Scan,,,4155.27,4200.53,2
CPT,78863,PET Scan,,,4155.27,4200.53,2
CPT,78864,PET Scan,,,4155.27,4200.53,2
CPT,78865,PET Scan,,,4155.27,4200.53,2
CPT,78869,PET Scan,,,4155.27,4200.53,2
CPT,78891,PET Scan,,,4155.27,4200.53,2
CPT,78899,PET Scan,,,4155.27,4200.53,2
CPT,78900,PET Scan,,,4155.27,4200.53,2
CPT,78901,PET Scan,,,4155.27,4200.53,2
CPT,78902,PET Scan,,,4155.27,4200.53,2
CPT,78903,PET Scan,,,4155.27,4200.53,2
CPT,78904,PET Scan,,,4155.27,4200.53,2
CPT,78905,PET Scan,,,4155.27,4200.53,2
CPT,78906,PET Scan,,,4155.27,4200.53,2
CPT,78907,PET Scan,,,4155.27,4200.53,2
CPT,78909,PET Scan,,,4155.27,4200.53,2
CPT,78930,PET Scan,,,4155.27,4200.53,2
CPT,78931,PET Scan,,,4155.27,4200.53,2
CPT,78932,PET Scan,,,4155.27,4200.53,2
CPT,78933,PET Scan,,,4155.27,4200.53,2
CPT,78934,PET Scan,,,4155.27,4200.53,2
CPT,78935,PET Scan,,,4155.27,4200.53,2
CPT,78936,PET Scan,,,4155.27,4200.53,2
CPT,78937,PET Scan,,,4155.27,4200.53,2
CPT,78939,PET Scan,,,4155.27,4200.53,2
CPT,78940,PET Scan,,,4155.27,4200.53,2
CPT,78941,PET Scan,,,4155.27,4200.53,2
CPT,78942,PET Scan,,,4155.27,4200.53,2
CPT,78943,PET Scan,,,4155.27,4200.53,2
CPT,78944,PET Scan,,,4155.27,4200.53,2
CPT,78945,PET Scan,,,4155.27,4200.53,2
CPT,78946,PET Scan,,,4155.27,4200.53,2
CPT,78947,PET Scan,,,4155.27,4200.53,2
CPT,78949,PET Scan,,,4155.27,4200.53,2
CPT,78951,PET Scan,,,4155.27,4200.53,2
CPT,78959,PET Scan,,,4155.27,4200.53,2
CPT,78960,PET Scan,,,4155.27,4200.53,2
CPT,78961,PET Scan,,,4155.27,4200.53,2
CPT,78962,PET Scan,,,4155.27,4200.53,2
CPT,78963,PET Scan,,,4155.27,4200.53,2
CPT,78964,PET Scan,,,4155.27,4200.53,2
CPT,78965,PET Scan,,,4155.27,4200.53,2
CPT,78966,PET Scan,,,4155.27,4200.53,2
CPT,78967,PET Scan,,,4155.27,4200.53,2
CPT,78969,PET Scan,,,4155.27,4200.53,2
CPT,78999,PET Scan,6279.86,4081.91,4155.27,4200.53,2
CPT,78999,"UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE",6279.86,4081.91,948.86,948.86,2
CPT,79001,PET Scan,,,4155.27,4200.53,2
CPT,79005,HB NM RADIOPHARM TX ORAL,4686.465,3046.205,279.08,14761.0,10
CPT,79005,PET Scan,4075.18,2648.87,4155.27,4200.53,2
CPT,79005,RADIATION THERAPY SERVICES,4075.18,2648.87,599.95,964.33,2
CPT,79005,"RADIOPHARMACEUTICAL THERAPY, BY ORAL ADMINISTRATION",4075.18,2648.87,126.65,1018.96,4
CPT,79009,PET Scan,,,4155.27,4200.53,2
CPT,79021,PET Scan,,,4155.27,4200.53,2
CPT,79022,PET Scan,,,4155.27,4200.53,2
CPT,79029,PET Scan,,,4155.27,4200.53,2
CPT,79091,PET Scan,,,4155.27,4200.53,2
CPT,79092,PET Scan,,,4155.27,4200.53,2
CPT,79093,PET Scan,,,4155.27,4200.53,2
CPT,79094,PET Scan,,,4155.27,4200.53,2
CPT,79095,PET Scan,,,4155.27,4200.53,2
CPT,79099,PET Scan,,,4155.27,4200.53,2
CPT,79101,"HB NM RADIOPHARM THERAPY, IV",4686.465,3046.205,279.08,14761.0,10
CPT,79101,PET Scan,4075.18,2648.87,4155.27,4200.53,2
CPT,79101,"RADIOPHARMACEUTICAL THERAPY, BY INTRAVENOUS ADMINISTRATION",4075.18,2648.87,132.48,1018.96,4
CPT,79200,INTRACAVITARY RADIOACTIVE COLLOID THERAPY,,,130.82,130.82,2
CPT,79200,PET Scan,,,4155.27,4200.53,2
CPT,79200,"RADIOPHARMACEUTICAL THERAPY, BY INTRACAVITARY ADMINISTRATION",,,657.68,1047.42,2
CPT,79300,GLOBAL RADIATION THERAPY,,,2493.67,3758.51,2
CPT,79300,INTERSTITIAL RADIOACTIVE COLLOID THERAPY,,,102.07,102.07,2
CPT,79300,PET Scan,,,4155.27,4200.53,2
CPT,79300,"RADIOPHARMACEUTICAL THERAPY, BY INTERSTITIAL RADIOACTIVE COLLOID ADMINISTRATION",,,2493.67,3971.43,2
CPT,79311,PET Scan,,,4155.27,4200.53,2
CPT,79319,PET Scan,,,4155.27,4200.53,2
CPT,79380,PET Scan,,,4155.27,4200.53,2
CPT,79381,PET Scan,,,4155.27,4200.53,2
CPT,79382,PET Scan,,,4155.27,4200.53,2
CPT,79389,PET Scan,,,4155.27,4200.53,2
CPT,79391,PET Scan,,,4155.27,4200.53,2
CPT,79399,PET Scan,,,4155.27,4200.53,2
CPT,79400,PET Scan,,,4155.27,4200.53,2
CPT,79401,PET Scan,,,4155.27,4200.53,2
CPT,79402,PET Scan,,,4155.27,4200.53,2
CPT,79403,PET Scan,4075.18,2648.87,4155.27,4200.53,2
CPT,79403,"RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONAL ANTIBODBY INTRAVENOUS INFUSION",4075.18,2648.87,1051.9,1675.26,2
CPT,79403,"RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONAL ANTIBODY BY INTRAVENOUS INFUSION",4075.18,2648.87,231.68,231.68,2
CPT,79409,PET Scan,,,4155.27,4200.53,2
CPT,79410,PET Scan,,,4155.27,4200.53,2
CPT,79411,PET Scan,,,4155.27,4200.53,2
CPT,79412,PET Scan,,,4155.27,4200.53,2
CPT,79413,PET Scan,,,4155.27,4200.53,2
CPT,79414,PET Scan,,,4155.27,4200.53,2
CPT,79415,PET Scan,,,4155.27,4200.53,2
CPT,79416,PET Scan,,,4155.27,4200.53,2
CPT,79417,PET Scan,,,4155.27,4200.53,2
CPT,79419,PET Scan,,,4155.27,4200.53,2
CPT,79430,PET Scan,,,4155.27,4200.53,2
CPT,79431,PET Scan,,,4155.27,4200.53,2
CPT,79439,PET Scan,,,4155.27,4200.53,2
CPT,79440,INTRA-ARTICULAR RADIONUCLIDE THERAPY,,,98.37,98.37,2
CPT,79440,PET Scan,,,4155.27,4200.53,2
CPT,79440,"RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTICULAR ADMINISTRATION",,,657.68,1047.42,2
CPT,79445,HB RADIOPHARM TX INTRAARTERIAL,4075.18,2648.87,279.08,320.95,8
CPT,79445,PET Scan,4075.18,2648.87,4155.27,4200.53,2
CPT,79445,"RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL PARTICULATE ADMINISTRATION",4075.18,2648.87,216.29,1025.14,4
CPT,79500,PET Scan,,,4155.27,4200.53,2
CPT,79501,PET Scan,,,4155.27,4200.53,2
CPT,79502,PET Scan,,,4155.27,4200.53,2
CPT,79503,PET Scan,,,4155.27,4200.53,2
CPT,79504,PET Scan,,,4155.27,4200.53,2
CPT,79505,PET Scan,,,4155.27,4200.53,2
CPT,79506,PET Scan,,,4155.27,4200.53,2
CPT,79507,PET Scan,,,4155.27,4200.53,2
CPT,79508,PET Scan,,,4155.27,4200.53,2
CPT,79509,PET Scan,,,4155.27,4200.53,2
CPT,79510,PET Scan,,,4155.27,4200.53,2
CPT,79511,PET Scan,,,4155.27,4200.53,2
CPT,79512,PET Scan,,,4155.27,4200.53,2
CPT,79513,PET Scan,,,4155.27,4200.53,2
CPT,79514,PET Scan,,,4155.27,4200.53,2
CPT,79515,PET Scan,,,4155.27,4200.53,2
CPT,79516,PET Scan,,,4155.27,4200.53,2
CPT,79518,PET Scan,,,4155.27,4200.53,2
CPT,79519,PET Scan,,,4155.27,4200.53,2
CPT,79531,PET Scan,,,4155.27,4200.53,2
CPT,79539,PET Scan,,,4155.27,4200.53,2
CPT,79551,PET Scan,,,4155.27,4200.53,2
CPT,79552,PET Scan,,,4155.27,4200.53,2
CPT,79571,PET Scan,,,4155.27,4200.53,2
CPT,79579,PET Scan,,,4155.27,4200.53,2
CPT,79581,PET Scan,,,4155.27,4200.53,2
CPT,79582,PET Scan,,,4155.27,4200.53,2
CPT,79589,PET Scan,,,4155.27,4200.53,2
CPT,79670,PET Scan,,,4155.27,4200.53,2
CPT,79671,PET Scan,,,4155.27,4200.53,2
CPT,79672,PET Scan,,,4155.27,4200.53,2
CPT,79673,PET Scan,,,4155.27,4200.53,2
CPT,79674,PET Scan,,,4155.27,4200.53,2
CPT,79675,PET Scan,,,4155.27,4200.53,2
CPT,79676,PET Scan,,,4155.27,4200.53,2
CPT,79677,PET Scan,,,4155.27,4200.53,2
CPT,79678,PET Scan,,,4155.27,4200.53,2
CPT,79679,PET Scan,,,4155.27,4200.53,2
CPT,79901,PET Scan,,,4155.27,4200.53,2
CPT,79902,PET Scan,,,4155.27,4200.53,2
CPT,79921,PET Scan,,,4155.27,4200.53,2
CPT,79922,PET Scan,,,4155.27,4200.53,2
CPT,79923,PET Scan,,,4155.27,4200.53,2
CPT,79924,PET Scan,,,4155.27,4200.53,2
CPT,79925,PET Scan,,,4155.27,4200.53,2
CPT,79929,PET Scan,,,4155.27,4200.53,2
CPT,79951,PET Scan,,,4155.27,4200.53,2
CPT,79952,PET Scan,,,4155.27,4200.53,2
CPT,79953,PET Scan,,,4155.27,4200.53,2
CPT,79954,PET Scan,,,4155.27,4200.53,2
CPT,79955,PET Scan,,,4155.27,4200.53,2
CPT,79959,PET Scan,,,4155.27,4200.53,2
CPT,79981,PET Scan,,,4155.27,4200.53,2
CPT,79982,PET Scan,,,4155.27,4200.53,2
CPT,79999,PET Scan,,,4155.27,4200.53,2
CPT,79999,UNLISTED RADIONUCLIDE THERAPEUTIC PROCEDURE,,,609.64,609.64,2
CPT,80047,"BASIC METABOLIC PANEL (CALCIUM, IONIZED)",1161.22,754.79,190.67,303.66,2
CPT,80047,"BASIC METABOLIC PANEL (CALCIUM, IONIZED) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, IONIZED (82330) CARBON DIOXIDE (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) POTASSIUM (84132) SO",1161.22,754.79,34.12,34.12,2
CPT,80047,HB LAB BASIC METABOLIC PANEL POC,1161.22,754.79,13270.0,14761.0,2
CPT,80047,Laboratory Services,1161.22,754.79,63.65,63.65,2
CPT,80048,BASIC METABOLIC PANEL,960.93,624.6,73.91,117.7,2
CPT,80048,BASIC METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM (82310) CARBON DIOXIDE (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) POTASSIUM (84132) SODIUM (84295) UREA NITROGEN (,960.93,624.6,20.8,20.8,2
CPT,80048,HB LAB BASIC METABOLIC PANEL,960.93,624.6,13270.0,14761.0,2
CPT,80048,Laboratory Services,960.93,624.6,63.65,63.65,2
CPT,80050,"GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BLOOD COUNT, COMPLETE (CBC), AUTOMATED AND AUTOMATED DIFFERENTIAL WBC COUNT (85025 OR 85027 AND 85004)",61.5,39.98,99.85,99.85,2
CPT,80050,GENERAL HEALTH SCREEN PANEL,61.5,39.98,262.11,417.43,2
CPT,80050,Laboratory Services,61.5,39.98,263.7,263.73,2
CPT,80051,ELECTROLYTE PANEL,499.19,324.47,61.26,97.57,2
CPT,80051,ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (82374) CHLORIDE (82435) POTASSIUM (84132) SODIUM (84295),499.19,324.47,17.48,17.48,2
CPT,80051,HB LAB ELECTROLYTES,499.19,324.47,13270.0,14761.0,2
CPT,80051,Laboratory Services,499.19,324.47,52.77,52.77,2
CPT,80053,COMPREHENSIVE METABOLIC PANEL,967.49,628.87,92.43,147.2,2
CPT,80053,"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (82247) CALCIUM (82310) CARBON DIOXIDE (BICARBONATE) (82374) CHLORIDE (82435) CREATININE (82565) G",967.49,628.87,25.8,25.8,2
CPT,80053,HB LAB COMP METABOLIC PANEL,967.49,628.87,13270.0,14761.0,2
CPT,80053,Laboratory Services,967.49,628.87,79.49,79.5,2
CPT,80055,Laboratory Services,,,385.59,385.62,2
CPT,80055,"OBSTETRIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: BLOOD COUNT, COMPLETE (CBC), AUTOMATED AND AUTOMATED DIFFERENTIAL WBC COUNT (85025 OR 85027 AND 85004) OR BLOOD COUNT, COMPLETE (CBC), AUTOMATED ",,,117.32,117.32,2
CPT,80055,OBSTETRIC PROFILE,,,143.81,229.04,2
CPT,80061,HB LAB LIPID PANEL,16.52,10.73,13270.0,14761.0,2
CPT,80061,HB MISC LAB SPECIAL TEST,16.52,10.73,,,0
CPT,80061,"LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DIRECT MEASUREMENT, HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) (83718) TRIGLYCERIDES (84478)",16.52,10.73,33.29,33.29,2
CPT,80061,LIPID PROFILE,16.52,10.73,116.94,186.24,2
CPT,80061,Laboratory Services,16.52,10.73,100.75,100.76,2
CPT,80069,HB LAB RENAL FUNCTION PANEL,1449.45,942.14,13270.0,14761.0,2
CPT,80069,Laboratory Services,1449.45,942.14,65.34,65.35,2
CPT,80069,RENAL FUNCTION PANEL,1449.45,942.14,75.79,120.7,2
CPT,80069,RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM (82310) CARBON DIOXIDE (BICARBONATE) (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) PHOSPHORUS INORGANI,1449.45,942.14,21.63,21.63,2
CPT,80074,ACUTE HEPATITIS PANEL,2102.13,1366.38,353.18,562.48,2
CPT,80074,"ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY (86709) HEPATITIS B CORE ANTIBODY (HBCAB), IGM ANTIBODY (86705) HEPATITIS B SURFACE ANTIGEN (HBSA",2102.13,1366.38,117.32,117.32,2
CPT,80074,HB LAB ACUTE HEPATITIS PANEL,2102.13,1366.38,13270.0,14761.0,2
CPT,80074,Laboratory Services,2102.13,1366.38,358.23,358.26,2
CPT,80076,HB LAB HEPATIC FUNCTION PANEL,960.93,624.6,13270.0,14761.0,2
CPT,80076,HEPATIC FUNCTION PANEL,960.93,624.6,71.38,113.68,2
CPT,80076,"HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (82247) BILIRUBIN, DIRECT (82248) PHOSPHATASE, ALKALINE (84075) PROTEIN, TOTAL (84155) TRANSFERASE, ALANI",960.93,624.6,19.97,19.97,2
CPT,80076,Laboratory Services,960.93,624.6,61.44,61.45,2
CPT,80081,Laboratory Services,,,545.08,545.13,2
CPT,80081,Obstetric panel,,,924.08,1471.69,2
CPT,80081,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,183.88,183.88,2
CPT,80143,Acetaminophen,799.49,519.67,45.76,93.73,4
CPT,80143,HB ACETAMINOPHEN,799.49,519.67,13270.0,14761.0,2
CPT,80143,Laboratory Services,799.49,519.67,99.62,99.63,2
CPT,80145,Adalimumab,,,94.86,194.2,4
CPT,80145,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,80145,Laboratory Services,,,206.16,206.18,2
CPT,80150,AMIKACIN,369.9,240.44,37.44,209.65,4
CPT,80150,HB LAB AMIKACIN,369.9,240.44,13270.0,14761.0,2
CPT,80150,Laboratory Services,369.9,240.44,113.39,113.4,2
CPT,80151,Amiodarone,27.99,18.19,45.76,93.73,4
CPT,80151,HB AMIODARONE & METABOLITE,27.99,18.19,13270.0,14761.0,2
CPT,80151,Laboratory Services,27.99,18.19,99.62,99.63,2
CPT,80155,CAFFEINE,19.3,12.55,75.86,120.81,4
CPT,80155,Laboratory Services,19.3,12.55,103.2,103.21,2
CPT,80156,CARBAMAZEPINE,,,127.17,202.54,2
CPT,80156,CARBAMAZEPINE; TOTAL,,,35.77,35.77,2
CPT,80156,Laboratory Services,,,109.56,109.57,2
CPT,80157,CARBAMAZEPINE; FREE,33.78,21.96,32.45,138.21,4
CPT,80157,Laboratory Services,33.78,21.96,99.75,99.76,2
CPT,80158,CYCLOSPORINE,531.26,345.32,44.1,251.13,4
CPT,80158,"HB LAB CYCLOSPORINE, MONOCLONAL",531.26,345.32,13270.0,14761.0,2
CPT,80158,Laboratory Services,531.26,345.32,135.78,135.8,2
CPT,80159,CLOZAPINE,25.09,16.31,49.09,158.03,4
CPT,80159,HB LAB CLOZAPINE,25.09,16.31,,,0
CPT,80159,Laboratory Services,25.09,16.31,134.9,134.91,2
CPT,80161,"Carbamazepine; -10,11-epoxide",1090.49,708.82,45.76,93.73,4
CPT,80161,HB LAB CARBAMAZEPINE,1090.49,708.82,13270.0,14761.0,2
CPT,80161,Laboratory Services,1090.49,708.82,99.62,99.63,2
CPT,80162,DIGOXIN,1237.32,804.26,32.45,184.65,4
CPT,80162,HB DIGOXIN,1237.32,804.26,13270.0,14761.0,4
CPT,80162,Laboratory Services,1237.32,804.26,99.93,99.94,2
CPT,80163,Assay of digoxin free,,,88.84,141.49,2
CPT,80163,Digoxin; free,,,32.45,32.45,2
CPT,80163,Laboratory Services,,,96.6,96.61,2
CPT,80164,DIPROPYLACETIC ACID,728.8,473.72,118.3,188.4,2
CPT,80164,DIPROPYLACETIC ACID (VALPROIC ACID),728.8,473.72,33.29,33.29,2
CPT,80164,HB LAB VALPROIC ACID,728.8,473.72,13270.0,14761.0,2
CPT,80164,Laboratory Services,728.8,473.72,101.88,101.89,2
CPT,80165,Dipropylacetic acid free,,,90.72,144.48,2
CPT,80165,Laboratory Services,,,98.55,98.56,2
CPT,80165,Valproic acid (dipropylacetic acid); free,,,33.29,33.29,2
CPT,80167,Felbamate,24.13,15.68,45.76,93.73,4
CPT,80167,"HB FELBAMATE, SERUM",24.13,15.68,13270.0,14761.0,2
CPT,80167,Laboratory Services,24.13,15.68,99.62,99.63,2
CPT,80168,ETHOSUXIMIDE,16.5,10.72,39.94,39.94,2
CPT,80168,ETHOSUXIMIDI,16.5,10.72,142.7,227.26,2
CPT,80168,"HB ETHOSUXIMIDE, SERUM",16.5,10.72,,,0
CPT,80168,Laboratory Services,16.5,10.72,122.95,122.96,2
CPT,80169,EVEROLIMUS,299.08,194.4,34.12,117.22,4
CPT,80169,HB EVEROLIMUS,299.08,194.4,13270.0,14761.0,2
CPT,80169,Laboratory Services,299.08,194.4,100.12,100.13,2
CPT,80170,GENTAMICIN,1041.52,676.99,39.94,206.47,4
CPT,80170,HB LAB GENTAMICIN,1041.52,676.99,13270.0,14761.0,2
CPT,80170,Laboratory Services,1041.52,676.99,123.33,123.34,2
CPT,80171,GABAPENTIN,24.13,15.68,53.25,113.26,4
CPT,80171,HB GABAPENTIN,24.13,15.68,,,0
CPT,80171,Laboratory Services,24.13,15.68,96.73,96.74,2
CPT,80173,HALOPERIDOL,21.23,13.8,39.11,202.35,4
CPT,80173,Laboratory Services,21.23,13.8,109.56,109.57,2
CPT,80175,HB LAMOTRIGINE,9.17,5.96,13270.0,14761.0,2
CPT,80175,LAMOTRIGINE,9.17,5.96,32.45,113.26,4
CPT,80175,Laboratory Services,9.17,5.96,96.73,96.74,2
CPT,80176,HB MISC LAB SPECIAL TEST,18.58,12.08,13270.0,14761.0,6
CPT,80176,LIDOCAINE,18.58,12.08,35.77,204.22,4
CPT,80176,Laboratory Services,18.58,12.08,110.5,110.51,2
CPT,80177,HB LAB KEPPRA (CHROMATOGRAPHY),61.65,40.07,13270.0,14761.0,4
CPT,80177,LEVETIRACETAM,61.65,40.07,32.45,113.26,4
CPT,80177,Laboratory Services,61.65,40.07,96.73,96.74,2
CPT,80178,HB LAB LITHIUM,364.42,236.87,13270.0,14761.0,2
CPT,80178,LITHIUM,364.42,236.87,16.64,91.86,4
CPT,80178,Laboratory Services,364.42,236.87,49.75,49.75,2
CPT,80179,Laboratory Services,,,99.62,99.63,2
CPT,80179,Salicylate,,,45.76,93.73,4
CPT,80180,HB LAB MYCOPHENOLIC ACID,14.62,9.5,13270.0,14761.0,4
CPT,80180,Laboratory Services,14.62,9.5,131.69,131.71,2
CPT,80180,MYCOPHENOLATE,14.62,9.5,44.1,44.1,2
CPT,80180,MYCOPHENOLATE (MYCOPHENOLIC ACID),14.62,9.5,96.86,154.25,2
CPT,80181,Flecainide,17.16,11.15,45.76,93.73,4
CPT,80181,"HB FLECAINIDE, SERUM",17.16,11.15,13270.0,14761.0,2
CPT,80181,Laboratory Services,17.16,11.15,99.62,99.63,2
CPT,80183,HB OXCARBAZEPINE METABOLITE,35.71,23.21,13270.0,14761.0,4
CPT,80183,Laboratory Services,35.71,23.21,96.73,96.74,2
CPT,80183,OXCARBAZEPINE,35.71,23.21,32.45,113.26,4
CPT,80184,HB LAB PHENOB QN SE SC,783.08,509.0,13270.0,14761.0,2
CPT,80184,HB LAB PHENOBARBITAL,783.08,509.0,13270.0,14761.0,2
CPT,80184,Laboratory Services,783.08,509.0,81.82,81.83,2
CPT,80184,PHENOBARBITAL,783.08,509.0,37.44,37.44,2
CPT,80184,PHENOBARITAL,783.08,509.0,99.83,159.0,2
CPT,80185,HB LAB DILANTN QN SE SC,1441.34,936.87,13270.0,14761.0,4
CPT,80185,Laboratory Services,1441.34,936.87,99.75,99.76,2
CPT,80185,PHENYTOIN; TOTAL,1441.34,936.87,32.45,184.37,4
CPT,80186,HB LAB FRPN PHENYTOIN FREE,21.71,14.11,13270.0,14761.0,4
CPT,80186,Laboratory Services,21.71,14.11,103.52,103.53,2
CPT,80186,PHENYTOIN; FREE,21.71,14.11,34.12,194.95,4
CPT,80187,Laboratory Services,,,144.9,144.92,2
CPT,80187,Posaconazole,,,66.56,136.43,4
CPT,80188,HB LAB PRIMIDONE,7.93,5.15,13270.0,14761.0,2
CPT,80188,Laboratory Services,7.93,5.15,109.49,109.5,2
CPT,80188,PRIMIDONE,7.93,5.15,40.77,230.91,4
CPT,80189,Itraconazole,,,66.56,136.43,4
CPT,80189,Laboratory Services,,,144.9,144.92,2
CPT,80190,Laboratory Services,,,125.97,125.98,2
CPT,80190,PROCAINAMAIDE,,,145.81,232.22,2
CPT,80190,PROCAINAMIDE;,,,147.27,147.27,2
CPT,80192,Laboratory Services,17.37,11.29,125.97,125.98,2
CPT,80192,PROCAINAMAIDE; W/ METABOLITES,17.37,11.29,145.81,232.22,2
CPT,80192,"PROCAINAMIDE; WITH METABOLITES (E.G., N-ACETYL PROCAINAMIDE)",17.37,11.29,40.77,40.77,2
CPT,80193,Laboratory Services,,,206.16,206.18,2
CPT,80193,Leflunomide,,,94.86,194.2,4
CPT,80194,Laboratory Services,13.27,8.63,109.81,109.82,2
CPT,80194,QUINIDINE,13.27,8.63,35.77,203.01,4
CPT,80195,HB LAB SIROLIMUS,303.1,197.02,13270.0,14761.0,4
CPT,80195,Laboratory Services,303.1,197.02,103.27,103.28,2
CPT,80195,SIROLIMUS,303.1,197.02,34.12,34.12,2
CPT,80195,SIROLIMUS ï,303.1,197.02,117.24,186.71,2
CPT,80197,HB LAB FK506,335.02,217.76,13270.0,14761.0,2
CPT,80197,Laboratory Services,335.02,217.76,103.27,103.28,2
CPT,80197,TACROLIMUS,335.02,217.76,34.12,206.38,4
CPT,80198,HB THEOQ ASSAY OF THEOPHYLLINE,13.51,8.78,13270.0,14761.0,2
CPT,80198,Laboratory Services,13.51,8.78,106.41,106.42,2
CPT,80198,THEOPHYLLINE,13.51,8.78,34.94,196.82,4
CPT,80199,Laboratory Services,,,131.69,131.71,2
CPT,80199,TIAGABINE,,,66.56,154.25,4
CPT,80200,HB LAB TOBRAMYCIN,1041.52,676.99,13270.0,14761.0,2
CPT,80200,Laboratory Services,1041.52,676.99,121.25,121.27,2
CPT,80200,TOBRAMYCIN,1041.52,676.99,39.94,224.17,4
CPT,80201,HB TOPIRAMATE,33.78,21.96,,,0
CPT,80201,Laboratory Services,33.78,21.96,89.68,89.69,2
CPT,80201,TOPIRAMATE,33.78,21.96,29.12,206.0,4
CPT,80202,HB LAB VANCOMYCIN,1101.35,715.88,13270.0,14761.0,2
CPT,80202,Laboratory Services,1101.35,715.88,101.88,101.89,2
CPT,80202,VANCOMYCIN,1101.35,715.88,33.29,188.4,4
CPT,80203,HB ZONISAMIDE,47.77,31.05,13270.0,14761.0,2
CPT,80203,Laboratory Services,47.77,31.05,96.73,96.74,2
CPT,80203,ZONISAMIDE,47.77,31.05,32.45,113.26,4
CPT,80204,HB LAB METHOTREXATE,367.69,239.0,13270.0,14761.0,2
CPT,80204,HB MISC LAB SPECIAL TEST,367.69,239.0,13270.0,14761.0,2
CPT,80204,Laboratory Services,367.69,239.0,206.16,206.18,2
CPT,80204,Methotrexate,367.69,239.0,94.86,194.2,4
CPT,80210,Rufinamide,62.76,40.79,66.56,136.43,4
CPT,80220,Hydroxychloroquine,,,45.76,74.54,4
CPT,80220,Laboratory Services,,,99.62,99.63,2
CPT,80230,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80230,Infliximab,,,94.86,194.2,4
CPT,80230,Laboratory Services,,,206.16,206.18,2
CPT,80235,Laboratory Services,,,144.9,144.92,2
CPT,80235,Lacosamide,,,66.56,136.43,4
CPT,80280,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80280,Laboratory Services,,,206.16,206.18,2
CPT,80280,Vedolizumab,,,94.86,194.2,4
CPT,80285,Laboratory Services,53.0,34.45,144.9,144.92,2
CPT,80285,Voriconazole,53.0,34.45,66.56,136.43,4
CPT,80299,HB APIXABAN,61.08,39.7,13270.0,14761.0,2
CPT,80299,HB LAB SULFONAMIDES,61.08,39.7,13270.0,14761.0,2
CPT,80299,HB MISC LAB SPECIAL TEST,61.08,39.7,13270.0,14761.0,6
CPT,80299,Laboratory Services,61.08,39.7,99.62,99.63,2
CPT,80299,"QUANTITATION OF DRUG, NOT ELSEWHERE SPECIFIED",61.08,39.7,45.76,202.54,4
CPT,80305,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cart",,,30.79,30.79,2
CPT,80305,"Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay); capable of being read by direct optical observation only (e.g., dipsticks, cups, cards,",,,103.07,164.15,2
CPT,80305,Laboratory Services,,,80.0,80.01,2
CPT,80306,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); read by instrument assisted direct optical observation (eg, dipsticks, cups, cards, cartri",279.01,181.36,42.43,42.43,2
CPT,80306,"Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay); read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, c",279.01,181.36,137.4,218.83,2
CPT,80306,"HB DRUGS OF ABUSE SCREEN, 8 ASSAYS",279.01,181.36,13270.0,14761.0,2
CPT,80306,Laboratory Services,279.01,181.36,106.66,106.67,2
CPT,80307,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), c",3768.72,2449.67,152.26,152.26,2
CPT,80307,"Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg utilizing immunoassay, enzyme assay, [eg EIA, ELISA, EMIT, FPIA, IA K",3768.72,2449.67,549.62,875.32,2
CPT,80307,HB DRUG SCREEN CLASS LIST A,3768.72,2449.67,13270.0,14761.0,2
CPT,80307,"HB DRUG TEST, GEN TOXICOLOGY, URINE",72.38,47.05,,,0
CPT,80307,HB MISC LAB SPECIAL TEST,3768.72,2449.67,13270.0,14761.0,4
CPT,80307,Laboratory Services,3768.72,2449.67,426.65,426.7,2
CPT,80320,Alcohols,72.38,47.05,59.07,147.2,4
CPT,80320,"HB DRUG TEST, GEN TOXICOLOGY, URINE",51.405,33.415,13270.0,14761.0,4
CPT,80320,HB LAB ETHANOL QUAN ER,370.375,240.745,13270.0,14761.0,2
CPT,80320,HB MISC LAB SPECIAL TEST,72.38,47.05,,,0
CPT,80320,Laboratory Services,72.38,47.05,0.06,0.06,2
CPT,80321,Alcohol biomarkers; 1 or 2,76.59,49.78,92.43,147.2,2
CPT,80321,HB MISC LAB SPECIAL TEST,76.59,49.78,13270.0,14761.0,8
CPT,80321,"HB PHOSPHOETHANOL, BLD",30.43,19.78,,,0
CPT,80321,Laboratory Services,76.59,49.78,0.06,0.06,2
CPT,80322,Alcohol biomarkers; 3 or more,,,101.66,161.9,2
CPT,80322,Laboratory Services,,,0.06,0.06,2
CPT,80323,"Alkaloids, not otherwise specified",43.97,28.58,59.07,409.01,4
CPT,80323,HB MISC LAB SPECIAL TEST,43.97,28.58,,,0
CPT,80323,"HB NICOTINE/COT, SERUM",43.97,28.58,13270.0,14761.0,4
CPT,80323,Laboratory Services,43.97,28.58,0.06,0.06,2
CPT,80324,Amphetamines; 1 or 2,22.0,14.3,59.07,211.81,4
CPT,80324,HB URN AMPHETAMINE,22.0,14.3,13270.0,14761.0,4
CPT,80324,Laboratory Services,22.0,14.3,0.06,0.06,2
CPT,80325,Amphetamines; 3 or 4,13.0,8.45,146.22,232.88,2
CPT,80325,Laboratory Services,13.0,8.45,0.06,0.06,2
CPT,80326,Amphetamines; 5 or more,10.0,6.5,159.57,254.13,2
CPT,80326,HB MISC LAB SPECIAL TEST,10.0,6.5,,,0
CPT,80326,Laboratory Services,10.0,6.5,0.06,0.06,2
CPT,80327,Anabolic steroids; 1 or 2,46.93,30.5,59.07,351.7,4
CPT,80327,"HB DIHYDROTESTOSTERON,LCMSMS",38.68,25.14,,,0
CPT,80327,Laboratory Services,46.93,30.5,0.06,0.06,2
CPT,80328,Anabolic steroids; 3 or more,,,242.94,386.91,2
CPT,80328,Laboratory Services,,,0.06,0.06,2
CPT,80329,"Analgesics, non-opioid; 1 or 2",300.36,195.23,59.07,275.76,4
CPT,80329,HB LAB SALICYL QN SE SC,300.36,195.23,13270.0,14761.0,2
CPT,80329,Laboratory Services,300.36,195.23,0.06,0.06,2
CPT,80330,"Analgesics, non-opioid; 3-5",,,190.44,303.29,2
CPT,80330,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80330,Laboratory Services,,,0.06,0.06,2
CPT,80331,"Analgesics, non-opioid; 6 or more",,,207.78,330.91,2
CPT,80331,Laboratory Services,,,0.06,0.06,2
CPT,80332,"Antidepressants, serotonergic class; 1 or 2",,,59.07,243.83,4
CPT,80332,Laboratory Services,,,0.06,0.06,2
CPT,80333,"Antidepressants, serotonergic class; 3-5",,,168.45,268.27,2
CPT,80333,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80333,Laboratory Services,,,0.06,0.06,2
CPT,80334,"Antidepressants, serotonergic class; 6 or more",,,183.79,292.71,2
CPT,80334,Laboratory Services,,,0.06,0.06,2
CPT,80335,"Antidepressants, tricyclic and other cyclicals; 1 or 2",21.23,13.8,59.07,243.83,4
CPT,80335,HB ITRACONAZOLE AND METABOLITE,21.23,13.8,13270.0,14761.0,2
CPT,80335,Laboratory Services,21.23,13.8,0.06,0.06,2
CPT,80336,"Antidepressants, tricyclic and other cyclicals; 3-5",,,168.45,268.27,2
CPT,80336,Laboratory Services,,,0.06,0.06,2
CPT,80337,"Antidepressants, tricyclic and other cyclicals; 6 or more",34.91,22.69,183.79,292.71,2
CPT,80337,HB MISC LAB SPECIAL TEST,34.91,22.69,,,0
CPT,80337,Laboratory Services,34.91,22.69,0.06,0.06,2
CPT,80338,"Antidepressants, not otherwise specified",,,153.1,243.83,2
CPT,80338,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80338,Laboratory Services,,,0.06,0.06,2
CPT,80339,"Antiepileptics, not otherwise specified; 1-3",11.76,7.64,59.07,188.68,4
CPT,80339,HB MISC LAB SPECIAL TEST,11.76,7.64,13270.0,14761.0,2
CPT,80339,Laboratory Services,11.76,7.64,0.06,0.06,2
CPT,80340,"Antiepileptics, not otherwise specified; 4-6",,,130.35,207.59,2
CPT,80340,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80340,Laboratory Services,,,0.06,0.06,2
CPT,80341,"Antiepileptics, not otherwise specified; 7 or more",,,142.17,226.41,2
CPT,80341,Laboratory Services,,,0.06,0.06,2
CPT,80342,"Antipsychotics, not otherwise specified; 1-3",73.0,47.45,59.07,212.28,4
CPT,80342,Laboratory Services,73.0,47.45,0.06,0.06,2
CPT,80343,"Antipsychotics, not otherwise specified; 4-6",,,146.63,233.53,2
CPT,80343,Laboratory Services,,,0.06,0.06,2
CPT,80344,"Antipsychotics, not otherwise specified; 7 or more",,,159.92,254.69,2
CPT,80344,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80344,Laboratory Services,,,0.06,0.06,2
CPT,80345,Barbiturates,24.9,16.18,59.07,156.09,4
CPT,80345,HB MISC LAB SPECIAL TEST,24.9,16.18,,,0
CPT,80345,HB PENTOBARBITAL,24.9,16.18,13270.0,14761.0,2
CPT,80345,HB URN BARBITURATES,24.9,16.18,13270.0,14761.0,2
CPT,80345,Laboratory Services,24.9,16.18,0.06,0.06,2
CPT,80346,Benzodiazepines; 1-12,36.05,23.43,59.07,251.98,4
CPT,80346,HB LAB CLONAZEPAM,36.05,23.43,13270.0,14761.0,2
CPT,80346,HB MISC LAB SPECIAL TEST,36.05,23.43,,,0
CPT,80346,HB URN BENZODIAZEPINE,36.05,23.43,13270.0,14761.0,2
CPT,80346,Laboratory Services,36.05,23.43,0.06,0.06,2
CPT,80347,Benzodiazepines; 13 or more,10.0,6.5,174.03,277.17,2
CPT,80347,Laboratory Services,10.0,6.5,0.06,0.06,2
CPT,80348,Buprenorphine,,,167.68,267.05,2
CPT,80348,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80348,Laboratory Services,,,0.06,0.06,2
CPT,80349,"Cannabinoids, natural",20.0,13.0,59.07,322.67,4
CPT,80349,HB MISC LAB SPECIAL TEST,20.0,13.0,,,0
CPT,80349,HB URN CANNABINOID,25.215,16.39,13270.0,14761.0,4
CPT,80349,Laboratory Services,20.0,13.0,0.06,0.06,2
CPT,80350,"Cannabinoids, synthetic; 1-3",,,59.07,322.67,4
CPT,80350,Laboratory Services,,,0.06,0.06,2
CPT,80351,"Cannabinoids, synthetic; 4-6",,,222.89,354.98,2
CPT,80351,Laboratory Services,,,0.06,0.06,2
CPT,80352,"Cannabinoids, synthetic; 7 or more",,,301.03,479.42,2
CPT,80352,Laboratory Services,,,0.06,0.06,2
CPT,80353,Cocaine,32.54,21.15,59.07,206.56,4
CPT,80353,HB MISC LAB SPECIAL TEST,32.54,21.15,,,0
CPT,80353,HB URN COCAINE/METAB,32.54,21.15,13270.0,14761.0,4
CPT,80353,Laboratory Services,32.54,21.15,0.06,0.06,2
CPT,80354,Fentanyl,179.03,116.37,59.07,265.09,4
CPT,80354,HB MISC LAB SPECIAL TEST,179.03,116.37,,,0
CPT,80354,Laboratory Services,179.03,116.37,0.06,0.06,2
CPT,80355,"Gabapentin, non-blood",10.0,6.5,59.07,180.16,4
CPT,80355,HB MISC LAB SPECIAL TEST,10.0,6.5,,,0
CPT,80355,Laboratory Services,10.0,6.5,0.06,0.06,2
CPT,80356,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80356,Heroin metabolite,,,59.07,265.09,4
CPT,80356,Laboratory Services,,,0.06,0.06,2
CPT,80357,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80357,Ketamine and norketamine,,,59.07,189.71,4
CPT,80357,Laboratory Services,,,0.06,0.06,2
CPT,80358,HB MISC LAB SPECIAL TEST,23.31,15.15,,,0
CPT,80358,HB URN METHADONE,23.31,15.15,13270.0,14761.0,4
CPT,80358,Laboratory Services,23.31,15.15,0.06,0.06,2
CPT,80358,Methadone,23.31,15.15,59.07,222.58,4
CPT,80359,HB MISC LAB SPECIAL TEST,13.0,8.45,,,0
CPT,80359,HB URN AMPHETAMINE,13.0,8.45,13270.0,14761.0,4
CPT,80359,Laboratory Services,13.0,8.45,0.06,0.06,2
CPT,80359,"Methylenedioxyamphetamines (MDA, MDEA, MDMA)",13.0,8.45,59.07,211.81,4
CPT,80360,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80360,Laboratory Services,,,0.06,0.06,2
CPT,80360,Methylphenidate,,,59.07,211.81,4
CPT,80361,"HB FENTANYL AND NORFENTANYL,",63.21,41.08,13270.0,14761.0,2
CPT,80361,HB MISC LAB SPECIAL TEST,63.21,41.08,,,0
CPT,80361,HB URINE FENTANYL,63.21,41.08,13270.0,14761.0,2
CPT,80361,Laboratory Services,63.21,41.08,0.06,0.06,2
CPT,80361,"Opiates, 1 or more",63.21,41.08,59.07,265.09,4
CPT,80362,HB URINE OXYCODONE,64.66,42.03,13270.0,14761.0,4
CPT,80362,Laboratory Services,64.66,42.03,0.06,0.06,2
CPT,80362,Opioids and opiate analogs; 1 or 2,64.66,42.03,59.07,265.09,4
CPT,80363,Laboratory Services,,,0.06,0.06,2
CPT,80363,Opioids and opiate analogs; 3 or 4,,,183.03,291.49,2
CPT,80364,HB MISC LAB SPECIAL TEST,10.0,6.5,,,0
CPT,80364,Laboratory Services,10.0,6.5,0.06,0.06,2
CPT,80364,Opioids and opiate analogs; 5 or more,10.0,6.5,199.73,318.08,2
CPT,80365,HB MISC LAB SPECIAL TEST,12.5,8.13,,,0
CPT,80365,HB URN OPIATES,12.5,8.13,13270.0,14761.0,4
CPT,80365,Laboratory Services,12.5,8.13,0.06,0.06,2
CPT,80365,Oxycodone,12.5,8.13,59.07,265.09,4
CPT,80366,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80366,Laboratory Services,,,0.06,0.06,2
CPT,80366,Pregabalin,,,59.07,59.07,2
CPT,80367,HB MISC LAB SPECIAL TEST,52.81,34.33,,,0
CPT,80367,HB URN METHADONE,52.81,34.33,13270.0,14761.0,4
CPT,80367,Laboratory Services,52.81,34.33,0.06,0.06,2
CPT,80367,Pregabalin,52.81,34.33,166.45,265.09,2
CPT,80367,Propoxyphene,52.81,34.33,59.07,59.07,2
CPT,80368,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80368,Laboratory Services,,,0.06,0.06,2
CPT,80368,Propoxyphene,,,158.22,251.98,2
CPT,80368,Sedative hypnotics (non-benzodiazepines),,,59.07,59.07,2
CPT,80369,HB MISC LAB SPECIAL TEST,38.15,24.8,13270.0,14761.0,2
CPT,80369,Laboratory Services,38.15,24.8,0.06,0.06,2
CPT,80369,Sedative hypnotics (non-benzodiazepines),38.15,24.8,150.75,240.09,2
CPT,80369,Skeletal muscle relaxants; 1 or 2,38.15,24.8,59.07,59.07,2
CPT,80370,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80370,Laboratory Services,,,0.06,0.06,2
CPT,80370,Skeletal muscle relaxants; 1 or 2,,,165.8,264.06,2
CPT,80371,Laboratory Services,,,0.06,0.06,2
CPT,80371,Skeletal muscle relaxants; 3 or more,,,132.99,211.81,2
CPT,80371,"Stimulants, synthetic",,,59.07,59.07,2
CPT,80372,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80372,Laboratory Services,,,0.06,0.06,2
CPT,80372,"Stimulants, synthetic",,,173.15,275.76,2
CPT,80372,Tapentadol,,,59.07,59.07,2
CPT,80373,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80373,Laboratory Services,,,0.06,0.06,2
CPT,80373,Tapentadol,,,166.45,265.09,2
CPT,80373,Tramadol,,,59.07,59.07,2
CPT,80374,Laboratory Services,,,0.06,0.06,2
CPT,80374,"Stereoisomer (enantiomer) analysis, single drug class",,,59.07,59.07,2
CPT,80374,Tramadol,,,154.16,245.52,2
CPT,80375,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3",,,59.07,59.07,2
CPT,80375,Laboratory Services,,,0.06,0.06,2
CPT,80375,"Stereoisomer (enantiomer) analysis, single drug class",,,154.16,245.52,2
CPT,80376,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3",,,169.56,270.05,2
CPT,80376,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6",,,59.07,59.07,2
CPT,80376,Laboratory Services,,,0.06,0.06,2
CPT,80377,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6",,,185.03,294.68,2
CPT,80377,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more",,,59.07,59.07,2
CPT,80377,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,80377,Laboratory Services,,,0.06,0.06,2
CPT,80380,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,80400,ACTH STIMULATION PANEL; FOR ADRENAL INSUFFICIENCY,,,284.98,453.86,2
CPT,80400,ACTH STIMULATION PANEL; FOR ADRENAL INSUFFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 2),,,79.88,79.88,2
CPT,80400,Laboratory Services,,,245.4,245.43,2
CPT,80402,ACTH STIMULATION PANEL; FOR 21 HYDROXYASE,,,644.69,1026.73,2
CPT,80402,ACTH STIMULATION PANEL; FOR 21 HYDROXYLASE DEFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 2) 17 HYDROXYPROGESTERONE (83498 X 2),,,213.83,213.83,2
CPT,80402,Laboratory Services,,,654.13,654.2,2
CPT,80406,ACTH STIMULATION PANEL; FOR 3 BETA-HYDROXYDEHYDROGENASE DEFICIENCY,,,580.37,924.29,2
CPT,80406,ACTH STIMULATION PANEL; FOR 3 BETA-HYDROXYDEHYDROGENASE DEFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 2) 17 HYDROXYPREGNENOLONE (84143 X 2),,,192.2,192.2,2
CPT,80406,Laboratory Services,,,588.79,588.85,2
CPT,80408,"ALDOSTERONE SUPPRESSION EVALUATION PANEL (E.G., SALINE INFUSION) THIS PANEL MUST INCLUDE THE FOLLOWING: ALDOSTERONE (82088 X 2) RENIN (84244 X 2)",154.94,100.71,307.86,307.86,2
CPT,80408,"ALDOSTERONE SUPPRESSION EVALUATION PANEL (EG, SALINE INFUSION)",154.94,100.71,930.55,1481.99,2
CPT,80408,Laboratory Services,154.94,100.71,944.06,944.15,2
CPT,80410,"CALCITONIN STIMULATION PANEL (E.G., CALCIUM, PENTAGASTRIN) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCITONIN (82308 X 3)",,,197.19,197.19,2
CPT,80410,CALCIUM-PENTAGASTRIN STIMULATION PANEL,,,794.26,1264.94,2
CPT,80410,Laboratory Services,,,604.45,604.51,2
CPT,80412,CORTICOTROPIC RELEASING HORMONE (CRH) STIMULATION PANEL,,,2443.99,3892.3,2
CPT,80412,CORTICOTROPIC RELEASING HORMONE (CRH) STIMULATION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 6) ADRENOCORTICOTROPIC HORMONE (ACTH) (82024 X 6),,,1968.61,1968.61,2
CPT,80412,Laboratory Services,,,2479.36,2479.6,2
CPT,80414,CHORIONIC GONADOTROPHIN STIMULATION PANEL; TESTOSTERONE RESPONSE,,,382.81,609.67,2
CPT,80414,CHORIONIC GONADOTROPIN STIMULATION PANEL; TESTOSTERONE RESPONSE THIS PANEL MUST INCLUDE THE FOLLOWING: TESTOSTERONE (84403 X 2 ON THREE POOLED BLOOD SAMPLES),,,126.47,126.47,2
CPT,80414,Laboratory Services,,,388.42,388.45,2
CPT,80415,CHORIONIC GONADOTROPHIN STIMULATION PANEL;ESTRADIOL RESPONSE,,,414.39,659.95,2
CPT,80415,CHORIONIC GONADOTROPIN STIMULATION PANEL; ESTRADIOL RESPONSE THIS PANEL MUST INCLUDE THE FOLLOWING: ESTRADIOL (82670 X 2 ON THREE POOLED BLOOD SAMPLES),,,137.29,137.29,2
CPT,80415,Laboratory Services,,,420.36,420.41,2
CPT,80416,Laboratory Services,,,992.74,992.84,2
CPT,80416,RENAL VEIN REIN STIMULATION PANEL,,,1115.34,1776.29,2
CPT,80416,"RENAL VEIN RENIN STIMULATION PANEL (E.G., CAPTOPRIL) THIS PANEL MUST INCLUDE THE FOLLOWING: RENIN (84244 X 6)",,,514.2,514.2,2
CPT,80417,Laboratory Services,,,330.93,330.97,2
CPT,80417,PERIPHERAL VEIN RENIN STIMULATION PANEL,,,371.76,592.07,2
CPT,80417,"PERIPHERAL VEIN RENIN STIMULATION PANEL (E.G., CAPTOPRIL) THIS PANEL MUST INCLUDE THE FOLLOWING: RENIN (84244 X 2)",,,108.17,108.17,2
CPT,80418,COMBINED RAPID ANTERIOR PITUITARY EVALUATION PANEL,,,4296.8,6843.09,2
CPT,80418,COMBINED RAPID ANTERIOR PITUITARY EVALUATION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ADRENOCORTICOTROPIC HORMONE (ACTH) (82024 X 4) LUTEINIZING HORMONE (LH) (83002 X 4) FOLLICLE STIMULATING HORMO,,,1422.79,1422.79,2
CPT,80418,Laboratory Services,,,4359.8,4360.24,2
CPT,80420,"DEXAMETHASONE SUPPRESSION PANEL, 48 HOUR THIS PANEL MUST INCLUDE THE FOLLOWING: FREE CORTISOL, URINE (82530 X 2) CORTISOL (82533 X 2) VOLUME MEASUREMENT FOR TIMED COLLECTION (81050 X 2)",,,397.71,397.71,2
CPT,80420,DEXAMETHASONE SUPPRESSION PANEL; 48 HOUR,,,537.86,856.59,2
CPT,80420,Laboratory Services,,,541.93,541.99,2
CPT,80422,GLUCAGON TOLERANCE PANEL; FOR INSULINOMA,,,341.72,544.22,2
CPT,80422,GLUCAGON TOLERANCE PANEL; FOR INSULINOMA THIS PANEL MUST INCLUDE THE FOLLOWING: GLUCOSE (82947 X 3) INSULIN (83525 X 3),,,113.16,113.16,2
CPT,80422,Laboratory Services,,,346.59,346.63,2
CPT,80424,GLUCAGON TOLERANCE PANEL; FOR PHEOCHROMOCYTOMA,,,374.47,596.37,2
CPT,80424,"GLUCAGON TOLERANCE PANEL; FOR PHEOCHROMOCYTOMA THIS PANEL MUST INCLUDE THE FOLLOWING: CATECHOLAMINES, FRACTIONATED (82384 X 2)",,,123.98,123.98,2
CPT,80424,Laboratory Services,,,379.86,379.9,2
CPT,80426,GONADOTROPIN RELEASING HORMONE STIMULATION PANEL,,,282.92,450.58,2
CPT,80426,GONADOTROPIN RELEASING HORMONE STIMULATION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: FOLLICLE STIMULATING HORMONE (FSH) (83001 X 4) LUTEINIZING HORMONE (LH) (83002 X 4),,,364.43,364.43,2
CPT,80426,Laboratory Services,,,1116.38,1116.49,2
CPT,80428,GROWTH HORMONE STIMMULATION PANEL,,,494.17,787.02,2
CPT,80428,"GROWTH HORMONE STIMULATION PANEL (E.G., ARGININE INFUSION, L-DOPA ADMINISTRATION) THIS PANEL MUST INCLUDE THE FOLLOWING: HUMAN GROWTH HORMONE (HGH) (83003 X 4)",,,163.92,163.92,2
CPT,80428,Laboratory Services,,,501.87,501.92,2
CPT,80430,GROWTH HORMONE SUPPRESSION PANEL,,,581.54,926.16,2
CPT,80430,GROWTH HORMONE SUPPRESSION PANEL (GLUCOSE ADMINISTRATION) THIS PANEL MUST INCLUDE THE FOLLOWING: GLUCOSE (82947 X 3) HUMAN GROWTH HORMONE (HGH) (83003 X 4),,,317.83,317.83,2
CPT,80430,Laboratory Services,,,590.36,590.42,2
CPT,80432,INSULIN-INDUCED C PEPTIDE SUPPRESSION PANEL,,,859.11,1368.22,2
CPT,80432,INSULIN-INDUCED C-PEPTIDE SUPPRESSION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: INSULIN (83525) C-PEPTIDE (84681 X 5) GLUCOSE (82947 X 5),,,406.87,406.87,2
CPT,80432,Laboratory Services,,,1016.19,1016.3,2
CPT,80434,INSULIN TOLERANCE PANEL; FOR ACTH INSUFFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 5) GLUCOSE (82947 X 5),,,699.75,699.75,2
CPT,80434,INSULIN TOLERANCE PANEL; FOR ACTH INSUFFICIENY,,,750.52,1195.28,2
CPT,80434,Laboratory Services,,,760.98,761.06,2
CPT,80435,INSULIN TOLERANCE PANEL; FOR GROWTH DEFICIENCY,,,763.28,1215.6,2
CPT,80435,INSULIN TOLERANCE PANEL; FOR GROWTH HORMONE DEFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: GLUCOSE (82947 X 5) HUMAN GROWTH HORMONE (HGH) (83003 X 5),,,252.94,252.94,2
CPT,80435,Laboratory Services,,,774.88,774.96,2
CPT,80436,Laboratory Services,,,685.89,685.96,2
CPT,80436,METYRAPONE PANEL,,,675.91,1076.45,2
CPT,80436,METYRAPONE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 2) 11 DEOXYCORTISOL (82634 X 2),,,223.82,223.82,2
CPT,80438,Laboratory Services,,,379.11,379.15,2
CPT,80438,THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; ONE HOUR,,,373.76,595.25,2
CPT,80438,THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; ONE HOUR THIS PANEL MUST INCLUDE THE FOLLOWING: THYROID STIMULATING HORMONE (TSH) (84443 X 3),,,123.98,123.98,2
CPT,80439,Laboratory Services,,,505.52,505.57,2
CPT,80439,THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; TWO HOUR THIS PANEL MUST INCLUDE THE FOLLOWING: THYROID STIMULATING HORMONE (TSH) (84443 X 4),,,164.74,164.74,2
CPT,80439,THYROTROPIN RELEASING HORMONE STIMULATION; TWO HOUR,,,498.29,793.57,2
CPT,80500,"CLINICAL PATHOLOGY CONSULTATION; LIMITED, WITHOUT REVIEW OF PATIENT'S HISTORY AND MEDICAL RECORDS",,,136.99,218.17,2
CPT,80502,"CLINICAL PATHOLOGY CONSULTATION; COMPREHENSIVE, FOR A COMPLEX DIAGNOSTIC PROBLEM, WITH REVIEW OF PATIENT'S HISTORY",,,327.14,521.0,2
CPT,80503,HB PROF PATH CONSULT 5 -20 MINS,,,66.53,14761.0,10
CPT,80503,Laboratory Services,,,129.62,129.63,2
CPT,80503,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making",,,102.36,163.02,2
CPT,80503,"Pathology clinical consultation; for a clinical problem, with limited review of patientSQUOTEs history and medical records and straightforward medical decision making When using time for code selectio",,,29.67,29.67,2
CPT,80504,HB PROF PATH CONSULT 21-40 MINS,,,213.38,14761.0,10
CPT,80504,Laboratory Services,,,276.91,276.94,2
CPT,80504,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making",,,203.49,324.08,2
CPT,80504,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patientSQUOTEs history and medical records and moderate level of medical decision making When using time for ",,,63.9,63.9,2
CPT,80505,HB PROF PATH CONSULT 41-60 MINS,,,213.38,14761.0,10
CPT,80505,Laboratory Services,,,521.62,521.67,2
CPT,80505,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making",,,367.12,584.67,2
CPT,80505,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patientSQUOTEs history and medical records and high level of medical decision making When using tim",,,121.4,121.4,2
CPT,80506,Laboratory Services,,,249.8,249.83,2
CPT,80506,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure)",,,57.95,261.81,4
CPT,81000,Laboratory Services,4.02,2.61,23.77,23.78,2
CPT,81000,"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATE",4.02,2.61,9.99,9.99,2
CPT,81000,"URINALYSIS, BY REAGENT STRIPS, ANY NUMBER OF COMPONENTS;WITHMICROSCOPY",4.02,2.61,27.57,43.92,2
CPT,81001,HB LAB URINALYSIS W/ MICROSCOPY,443.47,288.26,13270.0,14761.0,2
CPT,81001,Laboratory Services,443.47,288.26,23.77,23.78,2
CPT,81001,URINALYSIS BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN GLUCOSE ETC; AUTOMATED WITH MICROSCOPY,443.47,288.26,26.69,42.51,2
CPT,81001,"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, W",443.47,288.26,7.49,7.49,2
CPT,81002,HB LAB URINALYSIS,185.32,120.45,13270.0,14761.0,2
CPT,81002,Laboratory Services,185.32,120.45,19.24,19.25,2
CPT,81002,"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATE",185.32,120.45,8.32,8.32,2
CPT,81002,"URINALYSIS, BY REAGENT STRIPS, ANY NUMBER OF COMPONENTS; WITHOUT MICROSCOPY",185.32,120.45,20.75,33.05,2
CPT,81003,HB LAB SPECIFIC GRAV UR,369.88,240.42,13270.0,14761.0,2
CPT,81003,Laboratory Services,369.88,240.42,16.92,16.92,2
CPT,81003,"URINALYSIS, BY DIP SICK OR TABLET REAGENT FOR BILIRUBIN,ETC W/O MICROSCOPY, AUTOMATED",369.88,240.42,19.64,31.27,2
CPT,81003,"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, W",369.88,240.42,5.82,5.82,2
CPT,81005,Laboratory Services,,,16.29,16.29,2
CPT,81005,"URINALYSIS; CHEMICAL, QUALITATIVE, ANY NUMBER OF CONSTITUENTS",,,18.87,30.06,2
CPT,81005,"URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPT IMMUNOASSAYS",,,4.99,4.99,2
CPT,81007,Laboratory Services,,,19.31,19.31,2
CPT,81007,"URINALYSIS; BACTERIURIA SCREEN, EXCEPT BY CULTURE OR DIPSTICK",,,73.22,73.22,2
CPT,81007,"URINALYSIS;BACTERIURIA SCREEN,EXCEPT BY CULTURE OR DIPSTICK BY NON-CULTURE TECHNIQUE, COMMERCIAL KIT (SPECIFY TYPE)",,,22.4,35.68,2
CPT,81015,Laboratory Services,,,22.89,22.89,2
CPT,81015,URINALYSIS; MICROSCOPIC ONLY,,,7.49,42.23,4
CPT,81020,Laboratory Services,,,27.73,27.74,2
CPT,81020,URINALYSIS; TWO OR THREE GLASS TEST,,,11.64,51.31,4
CPT,81025,HB LAB PREGNANCY TEST URINE,728.8,473.72,13270.0,14761.0,2
CPT,81025,HB LAB URINE PREGNANCY TEST,728.8,473.72,13270.0,14761.0,2
CPT,81025,Laboratory Services,728.8,473.72,17.67,17.67,2
CPT,81025,"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS",728.8,473.72,20.8,70.98,4
CPT,81050,Laboratory Services,,,22.58,22.58,2
CPT,81050,"VOLUME MEASUREMENT FOR TIMED COLLECTION, EACH",,,9.15,35.39,4
CPT,81099,Unlisted urinalysis procedure,,,47.64,47.64,2
CPT,81105,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81105,Hpa-1 genotyping,,,1092.94,1740.62,2
CPT,81105,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), g",,,300.37,300.37,2
CPT,81105,Laboratory Services,,,806.64,806.72,2
CPT,81106,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81106,Hpa-2 genotyping,,,1092.94,1740.62,2
CPT,81106,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, c",,,300.37,300.37,2
CPT,81106,Laboratory Services,,,806.64,806.72,2
CPT,81107,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81107,Hpa-3 genotyping,,,1092.94,1740.62,2
CPT,81107,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-tr",,,300.37,300.37,2
CPT,81107,Laboratory Services,,,806.64,806.72,2
CPT,81108,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81108,Hpa-4 genotyping,,,1092.94,1740.62,2
CPT,81108,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), g",,,300.37,300.37,2
CPT,81108,Laboratory Services,,,806.64,806.72,2
CPT,81109,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81109,Hpa-5 genotyping,,,1092.94,1740.62,2
CPT,81109,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), ge",,,300.37,300.37,2
CPT,81109,Laboratory Services,,,806.64,806.72,2
CPT,81110,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81110,Hpa-6 genotyping,,,1092.94,1740.62,2
CPT,81110,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), ",,,300.37,300.37,2
CPT,81110,Laboratory Services,,,806.64,806.72,2
CPT,81111,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81111,Hpa-9 genotyping,,,1092.94,1740.62,2
CPT,81111,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-t",,,300.37,300.37,2
CPT,81111,Laboratory Services,,,806.64,806.72,2
CPT,81112,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81112,Hpa-15 genotyping,,,1092.94,1740.62,2
CPT,81112,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y)",,,300.37,300.37,2
CPT,81112,Laboratory Services,,,806.64,806.72,2
CPT,81120,"IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (eg, glioma), common variants (eg, R132H, R132C)",,,474.26,474.26,2
CPT,81120,Idh1 common variants,,,1399.79,2229.31,2
CPT,81120,Laboratory Services,,,1033.05,1033.15,2
CPT,81121,"IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (eg, glioma), common variants (eg, R140W, R172M)",,,726.37,726.37,2
CPT,81121,Idh2 common variants,,,2142.61,3412.32,2
CPT,81121,Laboratory Services,,,1581.21,1581.37,2
CPT,81161,"DMD (DYSTROPHIN) (EG DUCHENNE/BECKER MUSCULAR DUSTROPHY) DELETION ANALYSIS, AND DUPLICATION ANALYSIS, IF PERFORMED",,,1571.24,2502.36,2
CPT,81161,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed",,,684.76,684.76,2
CPT,81161,Laboratory Services,,,5188.51,5189.04,2
CPT,81162,"BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis",1763.54,1146.3,4480.53,4480.53,2
CPT,81162,Brca1&2 seq & full dup/del,1763.54,1146.3,22527.54,35877.39,2
CPT,81162,"HB BRCA,GENE ANALYSIS COMP",1763.54,1146.3,13270.0,14761.0,2
CPT,81162,HB MISC LAB SPECIAL TEST,1763.54,1146.3,13270.0,14761.0,2
CPT,81162,Laboratory Services,1763.54,1146.3,13288.76,13290.09,2
CPT,81163,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis",,,1149.05,4132.11,4
CPT,81163,Laboratory Services,,,2501.81,2502.06,2
CPT,81164,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,1434.44,5158.37,4
CPT,81164,Laboratory Services,,,3123.17,3123.48,2
CPT,81165,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis",,,694.75,2497.77,4
CPT,81165,Laboratory Services,,,1512.22,1512.37,2
CPT,81166,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)",,,739.68,2660.7,4
CPT,81166,Laboratory Services,,,1610.96,1611.12,2
CPT,81167,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)",,,694.75,2497.77,4
CPT,81167,Laboratory Services,,,1512.22,1512.37,2
CPT,81168,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed",,,509.2,1043.58,4
CPT,81170,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain",,,736.36,736.36,2
CPT,81170,Abl1 gene,,,2986.08,4755.64,2
CPT,81170,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81170,Laboratory Services,,,1761.45,1761.63,2
CPT,81171,"AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles",,,336.14,1209.7,4
CPT,81171,Laboratory Services,,,732.37,732.44,2
CPT,81172,"AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status)",,,674.79,2426.51,4
CPT,81172,Laboratory Services,,,1469.2,1469.35,2
CPT,81173,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence",,,739.68,2660.7,4
CPT,81173,Laboratory Services,,,1610.96,1611.12,2
CPT,81174,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant",,,455.13,1635.18,4
CPT,81174,Laboratory Services,,,990.03,990.13,2
CPT,81175,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence",,,1660.75,1660.75,2
CPT,81175,Asxl1 full gene sequence,,,5121.34,8156.25,2
CPT,81175,Laboratory Services,,,3779.57,3779.95,2
CPT,81176,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,594.07,594.07,2
CPT,81176,Asxl1 gene target seq alys,,,2163.24,3445.19,2
CPT,81176,Laboratory Services,,,1596.43,1596.59,2
CPT,81177,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81177,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81178,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81178,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81179,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81179,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81180,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81180,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81181,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81181,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81182,"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81182,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81183,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81183,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81184,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81184,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81185,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence",144.23,93.75,2077.6,7471.95,4
CPT,81185,Laboratory Services,144.23,93.75,4523.94,4524.4,2
CPT,81186,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant",,,455.13,1635.18,4
CPT,81186,Laboratory Services,,,990.03,990.13,2
CPT,81187,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",,,336.14,1209.7,4
CPT,81187,Laboratory Services,,,732.37,732.44,2
CPT,81188,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles",,,336.14,1209.7,4
CPT,81188,Laboratory Services,,,732.37,732.44,2
CPT,81189,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence",,,674.79,2426.51,4
CPT,81189,Laboratory Services,,,1469.2,1469.35,2
CPT,81190,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s)",,,455.13,1635.18,4
CPT,81190,Laboratory Services,,,990.03,990.13,2
CPT,81191,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis",,,509.2,1043.58,4
CPT,81192,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis",,,509.2,1043.58,4
CPT,81193,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis",,,509.2,1043.58,4
CPT,81194,"NTRK (neurotrophic-tropomyosin receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis",,,1272.19,2608.91,4
CPT,81200,"ASPA (ASPARTOACYLASE) (EG, CANAVAN DISEASE) GENE ANALYSIS, COMMON VARIANTS (EG, E285A, Y231X)",137.51,89.38,933.57,1486.81,2
CPT,81200,HB LAB MP ASPA GENE ANALYSIS,137.51,89.38,13270.0,14761.0,2
CPT,81200,HB MISC LAB SPECIAL TEST,137.51,89.38,,,0
CPT,81200,Laboratory Services,137.51,89.38,946.64,946.73,2
CPT,81200,aspartoacylase,137.51,89.38,115.65,115.65,2
CPT,81201,"APC (ADENOMATOUS POLYPOSIS COLI) (EG, FAMILIAL ADENOMATOSIS POLYPOSIS ?FAP¿, GENE ANALYSIS; FULL GENE SEQUENCE",,,212.49,338.4,2
CPT,81201,Laboratory Services,,,6011.95,6012.55,2
CPT,81201,adenomatous polyposis,,,1915.36,1915.36,2
CPT,81202,"APC (ADENOMATOUS POLYPOSIS COLI) (EG, FAMILIAL ADENOMATOSIS POLYPOSIS ?FAP¿, GENE ANALYSIS; KNOWN FAMILIAL VARRIANTS",,,116.83,186.06,2
CPT,81202,Laboratory Services,,,443.13,443.18,2
CPT,81202,adenomatous polyposis coli,,,687.26,687.26,2
CPT,81203,"APC (ADENOMATOUS POLYPOSIS COLI) (EG, FAMILIAL ADENOMATOSIS POLYPOSIS ?FAP¿, GENE ANALYSIS; DUPLICATION/DELETION VARIANT",,,121.41,193.36,2
CPT,81203,Laboratory Services,,,2693.06,2693.33,2
CPT,81203,adenomatous polyposis coli,,,490.9,490.9,2
CPT,81204,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)",,,336.14,1209.7,4
CPT,81204,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81204,Laboratory Services,,,732.37,732.44,2
CPT,81205,"BCKDHB (BRANCHED-CHAIN KETO ACID DEHYDROGENASE E1, BETA POLYPEPTIDE)GENE ANALYSIS, COMMON VARIANTS (EG, R183P, G278S,E4)",192.25,124.96,880.51,1402.31,2
CPT,81205,Laboratory Services,192.25,124.96,866.26,866.35,2
CPT,81205,beta polypeptide,192.25,124.96,232.98,232.98,2
CPT,81206,"CR/ABL1 (T(9;22))(EG, CHRONIC MYELOGENOUS LEUKEMIA) TRANSLO CATION ANALYSIS;MAJOR BREAKPOINT, QUALITATIVE OR QUANTITATI",2751.44,1788.44,360.22,573.69,2
CPT,81206,HB LAB MP BCR/ABL1 T922 MAJOR,2751.44,1788.44,13270.0,14761.0,2
CPT,81206,Laboratory Services,2751.44,1788.44,611.99,612.05,2
CPT,81206,myelogenous leukemia,2751.44,1788.44,402.7,402.7,2
CPT,81207,"BCR/ABL1 (T(9;22)) (EG, CHRONIC MYELOGENOUS LEUKEMIA) TRANSLOCATION ANALYSIS; MINOR BREAKPOINT, QUALITATIVE",2751.46,1788.45,360.22,573.69,2
CPT,81207,HB LAB MP BCR/ABL1 T922 MINOR,2751.46,1788.45,13270.0,14761.0,2
CPT,81207,Laboratory Services,2751.46,1788.45,544.51,544.57,2
CPT,81207,myelogenous leukemia,2751.46,1788.45,355.29,355.29,2
CPT,81208,"BCR/ABL1 (T(9;22)) (EG, CHRONIC MYELOGENOUS LEUKEMIA) TRANSLOCATION ANALYSIS; OTHER BREAKPOINT, QUALITATIVE",,,1043.75,1662.27,2
CPT,81208,Laboratory Services,,,544.51,544.57,2
CPT,81208,myelogenous leukemia,,,526.68,526.68,2
CPT,81209,"Bloom syndrome, RecQ helicase",76.93,50.0,96.51,96.51,2
CPT,81209,HB LAB MP BLM GENE ANALYSIS,76.93,50.0,13270.0,14761.0,2
CPT,81209,HB MISC LAB SPECIAL TEST,76.93,50.0,,,0
CPT,81209,"LM (BLOOM SYNDROME, RECQ HELICASE-LIKE) (EG, BLOOM SYNDROME) GENE ANALYSIS, 2281DEL6INS7 VARIANT",76.93,50.0,359.37,572.34,2
CPT,81209,Laboratory Services,76.93,50.0,418.16,418.2,2
CPT,81210,"BRAF (V-RAF MURINE SARCOMA VIRAL ONCOGENE HOMOLOG B1) (EG, COLON CANCER), GENE ANALYSIS, V600E VARIANT",,,432.98,689.56,2
CPT,81210,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81210,Laboratory Services,,,471.68,471.73,2
CPT,81210,oncogene homolog B1,,,431.0,431.0,2
CPT,81212,"BRCA1, BRCA2 (BREAST CANCER 1 AND 2) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; 185DELAG, 5385INSC, 6174D",,,3425.76,5455.88,2
CPT,81212,Laboratory Services,,,944.62,944.72,2
CPT,81212,gene analysis,,,1079.99,1079.99,2
CPT,81215,"BRCA1 (BREAST CANCER 1) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; KNOWN FAMILIAL VARIANT",,,2830.01,4507.07,2
CPT,81215,Laboratory Services,,,498.41,498.46,2
CPT,81215,gene analysis,,,921.07,921.07,2
CPT,81216,"BRCA2 (BREAST CANCER 2) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; FULL SEQUENCE ANALYSIS",,,12451.99,19831.06,2
CPT,81216,Laboratory Services,,,6592.43,6593.09,2
CPT,81216,gene analysis,,,454.3,454.3,2
CPT,81217,"BRCA2 (BREAST CANCER 2) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; KNOWN FAMILIAL VARIANT",,,2830.01,4507.07,2
CPT,81217,Laboratory Services,,,498.41,498.46,2
CPT,81217,gene analysis,,,921.07,921.07,2
CPT,81218,"CEBPA (CCAAT/enhancer binding protein [C/EBP], alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence",280.82,182.53,594.07,594.07,2
CPT,81218,Cebpa gene full sequence,280.82,182.53,2291.77,3649.88,2
CPT,81218,Laboratory Services,280.82,182.53,1761.45,1761.63,2
CPT,81219,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9",250.0,162.5,298.7,298.7,2
CPT,81219,Calr gene com variants,250.0,162.5,1152.32,1835.19,2
CPT,81219,HB MISC LAB SPECIAL TEST,250.0,162.5,,,0
CPT,81219,Laboratory Services,250.0,162.5,885.7,885.78,2
CPT,81220,"CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR)( EG, CYSTIC FIBROSIS) GENE ANALYSIS; COMMON VARIANTS(EG, ACM)",9775.24,6353.91,3780.96,6021.56,2
CPT,81220,HB LAB MP CTFR GEN ANAL COMMON,9775.24,6353.91,13270.0,14761.0,2
CPT,81220,HB MISC LAB SPECIAL TEST,9775.24,6353.91,,,0
CPT,81220,Laboratory Services,9775.24,6353.91,5134.81,5135.32,2
CPT,81220,gene analysis,9775.24,6353.91,1367.04,1367.04,2
CPT,81221,"CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR) (EG, CYSTIC FIBROSIS) GENE ANALYSIS; KNOWN FAMILIAL VARIANTS",,,570.13,907.99,2
CPT,81221,Laboratory Services,,,523.88,523.94,2
CPT,81221,gene analysis,,,238.8,238.8,2
CPT,81222,"CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR)( EG,CYSTIC FIBROSIS) GENE ANALYSIS; DUPLICATION/DELETION VAR",,,639.16,1017.93,2
CPT,81222,Laboratory Services,,,3538.69,3539.05,2
CPT,81222,gene analysis,,,1068.33,1068.33,2
CPT,81223,"CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR) (EG, CYSTIC FIBROSIS) GENE ANALYSIS; FULL GENE SEQUENCE",950.0,617.5,6840.58,10894.31,2
CPT,81223,HB MISC LAB SPECIAL TEST,950.0,617.5,13270.0,14761.0,4
CPT,81223,Laboratory Services,950.0,617.5,6946.38,6947.08,2
CPT,81223,gene analysis,950.0,617.5,1225.6,1225.6,2
CPT,81224,"CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR) (EG, CYSTIC FIBROSIS) GENE ANALYSIS; INTRON 8 POLY-T ANALYSIS",,,442.74,705.11,2
CPT,81224,Laboratory Services,,,367.66,367.7,2
CPT,81224,gene analysis,,,414.36,414.36,2
CPT,81225,"CYP2C19 (CYTOCHROME P450, FAMILY 2, SUBFAMILY C, POLYPEPTIDE 19)(EG, DRUG METABOLISM), GENE ANALYSIS, COMMON VARIANTS",168.88,109.77,964.95,1536.79,2
CPT,81225,Laboratory Services,168.88,109.77,840.98,841.06,2
CPT,81225,gene analysis,168.88,109.77,715.55,715.55,2
CPT,81226,"CYP2D6 (CYTOCHROME P450, FAMILY 2, SUBFAMILY D, POLYPEPTIDE 6) (EG, DRUG METABOLISM) GENE ANALYSIS, COMMON VARIANTS",199.76,129.84,1338.89,2132.32,2
CPT,81226,HB LAB CYP2D6 GENE COM VAR,199.76,129.84,,,0
CPT,81226,Laboratory Services,199.76,129.84,1289.08,1289.21,2
CPT,81226,gene analysis,199.76,129.84,1107.44,1107.44,2
CPT,81227,"CYP2C9 (CYTOCHROME P450, FAMILY 2, SUBFAMILY C, POLYPEPTIDE 9) (EG, DRUG METABOLISM), GENE ANALYSIS, COMMON VARIANTS",205.06,133.29,484.9,772.26,2
CPT,81227,HB VKORC1 GENOTYPING,205.06,133.29,13270.0,14761.0,2
CPT,81227,Laboratory Services,205.06,133.29,971.98,972.08,2
CPT,81227,gene analysis,205.06,133.29,429.33,429.33,2
CPT,81228,CYTOGENOMIC CONSTITUTIONAL (GENOME-WIDE) MICROARRAY ANALYSISINTERROGATION OF GENOMIC REGIONS FOR COPY NUMBER VARIANTS,,,2421.98,3857.25,2
CPT,81228,Cytogenomic constitutional,,,2209.89,2209.89,2
CPT,81228,Laboratory Services,,,1924.47,1924.66,2
CPT,81229,CYTOGENOMIC CONSTITUTIONAL (GENOME-WIDE) MICROARRAY ANALYSIS;INTERROGATION OF GENOMIC REGIONS FOR COPY NUMBER AND SINGLE,1325.75,861.74,105.15,167.47,2
CPT,81229,Cytogenomic constitutional,1325.75,861.74,2848.07,2848.07,2
CPT,81229,HB CHROM MA CONSTITUTIONAL,1325.75,861.74,13270.0,14761.0,2
CPT,81229,HB MISC LAB SPECIAL TEST,1325.75,861.74,,,0
CPT,81229,Laboratory Services,1325.75,861.74,1924.47,1924.66,2
CPT,81230,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22)",,,429.33,429.33,2
CPT,81230,Cyp3a4 gene common variants,,,1165.38,1855.98,2
CPT,81230,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81230,Laboratory Services,,,934.5,934.59,2
CPT,81231,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7)",,,429.33,429.33,2
CPT,81231,Cyp3a5 gene common variants,,,1165.38,1855.98,2
CPT,81231,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81231,Laboratory Services,,,934.5,934.59,2
CPT,81232,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6)",,,429.33,429.33,2
CPT,81232,Dpyd gene common variants,,,1165.38,1855.98,2
CPT,81232,Laboratory Services,,,934.5,934.59,2
CPT,81233,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F)",,,431.0,1548.66,4
CPT,81233,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81233,Laboratory Services,,,937.64,937.74,2
CPT,81234,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles",,,336.14,1209.7,4
CPT,81234,Laboratory Services,,,732.37,732.44,2
CPT,81235,"EGFR (GAP JUNCTION PROTEIN, BETA FACTOR RECEPTOR) (E.G. NON-SMALL CELL LUNG CANCER) GENE ANALYSIS, COMMON VARIANTS (E.G.",,,77.37,123.23,2
CPT,81235,Laboratory Services,,,1863.15,1863.34,2
CPT,81235,gene analysis,,,797.1,797.1,2
CPT,81236,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence",,,694.75,2497.77,4
CPT,81236,Laboratory Services,,,1512.22,1512.37,2
CPT,81237,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)",,,431.0,1548.66,4
CPT,81237,Laboratory Services,,,937.64,937.74,2
CPT,81238,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence",,,1473.54,1473.54,2
CPT,81238,F9 full gene sequence,,,3999.94,6370.31,2
CPT,81238,Laboratory Services,,,3207.45,3207.77,2
CPT,81239,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size)",,,674.79,2426.51,4
CPT,81239,Laboratory Services,,,1469.2,1469.35,2
CPT,81240,"F2 (PROTHROMBIN, COAGULATION FACTOR II) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, 20210G>A VARIANT",1303.56,847.31,282.22,449.46,2
CPT,81240,HB LAB MP F2 GENE ANALYSIS,1303.56,847.31,13270.0,14761.0,2
CPT,81240,Laboratory Services,1303.56,847.31,318.1,318.14,2
CPT,81240,gene analysis,1303.56,847.31,161.42,161.42,2
CPT,81241,"F5 (COAGULATION FACTOR V) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, LEIDEN VARIANT",1466.73,953.37,359.37,572.34,2
CPT,81241,HB LAB AJWQ F5 GENE,1466.73,953.37,13270.0,14761.0,2
CPT,81241,HB LAB MP F5 GENE ANALYSIS,1466.73,953.37,13270.0,14761.0,2
CPT,81241,Laboratory Services,1466.73,953.37,285.02,285.05,2
CPT,81241,gene analysis,1466.73,953.37,180.55,180.55,2
CPT,81242,"FANCC (FANCONI ANEMIA, COMPLEMENTATION GROUP C) (EG, FANCONI ANEMIA, TYPE C) GENE ANALYSIS, COMMON VARIANT (EG,IVS4+4A>)",96.11,62.47,431.34,686.95,2
CPT,81242,HB LAB MP FANCC GENE ANALYSIS,96.11,62.47,13270.0,14761.0,2
CPT,81242,HB MISC LAB SPECIAL TEST,96.11,62.47,,,0
CPT,81242,Laboratory Services,96.11,62.47,523.88,523.94,2
CPT,81242,gene analysis,96.11,62.47,89.86,89.86,2
CPT,81243,"FMR1 (FRAGILE X MENTAL RETARDATION 1) (EG, FRAGILE X MENTAL RETARDATION) GENE ANALYSIS; EVALUATION TO DETECT ABNORMAL",228.0,148.2,436.48,695.13,2
CPT,81243,HB LAB MP FMR1 GEN ANAL EVAL,228.0,148.2,13270.0,14761.0,2
CPT,81243,HB MISC LAB SPECIAL TEST,228.0,148.2,,,0
CPT,81243,Laboratory Services,228.0,148.2,553.94,554.0,2
CPT,81243,gene analysis,228.0,148.2,139.79,139.79,2
CPT,81244,"FMR1 (FRAGILE X MENTAL RETARDATION 1)(EG, FRAGILE X MENTAL RETARDATION)GENE ANALYSIS;CHARACTERIZATION OF ALLELES",,,175.31,279.2,2
CPT,81244,Laboratory Services,,,176.85,176.87,2
CPT,81244,gene analysis,,,109.83,109.83,2
CPT,81245,"FLT3 (FMS-RELATED TYROSINE KINASE 3) (EG, ACUTE MYELOID LEU KEMIA),GENE ANALYSIS INTERNAL TANDEM DUPLICATION (ITD)",166.67,108.34,558.84,890.02,2
CPT,81245,HB MISC LAB SPECIAL TEST,166.67,108.34,13270.0,14761.0,8
CPT,81245,Laboratory Services,166.67,108.34,498.6,498.65,2
CPT,81245,gene analysis,166.67,108.34,406.04,406.04,2
CPT,81246,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836)",108.55,70.56,203.85,203.85,2
CPT,81246,Flt3 gene analysis,108.55,70.56,1037.97,1653.07,2
CPT,81246,Laboratory Services,108.55,70.56,678.28,678.35,2
CPT,81247,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-)",,,429.33,429.33,2
CPT,81247,G6pd gene alys cmn variant,,,1165.38,1855.98,2
CPT,81247,Laboratory Services,,,934.5,934.59,2
CPT,81248,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s)",,,921.07,921.07,2
CPT,81248,G6pd known familial variant,,,2501.61,3984.07,2
CPT,81248,Laboratory Services,,,2005.97,2006.18,2
CPT,81249,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence",,,1473.54,1473.54,2
CPT,81249,G6pd full gene sequence,,,3999.94,6370.31,2
CPT,81249,Laboratory Services,,,3207.45,3207.77,2
CPT,81250,"G6PC(GLUCOSE-6-PHOSPHATASE, CATALYTIC SUBUNIT)(EG, GLYCOGE N STORAGE DISEASE, TYPE 1A VON GIERKE DISEASE)GENE ANALYSIS",176.33,114.61,534.35,851.0,2
CPT,81250,Laboratory Services,176.33,114.61,654.88,654.95,2
CPT,81250,gene analysis,176.33,114.61,143.94,143.94,2
CPT,81251,"GBA (GLUCOSIDASE, BETA, ACID) (EG, GAUCHER DISEASE) GENE ANALYSIS, COMMON VARIANTS (EG, N370S, 84GG, L444P, IVS2+1G>A)",43.85,28.5,1003.62,1598.36,2
CPT,81251,HB MISC LAB SPECIAL TEST,43.85,28.5,,,0
CPT,81251,Laboratory Services,43.85,28.5,1263.8,1263.92,2
CPT,81251,gene analysis,43.85,28.5,115.65,115.65,2
CPT,81252,"GJB2 (GAP JUNCTION PROTIEN, BETA 2 26KDA CONNEXIN 26) (EG, NONSYNDROMIC HEARING LOSS) GENE ANALYSIS; FULL GENE SEQUENCE",495.0,321.75,102.77,163.68,2
CPT,81252,Laboratory Services,495.0,321.75,999.34,999.44,2
CPT,81252,gene analysis,495.0,321.75,247.95,247.95,2
CPT,81253,"GJB2 (GAP JUNCTION PROTIEN, BETA 2 26KDA CONNEXIN 26) (EG,N ONSYNDROMIC HEARING LOSS) GENE ANALYSIS; KNOWN FAMILIAL VARI",,,82.2,130.9,2
CPT,81253,Laboratory Services,,,384.7,384.74,2
CPT,81253,gene analysis,,,151.43,151.43,2
CPT,81254,"GJB6 (GAP JUNCTION PROTEIN, BETA 6, 30KDA, CONNEXIN 30)(EG, NONSYNDROMIC HEARING LOSS) GENE ANALYSIS, COMMON VARIANTS 30",,,63.26,100.75,2
CPT,81254,Laboratory Services,,,181.5,181.52,2
CPT,81254,gene analysis,,,85.7,85.7,2
CPT,81255,HB LAB MP HEXA GENE ANALYSIS,114.59,74.48,13270.0,14761.0,2
CPT,81255,"HEXA (HEXOSAMINIDASE A ?ALPHA POLYPEPTIDE¿) (EG, TAY-SACHS DISEASE) GENE ANALYSIS, COMMON VARIANTS (EG, 1278INSTATC)",114.59,74.48,1317.05,2097.53,2
CPT,81255,Laboratory Services,114.59,74.48,1369.52,1369.65,2
CPT,81255,gene analysis,114.59,74.48,126.47,126.47,2
CPT,81256,HB HEREDITARY HEMOCHROMATOS,80.69,52.45,13270.0,14761.0,4
CPT,81256,HB MISC LAB SPECIAL TEST,80.69,52.45,,,0
CPT,81256,"HFE (HEMOCHROMATOSIS) (EG, HEREDITARY HEMOCHROMATOSIS) GENE ANALYSIS, COMMON VARIANTS (EG, C282Y, H63D)",80.69,52.45,480.39,765.07,2
CPT,81256,Laboratory Services,80.69,52.45,418.16,418.2,2
CPT,81256,gene analysis,80.69,52.45,160.58,160.58,2
CPT,81257,"HBA1/HBA2 (ALPHA GLOBIN 1 AND ALPHA GLOBIN 2) (EG, ALPHA THALASSEMIA, HB BART HYDROPS FETALIS SYNDROME,HBH DISEASE)",378.0,245.7,878.59,1399.25,2
CPT,81257,Laboratory Services,378.0,245.7,815.7,815.78,2
CPT,81257,gene analysis,378.0,245.7,251.27,251.27,2
CPT,81258,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant",,,921.07,921.07,2
CPT,81258,Hba1/hba2 gene fam vrnt,,,2501.61,3984.07,2
CPT,81258,Laboratory Services,,,2005.97,2006.18,2
CPT,81259,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81259,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence",,,1473.54,1473.54,2
CPT,81259,Hba1/hba2 full gene sequence,,,3999.94,6370.31,2
CPT,81259,Laboratory Services,,,3207.45,3207.77,2
CPT,81260,HB LAB MP IKBKAP GENE ANALYSIS,144.75,94.09,13270.0,14761.0,2
CPT,81260,HB MISC LAB SPECIAL TEST,144.75,94.09,,,0
CPT,81260,"IKBKAP (INHIBITOR OF KAPPA LIGHT POLYPEPTIDE GENE ENHANCER IN B-CELLS, KINASE COMPLEX-ASSOCIATED PROTEIN)GENE ANALYSIS,",144.75,94.09,534.35,851.0,2
CPT,81260,Laboratory Services,144.75,94.09,651.11,651.18,2
CPT,81260,gene analysis,144.75,94.09,96.51,96.51,2
CPT,81261,HB LAB MP IGH@ GEN REARR ANAL,6272.72,4077.27,13270.0,14761.0,2
CPT,81261,HB MISC LAB SPECIAL TEST,6272.72,4077.27,13270.0,14761.0,4
CPT,81261,"IGH (IMMUNOGLOBULIN HEAVY CHAIN LOCUS) (EG, LEUKEMIAS AND LYMPHOMAS, B-CELL),GENE REARRANGEMENT ANALYSIS TO DETECT ABNO",6272.72,4077.27,751.15,1196.28,2
CPT,81261,Laboratory Services,6272.72,4077.27,655.58,655.64,2
CPT,81261,gene analysis,6272.72,4077.27,485.92,485.92,2
CPT,81262,"IGH(IMMUNOGLOBULIN HEAVY CHAIN LOCUS) (EG,LEUKEMIAS AND LY MPHOMAS,B-CELL),GENE REARRANGEMENT ANALYSIS TO DETECTABNORMA",,,374.56,596.52,2
CPT,81262,Laboratory Services,,,318.35,318.39,2
CPT,81262,gene analysis,,,168.07,168.07,2
CPT,81263,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81263,"IGH (IMMUNOGLOBULIN HEAVY CHAIN LOCUS) (EG, LEUKEMIA AND LYMPHOMA, B-CELL), VARIABLE REGION SOMATIC MUTATION ANALYSIS",,,1068.41,1701.56,2
CPT,81263,Immunoglobulin heavy chain locus),,,723.05,723.05,2
CPT,81263,Laboratory Services,,,534.57,534.63,2
CPT,81264,HB LAB MP IGK@ GEN REARR ANAL,5844.82,3799.13,13270.0,14761.0,2
CPT,81264,HB MISC LAB SPECIAL TEST,5844.82,3799.13,13270.0,14761.0,4
CPT,81264,"IGK(IMMUNOGLOBULIN KAPPA LIGHT CHAIN LOCUS) (EG, LEUKEMIA AND LYMPHOMA,B-CELL),GENE REARRANGEMENT ANALYSIS,EVALUATION",5844.82,3799.13,2260.72,3600.43,2
CPT,81264,Immunoglobulin kappa light chain locus,5844.82,3799.13,424.34,424.34,2
CPT,81264,Laboratory Services,5844.82,3799.13,1089.02,1089.13,2
CPT,81265,"COMPARATIVE ANALYSIS USING SHORT TANDEM REPEAT(STR)MARKERS; PATIENT AND COMPARATIVE SPECIMEN(EG,PRE-TRANSPLANT RECIPIENT",10633.3,6911.64,2127.4,3388.1,2
CPT,81265,Laboratory Services,10633.3,6911.64,2830.1,2830.38,2
CPT,81265,Short Tandem Repeat (STR) markers,10633.3,6911.64,572.44,572.44,2
CPT,81266,"COMPARATIVE ANALYSIS USING SHORT TANDEM REPEAT(STR)MARKERS; EACH ADDITIONAL SPECIMEN (EG, ADDITIONAL CORD BLOOD DONOR,",10633.3,6911.64,2127.4,3388.1,2
CPT,81266,Laboratory Services,10633.3,6911.64,652.43,652.5,2
CPT,81266,Short Tandem Repeat (STR) markers,10633.3,6911.64,748.0,748.0,2
CPT,81267,"CHIMERISM(ENGRAFTMENT)ANALYSIS,POST TRANSPLANTATION SPECIMEN(EG,HEMATOPOIETIC STEM CELL),INCLUDES COMPARISON TO PREVIOUS",12635.7,8213.2,4887.36,7783.62,2
CPT,81267,HB CHIMERISM TESTING FOLLOW UP,12635.7,8213.2,13270.0,14761.0,2
CPT,81267,Laboratory Services,12635.7,8213.2,4938.02,4938.52,2
CPT,81267,Short Tandem Repeat (STR) markers,12635.7,8213.2,509.2,509.2,2
CPT,81268,"CHIMERISM ANALYSIS,POST TRANSPLANTATION SPECIMENINCLUDES COMP. TO PREVIOUSLY PERFORMED BASELINE ANALYSES;WITH CELL",4374.16,2843.2,2296.28,3657.06,2
CPT,81268,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",4374.16,2843.2,640.67,640.67,2
CPT,81268,HB CHIMERISM TESTING SORTED CD3 CELLS,4374.16,2843.2,13270.0,14761.0,2
CPT,81268,Laboratory Services,4374.16,2843.2,1901.89,1902.08,2
CPT,81269,HB MISC LAB SPECIAL TEST,250.0,162.5,13270.0,14761.0,4
CPT,81269,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants",250.0,162.5,496.73,496.73,2
CPT,81269,Hba1/hba2 gene dup/del vrnts,250.0,162.5,1349.35,2148.97,2
CPT,81269,Laboratory Services,250.0,162.5,1081.98,1082.09,2
CPT,81270,HB TARGETED GENOMIC SEQ ANALYS HEMATO LTD,45587.9,29632.14,,,0
CPT,81270,"JAK2 (JANUS KINASE 2) (EG, MYELOPROLIFERATIVE DISORDER) GENE ANALYSIS, P.VAL617PHE (V617F) VARIANT",,,431.34,686.95,2
CPT,81270,Laboratory Services,,,361.94,361.97,2
CPT,81270,myeloproliferative disorder,,,224.65,224.65,2
CPT,81271,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles",,,336.14,1209.7,4
CPT,81271,Laboratory Services,,,732.37,732.44,2
CPT,81272,HB KITQ MOPATH PROCEDURE LEV 5,334.86,217.66,13270.0,14761.0,2
CPT,81272,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor [GIST], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",334.86,217.66,808.74,808.74,2
CPT,81272,Kit gene targeted seq analys,334.86,217.66,2291.77,3649.88,2
CPT,81272,Laboratory Services,334.86,217.66,1761.45,1761.63,2
CPT,81273,HB MISC LAB SPECIAL TEST,442.94,287.91,,,0
CPT,81273,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s)",442.94,287.91,306.19,306.19,2
CPT,81273,Kit gene analys d816 variant,442.94,287.91,868.52,1383.21,2
CPT,81273,Laboratory Services,442.94,287.91,667.53,667.59,2
CPT,81274,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size)",,,674.79,2426.51,4
CPT,81274,Laboratory Services,,,1469.2,1469.35,2
CPT,81275,"KRAS (V-KI-RAS2 KIRSTEN RAT SARCOMA VIRAL ONCOGENE) (EG, CARCINOMA) GENE ANALYSIS, VARIANTS IN CODONS 12 AND 13",,,1005.87,1601.96,2
CPT,81275,"KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) (eg, carcinoma) gene analysis, variants in codons 12 and 13",,,474.26,474.26,2
CPT,81275,Laboratory Services,,,946.64,946.73,2
CPT,81276,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146)",,,474.26,474.26,2
CPT,81276,Lab tests - other (non-Medicare fee schedule),,,1371.45,2184.18,2
CPT,81276,Laboratory Services,,,1054.12,1054.22,2
CPT,81277,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities",,,2848.07,5839.39,4
CPT,81277,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81277,Laboratory Services,,,6201.06,6201.68,2
CPT,81278,"IGH @ / BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative",,,655.27,1043.58,2
CPT,81278,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative",,,509.2,509.2,2
CPT,81279,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81279,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13)",,,455.13,932.25,4
CPT,81279,Laboratory Services,,,990.03,990.13,2
CPT,81283,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant",,,180.55,180.55,2
CPT,81283,Ifnl3 gene,,,502.93,800.97,2
CPT,81283,Laboratory Services,,,403.26,403.3,2
CPT,81284,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81284,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81285,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)",,,674.79,2426.51,4
CPT,81285,Laboratory Services,,,1469.2,1469.35,2
CPT,81286,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence",144.23,93.75,674.79,2426.51,4
CPT,81286,Laboratory Services,144.23,93.75,1469.2,1469.35,2
CPT,81287,"HB MGMT PROMOTER METHYLATION, TUMOR",560.0,364.0,13270.0,14761.0,4
CPT,81287,Laboratory Services,560.0,364.0,2201.19,2201.41,2
CPT,81287,"MGMT (O-6-METHYLGUANINE-DNA METHYLTRANSFERASE) (EG, GLIOBLASTOMA MULTIFORME), METHYLATION ANALYSIS",560.0,364.0,1124.18,1790.37,2
CPT,81287,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis",560.0,364.0,306.19,306.19,2
CPT,81288,HB MLH1 HYPERMETHYLATION MLH1 GENE,508.3,330.4,13270.0,14761.0,4
CPT,81288,Laboratory Services,508.3,330.4,2032.14,2032.34,2
CPT,81288,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis",508.3,330.4,472.6,472.6,2
CPT,81288,Mlh1 gene,508.3,330.4,1192.83,1899.71,2
CPT,81289,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s)",,,455.13,1635.18,4
CPT,81289,Laboratory Services,,,990.03,990.13,2
CPT,81290,HB LAB MP MCOLN1 GENE ANALYSIS,114.45,74.39,13270.0,14761.0,2
CPT,81290,HB MISC LAB SPECIAL TEST,114.45,74.39,,,0
CPT,81290,Laboratory Services,114.45,74.39,523.88,523.94,2
CPT,81290,"MCOLN1 (MUCOLIPIN 1) (EG, MUCOLIPIDOSIS, TYPE IV) GENE ANALYSIS, COMMON VARIANTS (EG, IVS3-2A>G, DEL6.4KB)",114.45,74.39,514.99,820.17,2
CPT,81290,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb)",114.45,74.39,96.51,96.51,2
CPT,81291,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,81291,Laboratory Services,,,487.41,487.45,2
CPT,81291,"MTHFR (5,10-METHYLENETETRAHYDROFOLATE REDUCTASE) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, COMMON VARIANT",,,407.75,649.38,2
CPT,81291,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C)",,,160.58,160.58,2
CPT,81292,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81292,Laboratory Services,,,4087.92,4088.33,2
CPT,81292,"MLH1 (MUTL HOMOLOG 1,COLON CANCER,NONPOLYPOSIS TYPE 2)(EG, HEREDITARY NON-POLYPOSIS COLORECTAL CANCER, LYNCH SYNDROME)",,,4532.05,7217.75,2
CPT,81292,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis",,,1658.25,1658.25,2
CPT,81293,Laboratory Services,,,418.16,418.2,2
CPT,81293,"MLH1 (MUTL HOMOLOG 1, COLON CANCER, NONPOLYPOSIS TYPE 2) (EGLYNCH SYNDROME) GENE ANALYSIS; KNOWN FAMILIAL VARIANTS",,,491.96,783.49,2
CPT,81293,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants",,,812.9,812.9,2
CPT,81294,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81294,Laboratory Services,,,2435.71,2435.95,2
CPT,81294,"MLH1 (MUTL HOMOLOG 1, COLON CANCER, NONPOLYPOSIS TYPE 2) GENE ANALYSIS; DUPLICATION/DELETION VARIANTS",,,2413.85,3844.3,2
CPT,81294,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants",,,496.73,496.73,2
CPT,81295,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81295,Laboratory Services,,,3773.47,3773.84,2
CPT,81295,"MSH2 (MUTS HOMOLOG 2, COLON CANCER, NONPOLYPOSIS TYPE 1) (EGHEREDITARY NON-POLYPOSIS COLORECTAL CANCER, LYNCH SYNDROME)",,,4071.76,6484.68,2
CPT,81295,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis",,,936.88,936.88,2
CPT,81296,Laboratory Services,,,418.16,418.2,2
CPT,81296,"MSH2 (MUTS HOMOLOG 2, COLON CANCER, NONPOLYPOSIS TYPE 1) (EGLYNCH SYNDROME) GENE ANALYSIS; KNOWN FAMILIAL VARIANTS",,,491.96,783.49,2
CPT,81296,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants",,,829.55,829.55,2
CPT,81297,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81297,Laboratory Services,,,2159.99,2160.21,2
CPT,81297,"MSH2 (MUTS HOMOLOG 2, COLON CANCER, NONPOLYPOSIS TYPE 1)(EG,LYNCH SYNDROME) GENE ANALYSIS; DUPLICATION/DELETION VARIANTS",,,2140.55,3409.05,2
CPT,81297,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants",,,523.36,523.36,2
CPT,81298,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81298,Laboratory Services,,,5345.74,5346.28,2
CPT,81298,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants",,,1575.88,1575.88,2
CPT,81298,"MSH6 (MUTS HOMOLOG 6 ?E.COLI¿) (EG,HEREDITARY NON-POLYPOSIS COLORECTAL CANCER, LYNCH SYNDROME) GENE ANALYSIS; FULL",,,5734.18,9132.26,2
CPT,81299,Laboratory Services,,,418.16,418.2,2
CPT,81299,"MSH6 (MUTS HOMOLOG 6 ?E.COLI¿) (EG,HEREDITARY NON-POLYPOSIS LYNCH SYNDROME) GENE ANALYSIS; KNOWN FAMILIAL VARIANTS",,,491.96,783.49,2
CPT,81299,"MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants",,,756.32,756.32,2
CPT,81300,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81300,Laboratory Services,,,943.37,943.46,2
CPT,81300,"MSH6 (MUTS HOMOLOG 6?E.COLI¿)(EG,HEREDITARY NON-POLYPOSIS ,LYNCH SYNDROME) GENE ANALYSIS;DUPLICATION/DELETION VARIANTS",,,1550.66,2469.59,2
CPT,81300,"MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants",,,584.09,584.09,2
CPT,81301,Laboratory Services,435.7,283.2,1428.45,1428.59,2
CPT,81301,"MICROSATELLITE INSTABILITY ANALYSIS (EG, HEREDITARY NON- -POLYPOSIS COLORECTAL CANCER, LYNCH SYNDROME) OF MARKERS FOR",435.7,283.2,1474.47,2348.24,2
CPT,81301,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",435.7,283.2,856.17,856.17,2
CPT,81302,Laboratory Services,,,2028.99,2029.2,2
CPT,81302,"MECP2 (METHYL CPG BINDING PROTEIN 2) (EG, RETT SYNDROME) GENE ANALYSIS; FULL SEQUENCE ANALYSIS",,,2058.37,3278.16,2
CPT,81302,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis",,,1296.32,1296.32,2
CPT,81303,Laboratory Services,,,754.69,754.77,2
CPT,81303,"MECP2 (METHYL CPG BINDING PROTEIN 2) (EG, RETT SYNDROME) GENE ANALYSIS; KNOWN FAMILIAL VARIANT",,,55.88,88.99,2
CPT,81303,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant",,,294.55,294.55,2
CPT,81304,Laboratory Services,13.27,8.63,1318.95,1319.08,2
CPT,81304,"MECP2 (METHYL CPG BINDING PROTEIN 2) (EG, RETT SYNDROME) GENE ANALYSIS; DUPLICATION/DELETION VARIANTS",13.27,8.63,374.56,596.52,2
CPT,81304,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants",13.27,8.63,368.6,368.6,2
CPT,81305,HB MISC LAB SPECIAL TEST,376.5,244.72,,,0
CPT,81305,Laboratory Services,376.5,244.72,937.64,937.74,2
CPT,81305,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant",376.5,244.72,431.0,1548.66,4
CPT,81306,Laboratory Services,,,1557.56,1557.72,2
CPT,81306,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6)",,,715.55,2572.49,4
CPT,81307,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,81307,Laboratory Services,,,1512.22,1512.37,2
CPT,81307,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence",,,894.1,1660.75,4
CPT,81308,Laboratory Services,,,1610.96,1611.12,2
CPT,81308,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant",,,739.68,1517.01,4
CPT,81309,Laboratory Services,,,1469.2,1469.35,2
CPT,81309,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20)",,,674.79,1383.39,4
CPT,81310,HB LAB MP NPM1 GENE ANALYSIS,233.34,151.67,13270.0,14761.0,2
CPT,81310,HB MISC LAB SPECIAL TEST,233.34,151.67,13270.0,14761.0,4
CPT,81310,Laboratory Services,233.34,151.67,261.94,261.97,2
CPT,81310,"NPM1 (NUCLEOPHOSMIN) (EG, ACUTE MYELOID LEUKEMIA) GENE ANALYSIS, EXON 12 VARIANTS",233.34,151.67,335.16,533.78,2
CPT,81310,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants",233.34,151.67,604.89,604.89,2
CPT,81311,Laboratory Services,,,1581.21,1581.37,2
CPT,81311,"NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)",,,726.37,726.37,2
CPT,81311,Nras gene variants exon 2&3,,,2057.24,3276.36,2
CPT,81312,Laboratory Services,,,732.37,732.44,2
CPT,81312,"PABPN1 (poly[A] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",,,336.14,1209.7,4
CPT,81313,Laboratory Services,,,1257.82,1257.95,2
CPT,81313,"PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)",,,626.52,626.52,2
CPT,81313,Pca3/klk3 antigen,,,1254.27,1997.56,2
CPT,81314,Laboratory Services,,,1761.45,1761.63,2
CPT,81314,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor [GIST]), gene analysis, targeted sequence analysis (eg, exons 12, 18)",,,808.74,808.74,2
CPT,81314,Pdgfra gene,,,2291.77,3649.88,2
CPT,81315,HB LAB MP PML/RARALP TRNSL ANL,7332.66,4766.23,13270.0,14761.0,2
CPT,81315,Laboratory Services,7332.66,4766.23,711.93,712.0,2
CPT,81315,"PML/RARALPHA,(T(15;17)),(EG,PROMYELOCYTIC LEUKEMIA)TRANSLOC--ATION ANALYSIS;COMMON BREAKPOINTS(EG,INTRON 3 AND INTRON 6)",7332.66,4766.23,476.21,758.41,2
CPT,81315,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",7332.66,4766.23,509.2,509.2,2
CPT,81316,Laboratory Services,,,2306.09,2306.32,2
CPT,81316,"PML/RARALPHA, (T(15;17)), (PROMYELOCYTIC LEUKEMIA/RETINOIC ACID RECEPTOR ALPHA)(EG,PROMYELOCYTIC LEUKEMIA)TRANSLOCATION",,,522.04,831.41,2
CPT,81316,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,509.2,509.2,2
CPT,81317,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81317,Laboratory Services,,,4204.27,4204.69,2
CPT,81317,PMS2 (POSTMEIOTIC SEGREGATION INCREASED 2 ?S. CEREVISIAE¿) GENE ANALYSIS; FULL SEQUENCE ANALYSIS,,,4045.79,6443.33,2
CPT,81317,"PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis",,,1660.75,1660.75,2
CPT,81318,Laboratory Services,,,534.57,534.63,2
CPT,81318,PMS2 (POSTMEIOTIC SEGREGATION INCREASED 2 ?S. CEREVISIAE¿) GENE ANALYSIS; KNOWN FAMILIAL VARIANTS,,,411.53,655.4,2
CPT,81318,"PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis",,,812.9,812.9,2
CPT,81319,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81319,Laboratory Services,,,1091.16,1091.27,2
CPT,81319,"PMS2 (POSTMEIOTIC SEGREGATION INCREASED 2 ?S. CEREVISIAE¿) (EG, HEREDITARY NON-POLYPOSIS COLORECTAL CANCER, LYNCH",,,4072.38,6485.67,2
CPT,81319,"PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants",,,500.06,500.06,2
CPT,81320,Laboratory Services,,,1557.56,1557.72,2
CPT,81320,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F)",,,715.55,2572.49,4
CPT,81321,HB MISC LAB SPECIAL TEST,688.75,447.69,13270.0,14761.0,2
CPT,81321,Laboratory Services,688.75,447.69,2854.82,2855.1,2
CPT,81321,"PTEN (PHOSPHATES AND TENSIN HOMOLOG)(EG,COWDEN SYNDROME,PTEN HAMARTOMA TUMOR SYNDROME); GENE ANALYSIS; FULL SEQUENCE ANA",688.75,447.69,121.41,193.36,2
CPT,81321,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis",688.75,447.69,1473.54,1473.54,2
CPT,81322,Laboratory Services,,,277.54,277.57,2
CPT,81322,"PTEN (PHOSPHATES AND TENSIN HOMOLOG) (EG, COWDEN SYNDROME, PTEN HAMARTOMA TUMOR SYNDROME) GENE ANYLS; KNOWN FAMILIAL VAR",,,78.9,125.66,2
CPT,81322,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant",,,114.82,114.82,2
CPT,81323,HB MISC LAB SPECIAL TEST,688.75,447.69,13270.0,14761.0,2
CPT,81323,Laboratory Services,688.75,447.69,416.34,416.38,2
CPT,81323,"PTEN (PHOSPHATES AND TENSIN HOMOLOG) (EG, COWDEN SYNDROME, PTEN HAMARTOMA TUMOR SYNDROME) GENE ANLYS; DUPLICATION/DELETI",688.75,447.69,98.66,157.12,2
CPT,81323,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant",688.75,447.69,736.36,736.36,2
CPT,81324,Laboratory Services,319.78,207.86,5345.74,5346.28,2
CPT,81324,"PMP22 (PERIPHERAL MYELIN PROTEIN 22) (EG, CHARCOT-MARIE-TOOTH, HEREDITARY NEUROPATHY WITH LIABIITY) DUPLICATION/DELETION",319.78,207.86,4270.87,6801.79,2
CPT,81324,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis",319.78,207.86,1862.11,1862.11,2
CPT,81325,Laboratory Services,319.78,207.86,1402.03,1402.17,2
CPT,81325,"PMP22 (PERIPHERAL MYELIN PROTEIN 22) (EG, CHARCOT-MARIE-TOOTH, HEREDITARY NEUROPATHY WITH LIABIITY); FULL SEQUENCE ANLYS",319.78,207.86,4334.13,6902.55,2
CPT,81325,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis",319.78,207.86,1889.56,1889.56,2
CPT,81326,Laboratory Services,,,523.88,523.94,2
CPT,81326,"PMP22 (PERIPHERAL MYELIN PROTEIN 22) (EG, CHARCOT-MARIE-TOOTH, HEREDITARY NEUROPATHY WITH LIABIITY); KNOWN FAMILIAL VARI",,,262.46,418.0,2
CPT,81326,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant",,,114.82,114.82,2
CPT,81327,Laboratory Services,,,447.28,447.33,2
CPT,81327,"SEPT9 (SEPTIN9) (EG, COLORECTAL CANCER) METHYLATION ANALYSIS",,,455.48,725.41,2
CPT,81327,"SEPT9 (Septin9) (eg, colorectal cancer) methylation analysis",,,471.76,471.76,2
CPT,81328,Laboratory Services,,,934.5,934.59,2
CPT,81328,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5)",,,429.33,429.33,2
CPT,81328,Slco1b1 gene com variants,,,1165.38,1855.98,2
CPT,81329,Laboratory Services,217.55,141.41,732.37,732.44,2
CPT,81329,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",217.55,141.41,336.14,1209.7,4
CPT,81330,HB LAB MP SMPD1 GENE ANALYSIS,112.93,73.4,13270.0,14761.0,2
CPT,81330,HB MISC LAB SPECIAL TEST,112.93,73.4,,,0
CPT,81330,Laboratory Services,112.93,73.4,840.98,841.06,2
CPT,81330,"MPD1(SPHINGOMYELIN PHOSPHODIESTERASE 1, ACID LYSOSOMAL)(EG, NIEMANN-PICK DISEASE, TYPE A) GENE ANALYSIS, COMMON VARIANTS",112.93,73.4,690.3,1099.37,2
CPT,81330,"SMPD1(sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330)",112.93,73.4,115.65,115.65,2
CPT,81331,Laboratory Services,343.06,222.99,367.66,367.7,2
CPT,81331,"SNRPN/UBE3A (SMALL NUCLEAR RIBONUCLEOPROTEIN POLYPEPTIDE N AND UBIQUITIN PROTEIN LIGASE E3A)(EG,PRADER-WILLI SYNDROME",343.06,222.99,359.37,572.34,2
CPT,81331,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis",343.06,222.99,125.64,125.64,2
CPT,81332,Laboratory Services,,,418.16,418.2,2
CPT,81332,"SERPINA1 (SERPIN PEPTIDASE INHIBITOR, CLADE A, ALPHA-1 ANTIPROTEINASE,ANTITRYPSIN,MEMBER 1)(EG,ALPHA-1-ANTITRYPSIN",,,492.02,783.58,2
CPT,81332,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction)",,,107.33,107.33,2
CPT,81333,Laboratory Services,,,732.37,732.44,2
CPT,81333,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q)",,,336.14,1209.7,4
CPT,81334,Laboratory Services,,,1761.45,1761.63,2
CPT,81334,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy), gene analysis, targeted sequence analysis (eg, exons 3-8)",,,808.74,808.74,2
CPT,81334,Runx1 gene targeted seq alys,,,2196.7,3498.47,2
CPT,81335,HB LAB TPMT MOPATH PROC LEV 2,264.65,172.02,13270.0,14761.0,4
CPT,81335,Laboratory Services,264.65,172.02,934.5,934.59,2
CPT,81335,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3)",264.65,172.02,429.33,429.33,2
CPT,81335,Tpmt gene com variants,264.65,172.02,1165.38,1855.98,2
CPT,81336,Laboratory Services,,,1610.96,1611.12,2
CPT,81336,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence",,,739.68,2660.7,4
CPT,81337,Laboratory Services,,,990.03,990.13,2
CPT,81337,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)",,,455.13,1635.18,4
CPT,81338,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R)",,,369.43,756.77,4
CPT,81339,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10",,,455.13,932.25,4
CPT,81340,HB LAB MP TRB@ GEN REARR ANAL,2559.14,1663.44,13270.0,14761.0,2
CPT,81340,HB MISC LAB SPECIAL TEST,2559.14,1663.44,13270.0,14761.0,2
CPT,81340,Laboratory Services,2559.14,1663.44,1210.65,1210.77,2
CPT,81340,"TRB (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction)",2559.14,1663.44,513.37,513.37,2
CPT,81340,"TRB@,GENE REARRANGEMENT ANALYSIS TO DETECT ABNORMAL CLONAL POPULATION(S);USING AMPLIFICATION METHODOLOGY(EG,POLYMERASE",2559.14,1663.44,989.84,1576.43,2
CPT,81341,"(T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot)",,,121.48,121.48,2
CPT,81341,Laboratory Services,,,361.62,361.66,2
CPT,81341,"TRB@ (T CELL ANTIGEN RECEPTOR, BETA) (EG, LEUKEMIA AND LYMPHOMA), GENE REARRANGEMENT ANALYSIS TO DETECT ABNORMAL",,,374.56,596.52,2
CPT,81342,"(T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot)",2725.56,1771.61,495.06,495.06,2
CPT,81342,HB LAB MP TRG@ GENE REARR ANAL,2725.56,1771.61,13270.0,14761.0,2
CPT,81342,HB MISC LAB SPECIAL TEST,2725.56,1771.61,13270.0,14761.0,2
CPT,81342,Laboratory Services,2725.56,1771.61,1012.55,1012.65,2
CPT,81342,"TRG@ (T CELL ANTIGEN RECEPTOR, GAMMA) (EG, LEUKEMIA AND LYMPHOMA), GENE REARRANGEMENT ANALYSIS, EVALUATION TO DETECT",2725.56,1771.61,639.16,1017.93,2
CPT,81343,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81343,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81344,Laboratory Services,144.23,93.75,732.37,732.44,2
CPT,81344,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles",144.23,93.75,336.14,1209.7,4
CPT,81345,Laboratory Services,,,990.03,990.13,2
CPT,81345,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)",,,455.13,1635.18,4
CPT,81346,Laboratory Services,,,934.5,934.59,2
CPT,81346,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant)",,,429.33,429.33,2
CPT,81346,Tyms gene com variants,,,1165.38,1855.98,2
CPT,81347,Laboratory Services,,,1033.05,1033.15,2
CPT,81347,"SF3B1 (splicing factor [3b] subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L)",,,474.26,972.79,4
CPT,81348,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L)",,,431.0,882.9,4
CPT,81349,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis",,,2257.73,3595.66,4
CPT,81350,HB UGT1A1 GEN PLYMRPH (TA RP),210.0,136.5,13270.0,14761.0,2
CPT,81350,Laboratory Services,210.0,136.5,521.56,521.61,2
CPT,81350,"UGT1A1 (UDP GLUCURONOSYLTRANSFERASE 1 FAMILY,POLYPEPTIDE A1)(EG, IRINOTECAN METABOLISM), GENE ANALYSIS, COMMON VARIANTS",210.0,136.5,335.16,533.78,2
CPT,81350,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, irinotecan metabolism), gene analysis, common variants (eg, *28, *36, *37)",210.0,136.5,574.94,574.94,2
CPT,81351,Laboratory Services,,,3431.15,3431.49,2
CPT,81351,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence",,,1575.88,3230.94,4
CPT,81352,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81352,Laboratory Services,,,1761.45,1761.63,2
CPT,81352,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology)",,,808.74,1658.69,4
CPT,81353,Laboratory Services,,,1646.49,1646.65,2
CPT,81353,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant",,,756.32,1550.44,4
CPT,81355,HB CYP2C9 GENOTYPING,205.07,133.3,13270.0,14761.0,2
CPT,81355,Laboratory Services,205.07,133.3,312.44,312.47,2
CPT,81355,"VKORC1 (VITAMIN K EPOXIDE REDUCTASE COMPLEX, SUBUNIT 1) (EG,WARFARIN METABOLISM), GENE ANALYSIS, COMMON VARIANTS",205.07,133.3,488.46,777.92,2
CPT,81355,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variants (eg, -1639/3673)",205.07,133.3,216.33,216.33,2
CPT,81357,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P)",,,474.26,972.79,4
CPT,81360,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs)",,,474.26,972.79,4
CPT,81361,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE)",,,429.33,429.33,2
CPT,81361,Hbb gene com variants,,,1165.38,1855.98,2
CPT,81361,Laboratory Services,,,934.5,934.59,2
CPT,81362,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s)",,,921.07,921.07,2
CPT,81362,Hbb gene known fam variant,,,2501.61,3984.07,2
CPT,81362,Laboratory Services,,,2005.97,2006.18,2
CPT,81363,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s)",,,496.73,496.73,2
CPT,81363,Hbb gene dup/del variants,,,1349.35,2148.97,2
CPT,81363,Laboratory Services,,,1081.98,1082.09,2
CPT,81364,HB BETA-GLOBIN GENE DOSAGE,437.82,284.58,13270.0,14761.0,4
CPT,81364,HB MISC LAB SPECIAL TEST,437.82,284.58,,,0
CPT,81364,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence",437.82,284.58,797.1,797.1,2
CPT,81364,Hbb full gene sequence,437.82,284.58,2163.89,3446.22,2
CPT,81364,Laboratory Services,437.82,284.58,1735.1,1735.28,2
CPT,81370,"HB HLA-A, B, C, DR, DQB1 TYPING",12700.9,8255.59,13270.0,14761.0,2
CPT,81370,"HLA CLASS I AND II TYPING, LOW RESOLUTION (EG, ANTIGEN EQUIVALENTS); HLA-A, -B, -C, -DRB1/3/4/5, AND -DQB1",12700.9,8255.59,1474.18,2347.79,2
CPT,81370,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1",12700.9,8255.59,987.63,987.63,2
CPT,81370,Laboratory Services,12700.9,8255.59,2932.67,2932.97,2
CPT,81371,"HB HLA-A, B, DR TYPING",8322.28,5409.48,13270.0,14761.0,2
CPT,81371,"HLA CLASS I AND II TYPING, LOW RESOLUTION(EG,ANTIGEN EQUIVALENTS); HLA-A, -B, AND -DRB1/3/4/5 (EG, VERIFICATION",8322.28,5409.48,1474.18,2347.79,2
CPT,81371,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1/3/4/5 (eg, verification typing)",8322.28,5409.48,993.45,993.45,2
CPT,81371,Laboratory Services,8322.28,5409.48,1755.35,1755.53,2
CPT,81372,"HLA CLASS I TYPING, LOW RESOLUTION (EG,ANTIGEN EQUIVALENTS);COMPLETE (IE, HLA-A, -B, AND -C)",8230.56,5349.86,3183.51,5070.06,2
CPT,81372,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C)",8230.56,5349.86,990.95,990.95,2
CPT,81372,Laboratory Services,8230.56,5349.86,3009.53,3009.83,2
CPT,81373,HB HLA-A (SEROLOGICAL EQUIVALENT LEVEL),2785.9,1810.84,13270.0,14761.0,2
CPT,81373,HB MISC LAB SPECIAL TEST,2785.9,1810.84,,,0
CPT,81373,"HLA CLASS I TYPING, LOW RESOLUTION(EG,ANTIGEN EQUIVALENTS); ONE LOCUS (EG, HLA-A, -B, OR -C), EACH",2785.9,1810.84,1077.56,1716.12,2
CPT,81373,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each",2785.9,1810.84,312.85,312.85,2
CPT,81373,Laboratory Services,2785.9,1810.84,1020.03,1020.13,2
CPT,81374,HB B27 TYPING BY DNA,2785.9,1810.84,13270.0,14761.0,2
CPT,81374,"HLA CLASS I TYPING, LOW RESOLUTION(EG,ANTIGEN EQUIVALENTS); ONE ANTIGEN EQUIVALENT (EG, B*27), EACH",2785.9,1810.84,1077.56,1716.12,2
CPT,81374,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each",2785.9,1810.84,182.21,182.21,2
CPT,81374,Laboratory Services,2785.9,1810.84,1020.03,1020.13,2
CPT,81375,"HB HLA-DRB1,3,4,5,DQB1 (SEROLOGICAL EQUIV LVL)",6883.01,4473.95,,,0
CPT,81375,"HLA CLASS II TYPING,LOW RESOLUTION(EG,ANTIGEN EQUIVALENTS); HLA-DRB1/3/4/5 AND -DQB1",6883.01,4473.95,1180.34,1879.81,2
CPT,81375,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1",6883.01,4473.95,541.66,541.66,2
CPT,81375,Laboratory Services,6883.01,4473.95,1125.75,1125.86,2
CPT,81376,HB DQA1 (LOW RESOLUTION),2730.37,1774.74,13270.0,14761.0,2
CPT,81376,"HLA CLASS II TYPING,LOW RESOLUTION(EG,ANTIGEN EQUIVALENTS); ONE LOCUS (EG, HLA-DRB1/3/4/5, -DQB1, -DQA1, -DPB1,OR -DPA1)",2730.37,1774.74,674.5,1074.2,2
CPT,81376,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1/3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each",2730.37,1774.74,300.37,300.37,2
CPT,81376,Laboratory Services,2730.37,1774.74,595.83,595.89,2
CPT,81377,"HLA CLASS II TYPING,LOW RESOLUTION (EG,ANTIGEN EQUIVALENTS);ONE ANTIGEN EQUIVALENT, EACH",234.5,152.43,471.53,750.95,2
CPT,81377,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each",234.5,152.43,232.98,232.98,2
CPT,81377,Laboratory Services,234.5,152.43,484.7,484.75,2
CPT,81378,"HB HLA-A,B,C,DRB1 HIGH RESOLUTION",81540.1,53001.07,13270.0,14761.0,2
CPT,81378,"HLA CLASS I AND II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS), HLA-A, -B, -C, AND -DRB1",81540.1,53001.07,4060.47,6466.71,2
CPT,81378,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1",81540.1,53001.07,848.68,848.68,2
CPT,81378,Laboratory Services,81540.1,53001.07,2520.17,2520.42,2
CPT,81379,"HLA CLASS I TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); COMPLETE (IE, HLA-A, -B, AND -C)",,,3340.7,5320.41,2
CPT,81379,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C)",,,823.72,823.72,2
CPT,81379,Laboratory Services,,,2445.9,2446.14,2
CPT,81380,HB HLA-C HIGH RESOLUTION,20326.7,13212.36,,,0
CPT,81380,"HLA CLASS I TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE LOCUS (EG, HLA-A, -B, OR -C), EACH",20326.7,13212.36,956.77,1523.75,2
CPT,81380,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each",20326.7,13212.36,435.16,435.16,2
CPT,81380,Laboratory Services,20326.7,13212.36,896.14,896.23,2
CPT,81381,HB B-5701 TYPING,20326.7,13212.36,13270.0,14761.0,2
CPT,81381,"HLA CLASS I TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE ALLELE OR ALLELE GROUP (EG, B*57:01P), EACH",20326.7,13212.36,1077.56,1716.12,2
CPT,81381,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each",20326.7,13212.36,416.86,416.86,2
CPT,81381,Laboratory Services,20326.7,13212.36,1019.78,1019.88,2
CPT,81382,HB HLA-DQB1 HIGH RESOLUTION,15191.0,9874.15,13270.0,14761.0,2
CPT,81382,HB MISC LAB SPECIAL TEST,15191.0,9874.15,,,0
CPT,81382,"HLA CLASS II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE LOCUS (EG, HLA-DRB1, -DRB3, -DRB4, -DRB5, -DQB1",15191.0,9874.15,751.15,1196.28,2
CPT,81382,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3, -DRB4, -DRB5, -DQB1, -DQA1, -DPB1, or -DPA1), each",15191.0,9874.15,303.69,303.69,2
CPT,81382,Laboratory Services,15191.0,9874.15,603.44,603.5,2
CPT,81383,"HLA CLASS II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE ALLELE OR ALLELE GROUP (EG, HLA-DQB1*06:02P),",15191.0,9874.15,467.29,744.21,2
CPT,81383,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each",15191.0,9874.15,267.92,267.92,2
CPT,81383,Laboratory Services,15191.0,9874.15,436.53,436.57,2
CPT,81400,HB LAB LACTP MOPATH PROC LEV 1,205.31,133.45,13270.0,14761.0,2
CPT,81400,HB MISC LAB SPECIAL TEST,205.31,133.45,,,0
CPT,81400,HB MP PROC LEVL 1,205.31,133.45,13270.0,14761.0,2
CPT,81400,Laboratory Services,205.31,133.45,430.93,430.97,2
CPT,81400,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 1(EG,IDENTIFICATION OF SINGLE GERMLINE VARIANT ?EG, SNP¿ BY TECHNIQUES SUCH AS",205.31,133.45,282.22,449.46,2
CPT,81400,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis)ACADM (acyl-CoA dehydrogenase,",205.31,133.45,157.25,157.25,2
CPT,81401,HB LAB MP PROC LEVL 2,215.95,140.37,13270.0,14761.0,4
CPT,81401,HB MISC LAB SPECIAL TEST,215.95,140.37,,,0
CPT,81401,Laboratory Services,215.95,140.37,408.79,408.83,2
CPT,81401,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 2 (EG, 2-10 SNPS, METHYLATED VARIANT, OR 1 SOMATIC VARIANT ?TYPICALLY USING",215.95,140.37,282.22,449.46,2
CPT,81401,"Molecular pathology procedure Level 2 (eg 2-10 SNPs, 1 methylated variant or 1 somatic variant [typically using nonsequencing target variant analysis], or detection of a dynamic mutation disorder/trip",215.95,140.37,336.14,336.14,2
CPT,81402,HB KIT 816V MUTATION ANALYSIS,2851.59,1853.53,,,0
CPT,81402,HB MISC LAB SPECIAL TEST,2851.59,1853.53,13270.0,14761.0,2
CPT,81402,Laboratory Services,2851.59,1853.53,628.91,628.97,2
CPT,81402,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 3 (EG, >10 SNPS,2-10 METHYLATED VARIANTS,OR 2-10 SOMATIC VARIANTS?TYPICALLY USING",2851.59,1853.53,663.38,1056.5,2
CPT,81402,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants [typically using non-sequencing target variant analysis], immunoglobulin and T-cell receptor ge",2851.59,1853.53,369.43,369.43,2
CPT,81403,HB KIR GENOTYPING,400.0,260.0,13270.0,14761.0,2
CPT,81403,HB MISC LAB SPECIAL TEST,400.0,260.0,13270.0,14761.0,8
CPT,81403,HB RED BLOOD CELL GENOTYPING,400.0,260.0,13270.0,14761.0,2
CPT,81403,Laboratory Services,400.0,260.0,628.91,628.97,2
CPT,81403,"MOLECULAR PATHOLOGY PROCEDURE,LEVEL 4(EG, ANALYSIS OF SINGLEEXON BY DNA SEQUENCE ANALYSIS, ANALYSIS OF >10 AMPLICONS",400.0,260.0,1334.77,2125.75,2
CPT,81403,"Molecular pathology procedure, Level 4 (analysis of single exon by DNA seq analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/",400.0,260.0,455.13,455.13,2
CPT,81404,HB MISC LAB SPECIAL TEST,490.0,318.5,13270.0,14761.0,6
CPT,81404,Laboratory Services,490.0,318.5,1100.59,1100.7,2
CPT,81404,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 5 (EG, ANALYSIS OF 2-5 EXONS BY DNA SEQUENCE ANALYSIS, MUTATION SCANNING",490.0,318.5,1603.44,2553.64,2
CPT,81404,"Molecular pathology procedure, Lvl 5 (analysis of 2-5 exons by DNA seq analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of dynamic mutation disorder/trip",490.0,318.5,674.79,674.79,2
CPT,81405,HB MISC LAB SPECIAL TEST,300.06,195.04,13270.0,14761.0,4
CPT,81405,Laboratory Services,300.06,195.04,1100.59,1100.7,2
CPT,81405,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 6 (EG, ANALYSIS OF 6-10EXONS BY DNA SEQUENCE ANALYSIS, MUTATION SCANNING OR",300.06,195.04,2101.94,3347.56,2
CPT,81405,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons) CYP21A2 (cytochrome P450, family 21, sub",300.06,195.04,739.68,739.68,2
CPT,81406,HB MISC LAB SPECIAL TEST,520.46,338.3,13270.0,14761.0,4
CPT,81406,Laboratory Services,520.46,338.3,626.77,626.84,2
CPT,81406,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 7(EG,ANALYSIS OF 11-25 EXONS BY DNA SEQUENCE ANALYSIS, MUTATION SCANNING",520.46,338.3,2144.11,3414.71,2
CPT,81406,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons) CYP21A2 (cytochrome P450, family 21, sub",520.46,338.3,694.75,694.75,2
CPT,81407,HB MISC LAB SPECIAL TEST,144.23,93.75,13270.0,14761.0,4
CPT,81407,Laboratory Services,144.23,93.75,7546.93,7547.69,2
CPT,81407,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 8 (EG,ANALYSIS OF 26-50EXONS BY DNA SEQUENCE ANALYSIS, MUTATION SCANNING OR",144.23,93.75,17284.26,27526.94,2
CPT,81407,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA seq analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on 1 platf",144.23,93.75,2077.6,2077.6,2
CPT,81408,HB MISC LAB SPECIAL TEST,288.46,187.5,13270.0,14761.0,4
CPT,81408,Laboratory Services,288.46,187.5,7546.93,7547.69,2
CPT,81408,"MOLECULAR PATHOLOGY PROCEDURE, LEVEL 9 (EG, ANALYSIS OF >50 EXONS IN A SINGLE GENE BY DNA SEQUENCE ANALYSIS) FBN1",288.46,187.5,20199.16,32169.21,2
CPT,81408,"Molecular pathology procedure Lvl 9 (review of >50 exons in single gene by DNA seq analysis) FBN1(fibrillin 1 eg,Marfan syndrome), full gene sequence NF1(neurofibromin1 ie neurofibromatosis type1) RYR",288.46,187.5,4910.69,4910.69,2
CPT,81410,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,1237.24,1237.24,2
CPT,81410,Aortic dysfunction/dilation,,,19204.74,30585.5,2
CPT,81410,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,81410,Laboratory Services,,,2694.25,2694.52,2
CPT,81411,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,3314.85,3314.85,2
CPT,81411,Aortic dysfunction/dilation,,,19204.74,30585.5,2
CPT,81411,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,81411,Laboratory Services,,,4578.47,4578.93,2
CPT,81412,"ASHKENAZI JEWISH ASSOCIATED DISORDERS (EG, BLOOM SYNDROME, CANAVAN DISEASE, CYSTIC FIBROSIS, FAMILIAL DYSAUTONOMIA, FAN",,,13789.78,21961.62,2
CPT,81412,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,6012.31,6012.31,2
CPT,81412,Laboratory Services,,,3196.19,3196.51,2
CPT,81413,"Cardiac ion channelopathies (eg Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing ",,,4367.59,6955.82,2
CPT,81413,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,1436.1,1436.1,2
CPT,81413,Laboratory Services,,,4289.05,4289.48,2
CPT,81414,"Cardiac ion channelopathies (eg Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include an",,,4367.59,6955.82,2
CPT,81414,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,1436.1,1436.1,2
CPT,81414,Laboratory Services,,,4289.05,4289.48,2
CPT,81415,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis",,,11736.74,11736.74,2
CPT,81415,Exome sequence analysis,,,19204.74,30585.5,2
CPT,81415,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,81415,Laboratory Services,,,6289.11,6289.74,2
CPT,81416,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,29464.17,29464.17,2
CPT,81416,Exome sequence analysis,,,19204.74,30585.5,2
CPT,81416,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,81416,Laboratory Services,,,6289.11,6289.74,2
CPT,81417,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome)",,,785.44,785.44,2
CPT,81417,Exome re-evaluation,,,9602.34,15292.7,2
CPT,81417,Laboratory Services,,,1710.64,1710.81,2
CPT,81419,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,6012.31,12325.81,4
CPT,81419,Laboratory Services,,,13089.4,13090.71,2
CPT,81420,Fetal chrmoml aneuploidy,,,2787.29,4439.05,2
CPT,81420,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21",,,1863.76,1863.76,2
CPT,81420,Laboratory Services,,,3144.55,3144.87,2
CPT,81422,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome) circulating cell-free fetal DNA in maternal blood",,,4367.59,6955.82,2
CPT,81422,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood",,,1863.76,1863.76,2
CPT,81422,Laboratory Services,,,4289.05,4289.48,2
CPT,81425,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis",,,12353.28,12353.28,2
CPT,81425,Genome sequence analysis,,,19204.74,30585.5,2
CPT,81425,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,81425,Laboratory Services,,,0.06,0.06,2
CPT,81426,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,6653.81,6653.81,2
CPT,81426,Genome sequence analysis,,,19204.74,30585.5,2
CPT,81426,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,81426,Laboratory Services,,,0.06,0.06,2
CPT,81427,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome)",,,5739.41,5739.41,2
CPT,81427,Genome re-evaluation,,,9602.34,15292.7,2
CPT,81427,Laboratory Services,,,0.06,0.06,2
CPT,81430,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,3989.63,3989.63,2
CPT,81430,Hearing loss sequence analys,,,19204.74,30585.5,2
CPT,81430,Laboratory Services,,,8686.83,8687.7,2
CPT,81431,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,1668.24,1668.24,2
CPT,81431,Hearing loss dup/del analys,,,19204.74,30585.5,2
CPT,81431,Laboratory Services,,,3632.78,3633.14,2
CPT,81432,"HEREDITARY BREAST CANCER-RELATED DISORDERS (EG, HEREDITARY BREAST CANCER, HEREDITARY OVARIAN CANCER, HEREDITARY ENDOMET",,,3824.26,6090.53,2
CPT,81432,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer); genomic sequence analysis panel, must include sequencing of at leas",,,1667.41,1667.41,2
CPT,81432,Laboratory Services,,,4979.46,4979.96,2
CPT,81433,"HEREDITARY BREAST CANCER-RELATED DISORDERS;DUPLICATION/DELETION ANALYSIS PANEL, MUST INCLUDE ANALYSES FOR BRCA1, BRCA2,M",,,2471.92,3936.78,2
CPT,81433,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer); duplication/deletion analysis panel, must include analyses for BRCA",,,1077.49,1077.49,2
CPT,81433,Laboratory Services,,,3218.7,3219.03,2
CPT,81434,"HEREDITARY RETINAL DISORDERS (EG, RETINITIS PEGMENTOSA, LEBER CONGENITAL AMAUROSIS, CONE-ROD DYSTROPHY), GENOMIC SEQ",,,3367.31,5362.78,2
CPT,81434,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,1467.72,1467.72,2
CPT,81434,Laboratory Services,,,3218.7,3219.03,2
CPT,81435,Hereditary colon cancer,,,19204.74,30585.5,2
CPT,81435,"Hereditary colon cancer syndromes (eg, Lynch syndrome, familial adenomatosis polyposis); genomic sequence analysis panel, must include analysis of at least 7 genes, including APC, CHEK2, MLH1, MSH2, M",,,1436.1,1436.1,2
CPT,81435,Laboratory Services,,,3144.55,3144.87,2
CPT,81436,Hereditary colon ca synd,,,19204.74,30585.5,2
CPT,81436,"Hereditary colon cancer syndromes (eg, Lynch syndrome, familial adenomatosis polyposis); duplication/deletion gene analysis panel, must include analysis of at least 8 genes, including APC, MLH1, MSH2,",,,1436.1,1436.1,2
CPT,81436,Laboratory Services,,,2201.19,2201.41,2
CPT,81437,"HEREDITARY NEUROENDOCRINE TUMOR DISORDERS (EG, MEDULLARY THYROID CARCINOMA, PARATHYROID CARCINOMA, MALIGNANT PHEOCHRO",,,2471.92,3936.78,2
CPT,81437,"Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma); genomic sequence analysis panel, must include sequencin",,,1077.49,1077.49,2
CPT,81437,Laboratory Services,,,3218.7,3219.03,2
CPT,81438,"HEREDITARY NEUROENDOCRINE TUMOR DISORDERS (EG,DUPLICATION/DELETION ANALYSIS PANEL, MUST INCLUDE ANALYSES FOR SDHB,SDHC,S",,,2471.92,3936.78,2
CPT,81438,"Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma); duplication/deletion analysis panel, must include analy",,,1077.49,1077.49,2
CPT,81438,Laboratory Services,,,3218.7,3219.03,2
CPT,81439,"Inherited cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy) genomic sequence analysis panel, must include sequencing of at least",,,1436.1,6955.82,4
CPT,81439,Laboratory Services,,,4289.05,4289.48,2
CPT,81440,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81440,Laboratory Services,,,6289.11,6289.74,2
CPT,81440,Mitochondrial gene,,,19204.74,30585.5,2
CPT,81440,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,8161.47,8161.47,2
CPT,81441,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,6012.31,21961.62,4
CPT,81442,Laboratory Services,,,3257.07,3257.39,2
CPT,81442,"NOONAN SPECTRUM DISORDERS (EG, NOONAN SYNDROME, CARDIO-FACIO-CUTANEOUS SYNDROME, COSTELLO SYNDROME, LEOPARD",,,12072.32,19226.39,2
CPT,81442,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,5263.48,5263.48,2
CPT,81443,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders [eg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",277.35,180.28,6012.31,21619.19,4
CPT,81443,HB MISC LAB SPECIAL TEST,277.35,180.28,13270.0,14761.0,4
CPT,81443,Laboratory Services,277.35,180.28,13089.4,13090.71,2
CPT,81445,HB TARGETED GENOMIC SEQ ANALYS LTD,45587.9,29632.14,,,0
CPT,81445,Laboratory Services,45587.9,29632.14,4522.31,4522.76,2
CPT,81445,Targeted genomic seq analys,45587.9,29632.14,19204.74,30585.5,2
CPT,81445,"Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis, 5-50 genes (eg, ALK, BRAF, CDKN2A, EGFR, ERBB2, KIT, KRAS, NRAS, MET, PDGFRA, PDGFRB, PGR, PIK3CA, PTEN, RET), interrogati",45587.9,29632.14,1467.72,1467.72,2
CPT,81448,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,1436.1,1436.1,2
CPT,81448,Hrdtry perph neurphy panel,,,4813.9,7666.62,2
CPT,81448,Laboratory Services,,,3860.19,3860.58,2
CPT,81449,"Targeted genomic sequence analysis panel, solid organ neoplasm, 5-50 genes (eg, ALK, BRAF, CDKN2A, EGFR, ERBB2, KIT, KRAS, MET, NRAS, PDGFRA, PDGFRB, PGR, PIK3CA, PTEN, RET), interrogation for sequenc",,,1467.72,5362.78,4
CPT,81450,HB MISC LAB SPECIAL TEST,45587.9,29632.14,13270.0,14761.0,2
CPT,81450,HB TARGETED GENOMIC SEQ ANALYS HEMATO LTD,45587.9,29632.14,13270.0,14761.0,2
CPT,81450,Laboratory Services,45587.9,29632.14,4522.31,4522.76,2
CPT,81450,Targeted genomic seq analys,45587.9,29632.14,19204.74,30585.5,2
CPT,81450,"Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, DNA and RNA analysis when performed, 5-50 genes (eg, BRAF, CEBPA, DNMT3A, EZH2, FLT3, IDH1, IDH2, JAK2, KRAS, KIT, MLL, N",45587.9,29632.14,1864.6,1864.6,2
CPT,81451,"Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, 5-50 genes (eg, BRAF, CEBPA, DNMT3A, EZH2, FLT3, IDH1, IDH2, JAK2, KIT, KRAS, MLL, NOTCH1, NPM1, NRAS), interrogation for",45587.9,29632.14,1864.6,6812.37,4
CPT,81455,HB MISC LAB SPECIAL TEST,2504.55,1627.96,13270.0,14761.0,2
CPT,81455,HB TARGETED GENOMIC SEQ ANALYS EXTENDED,2504.55,1627.96,13270.0,14761.0,2
CPT,81455,HB TARGETED GENOMIC SEQ ANALYS MYELOID NGS,2504.55,1627.96,13270.0,14761.0,2
CPT,81455,Laboratory Services,2504.55,1627.96,4522.31,4522.76,2
CPT,81455,Targeted genomic seq analys,2504.55,1627.96,19204.74,30585.5,2
CPT,81455,"Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm, DNA analysis, and RNA analysis when performed, 51 or greater genes (eg, ALK, BRAF, CDKN2A, CEBPA, DNMT3A, EGFR, ERBB2,",2504.55,1627.96,7168.85,7168.85,2
CPT,81456,HB MISC LAB SPECIAL TEST,45587.9,29632.14,13270.0,14761.0,2
CPT,81456,Laboratory Services,45587.9,29632.14,15607.43,15609.0,2
CPT,81456,"Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes (eg, ALK, BRAF, CDKN2A, CEBPA, DNMT3A, EGFR, ERBB2, EZH2, FLT3, IDH1, IDH2, JAK2, KIT,",45587.9,29632.14,7168.85,26186.43,4
CPT,81460,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81460,Laboratory Services,,,9936.79,9937.79,2
CPT,81460,Whole mitochondrial genome,,,19204.74,30585.5,2
CPT,81460,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes [MELAS], myoclonic epilepsy with ragged-red fibers [MERFF], neuropathy, ataxi",,,3160.08,3160.08,2
CPT,81465,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81465,Laboratory Services,,,7232.47,7233.2,2
CPT,81465,Whole mitochondrial genome,,,19204.74,30585.5,2
CPT,81465,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed",,,2298.1,2298.1,2
CPT,81470,Laboratory Services,,,4522.31,4522.76,2
CPT,81470,X-linked intellectual dblt,,,19204.74,30585.5,2
CPT,81470,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,2244.01,2244.01,2
CPT,81471,Laboratory Services,,,0.06,0.06,2
CPT,81471,X-linked intellectual dblt,,,19204.74,30585.5,2
CPT,81471,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,2244.01,2244.01,2
CPT,81477,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,81479,HB MISC LAB SPECIAL TEST,241.25,156.81,13270.0,14761.0,8
CPT,81479,Laboratory Services,241.25,156.81,471.68,471.73,2
CPT,81479,UNLISTED MOLECULAR PATHOLOGY PROCEDURE,241.25,156.81,,,0
CPT,81479,Unlisted molecular pathology procedure,241.25,156.81,226.32,226.32,2
CPT,81490,"AUTOIMMUNE (RHEUMATOID ARTHRITIS), ANALYSIS OF 12 BIOMARKERSUSING IMMUNOASSAYS, UTILIZING SERUM, PROGNOSTIC ALGORITHM RE",,,4734.35,7539.93,2
CPT,81490,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score",,,2064.29,2064.29,2
CPT,81490,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81490,Laboratory Services,,,3157.26,3157.58,2
CPT,81493,"CORONARY ARTERY DISEASE, MRNA, GENE EXPRESSION PROFILING BY REAL-TIME RT-PCR OF 23 GENES, UTILIZING WHOLE PERIPHERAL BLO",,,5913.37,9417.63,2
CPT,81493,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score",,,2578.49,2578.49,2
CPT,81493,Laboratory Services,,,5572.15,5572.71,2
CPT,81500,Laboratory Services,,,1392.6,1392.74,2
CPT,81500,"ONCOLOGY (OVARIAN), BIOCHEMICAL ASSAYS OF 2 PROTIENS (CA-125AND HE4), UTILIZING SERUM, WITH MENOPAUSAL STATUS, ALGORITHM",,,1467.05,2336.43,2
CPT,81500,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score",,,639.83,639.83,2
CPT,81503,Laboratory Services,650.0,422.5,2767.21,2767.49,2
CPT,81503,"ONCOLOGY (OVARIAN), BIOCHEMICAL ASSAYS OF 5 PROTIENS(CA-125 , APOLIPROPROTEIN A1, BETA-2 MICROGLOBULIN, TRANSFERRIN AND",650.0,422.5,5051.73,8045.38,2
CPT,81503,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apoliproprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score",650.0,422.5,2202.41,2202.41,2
CPT,81504,Laboratory Services,,,2779.79,2780.07,2
CPT,81504,"ONCOLOGY (TISSUE OF ORIGIN), MICROARRAY GENE EXPRESSION PROFILING OF > 2000 GENES, UTILIZING FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE, ALGORITHM REPORTED AS TISSUE SIMILARITY SCORES",,,1254.28,1997.57,2
CPT,81504,"Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores",,,1277.18,1277.18,2
CPT,81506,"ENDOCRINOLOGY (TYPE 2 DIABETES), BIOCHEMICAL ASSAYS OF SEVENANALYTES, UTILIZING SERUM OR PLASMA, ALGORITHM REPORTING A R",,,388.16,618.19,2
CPT,81506,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,168.9,168.9,2
CPT,81506,Laboratory Services,,,226.41,226.43,2
CPT,81507,"FETAL ANEUPLOIDY (TRISOMY 21, 18, AND 13) DNA SEQUENCE ANALYSIS OF SELECTED REGIONS USING MATERNAL PLASMA, ALGORITHM REPORTED AS A RISK SCORE FOR EACH TRISOMY",,,2508.56,3995.14,2
CPT,81507,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy",,,1951.97,1951.97,2
CPT,81507,Laboratory Services,,,5188.51,5189.04,2
CPT,81508,"FETAL CONGENITAL ABNORMALITIES, BIOCHEMICAL ASSAYS OF 2 PROTEINS (PAPPA-A, HCG (ANY FORM),UTILIZING MATERNAL SERUM, ALG",,,305.79,487.01,2
CPT,81508,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG [any form]), utilizing maternal serum, algorithm reported as a risk score",,,133.13,133.13,2
CPT,81508,Laboratory Services,,,786.14,786.22,2
CPT,81509,"FETAL CONGENITAL ABNORMALITIES, BIOCHEMICAL ASSAYS OF 3 PROTEINS (PAPPA-A, HCG(ANY FORM),DIA), UTIL IZING MATERNAL SERUM",,,8376.52,13340.46,2
CPT,81509,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG [any form], DIA), utilizing maternal serum, algorithm reported as a risk score",,,3651.82,3651.82,2
CPT,81509,Laboratory Services,,,364.77,364.8,2
CPT,81510,"FETAL CONGENITAL ABNORMALITIES, BIOCHEMICAL ASSAYS OF THREE PROTEINS (AFP, UE3, HCG(ANY FORM),DIA) ULTILIZING MATERNAL",,,312.79,498.15,2
CPT,81510,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG [any form]), utilizing maternal serum, algorithm reported as a risk score",,,136.45,136.45,2
CPT,81510,Laboratory Services,,,849.03,849.11,2
CPT,81511,"FETAL CONGENITAL ABNORMALITIES, BIOCHEMICAL ASSAYS OF 4 PROTEINS, UTILIZING MATERNAL SERUM, ALGORITHM REPORTED AS A RISK",,,864.46,1376.74,2
CPT,81511,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [any form], DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,376.92,376.92,2
CPT,81511,HB MISC LAB SPECIAL TEST,868.53,564.54,,,0
CPT,81511,Laboratory Services,,,1100.59,1100.7,2
CPT,81512,"FETAL CONGENITAL ABNORMALITIES, BIOCHEMICAL ASSAYS OF 5 PROTEINS, UTILIZING MATERNAL SERUM, ALGORITHM REPORTED AS A RISK",,,391.57,623.62,2
CPT,81512,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score",,,170.57,170.57,2
CPT,81512,Laboratory Services,,,2201.19,2201.41,2
CPT,81513,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81513,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,350.29,718.01,4
CPT,81513,Laboratory Services,,,762.49,762.57,2
CPT,81514,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",1549.19,1006.97,645.67,1323.93,4
CPT,81514,Laboratory Services,1549.19,1006.97,1405.87,1406.01,2
CPT,81518,Laboratory Services,,,20704.06,20706.14,2
CPT,81518,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,9509.37,34195.95,4
CPT,81519,Laboratory Services,,,17923.96,17925.76,2
CPT,81519,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as recurrence score",,,9509.37,30585.5,4
CPT,81520,Laboratory Services,,,16566.58,16568.24,2
CPT,81520,Onc breast mrna 58 genes,,,20659.86,32902.92,2
CPT,81520,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,6163.74,6163.74,2
CPT,81521,Laboratory Services,,,20704.06,20706.14,2
CPT,81521,Onc breast mrna 70 genes,,,25819.59,41120.31,2
CPT,81521,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,9509.37,9509.37,2
CPT,81522,Laboratory Services,,,20704.06,20706.14,2
CPT,81522,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score",,,9509.37,19496.35,4
CPT,81523,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,9509.37,15473.33,4
CPT,81525,Laboratory Services,,,2016.23,2016.43,2
CPT,81525,"ONCOLOGY (COLON), MRNA, GENE EXPRESSION PROFILING BY REAL-TIME RT-PCR OF 12 GENES (7 CONTENT AND 5 HOUSEKEEPING),",,,17548.66,27948.02,2
CPT,81525,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,7650.6,7650.6,2
CPT,81528,Laboratory Services,,,2720.29,2720.56,2
CPT,81528,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,1249.73,1249.73,2
CPT,81528,Oncology colorectal scr,,,3539.22,5636.57,2
CPT,81529,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,17660.87,36209.05,4
CPT,81535,Laboratory Services,,,3097.64,3097.95,2
CPT,81535,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,1422.79,1422.79,2
CPT,81535,Oncology gynecologic,,,4030.16,6418.44,2
CPT,81536,Laboratory Services,,,949.22,949.31,2
CPT,81536,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,435.99,435.99,2
CPT,81536,Oncology gynecologic,,,1234.93,1966.75,2
CPT,81538,Laboratory Services,,,11369.2,11370.34,2
CPT,81538,"ONCOLOGY (LUNG), MASS SPECTROMETRIC 8-PROTEIN SIGNATURE, INCLUDING AMYLOID A, UTILIZING SERUM, PROGNOSTIC AND PREDICT",,,16168.86,25750.55,2
CPT,81538,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival",,,7049.04,7049.04,2
CPT,81539,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,81539,Laboratory Services,,,3218.7,3219.03,2
CPT,81539,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 [hK2]), utilizing plasma or serum, prognostic algorithm reported as a",,,1866.26,1866.26,2
CPT,81539,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 hK2), utilizing plasma or serum, prognostic algorithm reported as a p",,,3277.59,5219.89,2
CPT,81540,Laboratory Services,,,15611.2,15612.77,2
CPT,81540,"ONCOLOGY (TUMOR OF UNKNOWN ORIGIN), MRNA, GENE EXPRESSION PROFILING BY REAL-TIME RT-PCR OF 92 GENES (87 CONTENT AND 5",,,21119.16,33634.41,2
CPT,81540,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,9207.35,9207.35,2
CPT,81541,Laboratory Services,,,20704.06,20706.14,2
CPT,81541,Onc prostate mrna 46 genes,,,25819.59,41120.31,2
CPT,81541,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,9509.37,9509.37,2
CPT,81542,Laboratory Services,,,20704.06,20706.14,2
CPT,81542,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score",,,9509.37,38683.32,4
CPT,81546,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious)",,,8838.75,18122.13,4
CPT,81551,Laboratory Services,,,8306.65,8307.49,2
CPT,81551,Onc prostate 3 genes,,,4766.28,7590.78,2
CPT,81551,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,4983.92,4983.92,2
CPT,81552,Laboratory Services,,,15599.5,15601.07,2
CPT,81552,"ONCOLOGY (UVEAL MELANOMA), MRNA, GENE EXPRESSION PROFILING BY REAL-TIME RT-PCR OF 15 GENES (12 CONTENT AND 3 HOUSEKEEPIN",,,43792.69,69744.3,2
CPT,81552,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,19092.81,19092.81,2
CPT,81554,"Pulmonary disease (idiopathic pulmonary fibrosis [IPF]), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,13553.09,27686.59,4
CPT,81560,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,1573.38,1573.38,2
CPT,81595,"CARDIOLOGY (HEART TRANSPLANT), MRNA, GENE EXPRESSION PROFILING BY REAL-TIME QUANTITATIVE PCR OF 20 GENES (11",,,18246.97,29060.15,2
CPT,81595,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,7955.12,7955.12,2
CPT,81595,Laboratory Services,,,15185.93,15187.46,2
CPT,81596,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,81596,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,177.23,637.39,4
CPT,81596,Laboratory Services,,,385.9,385.94,2
CPT,81599,Unlisted multianalyte assay with algorithmic analysis,,,483.52,483.52,2
CPT,81707,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,82009,"ACETONE OR OTHER KETONE BODIES, SERUM; QUALITATIVE",399.75,259.84,10.82,10.82,2
CPT,82009,"KEYTONE BODY(S)(EG ACETONE, ACETOACETIC ACID, BETA-HYDROXYBUTYRATE); SERUM; QUALITATIVE",399.75,259.84,39.51,62.92,2
CPT,82009,Laboratory Services,399.75,259.84,34.02,34.03,2
CPT,82010,"ACETONE OR OTHER KETONE BODIES, SERUM; QUANTITATIVE",99.05,64.38,19.97,19.97,2
CPT,82010,ACETONE; QUANTITATIVE,99.05,64.38,70.97,113.02,2
CPT,82010,HB B-HYDROXYBUTYRATE:QUANT,99.05,64.38,13270.0,14761.0,2
CPT,82010,HB BETA-HYDROXYBUTYRATE,99.05,64.38,13270.0,14761.0,4
CPT,82010,Laboratory Services,99.05,64.38,61.51,61.51,2
CPT,82013,ACETYLCHOLINESTERASE,108.82,70.73,29.95,155.81,4
CPT,82013,Laboratory Services,108.82,70.73,84.02,84.03,2
CPT,82016,"ACYLCARNITINES; QUALITATIVE, EACH SPECIMEN",,,40.77,40.77,2
CPT,82016,"ACYLCARNITNES; QUALITATIVE, EACH SPECIMEN",,,120.53,191.96,2
CPT,82016,Laboratory Services,,,104.27,104.28,2
CPT,82017,"ACYLCARNITINES; QUANTITATIVE, EACH SPECIMEN",82.99,53.94,41.61,233.53,4
CPT,82017,"HB ACYLCARNITINE, PLASMA",82.99,53.94,13270.0,14761.0,2
CPT,82017,Laboratory Services,82.99,53.94,126.91,126.93,2
CPT,82024,ADRENOCORTICOTROPIC HORMONE (ACTH),309.57,201.22,94.86,94.86,2
CPT,82024,"ADRENOCORTICOTROPIC HORMONE (ACTH), RIA",309.57,201.22,337.31,537.2,2
CPT,82024,"HB ACTH, PLASMA",309.57,201.22,13270.0,14761.0,4
CPT,82024,Laboratory Services,309.57,201.22,290.56,290.59,2
CPT,82030,"ADENOSINE, 5-MONOPHOSPHATE, CYCLIC (CYCLIC AMP)",25.6,16.64,63.24,63.24,2
CPT,82030,"ADENOSINE; 5'-DIPHOSPHATE (ADP) AND 5'-MONOPHOSPHATE (AMP), CYCLIC, RIA BLOOD",25.6,16.64,225.24,358.72,2
CPT,82030,Laboratory Services,25.6,16.64,194.08,194.1,2
CPT,82040,ALBUMIN; SERUM,349.54,227.2,12.48,12.48,2
CPT,82040,"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD",349.54,227.2,43.27,68.92,2
CPT,82040,"HB LAB ALBUMIN, SERUM - ER",349.54,227.2,13270.0,14761.0,2
CPT,82040,HB MISC LAB SPECIAL TEST,349.54,227.2,13270.0,14761.0,4
CPT,82040,Laboratory Services,349.54,227.2,37.23,37.24,2
CPT,82042,"ALBUMIN; URINE OR OTHER SOURCE, QUANTITATIVE, EACH SPECIMEN",7.63,4.96,19.13,19.13,2
CPT,82042,"ALBUMIN; URINE,OR OTHER SOURCE QUANTITATIVE,EACH SPECIMEN",7.63,4.96,45.15,71.91,2
CPT,82042,HB MISC LAB SPECIAL TEST,7.63,4.96,13270.0,14761.0,8
CPT,82042,Laboratory Services,7.63,4.96,24.65,24.66,2
CPT,82043,"ALBUMIN; URINE, MICROALBUMIN, QUANTITATIVE",244.73,159.07,14.14,14.14,2
CPT,82043,"ALBUMIN;URINE, MICROALBUMIN,QUANTITATIVE",244.73,159.07,50.56,80.53,2
CPT,82043,"HB LAB URN MICROALBUMIN, TIMED",244.73,159.07,13270.0,14761.0,2
CPT,82043,Laboratory Services,244.73,159.07,43.52,43.53,2
CPT,82044,"ALBUMIN; URINE, MICROALBUMIN, SEMIQUANTITATIVE (E.G., REAGENT STRIP ASSA",,,14.98,14.98,2
CPT,82044,"ALBUMIN;URINE, MICROALBUMIN, SEMIQUANTITATIVE",,,38.63,61.52,2
CPT,82044,Laboratory Services,,,34.4,34.4,2
CPT,82045,ALBUMIN; ISCHEMIA MODIFIED,,,83.2,462.47,4
CPT,82045,Laboratory Services,,,255.34,255.36,2
CPT,82075,"ALCOHOL (ETHANOL), BREATH",,,101.89,162.27,2
CPT,82075,ALCOHOL (ETHANOL); BREATH,,,74.05,74.05,2
CPT,82075,Laboratory Services,,,0.06,0.06,2
CPT,82077,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)",,,42.43,86.9,4
CPT,82085,ALDOLASE,138.98,90.33,24.13,24.13,2
CPT,82085,"ALDOLASE, BLOOD; KINETIC ULTRAVIOLET METHOD",138.98,90.33,84.78,135.02,2
CPT,82085,HB ALDOLASE,138.98,90.33,13270.0,14761.0,4
CPT,82085,Laboratory Services,138.98,90.33,73.02,73.02,2
CPT,82088,ALDOSTERONE,14.86,9.66,99.85,99.85,2
CPT,82088,"ALDOSTERONE; RIA, BLOOD",14.86,9.66,355.94,566.88,2
CPT,82088,HB ALDOSTERONE,14.86,9.66,13270.0,14761.0,4
CPT,82088,HB MISC LAB SPECIAL TEST,14.86,9.66,,,0
CPT,82088,Laboratory Services,14.86,9.66,306.59,306.62,2
CPT,82103,ALPHA-1-ANTITRYPSIN; TOTAL,19.3,12.55,33.29,33.29,2
CPT,82103,ALPHA-1-ANTITRYPSIN;TOTAL,19.3,12.55,117.24,186.71,2
CPT,82103,"HB ALPHA 1 ANTITRYPSIN, STOOL",19.3,12.55,13270.0,14761.0,4
CPT,82103,HB LAB ALPHA ANTI TRYPS,19.3,12.55,13270.0,14761.0,2
CPT,82103,Laboratory Services,19.3,12.55,101.07,101.08,2
CPT,82104,ALPHA-1-ANTITRYPSIN; PHENOTYPE,16.21,10.53,35.77,201.04,4
CPT,82104,Laboratory Services,16.21,10.53,108.8,108.81,2
CPT,82105,ALPHA-FETOPROTEIN; SERUM,313.57,203.82,40.77,233.34,4
CPT,82105,HB LAB ALPHA FETOPROT,313.57,203.82,13270.0,14761.0,2
CPT,82105,Laboratory Services,313.57,203.82,126.22,126.24,2
CPT,82106,ALPHA-FETOPROTEIN; AMNIOTIC FLUID,117.9,76.63,41.61,41.61,2
CPT,82106,ALPHAFETOPROTEIN; AMNIOTIC FLUID,117.9,76.63,146.52,233.34,2
CPT,82106,HB LAB AMNIO FLD AFP W/REF,117.9,76.63,,,0
CPT,82106,Laboratory Services,117.9,76.63,126.22,126.24,2
CPT,82107,ALPHA-FETOPROTEIN (AFP); AFP-L3 FRACTION ISOFORM AND TOTAL AFP (INCLUDING RATIO),93.0,60.45,158.08,876.35,4
CPT,82107,HB ALPHA-1-FETOPROTEIN L3,93.0,60.45,13270.0,14761.0,4
CPT,82107,HB MISC LAB SPECIAL TEST,93.0,60.45,,,0
CPT,82107,Laboratory Services,93.0,60.45,484.51,484.56,2
CPT,82108,ALUMINUM,44.87,29.17,62.4,62.4,2
CPT,82108,"ALUMINUM, BLOOD (SERUM)",44.87,29.17,222.54,354.42,2
CPT,82108,HB ALUMINUM,44.87,29.17,13270.0,14761.0,2
CPT,82108,Laboratory Services,44.87,29.17,191.63,191.65,2
CPT,82120,"AMINES, VAGINAL FLUID, QUALITATIVE",,,14.98,52.53,4
CPT,82120,Laboratory Services,,,28.3,28.3,2
CPT,82127,"AMINO ACIDS; SINGLE, QUALITATIVE, EACH SPECIMEN",,,34.94,191.96,4
CPT,82127,Laboratory Services,,,104.27,104.28,2
CPT,82128,"AMINO ACIDS, QUALITATIVE",,,121.06,192.8,2
CPT,82128,"AMINO ACIDS; MULTIPLE, QUALITATIVE, EACH SPECIMEN",,,34.12,34.12,2
CPT,82128,Laboratory Services,,,104.27,104.28,2
CPT,82131,"AMINO ACIDS, FRACTIONATION AND QUANTITATION",41.9,27.23,146.52,233.34,2
CPT,82131,"AMINO ACIDS; SINGLE, QUANTITATIVE, EACH SPECIMEN",41.9,27.23,56.58,56.58,2
CPT,82131,HB URINE CYSTINE,41.9,27.23,13270.0,14761.0,4
CPT,82131,Laboratory Services,41.9,27.23,126.91,126.93,2
CPT,82135,"AMINOLEVULINIC ACID, DELTA (ALA)",26.54,17.25,40.77,228.94,4
CPT,82135,"HB DELTA ALA, 24 HR URINE",26.54,17.25,13270.0,14761.0,2
CPT,82135,Laboratory Services,26.54,17.25,123.83,123.84,2
CPT,82136,"AMINO ACIDS, 2 TO 5 AMINO ACIDS, QUANTITATIVE, EACH SPECIMEN",,,48.26,233.53,4
CPT,82136,Laboratory Services,,,126.91,126.93,2
CPT,82139,"AMINO ACIDS, 6 OR MORE AMINO ACIDS, QUANTITATIVE, EACH SPECIMEN",72.38,47.05,41.61,233.53,4
CPT,82139,"HB AMINO ACID, LC/MS, PLASMA",72.38,47.05,13270.0,14761.0,4
CPT,82139,Laboratory Services,72.38,47.05,126.91,126.93,2
CPT,82140,AMMONIA,606.43,394.18,35.77,35.77,2
CPT,82140,AMMONIA; BLOOD,606.43,394.18,127.29,202.72,2
CPT,82140,HB LAB AMMONIA BL ER,606.43,394.18,13270.0,14761.0,2
CPT,82140,HB MISC LAB SPECIAL TEST,606.43,394.18,,,0
CPT,82140,Laboratory Services,606.43,394.18,109.62,109.63,2
CPT,82143,AMNIOTIC FLUID SCAN (SPECTROPHOTOMETRIC),,,23.3,95.6,4
CPT,82143,Laboratory Services,,,51.7,51.7,2
CPT,82150,AMYLASE,362.62,235.7,15.81,15.81,2
CPT,82150,"AMYLASE, SERUM",362.62,235.7,56.68,90.27,2
CPT,82150,HB FLUID AMYLASE,362.62,235.7,13270.0,14761.0,2
CPT,82150,HB LAB AMYLASE SE,362.62,235.7,13270.0,14761.0,2
CPT,82150,HB MISC LAB SPECIAL TEST,362.62,235.7,13270.0,14761.0,2
CPT,82150,HB PANCREATIC AMYLASE,362.62,235.7,13270.0,14761.0,2
CPT,82150,Laboratory Services,362.62,235.7,48.74,48.75,2
CPT,82154,ANDROSTANEDIOL GLUCURONIDE,,,70.73,400.49,4
CPT,82154,Laboratory Services,,,216.85,216.87,2
CPT,82157,ANDROSTENEDIONE,18.5,12.03,71.56,71.56,2
CPT,82157,"ANDROSTENEDIONE, RIA",18.5,12.03,255.58,407.04,2
CPT,82157,"HB ANDROSTENEDIONE, LS/MS/MS",18.5,12.03,13270.0,14761.0,4
CPT,82157,HB MISC LAB SPECIAL TEST,18.5,12.03,,,0
CPT,82157,Laboratory Services,18.5,12.03,220.24,220.27,2
CPT,82160,ANDROSTERONE,,,62.4,62.4,2
CPT,82160,ANDROSTERONE; RIA,,,211.37,336.63,2
CPT,82160,Laboratory Services,,,188.11,188.13,2
CPT,82163,ANGIOTENSIN II,,,50.75,50.75,2
CPT,82163,"ANGIOTENSIN II, RIA",,,173.45,276.23,2
CPT,82163,Laboratory Services,,,154.4,154.41,2
CPT,82164,ANGIOTENSIN I - CONVERTING ENZYME (ACE),9.0,5.85,35.77,35.77,2
CPT,82164,ANGIOTENSIN-CONVERTING ENZYME,9.0,5.85,127.47,203.01,2
CPT,82164,"HB ACE, SERUM",9.0,5.85,13270.0,14761.0,4
CPT,82164,Laboratory Services,9.0,5.85,109.81,109.82,2
CPT,82172,"APOLIPOPROTEIN, EACH",10.06,6.54,51.58,51.58,2
CPT,82172,"APOLIPOPROTEIN, IMMUNOASSAY",10.06,6.54,102.48,163.21,2
CPT,82172,HB LAB APOLIPOPROTEIN A1,10.06,6.54,13270.0,14761.0,4
CPT,82172,HB MISC LAB SPECIAL TEST,10.06,6.54,,,0
CPT,82172,Laboratory Services,10.06,6.54,106.03,106.05,2
CPT,82175,ARSENIC,13.9,9.03,46.6,46.6,2
CPT,82175,"ARSENIC, BLOOD, URINE, GASTRIC CONTENTS, HAIR OR NAILS, QUANTITATIVE",13.9,9.03,165.68,263.87,2
CPT,82175,"HB ARSENIC, BLOOD",13.9,9.03,13270.0,14761.0,4
CPT,82175,HB MISC LAB SPECIAL TEST,13.9,9.03,,,0
CPT,82175,Laboratory Services,13.9,9.03,142.76,142.78,2
CPT,82180,"ASCORBIC ACID (VITAMIN C), BLOOD",14.0,9.1,24.13,137.37,4
CPT,82180,HB MISC LAB SPECIAL TEST,14.0,9.1,,,0
CPT,82180,Laboratory Services,14.0,9.1,74.34,74.34,2
CPT,82190,"ATOMIC ABSORPTION SPECTROSCOPY, EACH ANALYTE",,,39.11,39.11,2
CPT,82190,"ATOMIC ABSORPTIOON SPECTROSCOPY, EACH ANALYTE",,,125.94,200.57,2
CPT,82190,Laboratory Services,,,112.13,112.15,2
CPT,82232,BETA-2 MICROGLOBULIN,13.66,8.88,39.94,39.94,2
CPT,82232,"BETA-2 MICROGLOBULIN, RIA; SERUM",13.66,8.88,141.34,225.1,2
CPT,82232,HB LAB BETA-2 MICROGLOBULIN,13.66,8.88,13270.0,14761.0,2
CPT,82232,HB URN B-2-MICROGLOBULIN,13.66,8.88,13270.0,14761.0,2
CPT,82232,Laboratory Services,13.66,8.88,121.69,121.71,2
CPT,82239,BILE ACIDS; TOTAL,,,42.43,240.55,4
CPT,82239,Laboratory Services,,,128.86,128.88,2
CPT,82240,"BILE ACIDS, BLOOD, FRACTIONATED",,,232.12,369.68,2
CPT,82240,BILE ACIDS; CHOLYLGLYCINE,,,64.9,64.9,2
CPT,82240,Laboratory Services,,,199.93,199.95,2
CPT,82247,BILIRUBIN; TOTAL,295.52,192.08,12.48,69.57,4
CPT,82247,HB FLUID BILIRUBIN,295.52,192.08,13270.0,14761.0,2
CPT,82247,HB LAB BILIRU TOTAL ER,295.52,192.08,13270.0,14761.0,2
CPT,82247,HB MISC LAB SPECIAL TEST,295.52,192.08,13270.0,14761.0,4
CPT,82247,Laboratory Services,295.52,192.08,37.73,37.74,2
CPT,82248,BILIRUBIN; DIRECT,294.65,191.52,12.48,69.57,4
CPT,82248,"HB LAB BILIRUBIN, DIRECT",294.65,191.52,13270.0,14761.0,2
CPT,82248,Laboratory Services,294.65,191.52,37.73,37.74,2
CPT,82252,"BILIRUBIN; FECES, QUALITATIVE",,,10.82,61.14,4
CPT,82252,Laboratory Services,,,34.21,34.22,2
CPT,82261,"BIOTINIDASE, EACH SPECIMEN",18.25,11.86,41.61,233.53,4
CPT,82261,Laboratory Services,18.25,11.86,126.91,126.93,2
CPT,82270,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (E.G., GUAIAC), QUALITATIVE; FECESCONSECUTIVE COLLECTED SPECIMENS WITH SINGLE DETERMINATION, FOR COLORECTAL NEOPLASM SCREENING (I.E., PATIENT WAS PROVIDED THREE C",,,10.82,10.82,2
CPT,82270,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY, QUALITATIVE; FECES, CONSECUTIVE COLLECTED SPECIMENS WITH SINGLE DETERMINATION, FO",,,21.93,34.93,2
CPT,82270,Laboratory Services,,,24.46,24.47,2
CPT,82271,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (E.G., GUAIAC), QUALITATIVE; OTHERSOURCES",220.27,143.18,13.31,13.31,2
CPT,82271,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY, QUALITATIVE; OTHER SOURCES ï",220.27,143.18,27.75,44.2,2
CPT,82271,"HB LAB OCCULT BLOOD, GASTRIC",220.27,143.18,13270.0,14761.0,2
CPT,82271,Laboratory Services,220.27,143.18,24.46,24.47,2
CPT,82272,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (E.G., GUAIAC), QUALITATIVE, FECESSINGLE SPECIMEN (E.G., FROM DIGITAL RECTAL EXAM)",236.57,153.77,9.99,9.99,2
CPT,82272,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY, QUALITATIVE; FECES, SINGLE SPECIMEN ï",236.57,153.77,27.75,44.2,2
CPT,82272,HB LAB POC OCCULT BLOOD,236.57,153.77,13270.0,14761.0,2
CPT,82272,Laboratory Services,236.57,153.77,24.46,24.47,2
CPT,82274,"BLOOD,OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE,FECES, 1-3 SIMULTANEOUS DETERMINATI",391.6,254.54,21.93,34.93,2
CPT,82274,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations",391.6,254.54,39.11,39.11,2
CPT,82274,HB LAB OCCULT BLOOD (AB),391.6,254.54,13270.0,14761.0,2
CPT,82274,Laboratory Services,391.6,254.54,119.62,119.63,2
CPT,82286,BRADYKININ,,,12.48,92.7,4
CPT,82286,Laboratory Services,,,51.82,51.83,2
CPT,82300,CADMIUM,15.44,10.04,58.24,58.24,2
CPT,82300,"CADMIUM, URINE",15.44,10.04,202.02,321.74,2
CPT,82300,"HB CADMIUM, BLOOD",15.44,10.04,,,0
CPT,82300,Laboratory Services,15.44,10.04,174.08,174.1,2
CPT,82306,CALCIFEDIOL (25-OH VITAMIN D-3),352.46,229.1,72.39,72.39,2
CPT,82306,HB MISC LAB SPECIAL TEST,352.46,229.1,13270.0,14761.0,2
CPT,82306,HB VIT D:25-HYDROXY,352.46,229.1,13270.0,14761.0,2
CPT,82306,Laboratory Services,352.46,229.1,222.7,222.72,2
CPT,82306,"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED",352.46,229.1,258.52,411.72,2
CPT,82308,CALCITONIN,191.81,124.67,65.73,65.73,2
CPT,82308,"CALCITONIN, RIA",191.81,124.67,233.89,372.49,2
CPT,82308,HB CALCITONIN,191.81,124.67,13270.0,14761.0,4
CPT,82308,Laboratory Services,191.81,124.67,201.5,201.52,2
CPT,82310,"CALCIUM, BLOOD; CHEMICAL",583.1,379.02,44.92,71.54,2
CPT,82310,CALCIUM; TOTAL,583.1,379.02,12.48,12.48,2
CPT,82310,"HB LAB CALCIUM, FREE",583.1,379.02,13270.0,14761.0,2
CPT,82310,HB MISC LAB SPECIAL TEST,583.1,379.02,,,0
CPT,82310,Laboratory Services,583.1,379.02,38.8,38.81,2
CPT,82330,"CALCIUM, BLOOD; FRACTIONATED, DIFFUSIBLE",583.1,379.02,119.35,190.08,2
CPT,82330,CALCIUM; IONIZED,583.1,379.02,33.29,33.29,2
CPT,82330,"HB LAB CALCIUM, FREE",583.1,379.02,13270.0,14761.0,2
CPT,82330,HB MISC LAB SPECIAL TEST,583.1,379.02,,,0
CPT,82330,Laboratory Services,583.1,379.02,102.83,102.84,2
CPT,82331,"CALCIUM, BLOOD; AFTER CALCIUM INFUSION TEST",,,45.15,71.91,2
CPT,82331,CALCIUM; AFTER CALCIUM INFUSION TEST,,,32.45,32.45,2
CPT,82331,Laboratory Services,,,38.93,38.93,2
CPT,82340,"CALCIUM, URINE; QUANTITATIVE, TIMED SPECIMEN",305.02,198.26,52.68,83.9,2
CPT,82340,"CALCIUM; URINE QUANTITATIVE, TIMED SPECIMEN",305.02,198.26,14.98,14.98,2
CPT,82340,HB LAB CALCIUM UR AU,305.02,198.26,13270.0,14761.0,2
CPT,82340,"HB LAB URODSK CAL,URN QN TMDSP",305.02,198.26,13270.0,14761.0,2
CPT,82340,Laboratory Services,305.02,198.26,45.41,45.41,2
CPT,82355,"CALCULUS (STONE), QUALITATIVE, CHEMICAL",,,101.07,160.96,2
CPT,82355,CALCULUS; QUALITATIVE ANALYSIS,,,28.29,28.29,2
CPT,82355,Laboratory Services,,,87.1,87.11,2
CPT,82360,"CALCULUS (STONE), QUANTITATIVE; CHEMICAL",,,112.42,179.03,2
CPT,82360,"CALCULUS; QUANTITATIVE ANALYSIS, CHEMICAL",,,31.62,31.62,2
CPT,82360,Laboratory Services,,,96.85,96.86,2
CPT,82365,"CALCULUS (STONE), QUANTITATIVE; INFRARED SPECTROSCOPY",18.0,11.7,112.65,179.41,2
CPT,82365,CALCULUS; INFRARED SPECTROSCOPY,18.0,11.7,31.62,31.62,2
CPT,82365,HB STONE ANALYSIS,18.0,11.7,13270.0,14761.0,4
CPT,82365,Laboratory Services,18.0,11.7,96.98,96.99,2
CPT,82370,"CALCULUS (STONE), QUANTITATIVE; X-RAY DIFFRACTION",,,109.42,174.26,2
CPT,82370,CALCULUS; X-RAY DIFFRACTION,,,30.79,30.79,2
CPT,82370,Laboratory Services,,,94.27,94.28,2
CPT,82373,CARBOHYDRATE DEFICIENT TRANSFERRIN,82.8,53.82,44.1,100.1,4
CPT,82373,Laboratory Services,82.8,53.82,135.84,135.86,2
CPT,82374,CARBON DIOXIDE (BICARBONATE),583.1,379.02,11.64,11.64,2
CPT,82374,"CARBON DIOXIDE, COMBINING POWER OR CONTENT",583.1,379.02,41.45,66.01,2
CPT,82374,HB LAB BICARB-CO2 SE AU,583.1,379.02,13270.0,14761.0,2
CPT,82374,Laboratory Services,583.1,379.02,36.79,36.79,2
CPT,82375,"CARBON MONOXIDE, (CARBOXYHEMOGLOBIN); QUANTITATIVE",685.37,445.49,29.95,29.95,2
CPT,82375,CARBOXYHEMOGLOBIN; QUANTITATIVE,685.37,445.49,107.65,171.45,2
CPT,82375,HB LAB CARBOXYHEMOGLOBIN,685.37,445.49,,,0
CPT,82375,HB PF CO OXIMETRY,685.37,445.49,13270.0,14761.0,2
CPT,82375,Laboratory Services,685.37,445.49,92.76,92.77,2
CPT,82376,"CARBON MONOXIDE, (CARBOXYHEMOGLOBIN); QUALITATIVE",,,34.94,34.94,2
CPT,82376,CARBOXYHEMOGLOBIN; QUALITATIVE,,,52.33,83.34,2
CPT,82376,Laboratory Services,,,45.09,45.1,2
CPT,82378,CARCINOEMBRYONIC ANTIGEN (CEA),29.29,19.04,46.6,263.4,4
CPT,82378,HB LAB CARCINOEMB AN SE,29.29,19.04,13270.0,14761.0,2
CPT,82378,HB LAB FLD CEA PERITONEAL,29.29,19.04,13270.0,14761.0,2
CPT,82378,HB LAB FLD CEA PLEURAL,29.29,19.04,13270.0,14761.0,2
CPT,82378,Laboratory Services,29.29,19.04,142.76,142.78,2
CPT,82379,"CARNITINE (TOTAL AND FREE), QUANTITATIVE, EACH SPECIMEN",29.92,19.45,41.61,41.61,2
CPT,82379,"CARNITINE(TOTAL AND FREE), QUANTITATIVE, EACH SPECIMEN",29.92,19.45,146.63,233.53,2
CPT,82379,"HB CARNITINE, LC/MS/MS",29.92,19.45,13270.0,14761.0,4
CPT,82379,Laboratory Services,29.92,19.45,126.91,126.93,2
CPT,82380,CAROTENE,31.24,20.31,22.46,22.46,2
CPT,82380,"CAROTENE, BLOOD",31.24,20.31,80.61,128.38,2
CPT,82380,"HB CAROTENE, SERUM",31.24,20.31,13270.0,14761.0,2
CPT,82380,Laboratory Services,31.24,20.31,69.37,69.38,2
CPT,82382,"CATECHOLAMINES (DOPAMINE, NOREPINEPHRINE, EPINEPHRINE); TOTAL URINE",,,150.22,239.24,2
CPT,82382,CATECHOLAMINES; TOTAL URINE,,,67.39,67.39,2
CPT,82382,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,82382,Laboratory Services,,,129.37,129.38,2
CPT,82383,"CATECHOLAMINES (DOPAMINE, NOREPINEPHRINE, EPINEPHRINE); BLOOD",,,218.83,348.52,2
CPT,82383,CATECHOLAMINES; BLOOD,,,71.56,71.56,2
CPT,82383,Laboratory Services,,,188.48,188.5,2
CPT,82384,"CATECHOLAMINES (DOPAMINE, NOREPINEPHRINE, EPINEPHRINE); FRACTIONATED",27.27,17.73,220.54,351.23,2
CPT,82384,CATECHOLAMINES; FRACTIONATED,27.27,17.73,62.4,62.4,2
CPT,82384,"HB CATECHOLAMINES, PLASMA",27.27,17.73,13270.0,14761.0,2
CPT,82384,HB MISC LAB SPECIAL TEST,27.27,17.73,13270.0,14761.0,4
CPT,82384,Laboratory Services,27.27,17.73,189.93,189.95,2
CPT,82387,CATHEPSIN-D,,,44.1,289.34,4
CPT,82387,Laboratory Services,,,156.54,156.55,2
CPT,82390,CERULOPLASMIN,1063.28,691.13,26.63,26.63,2
CPT,82390,"CERULOPLASMIN, CHEMICAL (COPPER OXIDASE), BLOOD",1063.28,691.13,93.78,149.35,2
CPT,82390,HB LAB CERULOPLASMIN,1063.28,691.13,13270.0,14761.0,2
CPT,82390,Laboratory Services,1063.28,691.13,80.82,80.82,2
CPT,82397,CHEMILUMINESCENT ASSAY,32.58,21.17,34.94,196.54,4
CPT,82397,"HB LAB ANTI-GLIADIN ELISA, IGG",32.58,21.17,13270.0,14761.0,4
CPT,82397,HB MISC LAB SPECIAL TEST,32.58,21.17,13270.0,14761.0,4
CPT,82397,Laboratory Services,32.58,21.17,106.29,106.3,2
CPT,82415,CHLORAMPHENICOL,,,30.79,30.79,2
CPT,82415,"CHLORAMPHENICOL, BLOOD",,,110.65,176.22,2
CPT,82415,Laboratory Services,,,95.34,95.35,2
CPT,82435,CHLORIDE; BLOOD,583.1,379.02,11.64,11.64,2
CPT,82435,CHLORIDES; BLOOD (SPECIFY CHEMICAL OR ELECTROMETRIC),583.1,379.02,40.51,64.52,2
CPT,82435,HB CHLORIDE,583.1,379.02,13270.0,14761.0,2
CPT,82435,Laboratory Services,583.1,379.02,34.59,34.59,2
CPT,82436,CHLORIDE; URINE,606.43,394.18,14.14,14.14,2
CPT,82436,"CHLORIDES; URINE (SPECIFY CHEMICAL, ELECTROMETRIC OR FANTUS TEST)",606.43,394.18,43.86,69.85,2
CPT,82436,HB LAB CHLORIDE UR AU,606.43,394.18,13270.0,14761.0,2
CPT,82436,Laboratory Services,606.43,394.18,37.8,37.8,2
CPT,82438,CHLORIDE; OTHER SOURCE,16.2,10.53,12.48,12.48,2
CPT,82438,CHLORIDES; SPINAL FLUID,16.2,10.53,42.69,67.98,2
CPT,82438,HB LAB STOOL CL,16.2,10.53,13270.0,14761.0,4
CPT,82438,HB MISC LAB SPECIAL TEST,16.2,10.53,,,0
CPT,82438,Laboratory Services,16.2,10.53,36.79,36.79,2
CPT,82441,"CHLORINATED HYDROCARBONS, SCREEN",,,14.98,83.52,4
CPT,82441,Laboratory Services,,,45.16,45.16,2
CPT,82465,"CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL",6.59,4.28,10.82,10.82,2
CPT,82465,"CHOLESTEROL, SERUM,OR WHOLD BLOOD, TOTAL",6.59,4.28,37.98,60.49,2
CPT,82465,HB CHOLESTEROL,6.59,4.28,13270.0,14761.0,2
CPT,82465,HB LAB CHOLESTROL SE AU,6.59,4.28,13270.0,14761.0,2
CPT,82465,HB MISC LAB SPECIAL TEST,6.59,4.28,,,0
CPT,82465,Laboratory Services,6.59,4.28,32.77,32.77,2
CPT,82480,CHOLINESTERASE; SERUM,11.94,7.76,19.13,109.56,4
CPT,82480,"HB CHOLINESTERASE, PSEUDO",11.94,7.76,13270.0,14761.0,2
CPT,82480,Laboratory Services,11.94,7.76,59.31,59.31,2
CPT,82482,CHOLINESTERASE; RBC,11.94,7.76,24.13,106.84,4
CPT,82482,Laboratory Services,11.94,7.76,57.8,57.8,2
CPT,82485,"CHONDROITIN B SULFATE, QUANTITATIVE",,,50.75,243.92,4
CPT,82485,Laboratory Services,,,155.34,155.36,2
CPT,82495,CHROMIUM,21.47,13.96,49.92,49.92,2
CPT,82495,"CHROMIUM, URINE",21.47,13.96,177.09,282.03,2
CPT,82495,HB MISC LAB SPECIAL TEST,21.47,13.96,13270.0,14761.0,4
CPT,82495,Laboratory Services,21.47,13.96,152.57,152.59,2
CPT,82507,CITRATE,12.38,8.05,68.23,386.63,4
CPT,82507,HB LAB CITRATE  #,12.38,8.05,,,0
CPT,82507,HB LAB CITRATE #,12.38,8.05,13270.0,14761.0,2
CPT,82507,HB LAB URN CITRATE,12.38,8.05,13270.0,14761.0,2
CPT,82507,Laboratory Services,12.38,8.05,209.18,209.2,2
CPT,82523,COLLAGEN CROSS LINKS ANY METHOD,20.99,13.64,240.65,383.26,2
CPT,82523,"COLLAGEN CROSS LINKS, ANY METHOD",20.99,13.64,45.76,45.76,2
CPT,82523,HB LAB N-TELOPEPTIDE SE GC/MS,20.99,13.64,13270.0,14761.0,4
CPT,82523,HB MISC LAB SPECIAL TEST,20.99,13.64,,,0
CPT,82523,Laboratory Services,20.99,13.64,139.56,139.57,2
CPT,82525,COPPER,17.37,11.29,30.79,30.79,2
CPT,82525,COPPER; BLOOD,17.37,11.29,108.65,173.04,2
CPT,82525,HB LAB QUANTITATIVE COPPER #,17.37,11.29,13270.0,14761.0,4
CPT,82525,Laboratory Services,17.37,11.29,93.33,93.34,2
CPT,82528,CORTICOSTERONE,69.0,44.85,54.92,54.92,2
CPT,82528,"CORTICOSTERONE, RIA",69.0,44.85,190.2,302.92,2
CPT,82528,HB LAB CORTICOSTERONE,69.0,44.85,13270.0,14761.0,2
CPT,82528,Laboratory Services,69.0,44.85,169.37,169.38,2
CPT,82530,CORTISOL; FREE,17.86,11.61,40.77,235.87,4
CPT,82530,"HB CORTISOL, FREE, URINE",17.86,11.61,13270.0,14761.0,2
CPT,82530,HB LAB SERUM FREE CORTISOL,17.86,11.61,13270.0,14761.0,2
CPT,82530,Laboratory Services,17.86,11.61,125.72,125.73,2
CPT,82533,"CORTISOL; RIA, PLASMA",6.37,4.14,142.52,226.98,2
CPT,82533,CORTISOL; TOTAL,6.37,4.14,39.94,39.94,2
CPT,82533,HB LAB CORTISOL SE RI,6.37,4.14,13270.0,14761.0,2
CPT,82533,HB MISC LAB SPECIAL TEST,6.37,4.14,,,0
CPT,82533,Laboratory Services,6.37,4.14,122.7,122.71,2
CPT,82540,CREATINE,31.19,20.27,11.64,11.64,2
CPT,82540,CREATINE; BLOOD,31.19,20.27,40.1,63.86,2
CPT,82540,"HB LAB CREATINE, 24 HR URINE",31.19,20.27,13270.0,14761.0,2
CPT,82540,Laboratory Services,31.19,20.27,34.84,34.85,2
CPT,82542,"COLUMN CHROMATOGRAPHY/MASS SPECTOMETRY, ANALYTE NOT ELSE WHERE SPECIFIED; QUANTITATIVE SINGLE STATIONARY AND MOB",120.0,78.0,157.04,250.1,2
CPT,82542,"COLUMN CHROMATOGRAPHY/MASS SPECTROMETRY (E.G., GC/MS, OR HPLC/MS), ANALYNOT ELSEWHERE SPECIFIED; QUANTITATIVE, SINGLE STATIONARY AND MOBILE PHASE",120.0,78.0,59.07,59.07,2
CPT,82542,HB LAB TPMT ENZ COLMN SGL ANALYTE,120.0,78.0,13270.0,14761.0,2
CPT,82542,HB MISC LAB SPECIAL TEST,120.0,78.0,13270.0,14761.0,4
CPT,82542,Laboratory Services,120.0,78.0,135.84,135.86,2
CPT,82550,"CREATINE KINASE (CK), (CPK); TOTAL",396.74,257.88,15.81,15.81,2
CPT,82550,"CREATINE PHOSPHOKINASE (CPK), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD",396.74,257.88,57.27,91.2,2
CPT,82550,HB CK TOTAL,396.74,257.88,13270.0,14761.0,4
CPT,82550,HB LAB CPK TOTAL SE AU,396.74,257.88,13270.0,14761.0,2
CPT,82550,Laboratory Services,396.74,257.88,48.99,49.0,2
CPT,82552,"CREATINE KINASE (CK), (CPK); ISOENZYMES",9.49,6.17,33.29,33.29,2
CPT,82552,"CREATINE PHOSPHOKINASE (CPK), BLOOD; ISOENZYMES",9.49,6.17,116.94,186.24,2
CPT,82552,HB CK ISOENZYMES,9.49,6.17,13270.0,14761.0,4
CPT,82552,Laboratory Services,9.49,6.17,100.81,100.82,2
CPT,82553,"CREATINE KINASE (CK), (CPK); MB FRACTION ONLY",350.83,228.04,28.29,28.29,2
CPT,82553,HB MISC LAB SPECIAL TEST,350.83,228.04,13270.0,14761.0,2
CPT,82553,Laboratory Services,350.83,228.04,86.85,86.86,2
CPT,82553,MB FRACTION ONLY,350.83,228.04,100.83,160.59,2
CPT,82554,"CREATINE KINASE (CK), (CPK); ISOFORMS",,,29.12,29.12,2
CPT,82554,Laboratory Services,,,89.31,89.31,2
CPT,82554,MB FRACTION;ISOFORMS,,,100.77,160.49,2
CPT,82565,CREATININE; BLOOD,583.1,379.02,12.48,71.16,4
CPT,82565,HB CREATININE,583.1,379.02,13270.0,14761.0,2
CPT,82565,Laboratory Services,583.1,379.02,38.62,38.62,2
CPT,82570,CREATININE; OTHER SOURCE,6.48,4.21,12.48,12.48,2
CPT,82570,CREATININE; URINE,6.48,4.21,45.15,71.91,2
CPT,82570,HB LAB CREATININE FLD,6.48,4.21,13270.0,14761.0,2
CPT,82570,HB MISC LAB SPECIAL TEST,6.48,4.21,13270.0,14761.0,8
CPT,82570,Laboratory Services,6.48,4.21,38.93,38.93,2
CPT,82575,CREATININE; CLEARANCE,606.43,394.18,23.3,131.19,4
CPT,82575,HB LAB CREATININ-CLR AU,606.43,394.18,13270.0,14761.0,2
CPT,82575,Laboratory Services,606.43,394.18,71.13,71.14,2
CPT,82585,CRYOFIBRINOGEN,23.28,15.13,34.94,34.94,2
CPT,82585,"CRYOFIBRINOGEN, BLOOD",23.28,15.13,74.9,119.29,2
CPT,82585,HB MISC LAB SPECIAL TEST,23.28,15.13,13270.0,14761.0,2
CPT,82585,Laboratory Services,23.28,15.13,64.53,64.53,2
CPT,82595,"CRYOGLOBULIN, QUALITATIVE OR SEMI-QUANTITATIVE (E.G., CRYOCRIT)",264.21,171.73,15.81,15.81,2
CPT,82595,"CRYOGLOBULIN,QUALITATIVE OR SEMI-QUALITIVE(EG, CRYOCRIT)",264.21,171.73,55.03,87.64,2
CPT,82595,HB LAB CRYOGLOBULIN SE,264.21,171.73,13270.0,14761.0,2
CPT,82595,Laboratory Services,264.21,171.73,43.14,43.15,2
CPT,82600,CYANIDE,14.48,9.41,47.43,47.43,2
CPT,82600,CYANIDE; BLOOD,14.48,9.41,169.45,269.86,2
CPT,82600,"HB CYANIDE, BLOOD",14.48,9.41,13270.0,14761.0,2
CPT,82600,Laboratory Services,14.48,9.41,145.97,145.98,2
CPT,82607,CYANOCOBALAMIN (VITAMIN B-12);,826.48,537.21,37.44,37.44,2
CPT,82607,CYANOCOBALAMIN (VITAMIN B-12); RIA,826.48,537.21,131.64,209.65,2
CPT,82607,HB LAB VITAMIN B-12 RI,826.48,537.21,13270.0,14761.0,2
CPT,82607,Laboratory Services,826.48,537.21,113.39,113.4,2
CPT,82608,CYANOCOBALAMIN (VITAMIN B-12); UNSATURATED BINDING CAPACITY,24.2,15.73,34.94,199.26,4
CPT,82608,HB VITAMIN B12 BIND CAPACITY,24.2,15.73,13270.0,14761.0,2
CPT,82608,Laboratory Services,24.2,15.73,107.73,107.74,2
CPT,82610,CYSTATIN C,44.29,28.79,45.76,189.15,4
CPT,82610,HB CYSTATIN C W/EGFR,44.29,28.79,13270.0,14761.0,4
CPT,82610,Laboratory Services,44.29,28.79,102.26,102.27,2
CPT,82615,"CYSTINE AND HOMOCYSTINE, URINE, QUALITATIVE",,,23.3,23.3,2
CPT,82615,"CYSTINE AND HOMOCYSTINE, URINE; QUALITATIVE",,,71.32,113.58,2
CPT,82615,Laboratory Services,,,61.38,61.39,2
CPT,82626,DEHYDROEPIANDROSTERONE (DHEA),22.0,14.3,62.4,62.4,2
CPT,82626,"DEHYDROEPIANDROSTERONE (DHEA), RIA",22.0,14.3,220.72,351.51,2
CPT,82626,"HB DHEA,UNCONJUGATD,LC/MS/MS",22.0,14.3,13270.0,14761.0,4
CPT,82626,HB MISC LAB SPECIAL TEST,22.0,14.3,,,0
CPT,82626,Laboratory Services,22.0,14.3,190.12,190.14,2
CPT,82627,DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S),7.0,4.55,54.92,309.19,4
CPT,82627,HB DHEA SULFATE,7.0,4.55,13270.0,14761.0,4
CPT,82627,HB MISC LAB SPECIAL TEST,7.0,4.55,,,0
CPT,82627,Laboratory Services,7.0,4.55,167.29,167.31,2
CPT,82633,"DESOXYCORTICOSTERONE, 11-",47.29,30.74,75.71,75.71,2
CPT,82633,"DESOXYCORTICOSTERONE, 11-, RIA",47.29,30.74,261.76,416.87,2
CPT,82633,HB LAB DEOXYCORTICOSTERONE #,47.29,30.74,13270.0,14761.0,4
CPT,82633,HB MISC LAB SPECIAL TEST,47.29,30.74,,,0
CPT,82633,Laboratory Services,47.29,30.74,233.01,233.03,2
CPT,82634,"DEOXYCORTISOL, 11-",26.21,17.04,71.56,71.56,2
CPT,82634,"DEOXYCORTISOL, 11-(COMPOUND S), RIA",26.21,17.04,255.58,407.04,2
CPT,82634,"HB 11-DEOXYCORTISOL,LC/MS/MS",26.21,17.04,13270.0,14761.0,2
CPT,82634,HB MISC LAB SPECIAL TEST,26.21,17.04,,,0
CPT,82634,Laboratory Services,26.21,17.04,220.24,220.27,2
CPT,82638,DIBUCAINE NUMBER,14.33,9.31,29.95,170.33,4
CPT,82638,HB DIBUCAINE NUMBER,14.33,9.31,13270.0,14761.0,2
CPT,82638,Laboratory Services,14.33,9.31,92.14,92.14,2
CPT,82642,Dihydrotestosterone (DHT),,,71.56,287.28,4
CPT,82642,Laboratory Services,,,173.89,173.91,2
CPT,82652,"DIHYDROXYVITAMIN D, 1,25-",26.0,16.9,94.86,94.86,2
CPT,82652,"HB VITAMIN D(1,25OHD),LCMSMS",26.0,16.9,13270.0,14761.0,4
CPT,82652,Laboratory Services,26.0,16.9,289.61,289.64,2
CPT,82652,"VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED",26.0,16.9,261.52,416.5,2
CPT,82653,"Elastase, pancreatic (EL-1), fecal; quantitative",,,56.58,91.76,4
CPT,82653,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,82653,Laboratory Services,,,122.76,122.78,2
CPT,82656,"ELASTASE, PANCREATIC (EL-1), FECAL, QUALITATIVE OR SEMI-QUANTITATIVE",,,28.29,28.29,2
CPT,82656,"ELASTASE, PANCREATIC, FECAL, QUALITATIVE OR SEMI QUALITATIVE",,,79.49,126.6,2
CPT,82656,Laboratory Services,,,69.87,69.88,2
CPT,82657,"ENZYME ACTIVITY IN BLOOD CELLS, CULTURED CELLS, OR TISSUE, NOT ELSEWHERESPECIFIED; NONRADIOACTIVE SUBSTRATE, EACH SPECIMEN",77.0,50.05,54.08,54.08,2
CPT,82657,"ENZYME ACTIVITY IN BLOOD CELLS,CULTURED CELLS OR TISSUE NOT ELESWHERE SPECIFIED;NONRADIOACTIVE SUBSTRATE,EA SPECIMEN",77.0,50.05,157.04,250.1,2
CPT,82657,HB LAB TPMT ENZ NON-RADIO SUBSTRA,77.0,50.05,13270.0,14761.0,4
CPT,82657,HB MISC LAB SPECIAL TEST,77.0,50.05,,,0
CPT,82657,Laboratory Services,77.0,50.05,135.84,135.86,2
CPT,82658,"ENZYME ACTIVITY IN BLOOD CELLS, CULTURED CELLS, OR TISSUE, NOT ELSEWHERESPECIFIED; RADIOACTIVE SUBSTRATE, EACH SPECIMEN",,,108.17,108.17,2
CPT,82658,"ENZYME ACTIVITY IN BLOOD CELLS,CULTURED CELLS, OR TISSUE NOT ELSEWHERE SPECIFIED;RADIOACTIVE SUBSTRATE,EA SPECIMEN",,,157.04,250.1,2
CPT,82658,Laboratory Services,,,135.84,135.86,2
CPT,82664,"ELECTROPHORETIC TECHNIQUE, NOT ELSEWHERE SPECIFIED",12.07,7.85,150.6,405.64,4
CPT,82664,HB LIPOPROTEIN ELECTR SEP,12.07,7.85,,,0
CPT,82664,HB MISC LAB SPECIAL TEST,12.07,7.85,13270.0,14761.0,4
CPT,82664,Laboratory Services,12.07,7.85,258.48,258.51,2
CPT,82668,ERYTHROPOIETIN,1022.51,664.63,45.76,45.76,2
CPT,82668,"ERYTHROPOIETIN, BIOASSAY",1022.51,664.63,162.98,259.56,2
CPT,82668,HB LAB ERYTHROPOIETIN LEVEL,1022.51,664.63,13270.0,14761.0,2
CPT,82668,Laboratory Services,1022.51,664.63,141.44,141.46,2
CPT,82670,ESTRADIOL,24.0,15.6,68.23,388.69,4
CPT,82670,"HB ESTRADIOL, FREE",24.0,15.6,13270.0,14761.0,2
CPT,82670,HB LAB ESTRADIOL,24.0,15.6,13270.0,14761.0,2
CPT,82670,HB LAB ESTRADIOL SE,24.0,15.6,,,0
CPT,82670,HB MISC LAB SPECIAL TEST,24.0,15.6,,,0
CPT,82670,Laboratory Services,24.0,15.6,210.18,210.2,2
CPT,82671,ESTROGENS; FRACTIONATED,33.01,21.46,79.05,449.18,4
CPT,82671,Laboratory Services,33.01,21.46,242.95,242.97,2
CPT,82672,ESTROGENS; TOTAL,,,53.25,301.7,4
CPT,82672,HB LAB ESTROGEN TOTAL,449.47999999999996,292.15999999999997,13270.0,14761.0,2
CPT,82672,Laboratory Services,,,163.2,163.22,2
CPT,82677,ESTRIOL,19.59,12.73,59.07,59.07,2
CPT,82677,ESTRIOL; RIA,19.59,12.73,212.07,337.75,2
CPT,82677,"HB ESTRIOL, UNCONJUGATED",19.59,12.73,,,0
CPT,82677,Laboratory Services,19.59,12.73,181.94,181.96,2
CPT,82679,ESTRONE,27.24,17.7,61.57,61.57,2
CPT,82679,ESTRONE; RIA,27.24,17.7,217.95,347.11,2
CPT,82679,"HB ESTROGENS, FRACT ESTRONE",27.24,17.7,,,0
CPT,82679,Laboratory Services,27.24,17.7,187.73,187.75,2
CPT,82681,"Estradiol; free, direct measurement (eg, equilibrium dialysis)",,,68.23,140.55,4
CPT,82681,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,82681,Laboratory Services,,,149.37,149.38,2
CPT,82693,ETHYLENE,11.58,7.53,128.47,204.6,2
CPT,82693,ETHYLENE GLYCOL,11.58,7.53,36.61,36.61,2
CPT,82693,HB ETHYLENE GLYCOL,11.58,7.53,13270.0,14761.0,2
CPT,82693,Laboratory Services,11.58,7.53,112.07,112.08,2
CPT,82696,ETIOCHOLANOLONE,,,64.07,64.07,2
CPT,82696,"ETIOCHOLANOLONE, RIA",,,199.32,317.43,2
CPT,82696,Laboratory Services,,,177.42,177.43,2
CPT,82705,"FAT OR LIPIDS, FECES; QUALITATIVE",15.74,10.23,12.48,12.48,2
CPT,82705,"FAT OR LIPIDS, FECES; SCREENING",15.74,10.23,44.51,70.88,2
CPT,82705,"HB FECAL FAT, QUALITATIVE",15.74,10.23,13270.0,14761.0,4
CPT,82705,Laboratory Services,15.74,10.23,38.3,38.3,2
CPT,82710,"FAT OR LIPIDS, FECES; QUANTITATIVE",43.23,28.1,41.61,41.61,2
CPT,82710,"FAT OR LIPIDS, FECES; QUANTITATIVE, 24 OR 72 HOUR SPECIMEN",43.23,28.1,146.75,233.72,2
CPT,82710,"HB LAB FECAL FAT, TIMED",43.23,28.1,13270.0,14761.0,2
CPT,82710,Laboratory Services,43.23,28.1,126.35,126.36,2
CPT,82715,"FAT DIFFERENTIAL, FECES, QUANTITATIVE",,,56.58,231.66,4
CPT,82715,Laboratory Services,,,129.49,129.51,2
CPT,82725,"FATTY ACIDS, BLOOD; NONESTERIFIED",14.48,9.41,116.3,185.21,2
CPT,82725,"FATTY ACIDS, NONESTERIFIED",14.48,9.41,45.76,45.76,2
CPT,82725,HB MISC LAB SPECIAL TEST,14.48,9.41,13270.0,14761.0,4
CPT,82725,Laboratory Services,14.48,9.41,100.19,100.2,2
CPT,82726,HB VERY LONGCHAIN FATTY ACID,147.0,95.55,13270.0,14761.0,4
CPT,82726,Laboratory Services,147.0,95.55,135.84,135.86,2
CPT,82726,VERY LONG CHAIN FATTY ACIDS,147.0,95.55,48.26,250.1,4
CPT,82728,FERRITIN,485.67,315.69,33.29,33.29,2
CPT,82728,"FERRITIN, SPECIFY METHOD (EG, RIA, IMMUNORADIOMETRIC ASSAY)",485.67,315.69,119.0,189.52,2
CPT,82728,HB LAB FERRITIN,485.67,315.69,13270.0,14761.0,2
CPT,82728,Laboratory Services,485.67,315.69,102.45,102.46,2
CPT,82731,"FETAL FIBRONECTIN CERVICOVAGINAL SECRETIONS, SEMI-QUANTITATIVE",3040.12,1976.08,1175.9,1872.74,2
CPT,82731,"FETAL FIBRONECTIN, CERVICOVAGINAL SECRETIONS, SEMI-QUANTITATIVE",3040.12,1976.08,158.08,158.08,2
CPT,82731,Laboratory Services,3040.12,1976.08,484.51,484.56,2
CPT,82735,FLUORIDE,,,45.76,45.76,2
CPT,82735,FLUORIDE; BLOOD,,,161.92,257.88,2
CPT,82735,HB MISC LAB SPECIAL TEST,1396.56,907.76,13270.0,14761.0,2
CPT,82735,Laboratory Services,,,139.49,139.51,2
CPT,82746,"FOLIC ACID (FOLATE), BLOOD; RIA",588.32,382.4,128.41,204.5,2
CPT,82746,FOLIC ACID; SERUM,588.32,382.4,35.77,35.77,2
CPT,82746,HB LAB FOLATE SE RI,588.32,382.4,13270.0,14761.0,2
CPT,82746,HB MISC LAB SPECIAL TEST,588.32,382.4,,,0
CPT,82746,Laboratory Services,588.32,382.4,110.63,110.64,2
CPT,82747,FOLIC ACID; RBC,13.0,8.45,43.26,43.26,2
CPT,82747,"HB FOLATE, RBC",13.0,8.45,13270.0,14761.0,4
CPT,82747,Laboratory Services,13.0,8.45,130.31,130.32,2
CPT,82747,RBC,13.0,8.45,156.81,249.73,2
CPT,82757,"FRUCTOSE, SEMEN",,,42.43,242.05,4
CPT,82757,Laboratory Services,,,130.5,130.51,2
CPT,82759,"GALACTOKINASE, RBC",,,52.42,299.83,4
CPT,82759,Laboratory Services,,,161.63,161.65,2
CPT,82760,GALACTOSE,,,27.45,27.45,2
CPT,82760,GALACTOSE; BLOOD,,,97.83,155.81,2
CPT,82760,Laboratory Services,,,84.21,84.22,2
CPT,82775,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE; QUANTITATIVE,,,51.58,293.08,4
CPT,82775,Laboratory Services,,,158.42,158.44,2
CPT,82776,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE; SCREEN,18.25,11.86,29.12,116.58,4
CPT,82776,Laboratory Services,18.25,11.86,63.08,63.09,2
CPT,82777,GALECTIN-3,103.1,67.02,91.43,145.61,2
CPT,82777,Galectin-3,103.1,67.02,109.0,109.0,2
CPT,82777,HB MISC LAB SPECIAL TEST,103.1,67.02,,,0
CPT,82777,Laboratory Services,103.1,67.02,95.15,95.16,2
CPT,82784,"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH",188.98,122.84,67.67,107.78,2
CPT,82784,"GAMMAGLOBULIN; IGA, IGD, IGG, IGM, EACH",188.98,122.84,22.46,22.46,2
CPT,82784,HB LAB IG GAMAGLOB,188.98,122.84,13270.0,14761.0,2
CPT,82784,HB LAB IG M SE,188.98,122.84,13270.0,14761.0,2
CPT,82784,HB MISC LAB SPECIAL TEST,188.98,122.84,13270.0,14761.0,6
CPT,82784,Laboratory Services,188.98,122.84,49.31,49.31,2
CPT,82785,GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE,23.86,15.51,143.81,229.04,2
CPT,82785,GAMMAGLOBULIN; IGE,23.86,15.51,40.77,40.77,2
CPT,82785,HB LAB IMMUNOGLOBULIN IGE,23.86,15.51,13270.0,14761.0,4
CPT,82785,HB MISC LAB SPECIAL TEST,23.86,15.51,,,0
CPT,82785,Laboratory Services,23.86,15.51,123.9,123.91,2
CPT,82787,"GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH",7.5,4.88,290.92,463.32,2
CPT,82787,"GAMMAGLOBULIN; IMMUNOGLOBULIN SUBCLASSES, (IGG1, 2, 3, OR 4), EACH",7.5,4.88,19.97,19.97,2
CPT,82787,"HB IGG4 IGG 1, 2, 3 OR 4, EACH",7.5,4.88,13270.0,14761.0,2
CPT,82787,HB LAB IGG SUBCLASSES,7.5,4.88,13270.0,14761.0,2
CPT,82787,Laboratory Services,7.5,4.88,60.38,60.38,2
CPT,82800,"GASES, BLOOD, PH ONLY",,,26.63,26.63,2
CPT,82800,"GASES, BLOOD; PH ONLY",,,73.91,117.7,2
CPT,82800,Laboratory Services,,,61.51,61.51,2
CPT,82803,"GASES, BLOOD, ANY COMBINATION OF PH, PCO2, PO2, CO2, HCO3 (INCLUDING CALCULATED O2 SATURATION);",1868.23,1214.35,64.07,64.07,2
CPT,82803,"GASES, BLOOD; PH, PCO2, PO2 SIMULTANEOUS",1868.23,1214.35,168.98,269.11,2
CPT,82803,"HB LAB BLOOD GASES, ART POC",1868.23,1214.35,13270.0,14761.0,2
CPT,82803,Laboratory Services,1868.23,1214.35,145.53,145.54,2
CPT,82805,"GASES, BLOOD COMBINATION OF PH,PCO2,CO2,HCO2; WITH 02 STATURATION, BY DIRECT MEASUREMENT, EXCEPT PULSE OXI",,,245.53,391.03,2
CPT,82805,"GASES, BLOOD, ANY COMBINATION OF PH, PCO2, PO2, CO2, HCO3 (INCLUDING CALCULATED O2 SATURATION); WITH O2 SATURATION, BY DIRECT MEASUREMENT, EXCEPT PULSE OXIMETRY",,,193.04,193.04,2
CPT,82805,Laboratory Services,,,213.52,213.54,2
CPT,82810,"GASES, BLOOD, O2 SATURATION ONLY, BY DIRECT MEASUREMENT, EXCEPT PULSE OXIMETRY",,,24.13,24.13,2
CPT,82810,"GASES, BLOOD,02 SATURATION ONLY, BY DIRECT MEASUREMENT, EXCEPT PULSE OXIMETRY",,,76.2,121.35,2
CPT,82810,Laboratory Services,,,65.66,65.66,2
CPT,82820,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,82820,HEMOGLOBIN-OXYGEN AFFINITY,,,87.66,139.61,2
CPT,82820,HEMOGLOBIN-OXYGEN AFFINITY (PO2 FOR 50% HEMOGLOBIN SATURATION WITH OXYGEN),,,32.45,32.45,2
CPT,82820,Laboratory Services,,,75.22,75.23,2
CPT,82930,"GASTRIC ACID ANALYSIS, INCLUDES PH IF PERFORMED, EACH SPECIMEN",,,16.64,58.79,4
CPT,82930,Laboratory Services,,,39.31,39.31,2
CPT,82938,"GASTRIN (SERUM) AFTER SECRETIN STIMULATION (EG, FOR GASTRINOMA, ZOLLINGER-ELLISON SYNDROME)",,,149.57,238.21,2
CPT,82938,GASTRIN AFTER SECRETIN STIMULATION,,,43.26,43.26,2
CPT,82938,Laboratory Services,,,133.14,133.15,2
CPT,82941,GASTRIN,123.38,80.2,43.26,43.26,2
CPT,82941,"GASTRIN, RIA",123.38,80.2,154.04,245.33,2
CPT,82941,HB LAB GASTRIN SE,123.38,80.2,13270.0,14761.0,4
CPT,82941,Laboratory Services,123.38,80.2,132.7,132.71,2
CPT,82943,GLUCAGON,15.44,10.04,34.94,34.94,2
CPT,82943,"GLUCAGON, RIA",15.44,10.04,105.95,168.73,2
CPT,82943,HB GLUCAGON,15.44,10.04,13270.0,14761.0,2
CPT,82943,Laboratory Services,15.44,10.04,107.48,107.49,2
CPT,82945,"GLUCOLSE, BODY FLUID, OTHER THAN BLOOD",606.43,394.18,34.22,54.5,2
CPT,82945,"GLUCOSE, BODY FLUID, OTHER THAN BLOOD",606.43,394.18,9.99,9.99,2
CPT,82945,HB FLUID GLUCOSE,606.43,394.18,13270.0,14761.0,2
CPT,82945,HB LAB GLUCOSE CSF AU,606.43,394.18,13270.0,14761.0,2
CPT,82945,HB MISC LAB SPECIAL TEST,606.43,394.18,13270.0,14761.0,4
CPT,82945,Laboratory Services,606.43,394.18,29.5,29.5,2
CPT,82946,GLUCAGON TOLERANCE TEST,,,43.26,178.0,4
CPT,82946,Laboratory Services,,,113.39,113.4,2
CPT,82947,GLUCOSE; BLOOD (EXCEPT REAGENT STRIP),583.1,379.02,34.34,54.68,2
CPT,82947,"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)",583.1,379.02,9.99,9.99,2
CPT,82947,HB LAB GLUCOSE FAST AU,583.1,379.02,13270.0,14761.0,2
CPT,82947,Laboratory Services,583.1,379.02,29.5,29.5,2
CPT,82948,"GLUCOSE; BLOOD, REAGENT STRIP",,,12.48,12.48,2
CPT,82948,"GLUCOSE; BLOOD, STICK TEST",,,27.57,43.92,2
CPT,82948,Laboratory Services,,,23.77,23.78,2
CPT,82950,GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE),583.1,379.02,11.64,66.01,4
CPT,82950,HB LAB GLUCOSE 2H PP,583.1,379.02,13270.0,14761.0,2
CPT,82950,Laboratory Services,583.1,379.02,35.72,35.73,2
CPT,82951,"GLUCOSE; TOLERANCE TEST (GTT), THREE SPECIMENS (INCLUDES GLUCOSE)",970.63,630.91,31.62,179.03,4
CPT,82951,HB LAB GLUCOSE TOTAL 3H AU,970.63,630.91,,,0
CPT,82951,Laboratory Services,970.63,630.91,96.85,96.86,2
CPT,82952,"GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",606.43,394.18,34.28,54.59,2
CPT,82952,"GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND THREE SPECIMENS",606.43,394.18,9.99,9.99,2
CPT,82952,"HB LAB GLUC TOL, EA ADNL SPEC",606.43,394.18,,,0
CPT,82952,Laboratory Services,606.43,394.18,29.43,29.44,2
CPT,82955,GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE,15.0,9.75,24.13,134.84,4
CPT,82955,"HB G-6-PD, QN",15.0,9.75,13270.0,14761.0,4
CPT,82955,Laboratory Services,15.0,9.75,72.95,72.96,2
CPT,82960,GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); SCREEN,739.68,480.79,14.98,84.37,4
CPT,82960,Laboratory Services,739.68,480.79,45.53,45.54,2
CPT,82962,"GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE",,,8.32,8.32,2
CPT,82962,Laboratory Services,,,17.61,17.61,2
CPT,82963,"GLUCOSIDASE, BETA",,,52.42,253.66,4
CPT,82963,Laboratory Services,,,161.63,161.65,2
CPT,82965,GLUTAMATE DEHYDROGENASE,,,32.45,32.45,2
CPT,82965,"GLUTAMATE DEHYDROGENASE, BLOOD",,,67.5,107.5,2
CPT,82965,Laboratory Services,,,58.17,58.18,2
CPT,82977,"GLUTAMYL TRANSPEPTIDASE, GAMMA (GGT)",252.86,164.36,63.15,100.57,2
CPT,82977,"GLUTAMYLTRANSFERASE, GAMMA (GGT)",252.86,164.36,17.48,17.48,2
CPT,82977,HB LAB GAM GLUT TRAN SC,252.86,164.36,13270.0,14761.0,2
CPT,82977,Laboratory Services,252.86,164.36,54.15,54.15,2
CPT,82978,GLUTATHIONE,,,38.27,198.23,4
CPT,82978,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,82978,Laboratory Services,,,107.23,107.24,2
CPT,82979,"GLUTATHIONE REDUCTASE, RBC",,,23.3,95.7,4
CPT,82979,Laboratory Services,,,51.82,51.83,2
CPT,82985,GLYCATED PROTEIN,23.84,15.49,40.77,40.77,2
CPT,82985,"GLYCOPROTEIN, ELECTROPHORESIS",23.84,15.49,131.64,209.65,2
CPT,82985,HB FRUCTOSAMINE,23.84,15.49,13270.0,14761.0,4
CPT,82985,Laboratory Services,23.84,15.49,113.39,113.4,2
CPT,83001,"GONADOTROPIN, PITUITARY, FOLLICLE STIMULATING HORMONE (FSH); RIA",22.94,14.91,162.27,258.44,2
CPT,83001,GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH),22.94,14.91,45.76,45.76,2
CPT,83001,"HB FOLLICLE STIM HORM,PEDS",22.94,14.91,,,0
CPT,83001,HB LAB FOLLICLE STIM HORMONE,22.94,14.91,13270.0,14761.0,2
CPT,83001,Laboratory Services,22.94,14.91,139.81,139.82,2
CPT,83002,"GONADOTROPIN, PITUITARY, LUTEINIZING HORMONE (LH)(ICSH), RIA",22.86,14.86,161.75,257.6,2
CPT,83002,GONADOTROPIN; LUTEINIZING HORMONE (LH),22.86,14.86,45.76,45.76,2
CPT,83002,HB LAB LUTENIZING HORMONE,22.86,14.86,13270.0,14761.0,2
CPT,83002,"HB LUTEINIZING HORM,PEDS",22.86,14.86,,,0
CPT,83002,Laboratory Services,22.86,14.86,139.3,139.32,2
CPT,83003,"GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN)",12.06,7.84,40.77,40.77,2
CPT,83003,"GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN); RIA",12.06,7.84,145.52,231.75,2
CPT,83003,HB LAB HGH SE,12.06,7.84,13270.0,14761.0,4
CPT,83003,Laboratory Services,12.06,7.84,125.47,125.48,2
CPT,83006,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1)",,,185.55,185.55,2
CPT,83006,Growth stimulation gene 2,,,147.22,234.47,2
CPT,83006,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,83006,Laboratory Services,,,159.99,160.01,2
CPT,83009,"HELICOBACTER PYLORI, BLOOD TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (E.G., C-13)",,,165.57,165.57,2
CPT,83009,"HELICOBACTER PYLORI, BLOOD TEST ANALYSIS FOR UREASE ACTIVITYNON-RADIOACTIVE ISOTOPE",,,576.19,917.64,2
CPT,83009,Laboratory Services,,,506.71,506.76,2
CPT,83010,HAPTOGLOBIN; CHEMICAL,1022.51,664.63,109.83,174.91,2
CPT,83010,HAPTOGLOBIN; QUANTITATIVE,1022.51,664.63,30.79,30.79,2
CPT,83010,HB LAB HAPTOGLOBIN,1022.51,664.63,13270.0,14761.0,2
CPT,83010,Laboratory Services,1022.51,664.63,94.65,94.66,2
CPT,83012,HAPTOGLOBIN; PHENOTYPES,,,65.73,65.73,2
CPT,83012,"HAPTOGLOBIN; PHENOTYPES, ELECTROPHORESIS",,,150.22,239.24,2
CPT,83012,Laboratory Services,,,129.37,129.38,2
CPT,83013,HB HELIOBACTER PYLORI,755.44,491.03,,,0
CPT,83013,HB LAB H PYLORI BREATH TEST,755.44,491.03,,,0
CPT,83013,"HELICOBACTER PYLORI, BREATH TEST ANALYSIS FOR UREASE ACTIVITY NON-RADIOACTIVE ISOTOPE (EG, C-13)",755.44,491.03,558.67,889.74,2
CPT,83013,"HELICOBACTER PYLORI; BREATH TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (E.G., C-13)",755.44,491.03,165.57,165.57,2
CPT,83013,Laboratory Services,755.44,491.03,506.71,506.76,2
CPT,83014,HELICOBACTER PYLORI; DRUG ADMINISTRATION,,,19.13,108.81,4
CPT,83014,Laboratory Services,,,59.12,59.12,2
CPT,83015,"HEAVY METAL (E.G., ARSENIC, BARIUM, BERYLLIUM, BISMUTH, ANTIMONY, MERCURY); SCREEN",,,51.58,51.58,2
CPT,83015,"HEAVY METAL SCREEN (ARSENIC, BISMUTH, MERCURY, ANTIMONY); CHEMICAL (EG, REINSCH, GUTZEIT)",,,139.64,222.39,2
CPT,83015,Laboratory Services,,,98.55,98.56,2
CPT,83018,HB MISC LAB SPECIAL TEST,24.13,15.68,13270.0,14761.0,4
CPT,83018,"HEAVY METAL (E.G., ARSENIC, BARIUM, BERYLLIUM, BISMUTH, ANTIMONY, MERCURY); QUANTITATIVE, EACH",24.13,15.68,54.08,54.08,2
CPT,83018,"HEAVY METAL SCREEN (ARSENIC, BISMUTH, MERCURY, ANTIMONY); CHROMATOGRAPHY, DEAE COLUMN",24.13,15.68,162.74,259.19,2
CPT,83018,Laboratory Services,24.13,15.68,165.21,165.23,2
CPT,83020,HB MISC LAB SPECIAL TEST,635.71,413.21,,,0
CPT,83020,"HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (E.G., A2, S,C, AND/OR F)",635.71,413.21,31.62,31.62,2
CPT,83020,"HEMOGLOBIN; ELECTROPHORESIS (INCLUDES A2, S, C, ETC)",635.71,413.21,95.48,152.07,2
CPT,83020,Laboratory Services,635.71,413.21,96.85,96.86,2
CPT,83021,HB HGB EVAL W/RFLX,24.0,15.6,13270.0,14761.0,4
CPT,83021,HB MISC LAB SPECIAL TEST,24.0,15.6,,,0
CPT,83021,"HEMOGLOBIN FRACTIONATION AND QUANTITATION; CHROMATOGRAPHY (E.G., A2, S, AND/OR F)",24.0,15.6,44.1,44.1,2
CPT,83021,"HEMOGLOBIN, FRACTINATION AND QUANTITATION; CHROMOTOGRAPHY",24.0,15.6,157.04,250.1,2
CPT,83021,Laboratory Services,24.0,15.6,135.84,135.86,2
CPT,83026,"HEMOGLOBIN, BY COPPER SULFATE METHOD,NON-AUTOMATED",,,17.52,27.9,2
CPT,83026,"HEMOGLOBIN; BY COPPER SULFATE METHOD, NON-AUTOMATED",,,9.99,9.99,2
CPT,83026,Laboratory Services,,,17.74,17.74,2
CPT,83030,"HEMOGLOBIN; F(FETAL), CHEMICAL",,,26.63,114.99,4
CPT,83030,Laboratory Services,,,62.2,62.21,2
CPT,83033,HB LAB HGB FETAL APT,264.07,171.64,13270.0,14761.0,2
CPT,83033,"HEMOGLOBIN; F (FETAL), QUALITATIVE",264.07,171.64,19.97,19.97,2
CPT,83033,"HEMOGLOBIN; F(FETAL), QUALITATIVE (APT) TEST, FECAL",264.07,171.64,52.03,82.87,2
CPT,83033,Laboratory Services,264.07,171.64,44.84,44.85,2
CPT,83036,HB LAB HEMOGLOBIN A1C,312.73,203.27,13270.0,14761.0,2
CPT,83036,HEMOGLOBIN; GLYCOSYLATED (A1C),312.73,203.27,24.13,135.02,4
CPT,83036,Laboratory Services,312.73,203.27,73.02,73.02,2
CPT,83037,HEMOGLOBIN; GLYCOSYLATED (A1C) BY DEVICE CLEARED BY FDA FOR HOME USE,,,24.13,24.13,2
CPT,83037,HEMOGLOBIN; GLYCOSYLATED (A1C) DEVICE CLEARED BY FDA FOR HOME USE ï,,,84.78,135.02,2
CPT,83037,Laboratory Services,,,73.02,73.02,2
CPT,83045,"HEMOGLOBIN; METHEMOGLOBIN, QUALITATIVE",,,15.81,69.01,4
CPT,83045,Laboratory Services,,,37.23,37.24,2
CPT,83050,"HEMOGLOBIN; METHEMOGLOBIN, QUANTITATIVE",18.15,11.8,19.97,101.88,4
CPT,83050,Laboratory Services,18.15,11.8,55.09,55.1,2
CPT,83051,HB LAB PLASMA FREE HEMOGLOBIN,162.77,105.8,13270.0,14761.0,2
CPT,83051,HEMOGLOBIN; PLASMA,162.77,105.8,18.31,101.6,4
CPT,83051,Laboratory Services,162.77,105.8,55.03,55.04,2
CPT,83060,"HEMOGLOBIN; SULFHEMOGLOBIN, QUANTITATIVE",23.03,14.97,21.63,114.99,4
CPT,83060,Laboratory Services,23.03,14.97,62.2,62.21,2
CPT,83065,HEMOGLOBIN; THERMOLABILE,,,22.46,92.7,4
CPT,83065,Laboratory Services,,,51.82,51.83,2
CPT,83068,"HEMOGLOBIN; UNSTABLE, SCREEN",,,23.3,114.05,4
CPT,83068,Laboratory Services,,,63.65,63.65,2
CPT,83069,HEMOGLOBIN; URINE,,,9.99,54.87,4
CPT,83069,Laboratory Services,,,29.75,29.75,2
CPT,83070,HB MISC LAB SPECIAL TEST,399.75,259.84,,,0
CPT,83070,"HEMOSIDERIN, URINE",399.75,259.84,41.45,66.01,2
CPT,83070,HEMOSIDERIN; QUALITATIVE,399.75,259.84,11.64,11.64,2
CPT,83070,Laboratory Services,399.75,259.84,35.72,35.73,2
CPT,83080,"B-HEXOSAMINIDASE, EACH ASSAY",168.0,109.2,41.61,233.53,4
CPT,83080,HB MISC LAB SPECIAL TEST,168.0,109.2,,,0
CPT,83080,Laboratory Services,168.0,109.2,126.91,126.93,2
CPT,83088,"HB HISTAMINE, PLASMA",28.65,18.62,,,0
CPT,83088,HB URN HISTAMINE,28.65,18.62,13270.0,14761.0,2
CPT,83088,HISTAMINE,28.65,18.62,72.39,410.69,4
CPT,83088,Laboratory Services,28.65,18.62,222.19,222.22,2
CPT,83090,HB LAB HOMOCYSTEINE,208.71,135.66,13270.0,14761.0,2
CPT,83090,HOMOCYSTEINE,208.71,135.66,44.1,44.1,2
CPT,83090,HOMOCYSTINE,208.71,135.66,147.22,234.47,2
CPT,83090,Laboratory Services,208.71,135.66,126.91,126.93,2
CPT,83150,"HB HOMOVANILLIC ACID, 24 HR",19.11,12.42,13270.0,14761.0,2
CPT,83150,HB MISC LAB SPECIAL TEST,19.11,12.42,13270.0,14761.0,4
CPT,83150,HOMOVANILLIC ACID (HVA),19.11,12.42,54.92,54.92,2
CPT,83150,"HOMOVANILLIC ACID (HVA), URINE",19.11,12.42,143.4,228.38,2
CPT,83150,Laboratory Services,19.11,12.42,145.53,145.54,2
CPT,83491,"HYDROXYCORTICOSTEROIDS, 17- (17-OHCS)",24.13,15.68,44.1,44.1,2
CPT,83491,"HYDROXYCORTICOSTEROIDS, 17- (17-OHCS); RIA",24.13,15.68,148.05,235.78,2
CPT,83491,Laboratory Services,24.13,15.68,131.76,131.77,2
CPT,83497,"HB HIAA, 24 HOUR URINE",7.72,5.02,13270.0,14761.0,4
CPT,83497,"HYDROXYINDOLACETIC ACID, 5-(HIAA)",7.72,5.02,31.62,31.62,2
CPT,83497,"HYDROXYINDOLACETIC ACID, 5-(HIAA), URINE",7.72,5.02,112.65,179.41,2
CPT,83497,Laboratory Services,7.72,5.02,96.98,96.99,2
CPT,83498,HB 17-HYDROXYPROGESTERONE,16.38,10.64,13270.0,14761.0,4
CPT,83498,HB MISC LAB SPECIAL TEST,16.38,10.64,,,0
CPT,83498,"HYDROXYPROGESTERONE, 17-D",16.38,10.64,66.56,66.56,2
CPT,83498,"HYDROXYPROGESTERONE, 17-D, RIA",16.38,10.64,237.24,377.83,2
CPT,83498,Laboratory Services,16.38,10.64,204.4,204.42,2
CPT,83500,"HYDROXYPROLINE, URINE; FREE ONLY",27.96,18.17,197.85,315.09,2
CPT,83500,HYDROXYPROLINE; FREE,27.96,18.17,55.75,55.75,2
CPT,83500,Laboratory Services,27.96,18.17,170.37,170.39,2
CPT,83505,"HYDROXYPROLINE, URINE; TOTAL ONLY",,,212.31,338.12,2
CPT,83505,HYDROXYPROLINE; TOTAL,,,59.91,59.91,2
CPT,83505,Laboratory Services,,,182.89,182.91,2
CPT,83516,HB LAB TRANSGLUTAMIN IGG/IGA,22.36,14.53,13270.0,14761.0,4
CPT,83516,HB MISC LAB SPECIAL TEST,22.36,14.53,13270.0,14761.0,4
CPT,83516,HB PROTEASE 3 (PR3) IGG ABS,22.36,14.53,13270.0,14761.0,2
CPT,83516,"IMMUNOASSAY FOR ANALYTE OTHER THAN ANTIBODY OR INFESTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE",22.36,14.53,204.31,325.39,2
CPT,83516,"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE STEPMETHOD",22.36,14.53,28.29,28.29,2
CPT,83516,Laboratory Services,22.36,14.53,69.87,69.88,2
CPT,83518,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,83518,"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE; SINGLE STEP METHOD (E.G., REAGENT STRIP)",,,23.3,23.3,2
CPT,83518,IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE OR SEMIQUANTITATIV,,,84.08,133.9,2
CPT,83518,Laboratory Services,,,25.66,25.66,2
CPT,83519,HB LAB ALPHA SUBUNIT BLOOD #,152.27,98.98,13270.0,14761.0,2
CPT,83519,HB LAB IGF-II,152.27,98.98,13270.0,14761.0,2
CPT,83519,HB MISC LAB SPECIAL TEST,152.27,98.98,13270.0,14761.0,4
CPT,83519,"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, BY RADIOIMMUNOAS",152.27,98.98,118.0,187.93,2
CPT,83519,"IMMUNOASSAY, ANALYTE, QUANTITATIVE; BY RADIOPHARMACEUTICAL TECHNIQUE (E.G., RIA)",152.27,98.98,44.93,44.93,2
CPT,83519,Laboratory Services,152.27,98.98,101.63,101.64,2
CPT,83520,"HB IMMUNOASSAY,NOT SPEC QUANTI",93.61,60.85,13270.0,14761.0,2
CPT,83520,HB MISC LAB SPECIAL TEST,93.61,60.85,13270.0,14761.0,4
CPT,83520,HB RIBOSOMAL P PROTEIN,93.61,60.85,13270.0,14761.0,4
CPT,83520,"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, NOT OTHERWISE SP",93.61,60.85,113.06,180.06,2
CPT,83520,"IMMUNOASSAY, ANALYTE, QUANTITATIVE; NOT OTHERWISE SPECIFIED",93.61,60.85,42.43,42.43,2
CPT,83520,Laboratory Services,93.61,60.85,97.42,97.43,2
CPT,83521,HB IG LIGHT CHAINS FREE EACH,307.36,199.78,13270.0,14761.0,2
CPT,83521,"Immunoglobulin light chains (ie, kappa, lambda), free, each",307.36,199.78,42.43,69.01,4
CPT,83521,Laboratory Services,307.36,199.78,92.32,92.33,2
CPT,83525,HB INSULIN,130.86,85.06,13270.0,14761.0,2
CPT,83525,"HB INSULIN, TOTAL",130.86,85.06,13270.0,14761.0,4
CPT,83525,"INSULIN, RIA",130.86,85.06,99.83,159.0,2
CPT,83525,INSULIN; TOTAL,130.86,85.06,28.29,28.29,2
CPT,83525,Laboratory Services,130.86,85.06,86.04,86.04,2
CPT,83527,"HB INSULIN, FREE",10.78,7.01,13270.0,14761.0,4
CPT,83527,INSULIN; FREE,10.78,7.01,31.62,181.66,4
CPT,83527,Laboratory Services,10.78,7.01,97.48,97.49,2
CPT,83528,INTRINSIC FACTOR,,,48.26,48.26,2
CPT,83528,INTRINSIC FACTOR LEVEL,,,134.41,214.05,2
CPT,83528,Laboratory Services,,,119.62,119.63,2
CPT,83529,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,83529,Interleukin-6 (IL-6),,,42.43,69.01,4
CPT,83529,Laboratory Services,,,92.32,92.33,2
CPT,83540,"HB LAB PANEL IRON, TOTAL",227.78,148.06,13270.0,14761.0,2
CPT,83540,HB LAB QUANTITATIVE IRON #,227.78,148.06,13270.0,14761.0,2
CPT,83540,IRON,227.78,148.06,15.81,15.81,2
CPT,83540,"IRON, SERUM; CHEMICAL",227.78,148.06,56.56,90.08,2
CPT,83540,Laboratory Services,227.78,148.06,48.74,48.75,2
CPT,83550,HB LAB PANEL IRON BIND CAPACITY,273.95,178.06,13270.0,14761.0,2
CPT,83550,IRON BINDING CAPACITY,273.95,178.06,21.63,21.63,2
CPT,83550,"IRON BINDING CAPACITY, SERUM; CHEMICAL",273.95,178.06,59.74,95.14,2
CPT,83550,Laboratory Services,273.95,178.06,52.64,52.65,2
CPT,83570,ISOCITRIC DEHYDROGENASE (IDH),,,21.63,21.63,2
CPT,83570,"ISOCITRIC DEHYDROGENASE (IDH), BLOOD; KINETIC ULTRAVIOLET",,,77.26,123.04,2
CPT,83570,Laboratory Services,,,66.54,66.55,2
CPT,83582,"KETOGENIC STEROIDS, FRACTIONATION",,,38.27,38.27,2
CPT,83582,"KETOGENIC STEROIDS, URINE; 17- (17-KGS)",,,123.76,197.11,2
CPT,83582,Laboratory Services,,,106.6,106.61,2
CPT,83586,"KETOSTEROIDS, 17- (17-KS), BLOOD; TOTAL",19.3,12.55,111.83,178.1,2
CPT,83586,"KETOSTEROIDS, 17- (17-KS); TOTAL",19.3,12.55,31.62,31.62,2
CPT,83586,Laboratory Services,19.3,12.55,96.35,96.36,2
CPT,83593,"KETOSTEROIDS, 17- (17-KS), URINE; CHROMATOGRAPHIC FRACTIONATION",,,229.71,365.84,2
CPT,83593,"KETOSTEROIDS, 17- (17-KS); FRACTIONATION",,,69.89,69.89,2
CPT,83593,Laboratory Services,,,197.86,197.88,2
CPT,83605,HB LAB LACTIC AC BL SC,780.47,507.31,13270.0,14761.0,2
CPT,83605,"HB LACTIC ACID, CSF",780.47,507.31,13270.0,14761.0,4
CPT,83605,LACTATE (LACTIC ACID),780.47,507.31,28.29,148.51,4
CPT,83605,Laboratory Services,780.47,507.31,80.37,80.38,2
CPT,83615,HB LAB LDH SE AU,11.11,7.22,13270.0,14761.0,2
CPT,83615,HB LD ISOENZYME PNL - LACTATE,11.11,7.22,13270.0,14761.0,4
CPT,83615,"LACTATE DEHYDROGENASE (LD), (LDH);",11.11,7.22,14.98,14.98,2
CPT,83615,"LACTIC DEHYDROGENASE (LDH), BLOOD; KINETIC ULTRAVIOLET METHOD",11.11,7.22,52.56,83.71,2
CPT,83615,Laboratory Services,11.11,7.22,45.47,45.47,2
CPT,83625,HB LD ISOENZYME PNL - LDH ENZ,23.6,15.34,13270.0,14761.0,4
CPT,83625,"LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION",23.6,15.34,31.62,31.62,2
CPT,83625,"LACTIC DEHYDROGENASE (LDH), BLOOD; ISOENZYMES, ELECTROPHORETIC SEPARATION AND QUANTITATION",23.6,15.34,111.59,177.72,2
CPT,83625,Laboratory Services,23.6,15.34,96.29,96.3,2
CPT,83630,HB LAB STOOL LACTOFERRIN,60.31,39.2,13270.0,14761.0,2
CPT,83630,"LACTOFERRIN, FECAL; QUALITATIVE",60.31,39.2,48.26,126.6,4
CPT,83630,Laboratory Services,60.31,39.2,147.67,147.68,2
CPT,83631,"LACTOFERRIN, FECAL; QUANTITATIVE",,,48.26,48.26,2
CPT,83631,"LACTOFERRIN, FECAL; QUANTITATIVE ï",,,167.68,267.05,2
CPT,83631,Laboratory Services,,,147.67,147.68,2
CPT,83632,"LACTOGEN, HUMAN PLACENTAL (HPL) CHORIONIC SOMATOMAMMOTROPIN, RIA",,,176.5,281.1,2
CPT,83632,"LACTOGEN, HUMAN PLACENTAL (HPL) HUMAN CHORIONIC SOMATOMAMMOTROPIN",,,49.92,49.92,2
CPT,83632,Laboratory Services,,,152.07,152.09,2
CPT,83633,"LACTOSE, URINE; QUALITATIVE",,,27.45,74.07,4
CPT,83633,Laboratory Services,,,41.38,41.39,2
CPT,83655,"HB LEAD, BLOOD",8.0,5.2,13270.0,14761.0,4
CPT,83655,LEAD,8.0,5.2,29.95,29.95,2
CPT,83655,"LEAD, QUANTITATIVE; BLOOD",8.0,5.2,105.71,168.36,2
CPT,83655,Laboratory Services,8.0,5.2,91.07,91.08,2
CPT,83661,FETAL LUNG MATURITY ASSESSMENT; LECITHIN SPHINGOMYELIN (L/S) RATIO,,,54.08,54.08,2
CPT,83661,"LECITHIN-SPHINGOMYELIN RATIO (L/S RATIO),QUANTITATIVE FETAL LUNG MATURITY ASSESSMENT;LECITHIN SPHINOGOMYELIN(L/S)RATIO",,,191.91,305.63,2
CPT,83661,Laboratory Services,,,165.4,165.42,2
CPT,83662,FETAL LUNG MATURITY ASSESSMENT; FOAM STABILITY TEST,,,46.6,46.6,2
CPT,83662,LECITHIN-SPHINGOMYELIN;FOAM STABILITY TEST,,,165.16,263.03,2
CPT,83662,Laboratory Services,,,142.39,142.4,2
CPT,83663,FETAL LUNG MATURITY ASSESSMENT; FLUORESCENCE POLARIZATION,,,46.6,46.6,2
CPT,83663,"FOAM STABILITY TEST, FLUORESCENCE POLARIZATION",,,82.55,131.47,2
CPT,83663,Laboratory Services,,,142.39,142.4,2
CPT,83664,FETAL LUNG MATURITY ASSESSMENT; LAMELLAR BODY DENSITY,231.12,150.23,47.43,47.43,2
CPT,83664,"FOAM STABILITY TEST, LAMELLAR BODY DENSITY",231.12,150.23,41.22,65.64,2
CPT,83664,Laboratory Services,231.12,150.23,142.39,142.4,2
CPT,83670,LEUCINE AMINOPEPTIDASE (LAP),,,24.13,24.13,2
CPT,83670,"LEUCINE AMINOPEPTIDASE (LAP), BLOOD; KINETIC ULTRAVIOLET METHOD",,,79.73,126.97,2
CPT,83670,Laboratory Services,,,68.99,69.0,2
CPT,83690,HB LAB LIPASE SE ST,12.61,8.2,13270.0,14761.0,2
CPT,83690,"HB LIPASE, PLEURAL FLUID",12.61,8.2,13270.0,14761.0,4
CPT,83690,LIPASE,12.61,8.2,16.64,16.64,2
CPT,83690,"LIPASE, BLOOD",12.61,8.2,60.09,95.7,2
CPT,83690,Laboratory Services,12.61,8.2,51.82,51.83,2
CPT,83695,HB LIPOPROTEIN (A),7.07,4.6,13270.0,14761.0,4
CPT,83695,HB MISC LAB SPECIAL TEST,7.07,4.6,,,0
CPT,83695,LIPOPROTEIN (A),7.07,4.6,34.94,34.94,2
CPT,83695,LIPOPROTEIN (A) ï,7.07,4.6,110.59,176.13,2
CPT,83695,Laboratory Services,7.07,4.6,97.42,97.43,2
CPT,83698,HB MISC LAB SPECIAL TEST,50.0,32.5,,,0
CPT,83698,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2(LP-PLA2) ï,50.0,32.5,290.04,461.91,2
CPT,83698,"LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2, (LP-PLA2)",50.0,32.5,113.99,113.99,2
CPT,83698,Laboratory Services,50.0,32.5,255.34,255.36,2
CPT,83700,"LIPOPROTEIN, BLOOD; ELECTROPHORETIC SEPARATION AND QUANTITATION",15.0,9.75,27.45,27.45,2
CPT,83700,"LIPOPROTEIN, BLOOD; ELECTROPHORETIC SEPARATION AND QUANTITATION ï",15.0,9.75,96.84,154.22,2
CPT,83700,Laboratory Services,15.0,9.75,84.65,84.66,2
CPT,83701,"LIPOPROTEIN, BLOOD; HIGH RESOLUTION FRACTIONATION AND QUANTITATION OF LIPOPROTEINS INCLUDING LIPOPROTEIN SUBCLASSES WHE",,,212.07,337.75,2
CPT,83701,"LIPOPROTEIN, BLOOD; HIGH RESOLUTION FRACTIONATION AND QUANTITATION OF LIPOPROTEINS INCLUDING LIPOPROTEIN SUBCLASSES WHEN PERFORMED (E.G., ELECTROPHORESIS, ULTRACENTRIFUGATION)",,,83.2,83.2,2
CPT,83701,Laboratory Services,,,186.72,186.74,2
CPT,83704,HB MISC LAB SPECIAL TEST,16.96,11.02,,,0
CPT,83704,"LIPOPROTEIN, BLOOD; QUANTITATION OF LIPOPROTEIN PARTICLE NUMBERS AND LIPOPROTEIN PARTICLE SUBCLASSES (E.G., BY NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY)",16.96,11.02,84.04,84.04,2
CPT,83704,"LIPOPROTEIN, BLOOD; QUANTITATION OF LIPOPROTEIN PARTICLE NUMBERS AND LIPOPROTEIN PARTICLE SUBCLASSES ï",16.96,11.02,269.52,429.23,2
CPT,83704,Laboratory Services,16.96,11.02,237.35,237.37,2
CPT,83718,HB LAB HDL CHOLESTEROL,95.92,62.34,13270.0,14761.0,2
CPT,83718,HB MISC LAB SPECIAL TEST,95.92,62.34,,,0
CPT,83718,LIPOPROTEIN HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) BY PRECIPITATION METHOD,95.92,62.34,71.44,113.77,2
CPT,83718,"LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL)",95.92,62.34,19.97,19.97,2
CPT,83718,Laboratory Services,95.92,62.34,61.57,61.58,2
CPT,83719,LIPOPROTEIN VERY LOW DENSITY CHOLESTEROL (VLDL CHOLESTEROL) BY ULTRACENTRIFUGATION,,,84.19,134.09,2
CPT,83719,"LIPOPROTEIN, DIRECT MEASUREMENT; VLDL CHOLESTEROL",,,31.62,31.62,2
CPT,83719,Laboratory Services,,,87.54,87.55,2
CPT,83721,HB LAB LDL CHOLESTEROL,20.5,13.33,13270.0,14761.0,2
CPT,83721,LDL CHOLESTEROL,20.5,13.33,82.37,131.19,2
CPT,83721,"LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL",20.5,13.33,25.8,25.8,2
CPT,83721,Laboratory Services,20.5,13.33,71.76,71.77,2
CPT,83722,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,83722,Laboratory Services,,,187.42,187.43,2
CPT,83722,"Lipoprotein, direct measurement; small dense LDL cholesterol",,,84.04,309.47,4
CPT,83727,HB LAB GONADOTROPIN RELEAS HRM,225.0,146.25,,,0
CPT,83727,LUTEINIZING RELEASING FACTOR (LRH),225.0,146.25,42.43,42.43,2
CPT,83727,"LUTEINIZING RELEASING FACTOR (LRH), RIA",225.0,146.25,145.28,231.38,2
CPT,83727,Laboratory Services,225.0,146.25,129.37,129.38,2
CPT,83735,HB LAB MAGNESIUM SE ER,25.31,16.45,13270.0,14761.0,2
CPT,83735,HB MISC LAB SPECIAL TEST,25.31,16.45,13270.0,14761.0,8
CPT,83735,Laboratory Services,25.31,16.45,50.44,50.44,2
CPT,83735,MAGNESIUM,25.31,16.45,16.64,16.64,2
CPT,83735,"MAGNESIUM, BLOOD; CHEMICAL",25.31,16.45,58.15,92.61,2
CPT,83775,Laboratory Services,,,55.41,55.41,2
CPT,83775,MALATE DEHYDROGENASE,,,18.31,18.31,2
CPT,83775,"MALATE DEHYDROGENASE, KINETIC ULTRAVIOLET METHOD",,,64.38,102.53,2
CPT,83785,"HB MANGANESE, BLOOD",28.46,18.5,13270.0,14761.0,2
CPT,83785,Laboratory Services,28.46,18.5,185.03,185.04,2
CPT,83785,MANGANESE,28.46,18.5,65.73,65.73,2
CPT,83785,"MANGANESE, BLOOD OR URINE",28.46,18.5,214.72,341.96,2
CPT,83789,"HB LAB BILE ACIDS, FRAC",110.98,72.14,13270.0,14761.0,4
CPT,83789,HB MISC LAB SPECIAL TEST,110.98,72.14,,,0
CPT,83789,Laboratory Services,110.98,72.14,135.84,135.86,2
CPT,83789,"MASS SPECTROMETRY AND TANDEM MASS SPECTROMETRY (MS, MS/MS), ANALYTE NOT ELSEWHERE SPECIFIED; QUANTITATIVE, EACH SPECIMEN",110.98,72.14,59.07,59.07,2
CPT,83789,"MASS SPECTROMETRY AND TANDEM MASS SPECTROMETY,ANALYTE NOT ELESWHERE;QUANTITATIVE,EACH SPECIMEN",110.98,72.14,157.04,250.1,2
CPT,83825,"HB MERCURY, BLOOD",12.48,8.11,13270.0,14761.0,4
CPT,83825,HB MISC LAB SPECIAL TEST,12.48,8.11,,,0
CPT,83825,Laboratory Services,12.48,8.11,122.32,122.34,2
CPT,83825,"MERCURY, QUANTITATIVE",12.48,8.11,39.94,39.94,2
CPT,83825,"MERCURY, QUANTITATIVE; BLOOD",12.48,8.11,141.34,225.1,2
CPT,83835,"HB LAB METANEPHRINES, FRAC",24.25,15.76,13270.0,14761.0,4
CPT,83835,HB MISC LAB SPECIAL TEST,24.25,15.76,,,0
CPT,83835,Laboratory Services,24.25,15.76,127.42,127.43,2
CPT,83835,METANEPHRINES,24.25,15.76,41.61,41.61,2
CPT,83835,"METANEPHRINES, URINE",24.25,15.76,147.99,235.68,2
CPT,83857,Laboratory Services,,,80.82,80.82,2
CPT,83857,METHEMALBUMIN,,,26.63,149.35,4
CPT,83861,Laboratory Services,,,126.03,126.05,2
CPT,83861,"MICROFLUIDIC ANALYSIS UTILIZING AN INTEGRATED COLLECTION AND ANALYSIS DEVICE, TEAR OSMOLARITY",,,54.92,188.68,4
CPT,83864,Laboratory Services,59.95,38.97,149.81,149.82,2
CPT,83864,"MUCOPOLYSACCHARIDES, ACID, BLOOD",59.95,38.97,168.21,267.9,2
CPT,83864,"MUCOPOLYSACCHARIDES, ACID; QUANTITATIVE",59.95,38.97,69.89,69.89,2
CPT,83872,Laboratory Services,210.67,136.93,43.14,43.15,2
CPT,83872,"MUCIN, SYNOVIAL FLUID (ROPES TEST)",210.67,136.93,14.14,81.56,4
CPT,83873,HB MYELIN BASIC PROTEIN,18.34,11.92,13270.0,14761.0,2
CPT,83873,Laboratory Services,18.34,11.92,129.43,129.44,2
CPT,83873,"MYELIN BASIC PROTEIN, CEREBROSPINAL FLUID",18.34,11.92,42.43,42.43,2
CPT,83873,"MYELIN BASIC PROTEIN, CSF, RIA",18.34,11.92,145.4,231.56,2
CPT,83874,HB MYOGLOBIN,13.12,8.53,13270.0,14761.0,4
CPT,83874,Laboratory Services,13.12,8.53,97.1,97.11,2
CPT,83874,MYOGLOBIN,13.12,8.53,31.62,31.62,2
CPT,83874,"MYOGLOBIN, ELECTROPHORESIS",13.12,8.53,113.12,180.16,2
CPT,83876,Laboratory Services,,,255.34,255.36,2
CPT,83876,MYELOPEROXIDASE (MPO),,,115.12,183.34,4
CPT,83880,HB LAB NATRIURETIC PEPTIDE ASSY,665.71,432.71,13270.0,14761.0,2
CPT,83880,Laboratory Services,665.71,432.71,255.34,255.36,2
CPT,83880,NATRIURETIC PEPTIDE,665.71,432.71,296.5,472.21,2
CPT,83880,Natriuretic peptide,665.71,432.71,96.51,96.51,2
CPT,83883,"HB LAB IGG SYNTHETIC RATE, CSF",65.75,42.74,13270.0,14761.0,2
CPT,83883,HB LAB URN FREE LIGHT CHAINS NEPH,65.75,42.74,13270.0,14761.0,4
CPT,83883,HB MISC LAB SPECIAL TEST,65.75,42.74,,,0
CPT,83883,Laboratory Services,65.75,42.74,102.26,102.27,2
CPT,83883,"NEPHELOMETRY, EACH ANALYTE NOT ELSEWHERE SPECIFIED",65.75,42.74,33.29,189.33,4
CPT,83885,Laboratory Services,38.65,25.12,184.33,184.35,2
CPT,83885,NICKEL,38.65,25.12,59.91,59.91,2
CPT,83885,"NICKEL, URINE",38.65,25.12,214.01,340.84,2
CPT,83915,HB 5' NUCLEOTIDASE,52.45,34.09,13270.0,14761.0,2
CPT,83915,Laboratory Services,52.45,34.09,83.96,83.97,2
CPT,83915,NUCLEOTIDASE 5'-,52.45,34.09,27.45,155.06,4
CPT,83916,HB LAB PROTEIN ELECT SP,1351.55,878.51,13270.0,14761.0,2
CPT,83916,HB MISC LAB SPECIAL TEST,1351.55,878.51,13270.0,14761.0,4
CPT,83916,Laboratory Services,1351.55,878.51,151.32,151.33,2
CPT,83916,OLIGOCLONAL IMMUNE (OLIGOCLONAL BANDS),1351.55,878.51,67.39,67.39,2
CPT,83916,"OLIGOCLONAL IMMUNE GLOBULIN (IG), CSF, BY ELECTROPHORESIS",1351.55,878.51,175.56,279.6,2
CPT,83918,"HB LAB URN ORGANIC ACIDS,QUANT",113.0,73.45,13270.0,14761.0,2
CPT,83918,Laboratory Services,113.0,73.45,123.83,123.84,2
CPT,83918,"ORGANIC ACIDS; TOTAL, QUANTITATIVE, EACH SPECIMEN",113.0,73.45,58.24,58.24,2
CPT,83918,"ORGANIC ACIDS;TOTAL, QUANTITATIVE, EACH SPECIMEN",113.0,73.45,139.11,221.55,2
CPT,83919,Laboratory Services,,,123.83,123.84,2
CPT,83919,"ORGANIC ACIDS; QUALITATIVE, EACH SPECIMEN",,,40.77,40.77,2
CPT,83919,"ORGANIC ACIDS;QUALITATIV, EACH SPECIMEN",,,143.11,227.91,2
CPT,83921,"HB METHYLMALONIC ACID, SERUM",21.53,13.99,13270.0,14761.0,4
CPT,83921,Laboratory Services,21.53,13.99,123.83,123.84,2
CPT,83921,"ORGANIC ACID, SINGLE, QUANTITATIVE",21.53,13.99,52.42,228.85,4
CPT,83930,HB LAB OSMOLALITY SE AU,448.69,291.65,13270.0,14761.0,2
CPT,83930,Laboratory Services,448.69,291.65,49.75,49.75,2
CPT,83930,OSMOLALITY; BLOOD,448.69,291.65,16.64,125.19,4
CPT,83935,"HB OSMOLALITY, URINE",448.69,291.65,13270.0,14761.0,2
CPT,83935,Laboratory Services,448.69,291.65,51.26,51.26,2
CPT,83935,OSMOLALITY; URINE,448.69,291.65,16.64,94.85,4
CPT,83937,HB LAB OSTEOCALCIN #,26.61,17.3,13270.0,14761.0,4
CPT,83937,Laboratory Services,26.61,17.3,214.21,214.23,2
CPT,83937,OSTEOCALCIN,26.61,17.3,102.24,162.83,2
CPT,83937,OSTEOCALCIN (BONE G1A PROTEIN),26.61,17.3,73.22,73.22,2
CPT,83945,HB OXALIC ACID 24U W/O CREAT,11.58,7.53,13270.0,14761.0,4
CPT,83945,Laboratory Services,11.58,7.53,96.85,96.86,2
CPT,83945,OXALATE,11.58,7.53,35.77,35.77,2
CPT,83945,"OXALATE, URINE",11.58,7.53,112.42,179.03,2
CPT,83950,Laboratory Services,,,484.51,484.56,2
CPT,83950,ONCOPROTEIN: HER-2/NEU,,,562.61,896.01,2
CPT,83950,"Oncoprotein, HER-2/neu",,,158.08,158.08,2
CPT,83951,HB DES-GAMMA-CARBOXY-PROTHROMBIN,93.0,60.45,13270.0,14761.0,4
CPT,83951,HB MISC LAB SPECIAL TEST,93.0,60.45,,,0
CPT,83951,Laboratory Services,93.0,60.45,484.51,484.56,2
CPT,83951,ONCOPROTEIN; DES-GAMMA-CARBOXY-PROTHROMBIN (DCP),93.0,60.45,158.08,911.74,4
CPT,83970,HB LAB PTH,931.97,605.78,13270.0,14761.0,2
CPT,83970,HB MISC LAB SPECIAL TEST,931.97,605.78,,,0
CPT,83970,Laboratory Services,931.97,605.78,310.49,310.52,2
CPT,83970,PARATHORMONE (PARATHYROID HORMONE),931.97,605.78,101.51,101.51,2
CPT,83970,"PARATHORMONE (PARATHYROID HORMONE), RIA",931.97,605.78,360.47,574.09,2
CPT,83986,"HB LAB PH, URINE",82.46,53.6,13270.0,14761.0,2
CPT,83986,HB MISC LAB SPECIAL TEST,82.46,53.6,13270.0,14761.0,4
CPT,83986,Laboratory Services,82.46,53.6,26.92,26.92,2
CPT,83986,"PH, BODY FLUID, EXCEPT BLOOD",82.46,53.6,9.15,9.15,2
CPT,83986,"PH; BODY FLUID, NOT OTHERWISE SPECIFIED",82.46,53.6,31.22,49.72,2
CPT,83987,Laboratory Services,,,119.49,119.51,2
CPT,83987,PH; EXHALED BREATH CONDENSATE,,,125.06,199.17,2
CPT,83987,pH; exhaled breath condensate,,,9.15,9.15,2
CPT,83992,HB MISC LAB SPECIAL TEST,38.95,25.32,,,0
CPT,83992,HB URN PHENCYCLIDINE,38.95,25.32,13270.0,14761.0,4
CPT,83992,Laboratory Services,38.95,25.32,0.06,0.06,2
CPT,83992,PHENCYCLIDINE (PCP),38.95,25.32,90.69,179.5,4
CPT,83993,"CALPROTECTIN, FECAL",213.46,138.75,48.26,48.26,2
CPT,83993,"CALPROTECTION, FECAL",213.46,138.75,171.39,272.95,2
CPT,83993,HB STOOL CALPROTECTIN,213.46,138.75,13270.0,14761.0,2
CPT,83993,Laboratory Services,213.46,138.75,147.67,147.68,2
CPT,84030,Laboratory Services,19.3,12.55,41.38,41.39,2
CPT,84030,"PHENYLALANINE (PKU), BLOOD",19.3,12.55,13.31,13.31,2
CPT,84030,"PHENYLALANINE (PKU), BLOOD; GUTHRIE",19.3,12.55,48.09,76.6,2
CPT,84035,Laboratory Services,,,27.55,27.55,2
CPT,84035,"PHENYLKETONES, QUALITATIVE",,,9.99,9.99,2
CPT,84035,"PHENYLKETONES; BLOOD, QUALITATIVE",,,31.98,50.94,2
CPT,84060,Laboratory Services,,,55.53,55.54,2
CPT,84060,"PHOSPHATASE, ACID; BLOOD",,,65.2,103.84,2
CPT,84060,"PHOSPHATASE, ACID; TOTAL",,,19.13,19.13,2
CPT,84066,HB PROSTATIC ACID PHOSPHATASE,9.41,6.12,,,0
CPT,84066,Laboratory Services,9.41,6.12,72.64,72.65,2
CPT,84066,"PHOSPHATASE, ACID; PROSTATIC",9.41,6.12,24.13,24.13,2
CPT,84066,"PHOSPHATASE, ACID; PROSTATIC FRACTION, RIA",9.41,6.12,84.49,134.56,2
CPT,84075,HB LAB ALK PHOS SE AU,293.33,190.66,13270.0,14761.0,2
CPT,84075,HB TOTAL ALKALINE PHOSPHATASE,293.33,190.66,13270.0,14761.0,4
CPT,84075,Laboratory Services,293.33,190.66,38.93,38.93,2
CPT,84075,"PHOSPHATASE, ALKALINE, BLOOD;",293.33,190.66,45.15,71.91,2
CPT,84075,"PHOSPHATASE, ALKALINE;",293.33,190.66,12.48,12.48,2
CPT,84078,Laboratory Services,,,49.31,49.31,2
CPT,84078,"PHOSPHATASE, ALKALINE, BLOOD; HEAT STABLE (TOTAL NOT INCLUDED)",,,62.85,100.1,2
CPT,84078,"PHOSPHATASE, ALKALINE; HEAT STABLE (TOTAL NOT INCLUDED)",,,19.97,19.97,2
CPT,84080,HB LAB BONE SPECIFIC ALK PHOSPH#,12.55,8.16,13270.0,14761.0,4
CPT,84080,Laboratory Services,12.55,8.16,111.32,111.33,2
CPT,84080,"PHOSPHATASE, ALKALINE, BLOOD; ISOENZYMES, ELECTROPHORETIC METHOD",12.55,8.16,129.17,205.72,2
CPT,84080,"PHOSPHATASE, ALKALINE; ISOENZYMES",12.55,8.16,36.61,36.61,2
CPT,84081,Laboratory Services,25.08,16.3,124.27,124.29,2
CPT,84081,PHOSPHATIDYLGLYCEROL,25.08,16.3,40.77,40.77,2
CPT,84081,PHOSPHATYDYLGLYCEROL,25.08,16.3,139.64,222.39,2
CPT,84085,Laboratory Services,,,50.75,50.76,2
CPT,84085,"PHOSPHOGLUCONATE, 6-, DEHYDROGENASE, RBC",,,23.3,93.73,4
CPT,84087,Laboratory Services,,,77.67,77.68,2
CPT,84087,PHOSPHOHEXOSE ISOMERASE,,,26.63,143.55,4
CPT,84100,HB LAB PHOSPHOR SE AU,16.2,10.53,13270.0,14761.0,2
CPT,84100,HB SLYT ASSAY OF PHOSPHORUS,16.2,10.53,13270.0,14761.0,4
CPT,84100,Laboratory Services,16.2,10.53,35.66,35.66,2
CPT,84100,PHOSPHORUS (PHOSPHATE); BLOOD,16.2,10.53,41.33,65.83,2
CPT,84100,PHOSPHORUS INORGANIC (PHOSPHATE);,16.2,10.53,11.64,11.64,2
CPT,84105,HB LAB PHOSPHOR UR AU,293.3,190.65,13270.0,14761.0,2
CPT,84105,HB LAB URODISK PHOS URINE,293.3,190.65,13270.0,14761.0,2
CPT,84105,Laboratory Services,293.3,190.65,38.93,38.93,2
CPT,84105,PHOSPHORUS (PHOSPHATE); URINE,293.3,190.65,45.15,71.91,2
CPT,84105,PHOSPHORUS INORGANIC (PHOSPHATE); URINE,293.3,190.65,14.14,14.14,2
CPT,84106,Laboratory Services,,,32.2,32.2,2
CPT,84106,"PORPHOBILINOGEN, URINE; QUALITATIVE",,,14.14,59.55,4
CPT,84110,HB LAB UPBGR PORPHOBILINOGEN,24.13,15.68,13270.0,14761.0,4
CPT,84110,Laboratory Services,24.13,15.68,63.52,63.53,2
CPT,84110,"PORPHOBILINOGEN, URINE; QUANTITATIVE",24.13,15.68,20.8,117.51,4
CPT,84112,HB AMNISURE,1368.83,889.74,13270.0,14761.0,2
CPT,84112,Laboratory Services,1368.83,889.74,484.51,484.56,2
CPT,84112,"PLACENTAL ALPHA MICROGLOBULIN-1 (PAMG-1), CERVICOVAGINAL SECRETION, QUALITATIVE",1368.83,889.74,241.29,725.42,4
CPT,84119,Laboratory Services,,,64.78,64.78,2
CPT,84119,"PORPHYRINS, COPRO-, URINE; QUALITATIVE",,,75.14,119.67,2
CPT,84119,"PORPHYRINS, URINE; QUALITATIVE",,,32.45,32.45,2
CPT,84120,"HB PORPHYRINS,FRACT,RAND UR",16.41,10.67,13270.0,14761.0,4
CPT,84120,Laboratory Services,16.41,10.67,110.69,110.7,2
CPT,84120,"PORPHYRINS, URINE; QUANTITATION AND FRACTIONATION",16.41,10.67,35.77,35.77,2
CPT,84120,"PORPHYRINS; COPRO- AND URO-, FRACTIONATED, URINE",16.41,10.67,128.47,204.6,2
CPT,84126,HB LAB STOOL PORPHYRINS,284.4,184.86,,,0
CPT,84126,Laboratory Services,284.4,184.86,191.63,191.65,2
CPT,84126,"PORPHYRINS, FECES, QUANTITATIVE",284.4,184.86,222.48,354.32,2
CPT,84126,"PORPHYRINS, FECES; QUANTITATIVE",284.4,184.86,95.68,95.68,2
CPT,84132,HB LAB POTASSIUM,580.5,377.32,13270.0,14761.0,4
CPT,84132,Laboratory Services,580.5,377.32,34.59,34.59,2
CPT,84132,POTASSIUM; SERUM,580.5,377.32,11.64,11.64,2
CPT,84132,"POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD",580.5,377.32,40.51,64.52,2
CPT,84133,HB LAB POTASSIUM UR AU,304.97,198.23,13270.0,14761.0,2
CPT,84133,HB LAB URODISK POTASSIUM;URINE,304.97,198.23,13270.0,14761.0,2
CPT,84133,Laboratory Services,304.97,198.23,32.33,32.33,2
CPT,84133,POTASSIUM; URINE,304.97,198.23,11.64,59.83,4
CPT,84134,HB LAB PREALBUMIN,685.32,445.46,13270.0,14761.0,2
CPT,84134,Laboratory Services,685.32,445.46,109.68,109.69,2
CPT,84134,PREALBUMIN,685.32,445.46,35.77,203.47,4
CPT,84135,Laboratory Services,,,143.89,143.91,2
CPT,84135,PREGNANEDIOL,,,52.42,52.42,2
CPT,84135,PREGNANEDIOL; RIA,,,141.75,225.76,2
CPT,84138,Laboratory Services,67.54,43.9,142.45,142.46,2
CPT,84138,PREGNANETRIOL,67.54,43.9,51.58,51.58,2
CPT,84138,PREGNANETRIOL; RIA,67.54,43.9,165.27,263.21,2
CPT,84140,HB PREGNENOLONE,68.0,44.2,13270.0,14761.0,2
CPT,84140,Laboratory Services,68.0,44.2,155.59,155.61,2
CPT,84140,PREGNENOLONE,68.0,44.2,50.75,50.75,2
CPT,84140,PREGNEONOLONE,68.0,44.2,176.68,281.38,2
CPT,84143,17-HYDROXPREGNENOLONE,32.09,20.86,199.32,317.43,2
CPT,84143,17-HYDROXYPREGNENOLONE,32.09,20.86,55.75,55.75,2
CPT,84143,HB LAB 17-HYDROXYPREGNENOLONE,32.09,20.86,,,0
CPT,84143,HB MISC LAB SPECIAL TEST,32.09,20.86,,,0
CPT,84143,Laboratory Services,32.09,20.86,171.69,171.71,2
CPT,84144,HB LAB PROGESTERONE,471.05,306.18,13270.0,14761.0,4
CPT,84144,HB MISC LAB SPECIAL TEST,471.05,306.18,,,0
CPT,84144,Laboratory Services,471.05,306.18,156.98,156.99,2
CPT,84144,PROGESTERONE,471.05,306.18,51.58,51.58,2
CPT,84144,"PROGESTERONE, ANY METHOD",471.05,306.18,182.21,290.18,2
CPT,84145,HB PROCALCITONIN,291.65,189.57,13270.0,14761.0,2
CPT,84145,Laboratory Services,291.65,189.57,201.5,201.52,2
CPT,84145,PROCALCITONIN (PCT),291.65,189.57,152.69,243.18,2
CPT,84145,Procalcitonin (PCT),291.65,189.57,66.56,66.56,2
CPT,84146,HB LAB PROLACTIN,223.56,145.31,13270.0,14761.0,2
CPT,84146,"HB PROLACTIN,TOTAL,MONOMERIC",223.56,145.31,,,0
CPT,84146,Laboratory Services,223.56,145.31,145.78,145.8,2
CPT,84146,PROLACTIN,223.56,145.31,47.43,47.43,2
CPT,84146,"PROLACTIN (MAMMOTROPIN), RIA",223.56,145.31,169.21,269.49,2
CPT,84150,HB MISC LAB SPECIAL TEST,275.0,178.75,13270.0,14761.0,4
CPT,84150,Laboratory Services,275.0,178.75,187.73,187.75,2
CPT,84150,"PROSTAGLANDIN, ANY ONE, RIA",275.0,178.75,217.95,347.11,2
CPT,84150,"PROSTAGLANDIN, EACH",275.0,178.75,102.34,102.34,2
CPT,84152,Laboratory Services,,,138.42,138.44,2
CPT,84152,PROSTATE SPECIFIC ANTIGEN (PSA); COMPLEXED,,,160.51,255.63,2
CPT,84152,PROSTATE SPECIFIC ANTIGEN (PSA); COMPLEXED (DIRECT MEASUREMENT),,,44.93,44.93,2
CPT,84153,HB LAB PROSTATE SPECIFIC ANTGN,22.71,14.76,13270.0,14761.0,2
CPT,84153,"HB LAB PSA, POST-PROSTATECTOMY",22.71,14.76,,,0
CPT,84153,Laboratory Services,22.71,14.76,138.42,138.44,2
CPT,84153,PROSTATE SPECIFIC ANTIGEN,22.71,14.76,160.63,255.82,2
CPT,84153,PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL,22.71,14.76,44.93,44.93,2
CPT,84154,"HB LAB PSA, FREE",503.09,327.01,13270.0,14761.0,2
CPT,84154,Laboratory Services,503.09,327.01,138.42,138.44,2
CPT,84154,PROSTATE SPECIFIC ANTIGEN (PSA); FREE,503.09,327.01,44.93,44.93,2
CPT,84154,PROSTATE SPECIFIC ANTIGEN(PSA);FREE,503.09,327.01,159.92,254.69,2
CPT,84155,HB LAB PROTEN TOT SE AU,533.43,346.73,13270.0,14761.0,2
CPT,84155,HB MISC LAB SPECIAL TEST,533.43,346.73,,,0
CPT,84155,Laboratory Services,533.43,346.73,27.61,27.61,2
CPT,84155,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM",533.43,346.73,9.15,9.15,2
CPT,84155,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD",533.43,346.73,31.98,50.94,2
CPT,84156,HB LAB PROTEN TOT UR SC,554.76,360.59,13270.0,14761.0,4
CPT,84156,Laboratory Services,554.76,360.59,27.61,27.61,2
CPT,84156,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE",554.76,360.59,9.15,9.15,2
CPT,84156,PROTEIN; URINE,554.76,360.59,32.1,51.13,2
CPT,84157,HB FLUID PROTEIN,554.76,360.59,13270.0,14761.0,4
CPT,84157,HB LAB PROTEN TOT FL SC,554.76,360.59,13270.0,14761.0,2
CPT,84157,Laboratory Services,554.76,360.59,27.61,27.61,2
CPT,84157,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; OTHER SOURCE (E.G., SYNOVIAL FLUID, CEREBROSPINAL FLUID)",554.76,360.59,9.99,9.99,2
CPT,84157,PROTEIN; OTHER SOURCE,554.76,360.59,32.1,51.13,2
CPT,84160,Laboratory Services,,,38.93,38.93,2
CPT,84160,"PROTEIN, TOTAL, BY REFRACTOMETRY, ANY SOURCE",,,14.14,71.91,4
CPT,84163,Laboratory Services,,,113.27,113.28,2
CPT,84163,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A,,,128.76,205.07,2
CPT,84163,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A (PAPP-A),,,36.61,36.61,2
CPT,84165,HB LAB PROTEIN ELECTROPHORESIS SE,1237.32,804.26,13270.0,14761.0,2
CPT,84165,HB MISC LAB SPECIAL TEST,1237.32,804.26,,,0
CPT,84165,Laboratory Services,1237.32,804.26,80.82,80.82,2
CPT,84165,"PROTEIN, ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM",1237.32,804.26,93.9,149.54,2
CPT,84165,"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM",1237.32,804.26,26.63,26.63,2
CPT,84166,HB LAB PROTEIN ELECTROPHORESIS UR,1351.55,878.51,13270.0,14761.0,2
CPT,84166,Laboratory Services,1351.55,878.51,134.15,134.16,2
CPT,84166,"PROTEIN; ELECTROPHORECTIC FRACTIONATION AND QUANTITATION, OTHER FLUIDS WITH CONCENTRATION",1351.55,878.51,152.57,242.99,2
CPT,84166,"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, OTHER FLUIDS WITH CONCENTRATION (E.G., URINE, CSF)",1351.55,878.51,44.1,44.1,2
CPT,84181,HB MISC LAB SPECIAL TEST,93.6,60.84,13270.0,14761.0,4
CPT,84181,HB MOT SEN NEUR WEST BLOT,93.6,60.84,13270.0,14761.0,2
CPT,84181,Laboratory Services,93.6,60.84,128.11,128.12,2
CPT,84181,"PROTEIN; WESTERN BLOT, WITH INTERPRETATION AND REPORT, BLOOD OR OTHER BODY FLUID",93.6,60.84,41.61,41.61,2
CPT,84181,"WESTERN BLOT, INTERPRETATION AND REPORT, BLOOD OR OTHER BODY FLUID",93.6,60.84,148.75,236.9,2
CPT,84182,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,8
CPT,84182,Laboratory Services,,,135.4,135.42,2
CPT,84182,"PROTEIN; WESTERN BLOT, WITH INTERPRETATION AND REPORT, BLOOD OR OTHER BODY FLUID,IMMUNOLOGICAL PROBE FOR BAND IDENTIFICATION, EACH",,,71.56,71.56,2
CPT,84182,"WESTERN BLOT, WITH INTERPRETATION AND REPORT, BLOOD OR OTHERBODY FLUID,IMMUNOLOGICAL PROBE FOR BAND IDENTIFICATION, EACH",,,157.16,250.29,2
CPT,84202,HB LAB PFRBC ASY RBC PRTPRPH,31.81,20.68,,,0
CPT,84202,HB ZINC PROTOPORPHYRIN (ZPP),31.81,20.68,13270.0,14761.0,2
CPT,84202,Laboratory Services,31.81,20.68,107.92,107.93,2
CPT,84202,"PROTOPORPHYRIN, RBC; QUANTITATIVE",31.81,20.68,34.94,199.63,4
CPT,84203,Laboratory Services,,,64.71,64.72,2
CPT,84203,"PROTOPORPHYRIN, RBC; SCREEN",,,24.13,119.67,4
CPT,84206,HB PROINSULIN,38.6,25.09,13270.0,14761.0,4
CPT,84206,Laboratory Services,38.6,25.09,134.02,134.03,2
CPT,84206,PROINSULIN,38.6,25.09,65.73,65.73,2
CPT,84206,"PROINSULIN, RIA",38.6,25.09,150.52,239.71,2
CPT,84207,HB LAB VITAMIN B6 #,8.0,5.2,13270.0,14761.0,4
CPT,84207,Laboratory Services,8.0,5.2,211.38,211.4,2
CPT,84207,PYRIDOXAL PHOSPHATE (VITAMIN B-6),8.0,5.2,69.06,69.06,2
CPT,84207,PYRIDOXINE (VITAMIN B-6),8.0,5.2,208.25,331.66,2
CPT,84210,HB LAB PYRUVIC ACID,22.8,14.82,13270.0,14761.0,4
CPT,84210,Laboratory Services,22.8,14.82,81.63,81.64,2
CPT,84210,PYRUVATE,22.8,14.82,35.77,35.77,2
CPT,84210,"PYRUVATE, BLOOD",22.8,14.82,94.84,151.04,2
CPT,84220,HB LAB PYRUVATE KINASE,58.0,37.7,13270.0,14761.0,2
CPT,84220,Laboratory Services,58.0,37.7,71.0,71.01,2
CPT,84220,PYRUVATE KINASE,58.0,37.7,23.3,23.3,2
CPT,84220,"PYRUVIC KINASE, RBC",58.0,37.7,82.37,131.19,2
CPT,84228,Laboratory Services,,,87.54,87.55,2
CPT,84228,QUININE,,,28.29,156.56,4
CPT,84233,Laboratory Services,,,484.51,484.56,2
CPT,84233,RECEPTOR ASSAY; ESTROGEN,,,215.5,215.5,2
CPT,84233,RECEPTOR ASSAY; ESTROGEN (ESTRADIOL),,,477.47,760.43,2
CPT,84234,Laboratory Services,,,488.03,488.08,2
CPT,84234,RECEPTOR ASSAY; PROGESTERONE,,,158.92,765.95,4
CPT,84235,Laboratory Services,,,393.7,393.74,2
CPT,84235,"RECEPTOR ASSAY; ENDOCRINE, OTHER THAN ESTROGEN OR PROGESTERONE (SPECIFY HORMONE)",,,174.73,704.15,4
CPT,84238,HB SOLUBLE TRANSFERRIN RECPT,70.81,46.03,13270.0,14761.0,4
CPT,84238,Laboratory Services,70.81,46.03,275.09,275.11,2
CPT,84238,RECEPTOR ASSAY; NON-ENDOCRINE (SPECIFY RECEPTOR),70.81,46.03,89.86,492.06,4
CPT,84244,HB LAB PLASMA RENIN ACTIVITY,15.0,9.75,13270.0,14761.0,4
CPT,84244,Laboratory Services,15.0,9.75,165.47,165.48,2
CPT,84244,RENIN,15.0,9.75,54.08,54.08,2
CPT,84244,RENIN (ANGIOTENSIN I); (RIA),15.0,9.75,192.08,305.91,2
CPT,84252,"HB VIT B2, RIBOFLAVIN",141.08,91.7,13270.0,14761.0,4
CPT,84252,Laboratory Services,141.08,91.7,152.26,152.27,2
CPT,84252,RIBOFLAVIN (VITAMIN B-2),141.08,91.7,49.92,238.96,4
CPT,84255,HB MISC LAB SPECIAL TEST,182.54,118.65,,,0
CPT,84255,HB SELENIUM,182.54,118.65,13270.0,14761.0,4
CPT,84255,Laboratory Services,182.54,118.65,192.07,192.09,2
CPT,84255,SELENIUM,182.54,118.65,62.4,62.4,2
CPT,84255,"SELENIUM, BLOOD, URINE OR TISSUE",182.54,118.65,223.01,355.17,2
CPT,84260,HB LAB SEROTONIN,47.29,30.74,13270.0,14761.0,2
CPT,84260,Laboratory Services,47.29,30.74,233.01,233.03,2
CPT,84260,SEROTONIN,47.29,30.74,75.71,75.71,2
CPT,84260,"SEROTONIN, BLOOD",47.29,30.74,270.52,430.82,2
CPT,84270,HB LAB SEX HORMONE BIND GLOB,7.5,4.88,13270.0,14761.0,2
CPT,84270,Laboratory Services,7.5,4.88,163.45,163.47,2
CPT,84270,SEX HORMONE BINDING GLOBULIN,7.5,4.88,189.67,302.07,2
CPT,84270,SEX HORMONE BINDING GLOBULIN (SHBG),7.5,4.88,53.25,53.25,2
CPT,84275,Laboratory Services,,,101.07,101.08,2
CPT,84275,SIALIC ACID,,,33.29,33.29,2
CPT,84275,"SIALIC ACID, BLOOD",,,117.24,186.71,2
CPT,84285,Laboratory Services,,,177.16,177.18,2
CPT,84285,SILICA,,,61.57,61.57,2
CPT,84285,"SILICA, BLOOD, URINE OR TISSUE",,,205.61,327.45,2
CPT,84295,HB LAB SODIUM SE AU,583.1,379.02,13270.0,14761.0,2
CPT,84295,Laboratory Services,583.1,379.02,36.16,36.17,2
CPT,84295,SODIUM; SERUM,583.1,379.02,11.64,11.64,2
CPT,84295,"SODIUM; SERUM, PLASMA OR WHOLE BLOOD",583.1,379.02,41.86,66.67,2
CPT,84300,HB LAB SODIUM UR AU,293.3,190.65,13270.0,14761.0,2
CPT,84300,HB LAB URODISK SODIUM; URINE,293.3,190.65,13270.0,14761.0,2
CPT,84300,Laboratory Services,293.3,190.65,36.6,36.61,2
CPT,84300,SODIUM; URINE,293.3,190.65,12.48,67.61,4
CPT,84302,HB LAB STOOL NA,12.95,8.42,13270.0,14761.0,4
CPT,84302,HB MISC LAB SPECIAL TEST,12.95,8.42,,,0
CPT,84302,Laboratory Services,12.95,8.42,36.6,36.61,2
CPT,84302,SODIUM: OTHER SOURCE,12.95,8.42,42.27,67.33,2
CPT,84302,Sodium; other source,12.95,8.42,11.64,11.64,2
CPT,84305,"HB LAB SOMATOMEDIN-C, RIA",13.0,8.45,13270.0,14761.0,4
CPT,84305,HB MISC LAB SPECIAL TEST,13.0,8.45,,,0
CPT,84305,Laboratory Services,13.0,8.45,159.93,159.95,2
CPT,84305,SOMATOMEDIN,13.0,8.45,52.42,236.53,4
CPT,84307,HB SOMATOSTATIN,86.24,56.06,13270.0,14761.0,2
CPT,84307,Laboratory Services,86.24,56.06,137.54,137.56,2
CPT,84307,SOMATOSTATIN,86.24,56.06,44.93,246.08,4
CPT,84311,"HB ADA, PLEURAL FLUID",27.36,17.78,13270.0,14761.0,2
CPT,84311,HB MISC LAB SPECIAL TEST,27.36,17.78,13270.0,14761.0,4
CPT,84311,Laboratory Services,27.36,17.78,52.58,52.58,2
CPT,84311,SPECTROPHOTOMETRY,27.36,17.78,61.09,97.29,2
CPT,84311,"SPECTROPHOTOMETRY, ANALYTE NOT ELSEWHERE SPECIFIED",27.36,17.78,19.97,19.97,2
CPT,84315,Laboratory Services,,,18.87,18.87,2
CPT,84315,SPECIFIC GRAVITY (EXCEPT URINE),,,8.32,34.93,4
CPT,84375,Laboratory Services,,,147.48,147.49,2
CPT,84375,"SUGARS, CHROMATOGRAPHIC, TLC OR PAPER CHROMATOGRAPHY",,,95.68,272.67,4
CPT,84376,HB STOOL REDUCING SUBSTANCE,293.73,190.92,13270.0,14761.0,4
CPT,84376,Laboratory Services,293.73,190.92,41.38,41.39,2
CPT,84376,"SUGAR(MOM-,DI,AND OLIGOSACCHARIDES);SINGLE QUALITATIVE, EACH SPECIMEN",293.73,190.92,47.86,76.22,2
CPT,84376,"SUGARS (MONO-, DI-, AND OLIGOSACCHARIDES); SINGLE QUALITATIVE, EACH SPECIMEN",293.73,190.92,13.31,13.31,2
CPT,84377,Laboratory Services,,,41.38,41.39,2
CPT,84377,"SUGAR(MOM-,DI,AND OLIGOSACCARIDES);MULTIPLE QUALITATIVE, EACH SPECIMEN",,,47.86,76.22,2
CPT,84377,"SUGARS (MONO-, DI-, AND OLIGOSACCHARIDES); MULTIPLE QUALITATIVE, EACH SPECIMEN",,,13.31,13.31,2
CPT,84378,"HB LAB 1,5-ANHYDROGLUCITOL",26.06,16.94,13270.0,14761.0,2
CPT,84378,Laboratory Services,26.06,16.94,86.73,86.74,2
CPT,84378,"SUGARS (MONO-, DI-, AND OLIGOSACCHARIDES); SINGLE QUANTITATIVE, EACH SPECIMEN",26.06,16.94,28.29,28.29,2
CPT,84378,"SUGARS(MOM-,DI, AND OLIGOSACCHARIDES); SINGLE QUANTITATIVE, EACH SPECIMEN",26.06,16.94,100.13,159.46,2
CPT,84379,Laboratory Services,,,86.73,86.74,2
CPT,84379,"SUGARS (MONO-, DI-, AND OLIGOSACCHARIDES); MULTIPLE QUANTITATIVE, EACH SPECIMEN",,,28.29,28.29,2
CPT,84379,"SUGARS(MOM-,DI, AND OLIGOSACCHARIDES); MULTIPLE QUANTITATIVEEACH SPECIMEN",,,100.13,159.46,2
CPT,84392,"HB LAB URODISK SULFATE, URINE",3.5,2.27,13270.0,14761.0,2
CPT,84392,Laboratory Services,3.5,2.27,35.72,35.73,2
CPT,84392,"SULFATE, URINE",3.5,2.27,13.31,66.29,4
CPT,84402,HB LAB TESTOSTERONE FREE,15.0,9.75,13270.0,14761.0,4
CPT,84402,Laboratory Services,15.0,9.75,191.57,191.59,2
CPT,84402,TESTOSTERONE; FREE,15.0,9.75,62.4,361.72,4
CPT,84403,HB LAB TESTOSTERONE TOTAL,14.6,9.49,13270.0,14761.0,4
CPT,84403,"HB LAB TESTOSTERONE, TOTAL",14.6,9.49,13270.0,14761.0,2
CPT,84403,HB MISC LAB SPECIAL TEST,14.6,9.49,,,0
CPT,84403,Laboratory Services,14.6,9.49,194.21,194.23,2
CPT,84403,"TESTOSTERONE, BLOOD, RIA",14.6,9.49,225.42,359.0,2
CPT,84403,TESTOSTERONE; TOTAL,14.6,9.49,63.24,63.24,2
CPT,84410,Laboratory Services,,,387.85,387.89,2
CPT,84410,"Testosterone; bioavailable, direct meansurement (eg, differential precipitation)",,,394.93,628.96,2
CPT,84410,"Testosterone; bioavailable, direct measurement (eg, differential precipitation)",,,125.64,125.64,2
CPT,84425,HB MISC LAB SPECIAL TEST,12.0,7.8,13270.0,14761.0,4
CPT,84425,"HB VITAMIN B1 (THIAMINE), (B)",12.0,7.8,13270.0,14761.0,2
CPT,84425,Laboratory Services,12.0,7.8,159.74,159.76,2
CPT,84425,THIAMINE (VITAMIN B-1),12.0,7.8,52.42,250.85,4
CPT,84430,"HB THIOCYANATE, SERUM",27.74,18.03,13270.0,14761.0,2
CPT,84430,Laboratory Services,27.74,18.03,87.54,87.55,2
CPT,84430,THIOCYANATE,27.74,18.03,28.29,28.29,2
CPT,84430,"THIOCYANATE, BLOOD",27.74,18.03,101.6,161.8,2
CPT,84431,Laboratory Services,,,126.35,126.36,2
CPT,84431,"THROMBOXANE METABOLITE(S), INCLUDING THROMBOXANE IF PERFORMED, URINE",,,102.01,162.46,2
CPT,84431,"Thromboxane metabolite(s), including thromboxane if performed, urine",,,86.54,86.54,2
CPT,84432,HB THYROGLOB PNL THYROGLOBULIN,40.0,26.0,13270.0,14761.0,4
CPT,84432,Laboratory Services,40.0,26.0,120.88,120.89,2
CPT,84432,THYROGLOBULIN,40.0,26.0,39.11,227.82,4
CPT,84433,Thiopurine S-methyltransferase (TPMT),,,54.08,198.88,4
CPT,84436,HB LAB THYROXINE,460.7,299.45,13270.0,14761.0,2
CPT,84436,HB MISC LAB SPECIAL TEST,460.7,299.45,,,0
CPT,84436,Laboratory Services,460.7,299.45,51.7,51.7,2
CPT,84436,"THYROXINE, TRUE (TT-4), RIA",460.7,299.45,60.03,95.6,2
CPT,84436,THYROXINE; TOTAL,460.7,299.45,16.64,16.64,2
CPT,84437,Laboratory Services,,,48.68,48.68,2
CPT,84437,THYROXINE (T-4) NEONATAL,,,56.5,89.99,2
CPT,84437,"THYROXINE; REQUIRING ELUTION (E.G., NEONATAL)",,,15.81,15.81,2
CPT,84439,HB LAB FREE T4,11.13,7.23,13270.0,14761.0,2
CPT,84439,HB LAB FREE T4 BY DIALYSIS,11.13,7.23,13270.0,14761.0,4
CPT,84439,Laboratory Services,11.13,7.23,67.86,67.87,2
CPT,84439,"THYROXINE, FREE (FT-4), RIA (UNBOUND T-4 ONLY)",11.13,7.23,78.73,125.38,2
CPT,84439,THYROXINE; FREE,11.13,7.23,22.46,22.46,2
CPT,84442,HB LAB TBG RIA SE,17.61,11.45,,,0
CPT,84442,Laboratory Services,17.61,11.45,111.32,111.33,2
CPT,84442,THYROXINE BINDING GLOBULIN (TBG),17.61,11.45,36.61,192.14,4
CPT,84443,HB LAB THYRO TSH SE RI,20.75,13.49,13270.0,14761.0,2
CPT,84443,HB MISC LAB SPECIAL TEST,20.75,13.49,,,0
CPT,84443,Laboratory Services,20.75,13.49,126.35,126.36,2
CPT,84443,THYROID STIMULATING HORMONE (TSH),20.75,13.49,41.61,41.61,2
CPT,84443,"THYROID STIMULATING HORMONE (TSH), RIA OR EIA",20.75,13.49,146.75,233.72,2
CPT,84445,HB THYROID STIMULAT IGG,39.15,25.45,13270.0,14761.0,4
CPT,84445,Laboratory Services,39.15,25.45,382.57,382.6,2
CPT,84445,THYROID STIMULATING IMMUNE GLOBULINS (TSI),39.15,25.45,124.81,124.81,2
CPT,84445,"THYROTROPIN RELEASING FACTOR (TRF), RIA; PLUS LONG ACTING (LATS)",39.15,25.45,350.71,558.54,2
CPT,84446,HB VITAMIN E (TOCOPHEROL),10.0,6.5,13270.0,14761.0,4
CPT,84446,Laboratory Services,10.0,6.5,106.66,106.67,2
CPT,84446,TOCOPHEROL ALPHA (VITAMIN E),10.0,6.5,34.94,197.11,4
CPT,84449,HB CORTISOL BINDING GLOBULIN,75.0,48.75,,,0
CPT,84449,Laboratory Services,75.0,48.75,126.35,126.36,2
CPT,84449,TRANSCORTIN,75.0,48.75,135.64,216.02,2
CPT,84449,TRANSCORTIN (CORTISOL BINDING GLOBULIN),75.0,48.75,44.1,44.1,2
CPT,84450,HB LAB S G O T SE ER,583.1,379.02,13270.0,14761.0,2
CPT,84450,Laboratory Services,583.1,379.02,38.93,38.93,2
CPT,84450,"TRANSAMINASE, GLUTAMIC OXALOACETIC (SGOT), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD",583.1,379.02,45.15,71.91,2
CPT,84450,TRANSFERASE; ASPARTATE AMINO (AST) (SGOT),583.1,379.02,12.48,12.48,2
CPT,84460,HB LAB SGPT SE ER,583.1,379.02,13270.0,14761.0,2
CPT,84460,Laboratory Services,583.1,379.02,39.75,39.75,2
CPT,84460,"TRANSAMINASE, GLUTAMIC PYRUVIC (SGPT), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD",583.1,379.02,45.68,72.76,2
CPT,84460,TRANSFERASE; ALANINE AMINO (ALT) (SGPT),583.1,379.02,13.31,13.31,2
CPT,84466,HB LAB TRANSFERRIN SE,739.68,480.79,13270.0,14761.0,2
CPT,84466,Laboratory Services,739.68,480.79,96.03,96.04,2
CPT,84466,TRANSFERRIN,739.68,480.79,31.62,182.78,4
CPT,84478,HB FLUID TRIGLYCERIDES,7.14,4.64,13270.0,14761.0,2
CPT,84478,HB LAB TRIGLYCER SE SC,7.14,4.64,13270.0,14761.0,2
CPT,84478,HB MISC LAB SPECIAL TEST,7.14,4.64,13270.0,14761.0,2
CPT,84478,HB TRIGLYCERIDES,7.14,4.64,13270.0,14761.0,2
CPT,84478,Laboratory Services,7.14,4.64,43.33,43.34,2
CPT,84478,TRIGLYCERIDES,7.14,4.64,14.14,14.14,2
CPT,84478,"TRIGLYCERIDES, BLOOD",7.14,4.64,49.98,79.59,2
CPT,84479,HB LAB T UPTAKE,460.7,299.45,13270.0,14761.0,2
CPT,84479,HB MISC LAB SPECIAL TEST,460.7,299.45,,,0
CPT,84479,Laboratory Services,460.7,299.45,48.68,48.68,2
CPT,84479,THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR),460.7,299.45,15.81,15.81,2
CPT,84479,"TRIIODOTHYRONINE (T-3), RESIN UPTAKE",460.7,299.45,56.5,89.99,2
CPT,84480,HB MISC LAB SPECIAL TEST,10.89,7.08,,,0
CPT,84480,"HB T3, TOTAL",10.89,7.08,13270.0,14761.0,4
CPT,84480,Laboratory Services,10.89,7.08,106.66,106.67,2
CPT,84480,TRIIODOTHYRONINE T3; TOTAL (TT-3),10.89,7.08,34.94,34.94,2
CPT,84480,"TRIIODOTHYRONINE TRUE (TT-3), RIA",10.89,7.08,123.76,197.11,2
CPT,84481,HB LAB T3;FREE,410.41,266.77,13270.0,14761.0,2
CPT,84481,Laboratory Services,410.41,266.77,127.42,127.43,2
CPT,84481,TRIIODOTHYRONINE T3; FREE,410.41,266.77,41.61,41.61,2
CPT,84481,"TRIIODOTHYRONINE, FREE (FT-3), RIA (UNBOUND T-3 ONLY)",410.41,266.77,147.99,235.68,2
CPT,84482,"HB T3, REVERSE",14.23,9.25,13270.0,14761.0,4
CPT,84482,Laboratory Services,14.23,9.25,118.55,118.56,2
CPT,84482,TRIIODOTHYRONINE T3; REVERSE,14.23,9.25,39.11,39.11,2
CPT,84482,"TRIIODOTHYRONINE,REVERSE",14.23,9.25,145.05,231.0,2
CPT,84484,HB LAB TROPONIN I,430.81,280.03,13270.0,14761.0,2
CPT,84484,HB MISC LAB SPECIAL TEST,430.81,280.03,,,0
CPT,84484,HB TROPONIN T,430.81,280.03,13270.0,14761.0,4
CPT,84484,Laboratory Services,430.81,280.03,74.02,74.03,2
CPT,84484,TROPONIN,430.81,280.03,166.63,265.37,2
CPT,84484,"TROPONIN, QUANTITATIVE",430.81,280.03,30.79,30.79,2
CPT,84485,Laboratory Services,,,56.48,56.48,2
CPT,84485,"TRYPSIN, DUODENAL FLUID",,,65.56,104.41,2
CPT,84485,TRYPSIN; DUODENAL FLUID,,,17.48,17.48,2
CPT,84488,Laboratory Services,,,54.9,54.91,2
CPT,84488,"TRYPSIN, FECES; QUALITATIVE, 24-HOUR SPECIMEN",,,63.73,101.5,2
CPT,84488,"TRYPSIN; FECES, QUALITATIVE",,,18.31,18.31,2
CPT,84490,Laboratory Services,,,57.23,57.24,2
CPT,84490,"TRYPSIN, FECES; QUANTITATIVE",,,66.44,105.81,2
CPT,84490,"TRYPSIN; FECES, QUANTITATIVE, 24-HOUR COLLECTION",,,24.13,24.13,2
CPT,84510,Laboratory Services,24.13,15.68,78.24,78.24,2
CPT,84510,TYROSINE,24.13,15.68,25.8,25.8,2
CPT,84510,"TYROSINE, BLOOD",24.13,15.68,90.84,144.67,2
CPT,84512,Laboratory Services,,,57.92,57.93,2
CPT,84512,"TROPONIN, QUALITATIVE",,,24.96,24.96,2
CPT,84512,"TROPONIN, QUANTITATIVE",,,129.35,206.0,2
CPT,84520,HB LAB UREA NITROGEN,583.1,379.02,13270.0,14761.0,2
CPT,84520,Laboratory Services,583.1,379.02,29.75,29.75,2
CPT,84520,"UREA NITROGEN, BLOOD (BUN); QUANTITATIVE",583.1,379.02,34.45,54.87,2
CPT,84520,UREA NITROGEN; QUANTITATIVE,583.1,379.02,9.99,9.99,2
CPT,84525,Laboratory Services,,,28.3,28.3,2
CPT,84525,"UREA NITROGEN, BLOOD (BUN); STICK TEST",,,32.81,52.25,2
CPT,84525,"UREA NITROGEN; SEMIQUANTITATIVE (E.G., REAGENT STRIP TEST)",,,12.48,12.48,2
CPT,84540,HB LAB UREA NITRO UR,606.43,394.18,13270.0,14761.0,2
CPT,84540,Laboratory Services,606.43,394.18,35.72,35.73,2
CPT,84540,"UREA NITROGEN, URINE",606.43,394.18,13.31,66.01,4
CPT,84545,Laboratory Services,,,49.68,49.69,2
CPT,84545,"UREA NITROGEN, CLEARANCE",,,17.48,91.76,4
CPT,84550,HB LAB URIC ACID SE AU,291.74,189.63,13270.0,14761.0,2
CPT,84550,Laboratory Services,291.74,189.63,34.02,34.03,2
CPT,84550,URIC ACID; BLOOD,291.74,189.63,10.82,10.82,2
CPT,84550,"URIC ACID; BLOOD, CHEMICAL",291.74,189.63,39.51,62.92,2
CPT,84560,HB LAB URIC ACID UR AU,7.8,5.07,13270.0,14761.0,2
CPT,84560,"HB LAB URODSK URIC ACID,URINE",7.8,5.07,13270.0,14761.0,2
CPT,84560,HB MISC LAB SPECIAL TEST,7.8,5.07,,,0
CPT,84560,Laboratory Services,7.8,5.07,35.72,35.73,2
CPT,84560,"URIC ACID, URINE",7.8,5.07,41.45,66.01,2
CPT,84560,URIC ACID; OTHER SOURCE,7.8,5.07,12.48,12.48,2
CPT,84577,Laboratory Services,,,93.9,93.91,2
CPT,84577,"UROBILINOGEN, FECES, QUANTITATIVE",,,41.61,167.89,4
CPT,84578,Laboratory Services,,,24.4,24.4,2
CPT,84578,"UROBILINOGEN, URINE; QUALITATIVE",,,10.82,45.13,4
CPT,84580,Laboratory Services,,,53.33,53.34,2
CPT,84580,"UROBILINOGEN, URINE; QUANTITATIVE, TIMED SPECIMEN",,,23.3,98.69,4
CPT,84583,Laboratory Services,,,37.8,37.8,2
CPT,84583,"UROBILINOGEN, URINE; SEMIQUANTITATIVE",,,14.98,69.85,4
CPT,84585,HB MISC LAB SPECIAL TEST,11.58,7.53,13270.0,14761.0,4
CPT,84585,"HB VMA, 24 HR URINE",11.58,7.53,13270.0,14761.0,2
CPT,84585,Laboratory Services,11.58,7.53,116.66,116.67,2
CPT,84585,"VANILLYLMANDELIC ACID (VMA), URINE",11.58,7.53,38.27,38.27,2
CPT,84585,"VANILLYMANDELIC ACID (VMA), URINE",11.58,7.53,135.4,215.65,2
CPT,84586,HB VSOACTV INTST PLYPEP,78.95,51.32,13270.0,14761.0,2
CPT,84586,Laboratory Services,78.95,51.32,265.78,265.8,2
CPT,84586,VASOACTIVE INTESINAL PEPTIDE (VIP),78.95,51.32,102.24,162.83,2
CPT,84586,VASOACTIVE INTESTINAL PEPTIDE (VIP),78.95,51.32,86.54,86.54,2
CPT,84588,HB MISC LAB SPECIAL TEST,24.13,15.68,,,0
CPT,84588,Laboratory Services,24.13,15.68,255.34,255.36,2
CPT,84588,"VASOPRESSIN (ANTIDIURETIC HORMONE), RIA",24.13,15.68,297.56,473.9,2
CPT,84588,"VASOPRESSIN (ANTIDIURETIC HORMONE, ADH)",24.13,15.68,83.2,83.2,2
CPT,84590,HB LAB VITAMIN A #,10.0,6.5,13270.0,14761.0,4
CPT,84590,Laboratory Services,10.0,6.5,87.23,87.24,2
CPT,84590,VITAMIN A,10.0,6.5,28.29,28.29,2
CPT,84590,"VITAMIN A, BLOOD;",10.0,6.5,101.24,161.24,2
CPT,84591,HB VITAMIN B3,75.0,48.75,13270.0,14761.0,4
CPT,84591,Laboratory Services,75.0,48.75,87.23,87.24,2
CPT,84591,"VITAMIN, NOT OTHERWISE SPECIFIED",75.0,48.75,41.61,161.15,4
CPT,84597,HB VITAMIN K,117.37,76.29,13270.0,14761.0,4
CPT,84597,Laboratory Services,117.37,76.29,103.14,103.15,2
CPT,84597,VITAMIN K,117.37,76.29,33.29,184.46,4
CPT,84600,HB VOLSQ VOLATILES,29.49,19.17,13270.0,14761.0,4
CPT,84600,Laboratory Services,29.49,19.17,120.94,120.95,2
CPT,84600,"VOLATILES (ACETIC ANHYDRIDE, CARBON TETRACHLORIDE, DICHLOROETHANE, DICHLOROMETHANE, DIETHYLETHER)",29.49,19.17,140.34,223.51,2
CPT,84600,"VOLATILES (E.G., ACETIC ANHYDRIDE, CARBON TETRACHLORIDE, DICHLOROETHANE,DICHLOROMETHANE, DIETHYLETHER, ISOPROPYL ALCOHOL, METHANOL)",29.49,19.17,41.61,41.61,2
CPT,84620,Laboratory Services,45.24,29.4,89.12,89.13,2
CPT,84620,"XYLOSE ABSORPTION TEST, BLOOD AND/OR URINE",45.24,29.4,31.62,164.71,4
CPT,84630,HB MISC LAB SPECIAL TEST,14.31,9.3,,,0
CPT,84630,HB ZINC,14.31,9.3,13270.0,14761.0,4
CPT,84630,Laboratory Services,14.31,9.3,85.66,85.67,2
CPT,84630,ZINC,14.31,9.3,28.29,28.29,2
CPT,84630,"ZINC, QUANTITATIVE; BLOOD",14.31,9.3,99.48,158.43,2
CPT,84681,C-PEPTIDE,240.09,156.06,50.75,50.75,2
CPT,84681,"C-PEPTIDE, ANY METHOD",240.09,156.06,148.1,235.87,2
CPT,84681,HB C-PEPTIDE,240.09,156.06,13270.0,14761.0,4
CPT,84681,Laboratory Services,240.09,156.06,156.54,156.55,2
CPT,84702,"GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE",80.0,52.0,36.61,36.61,2
CPT,84702,"GONADOTROPIN, CHORIONIC; QUANTITATIVE",80.0,52.0,125.82,200.38,2
CPT,84702,HB FLD HCG PERICARDIAL,80.0,52.0,13270.0,14761.0,2
CPT,84702,HB LAB HCG B SUB RI,80.0,52.0,13270.0,14761.0,2
CPT,84702,Laboratory Services,80.0,52.0,113.27,113.28,2
CPT,84703,"GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE",728.8,473.72,18.31,18.31,2
CPT,84703,"GONADOTROPIN, CHORIONIC; QUALITATIVE",728.8,473.72,65.62,104.5,2
CPT,84703,"HB LAB BETA HCG, QUAL",728.8,473.72,13270.0,14761.0,2
CPT,84703,Laboratory Services,728.8,473.72,56.48,56.48,2
CPT,84704,GONADOTROPIN CHROIONIC (HCG); FREE BETA CHAIN,,,131.41,209.28,2
CPT,84704,"GONADOTROPIN, CHORIONIC (HCG); FREE BETA CHAIN",,,37.44,37.44,2
CPT,84704,Laboratory Services,,,113.27,113.28,2
CPT,84830,Laboratory Services,,,58.61,58.62,2
CPT,84830,"OVULATION TEST, BY VISUAL COLOR COMPARISON METHODS FOR HUMAN LUTEINIZING HORMONE",,,87.6,139.52,2
CPT,84830,"OVULATION TESTS, BY VISUAL COLOR COMPARISON METHODS FOR HUMAN LUTEINIZING HORMONE",,,30.79,30.79,2
CPT,84999,HB LAB STOOL K,251.25,163.31,13270.0,14761.0,4
CPT,84999,HB MISC LAB SPECIAL TEST,251.25,163.31,13270.0,14761.0,2
CPT,84999,Laboratory Services,251.25,163.31,,,0
CPT,84999,UNLISTED CHEMISTRY OR TOXICOLOGY PROCEDURE,251.25,163.31,,,0
CPT,84999,Unlisted chemistry procedure,251.25,163.31,47.64,47.64,2
CPT,85002,BLEEDING TIME,,,11.64,11.64,2
CPT,85002,BLEEDING TIME; IVY OR TEMPLATE,,,39.39,62.74,2
CPT,85002,Laboratory Services,,,33.84,33.84,2
CPT,85004,BLOOD COUNT; AUTOMATED DIFFERENTIAL WBC COUNT,584.65,380.02,56.44,89.89,2
CPT,85004,Blood count; automated differential WBC count,584.65,380.02,15.81,15.81,2
CPT,85004,Laboratory Services,584.65,380.02,48.68,48.68,2
CPT,85007,"BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION W/ MANUAL DIFFERENTIAL WBC COUNT",750.55,487.86,30.04,47.85,2
CPT,85007,"BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITH MANUAL DIFFERENTIAL WBC COUNT",750.55,487.86,9.15,9.15,2
CPT,85007,HB MANUAL DIFFERENTIAL,750.55,487.86,13270.0,14761.0,2
CPT,85007,Laboratory Services,750.55,487.86,25.85,25.85,2
CPT,85008,"BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION W/O MANUALDIFFERENTIAL WBC COUNT",,,30.04,47.85,2
CPT,85008,"BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITHOUT MANUAL DIFFERENTIAL WBC COUNT",,,8.32,8.32,2
CPT,85008,Laboratory Services,,,25.85,25.85,2
CPT,85009,"BLOOD COUNT; MANUAL DIFFERENTIAL WBC COUNT, BUFFY COAT",,,12.48,51.69,4
CPT,85009,Laboratory Services,,,27.99,27.99,2
CPT,85013,"BLOOD COUNT, SPUN MICROHEMATOCRIT",,,20.64,32.87,2
CPT,85013,BLOOD COUNT; SPUN MICROHEMATOCRIT,,,17.48,17.48,2
CPT,85013,Laboratory Services,,,17.8,17.8,2
CPT,85014,BLOOD COUNT; HEMATOCRIT (HCT),380.71,247.46,5.82,32.87,4
CPT,85014,HB LAB HEMATOCRIT,380.71,247.46,13270.0,14761.0,2
CPT,85014,HB MISC LAB SPECIAL TEST,380.71,247.46,,,0
CPT,85014,Laboratory Services,380.71,247.46,17.8,17.8,2
CPT,85018,BLOOD COUNT; HEMOGLOBIN (HGB),258.36,167.93,5.82,32.87,4
CPT,85018,HB MISC LAB SPECIAL TEST,258.36,167.93,,,0
CPT,85018,Laboratory Services,258.36,167.93,17.8,17.8,2
CPT,85025,"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERENTIAL WBC COUNT",909.68,591.29,19.13,108.15,4
CPT,85025,HB CBC WITH AUTO DIFF,909.68,591.29,13270.0,14761.0,2
CPT,85025,Laboratory Services,909.68,591.29,58.49,58.49,2
CPT,85027,"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)",496.83,322.94,15.81,89.99,4
CPT,85027,HB LAB CBC HEMOGRAM W/PLT,496.83,322.94,13270.0,14761.0,2
CPT,85027,Laboratory Services,496.83,322.94,48.68,48.68,2
CPT,85032,"BLOOD COUNT: MANUAL CELL COUNT (ERYTHROCYTE, LEUKOCYTE, OR PLATELET) EACH",448.69,291.65,37.63,59.93,2
CPT,85032,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each",448.69,291.65,10.82,10.82,2
CPT,85032,HB LAB CELL C EOSINO BL,448.69,291.65,13270.0,14761.0,2
CPT,85032,Laboratory Services,448.69,291.65,32.33,32.33,2
CPT,85041,"BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED",,,7.49,41.86,4
CPT,85041,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,85041,Laboratory Services,,,22.64,22.64,2
CPT,85044,"BLOOD COUNT; RETICULOCYTE, MANUAL",,,10.82,59.83,4
CPT,85044,Laboratory Services,,,32.33,32.33,2
CPT,85045,"BLOOD COUNT; RETICULOCYTE, AUTOMATED",279.85,181.9,9.99,55.62,4
CPT,85045,Laboratory Services,279.85,181.9,30.12,30.13,2
CPT,85046,"BLOOD COUNT; RETICULOCYTES, AUTOMATED, INCLUDING ONE OR MORE CELLULAR PARAMETERS (E.G., RETICULOCYTE HEMOGLOBIN CONTENT (CHR), IMMATURE RETICULOCYTE FRACTION (IRF), RETICULOCYTE VOLUME (MRV), RNA CONT",362.77,235.8,13.31,13.31,2
CPT,85046,"BLOOD COUNT; RETICULOCYTES, AUTOMATED, INCLUDING ONE OR MORE CELLULAR PARAMETERS (EG, RETICULOCYTE HEMOGLOBIN CONTENT (C",362.77,235.8,48.56,77.34,2
CPT,85046,HB LAB RETICULOCYTE AUTO,362.77,235.8,13270.0,14761.0,2
CPT,85046,Laboratory Services,362.77,235.8,41.95,41.95,2
CPT,85048,"BLOOD COUNT; LEUKOCYTE (WBC), AUTOMATED",,,5.82,35.58,4
CPT,85048,Laboratory Services,,,19.06,19.06,2
CPT,85049,"BLOOD COUNT; PLATELET, AUTOMATED",236.57,153.77,39.1,62.27,2
CPT,85049,"Blood count; platelet, automated",236.57,153.77,10.82,10.82,2
CPT,85049,HB PLATELET CT AUTOMATED,236.57,153.77,13270.0,14761.0,2
CPT,85049,Laboratory Services,236.57,153.77,33.65,33.65,2
CPT,85055,Laboratory Services,35.74,23.23,201.38,201.4,2
CPT,85055,RETICULATED PLATELET ASSAY,35.74,23.23,87.37,373.8,4
CPT,85060,"BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT",,,32.41,218.74,4
CPT,85060,HB PROF PERIPHERAL BLOOD INTER,,,13270.0,14761.0,2
CPT,85060,Laboratory Services,,,133.2,133.22,2
CPT,85097,"BONE MARROW SMEAR AND/OR CELL BLOCK; SMEAR INTERPRETATION ONLY, WITH OR WITHOUT DIFFERENTIAL CELL COUNT",,,344.77,549.09,2
CPT,85097,"BONE MARROW, SMEAR INTERPRETATION",,,64.36,64.36,2
CPT,85097,HB PROF BONE MAR ASP STAIN,,,1017.19,14761.0,10
CPT,85097,Laboratory Services,,,270.37,270.4,2
CPT,85130,CHROMOGENIC SUBSTRATE ASSAY,,,29.12,164.15,4
CPT,85130,Laboratory Services,,,89.49,89.5,2
CPT,85170,CLOT RETRACTION,,,39.94,39.94,2
CPT,85170,CLOT RETRACTION; SCREEN,,,31.57,50.28,2
CPT,85170,Laboratory Services,,,27.23,27.23,2
CPT,85175,"CLOT LYSIS TIME, WHOLE BLOOD DILUTION",,,38.39,61.14,4
CPT,85175,Laboratory Services,,,34.21,34.22,2
CPT,85210,"CLOTTING; FACTOR II, PROTHROMBIN, SPECIFIC",536.73,348.87,31.62,180.63,4
CPT,85210,HB FACTOR II ASSAY,536.73,348.87,13270.0,14761.0,2
CPT,85210,Laboratory Services,536.73,348.87,97.67,97.68,2
CPT,85220,"CLOTTING; FACTOR V (ACG OR PROACCELERIN), LABILE FACTOR",523.82,340.48,43.26,245.52,4
CPT,85220,HB LAB FACTOR 5 ASSAY,523.82,340.48,13270.0,14761.0,2
CPT,85220,Laboratory Services,523.82,340.48,132.76,132.78,2
CPT,85230,"CLOTTING; FACTOR VII (PROCONVERTIN, STABLE FACTOR)",954.51,620.43,44.1,249.07,4
CPT,85230,HB LAB FACTOR 7 ASSAY,954.51,620.43,13270.0,14761.0,2
CPT,85230,Laboratory Services,954.51,620.43,134.71,134.73,2
CPT,85240,"CLOTTING; FACTOR VIII (AHG), ONE STAGE",849.18,551.97,44.1,249.07,4
CPT,85240,HB LAB FACTOR 8 ASSAY,849.18,551.97,13270.0,14761.0,2
CPT,85240,HB MISC LAB SPECIAL TEST,849.18,551.97,,,0
CPT,85240,Laboratory Services,849.18,551.97,134.71,134.73,2
CPT,85244,CLOTTING; FACTOR VIII RELATED ANTIGEN,,,49.92,49.92,2
CPT,85244,CLOTTING; FACTOR VIII RELATED ANTIGEN QUANTITATION,,,172.56,274.82,2
CPT,85244,Laboratory Services,,,153.58,153.6,2
CPT,85245,"CLOTTING; FACTOR VIII, VW FACTOR, RESTOCETIN COFACTOR",954.51,620.43,200.37,319.11,2
CPT,85245,"CLOTTING; FACTOR VIII, VW FACTOR, RISTOCETIN COFACTOR",954.51,620.43,56.58,56.58,2
CPT,85245,HB RISQ RISTOCETIN CO-FACTOR,954.51,620.43,13270.0,14761.0,2
CPT,85245,HB VWF ACTIVITY RISTOCETIN CO-FACTOR,954.51,620.43,13270.0,14761.0,2
CPT,85245,Laboratory Services,954.51,620.43,172.64,172.65,2
CPT,85246,"CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN",913.75,593.94,56.58,56.58,2
CPT,85246,"CLOTTING; FACTOR VIII,VW FACTOR ANTIGEN",913.75,593.94,200.37,319.11,2
CPT,85246,HB VON WILLEBRAND FACTOR AG,913.75,593.94,13270.0,14761.0,2
CPT,85246,Laboratory Services,913.75,593.94,172.64,172.65,2
CPT,85247,"CLOTTING; FACTOR VIII, VON WILLEBRAND FACTOR, MULTIMETRIC ANALYSIS",43.43,28.23,56.58,56.58,2
CPT,85247,"CLOTTING;FACTOR VIIII, VON WILLEBRAND'S FACTOR, MULTIMETRIC ANALYSIS",43.43,28.23,200.37,319.11,2
CPT,85247,HB VWF QUANTITATIVE MULTIMERS,43.43,28.23,13270.0,14761.0,4
CPT,85247,Laboratory Services,43.43,28.23,172.64,172.65,2
CPT,85250,CLOTTING; FACTOR IX (PTC OR CHRISTMAS),548.66,356.63,46.6,264.81,4
CPT,85250,HB FACTOR IX ASSAY,548.66,356.63,13270.0,14761.0,2
CPT,85250,HB FACTOR IX BLD CLT TEST,548.66,356.63,,,0
CPT,85250,Laboratory Services,548.66,356.63,143.27,143.28,2
CPT,85260,CLOTTING; FACTOR X (STUART-PROWER),550.97,358.13,44.1,249.07,4
CPT,85260,HB FACTOR X ASSAY,550.97,358.13,13270.0,14761.0,2
CPT,85260,HB FACTOR X BLD CLT FAC,550.97,358.13,,,0
CPT,85260,Laboratory Services,550.97,358.13,134.71,134.73,2
CPT,85270,CLOTTING; FACTOR XI (PTA),522.06,339.34,44.1,249.07,4
CPT,85270,HB LAB FACTOR 11 ASSAY,522.06,339.34,13270.0,14761.0,2
CPT,85270,Laboratory Services,522.06,339.34,134.71,134.73,2
CPT,85280,CLOTTING; FACTOR XII (HAGEMAN),954.51,620.43,47.43,269.11,4
CPT,85280,HB FACTOR XII ASSAY,954.51,620.43,13270.0,14761.0,2
CPT,85280,Laboratory Services,954.51,620.43,145.53,145.54,2
CPT,85290,CLOTTING; FACTOR XIII (FIBRIN STABILIZING),38.6,25.09,39.94,227.26,4
CPT,85290,HB FACTOR 13 ACTIVITY,38.6,25.09,13270.0,14761.0,4
CPT,85290,Laboratory Services,38.6,25.09,122.95,122.96,2
CPT,85291,"CLOTTING; FACTOR XIII (FIBRIN STABILIZING), SCREEN SOLUBILITY",606.43,394.18,22.46,123.6,4
CPT,85291,Laboratory Services,606.43,394.18,66.85,66.86,2
CPT,85292,CLOTTING; PREKALLIKREIN ASSAY (FLETCHER FACTOR ASSAY),,,46.6,254.88,4
CPT,85292,Laboratory Services,,,142.45,142.46,2
CPT,85293,CLOTTING; HIGH MOLECULAR WEIGHT KININOGEN ASSAY (FITZGERALD FACTOR ASSAY),125.0,81.25,46.6,254.88,4
CPT,85293,Laboratory Services,125.0,81.25,142.45,142.46,2
CPT,85300,"CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY",,,29.12,29.12,2
CPT,85300,"CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, EXCEPT ANTIGEN ASSAY",,,103.48,164.8,2
CPT,85300,Laboratory Services,,,89.18,89.19,2
CPT,85301,"CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ANTIGEN ASSAY",450.38,292.75,26.63,150.38,4
CPT,85301,HB ANTI-THROMBIN 3,450.38,292.75,13270.0,14761.0,2
CPT,85301,HB LAB ANTITHROMBIN III ANTIGEN,450.38,292.75,13270.0,14761.0,4
CPT,85301,Laboratory Services,450.38,292.75,81.32,81.33,2
CPT,85302,CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C ASSAY,91.0,59.15,105.3,167.7,2
CPT,85302,"CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ANTIGEN",91.0,59.15,29.12,29.12,2
CPT,85302,HB PROTEIN C ANTIGEN,91.0,59.15,13270.0,14761.0,4
CPT,85302,Laboratory Services,91.0,59.15,90.44,90.45,2
CPT,85303,"CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY",1430.43,929.78,34.12,192.52,4
CPT,85303,HB MISC LAB SPECIAL TEST,1430.43,929.78,,,0
CPT,85303,HB PROTEIN C FUNCTIONAL,1430.43,929.78,13270.0,14761.0,2
CPT,85303,Laboratory Services,1430.43,929.78,104.02,104.03,2
CPT,85305,"CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, TOTAL",549.95,357.46,28.29,28.29,2
CPT,85305,CLOTTING INHIBITORS OR ANTICOAGULANTS;PROTEIN S ASSAY,549.95,357.46,101.54,161.71,2
CPT,85305,HB LAB PROTEIN S TOTAL AG,549.95,357.46,13270.0,14761.0,2
CPT,85305,Laboratory Services,549.95,357.46,87.23,87.24,2
CPT,85306,"CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE",1185.68,770.69,37.44,37.44,2
CPT,85306,"CLOTTING INHIBITORS OR ANTICOAGULANTS;PROTEIN S, FREE",1185.68,770.69,133.88,213.21,2
CPT,85306,HB LAB PROTEIN S ASSAY,1185.68,770.69,13270.0,14761.0,2
CPT,85306,HB MISC LAB SPECIAL TEST,1185.68,770.69,,,0
CPT,85306,Laboratory Services,1185.68,770.69,115.28,115.29,2
CPT,85307,ACTIVATED PROTEIN C (APC) RESISTANCE ASSAY,43.43,28.23,37.44,213.02,4
CPT,85307,HB LAB ACT PROT C RESISTANCE,43.43,28.23,13270.0,14761.0,4
CPT,85307,Laboratory Services,43.43,28.23,115.28,115.29,2
CPT,85335,FACTOR INHIBITOR TEST,105.97,68.88,31.62,179.03,4
CPT,85335,HB AMD13X FAC INHIBITOR TST,105.97,68.88,13270.0,14761.0,4
CPT,85335,HB FACTOR INHIBITOR TEST,105.97,68.88,,,0
CPT,85335,HB MISC LAB SPECIAL TEST,105.97,68.88,,,0
CPT,85335,Laboratory Services,105.97,68.88,96.85,96.86,2
CPT,85337,Laboratory Services,,,78.43,78.43,2
CPT,85337,THROMBOMODULIN,,,42.43,140.36,4
CPT,85345,COAGULATION TIME; LEE AND WHITE,,,11.64,59.83,4
CPT,85345,Laboratory Services,,,32.33,32.33,2
CPT,85347,COAGULATION TIME; ACTIVATED,128.15,83.3,10.82,59.18,4
CPT,85347,HB LAB WHOLE BLOOD ACT,128.15,83.3,13270.0,14761.0,2
CPT,85347,Laboratory Services,128.15,83.3,32.01,32.01,2
CPT,85348,COAGULATION TIME; OTHER METHODS,875.67,569.19,10.82,50.1,4
CPT,85348,HB LAB HEPARIN DOSE RESPONSE,875.67,569.19,13270.0,14761.0,2
CPT,85348,Laboratory Services,875.67,569.19,27.99,27.99,2
CPT,85360,EUGLOBULIN LYSIS,28.95,18.82,20.8,113.02,4
CPT,85360,HB EUGLOBULIN CLOT LYSIS,28.95,18.82,13270.0,14761.0,2
CPT,85360,Laboratory Services,28.95,18.82,63.27,63.27,2
CPT,85362,"FIBRIN DEGRADATION (SPLIT) PRODUCTS (FDP) (FSP); AGGLUTINATION, SLIDE",535.72,348.22,60.09,95.7,2
CPT,85362,"FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); AGGLUTINATION SLIDE, SEMIQUANTITATIVE",535.72,348.22,16.64,16.64,2
CPT,85362,HB LAB FIBRIN MONOMER,535.72,348.22,13270.0,14761.0,2
CPT,85362,Laboratory Services,535.72,348.22,49.31,49.31,2
CPT,85366,FIBRIN DEGRADATION PRODUCTS; PARACOAGULATION,,,75.14,119.67,2
CPT,85366,FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); PARACOAGULATION,,,197.19,197.19,2
CPT,85366,Laboratory Services,,,61.51,61.51,2
CPT,85370,FIBRIN DEGRADATION PRODUCTS,14.02,9.11,99.19,157.97,2
CPT,85370,FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); QUANTITATIVE,14.02,9.11,30.79,30.79,2
CPT,85370,Laboratory Services,14.02,9.11,85.41,85.41,2
CPT,85378,"FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUALITATIVE OR SEMI- QUANTITATIVE",,,65.03,103.56,2
CPT,85378,"FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUALITATIVE OR SEMIQUANTITATIVE",,,24.13,24.13,2
CPT,85378,Laboratory Services,,,53.65,53.65,2
CPT,85379,"FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE",965.36,627.48,24.96,141.49,4
CPT,85379,HB PLASMA D-DIMER,965.36,627.48,13270.0,14761.0,2
CPT,85379,Laboratory Services,965.36,627.48,76.54,76.55,2
CPT,85380,"FIBRIN DEGRADATION PRODUCTS, D-DIMER; ULTRA SENSITIVE QUALITATIVE OR SEMI QUANTITATIVE",,,92.72,147.67,2
CPT,85380,"FIBRIN DEGRADATION PRODUCTS, D-DIMER; ULTRASENSITIVE (E.G., FOR EVALUATIFOR VENOUS THROMBOEMBOLISM), QUALITATIVE OR SEMIQUANTITATIVE",,,24.96,24.96,2
CPT,85380,Laboratory Services,,,76.54,76.55,2
CPT,85384,FIBRINOGEN; ACTIVITY,191.55,124.51,24.13,117.42,4
CPT,85384,HB FIBRINOGEN,191.55,124.51,13270.0,14761.0,2
CPT,85384,Laboratory Services,191.55,124.51,63.9,63.9,2
CPT,85385,FIBRINOGEN; ANTIGEN,14.48,9.41,35.77,35.77,2
CPT,85385,FIBRINOGEN;ANTIGEN,14.48,9.41,73.73,117.42,2
CPT,85385,"HB FIBRINOGEN AG,NEPHLOMETRY",14.48,9.41,13270.0,14761.0,2
CPT,85385,Laboratory Services,14.48,9.41,63.9,63.9,2
CPT,85390,"FIBRINOLYSINS OR COAGULOPATHY SCREEN, INTERPRETATION AND REPORT",455.63,296.16,38.27,38.27,2
CPT,85390,FIBRINOLYSINS; SCREENING,455.63,296.16,45.04,71.73,2
CPT,85390,HB LAB TEG HEPARINASE CK-LY30,455.63,296.16,13270.0,14761.0,2
CPT,85390,HB MISC LAB SPECIAL TEST,455.63,296.16,,,0
CPT,85390,Laboratory Services,455.63,296.16,38.87,38.87,2
CPT,85396,"COAGULATION/FIBRINOLYSIS ASSAY, WHOLE BLOOD (E.G., VISCOELASTIC CLOT ASSESSMENT), INCLUDING USE OF ANY PHARMACOLOGIC ADDITIVE(S), AS INDICATED, INCLUDING INTERPRETATION AND WRITTEN REPORT, PER DAY",,,26.02,26.02,2
CPT,85396,"COAGULATION/FIBRINOLYSIS ASSAY, WHOLE BLOOD, INCLUDING USE OF ANY PHARMACOLOGIC ADDITIVE(S), AS INDICATED, INCLUDING IN",,,140.05,223.04,2
CPT,85396,Laboratory Services,,,109.24,109.25,2
CPT,85397,"COAGULATION & FIBRINOLYSIS, FUNCTIONAL ACTIVITY, NOT OTHERWISE SPECIFIED (EG, ADAMTS-13), EACH ANALYTE",176.0,114.4,204.04,324.96,2
CPT,85397,"COAGULATION AND FIBRINOLYSIS, FUNCTIONAL ACTIVITY, NOT OTHERWISE SPECIFIED (EG. ADAMTS-13), EACH ANALYTE",176.0,114.4,75.71,75.71,2
CPT,85397,HB ADAMTS-13 ACTIVITY,176.0,114.4,13270.0,14761.0,2
CPT,85397,HB MISC LAB SPECIAL TEST,176.0,114.4,13270.0,14761.0,4
CPT,85397,Laboratory Services,176.0,114.4,172.64,172.65,2
CPT,85400,FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMIN,,,19.13,19.13,2
CPT,85400,FIBRINOLYTIC MECHANISMS; PLASMIN,,,74.73,119.01,2
CPT,85400,Laboratory Services,,,66.54,66.55,2
CPT,85410,FIBRINOLYTIC FACTORS AND INHIBITORS; ALPHA-2 ANTIPLASMIN,48.73,31.67,19.13,19.13,2
CPT,85410,FIBRINOLYTIC MECHANISMS; ALPHA-2 ANTIPLASMIN,48.73,31.67,65.2,103.84,2
CPT,85410,Laboratory Services,48.73,31.67,58.05,58.05,2
CPT,85415,FIBRINOGEN;PLASMINOGEN ACTIVATOR,56.0,36.4,150.22,239.24,2
CPT,85415,FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN ACTIVATOR,56.0,36.4,42.43,42.43,2
CPT,85415,HB LAB PLASMINOGEN ACTIVTR INHIB,56.0,36.4,13270.0,14761.0,4
CPT,85415,HB MISC LAB SPECIAL TEST,56.0,36.4,,,0
CPT,85415,Laboratory Services,56.0,36.4,129.37,129.38,2
CPT,85420,"FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN, EXCEPT ANTIGENIC ASSAY",63.0,40.95,15.81,15.81,2
CPT,85420,"FIBRINOLYTIC MECHANISMS; PLASMINOGEN, EXCEPT ANTIGENIC ASSAY",63.0,40.95,57.15,91.02,2
CPT,85420,HB PLASMINOGEN ACTIVITY,63.0,40.95,13270.0,14761.0,2
CPT,85420,Laboratory Services,63.0,40.95,49.18,49.19,2
CPT,85421,"FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN, ANTIGENIC ASSAY",72.69,47.25,24.96,24.96,2
CPT,85421,"FIBRINOLYTIC MECHANISMS; PLASMINOGEN, ANTIGENIC ASSAY",72.69,47.25,86.02,136.99,2
CPT,85421,Laboratory Services,72.69,47.25,76.6,76.61,2
CPT,85441,"HB HEINZ BODIES, DIRECT",53.91,35.04,,,0
CPT,85441,HEINZ BODIES; DIRECT,53.91,35.04,9.99,58.34,4
CPT,85441,Laboratory Services,53.91,35.04,31.63,31.64,2
CPT,85445,"HB HEINZ BODIES, INDUCED",53.91,35.04,,,0
CPT,85445,"HEINZ BODIES; INDUCED, ACETYL PHENYLHYDRAZINE",53.91,35.04,16.64,94.85,4
CPT,85445,Laboratory Services,53.91,35.04,51.26,51.26,2
CPT,85460,HB FETAL KLEIHAUER BETKE,1022.51,664.63,13270.0,14761.0,2
CPT,85460,"HEMOGLOBIN OR RBCS, FETAL, FOR FETOMATERNAL HEMORRHAGE; DIFFERENTIAL LYSIS (KLEIHAUER-BETKE)",1022.51,664.63,19.13,19.13,2
CPT,85460,"HEMOGLOBIN, FETAL, DIFFERENTIAL LYSIS (KLEIHAUER)",1022.51,664.63,67.56,107.59,2
CPT,85460,Laboratory Services,1022.51,664.63,58.24,58.24,2
CPT,85461,HB SCRN FETAL-MATERNAL,388.9,252.78,13270.0,14761.0,2
CPT,85461,"HEMOGLOBIN OR RBCS, FETAL, FOR FETOMATERNAL HEMORRHAGE; ROSETTE",388.9,252.78,23.3,23.3,2
CPT,85461,"HEMOGLOGBIN OR RBCS, FETAL, FOR FETOMATERNAL HEMORRHAGE; ROSETTE",388.9,252.78,133.58,212.74,2
CPT,85461,Laboratory Services,388.9,252.78,49.94,49.94,2
CPT,85475,"HEMOLYSIN, ACID",,,21.63,123.32,4
CPT,85475,Laboratory Services,,,66.73,66.73,2
CPT,85520,HB LAB UNFRACTIONATED HEPARIN,251.12,163.23,13270.0,14761.0,2
CPT,85520,HEPARIN ASSAY,251.12,163.23,32.45,154.69,4
CPT,85520,Laboratory Services,251.12,163.23,98.55,98.56,2
CPT,85525,HEPARIN NEUTRALIZATION,,,29.12,119.48,4
CPT,85525,Laboratory Services,,,69.87,69.88,2
CPT,85530,HEPARIN-PROTAMINE TOLERANCE TEST,,,32.45,167.42,4
CPT,85530,Laboratory Services,,,106.66,106.67,2
CPT,85536,"IRON STAIN, PERIPHERAL BLOOD",,,16.64,16.64,2
CPT,85536,"IRON STAIN, PREIPHERAL BLOOD",,,56.5,89.99,2
CPT,85536,Laboratory Services,,,48.68,48.68,2
CPT,85540,HB LEUKOCYTE ALK PHOS,456.23,296.55,13270.0,14761.0,2
CPT,85540,LEUKOCYTE ALKALINE PHOSPHATASE WITH COUNT,456.23,296.55,20.8,119.57,4
CPT,85540,Laboratory Services,456.23,296.55,64.71,64.72,2
CPT,85547,Laboratory Services,,,64.71,64.72,2
CPT,85547,"MECHANICAL FRAGILITY, RBC",,,20.8,119.57,4
CPT,85549,"HB LYSOZYME, SERUM",48.86,31.76,,,0
CPT,85549,Laboratory Services,48.86,31.76,141.13,141.14,2
CPT,85549,MURAMIDASE,48.86,31.76,45.76,45.76,2
CPT,85549,"MURAMIDASE, SERUM",48.86,31.76,163.8,260.87,2
CPT,85555,HB RED CELL FRAGILITY,68.57,44.57,13270.0,14761.0,2
CPT,85555,Laboratory Services,68.57,44.57,50.31,50.32,2
CPT,85555,"OSMOTIC FRAGILITY, RBC;",68.57,44.57,58.38,92.98,2
CPT,85555,"OSMOTIC FRAGILITY, RBC; UNINCUBATED",68.57,44.57,18.31,18.31,2
CPT,85557,Laboratory Services,25.81,16.78,100.5,100.51,2
CPT,85557,"OSMOTIC FRAGILITY, RBC; INCUBATED",25.81,16.78,32.45,32.45,2
CPT,85557,"OSMOTIC FRAGILITY, RBC; INCUBATED, QUANTITATIVE",25.81,16.78,116.65,185.78,2
CPT,85576,HB LAB ASPIRIN ASSAY,412.09,267.86,13270.0,14761.0,2
CPT,85576,Laboratory Services,412.09,267.86,161.63,161.65,2
CPT,85576,"PLATELET, AGGREGATION (IN VITRO), EACH AGENT",412.09,267.86,61.57,61.57,2
CPT,85576,"PLATELET; AGGREGATION (IN VITRO), EACH AGENT",412.09,267.86,159.39,253.85,2
CPT,85597,Laboratory Services,,,135.28,135.29,2
CPT,85597,PHOSPHOLIPID NEUTRALIZATION; PLATELET,,,133.35,212.37,2
CPT,85597,PLATELET NEUTRALIZATION,,,44.1,44.1,2
CPT,85598,HB LAB LUPUS ANTICOAG/ HEXA PL,769.58,500.23,13270.0,14761.0,2
CPT,85598,Laboratory Services,769.58,500.23,135.28,135.29,2
CPT,85598,PHOSPHOLIPID NEUTRALIZATION; HEXAGONAL PHOSPHOLIPID,769.58,500.23,44.1,202.44,4
CPT,85610,HB LAB PRO TIME ER,234.76,152.59,13270.0,14761.0,2
CPT,85610,HB MISC LAB SPECIAL TEST,234.76,152.59,,,0
CPT,85610,Laboratory Services,234.76,152.59,29.56,29.56,2
CPT,85610,PROTHROMBIN TIME;,234.76,152.59,10.82,54.78,4
CPT,85611,HB FACTOR X PROTHROMBIN,36.09,23.46,,,0
CPT,85611,HB LAB PRO TIME DIFF PL,36.09,23.46,13270.0,14761.0,2
CPT,85611,Laboratory Services,36.09,23.46,29.62,29.62,2
CPT,85611,"PROTHROMBIN TIME; SUBSTITUTION, PLASMA FRACTIONS, EACH",36.09,23.46,9.99,54.78,4
CPT,85612,Laboratory Services,,,72.01,72.02,2
CPT,85612,PROTHROMBIN TIME; RUSSELL VIPER VENOM TYPE (INCLUDES VENOM),,,83.55,133.06,2
CPT,85612,RUSSELL VIPER VENOM TIME (INCLUDES VENOM); UNDILUTED,,,43.26,43.26,2
CPT,85613,HB LAB DRVV CONFIRM,223.02,144.96,13270.0,14761.0,2
CPT,85613,HB MISC LAB SPECIAL TEST,223.02,144.96,,,0
CPT,85613,Laboratory Services,223.02,144.96,72.01,72.02,2
CPT,85613,PROTHROMBIN TIME; DILUTED,223.02,144.96,83.55,133.06,2
CPT,85613,RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED,223.02,144.96,23.3,23.3,2
CPT,85635,Laboratory Services,,,74.09,74.09,2
CPT,85635,REPTILASE TEST,,,24.13,136.99,4
CPT,85651,Laboratory Services,508.56,330.56,26.73,26.73,2
CPT,85651,SEDIMENTATION RATE (ESR); WESTERGREN TYPE,508.56,330.56,30.98,49.35,2
CPT,85651,"SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED",508.56,330.56,10.82,10.82,2
CPT,85652,"HB SEDIMENTATION RATE, RBC, AUTOMATED",475.27,308.93,13270.0,14761.0,2
CPT,85652,Laboratory Services,475.27,308.93,20.31,20.32,2
CPT,85652,SEDIMENTATION RATE ERYTHROCYTE; AUTOMATED,475.27,308.93,22.81,36.33,2
CPT,85652,"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED",475.27,308.93,6.66,6.66,2
CPT,85660,Laboratory Services,208.17,135.31,41.51,41.51,2
CPT,85660,"SICKLING OF RBC, REDUCTION",208.17,135.31,13.31,13.31,2
CPT,85660,"SICKLING OF RBC, REDUCTION, SLIDE METHOD",208.17,135.31,48.33,76.97,2
CPT,85670,HB LAB THROMBIN TIME PL,554.76,360.59,13270.0,14761.0,2
CPT,85670,Laboratory Services,554.76,360.59,43.46,43.46,2
CPT,85670,THROMBIN TIME; PLASMA,554.76,360.59,14.14,80.43,4
CPT,85675,Laboratory Services,,,51.51,51.51,2
CPT,85675,THROMBIN TIME; TITER,,,16.64,95.32,4
CPT,85705,Laboratory Services,,,72.45,72.46,2
CPT,85705,"THROMBOPLASTIN INHIBITION, TISSUE",,,23.3,23.3,2
CPT,85705,THROMBOPLASTIN INHIBITION; TISSUE,,,74.08,117.98,2
CPT,85730,HB LAB PTT ER,244.27,158.78,13270.0,14761.0,2
CPT,85730,HB MISC LAB SPECIAL TEST,244.27,158.78,,,0
CPT,85730,Laboratory Services,244.27,158.78,45.16,45.16,2
CPT,85730,"THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD",244.27,158.78,14.98,83.52,4
CPT,85732,HB LAB PTT DIFF PL,554.76,360.59,13270.0,14761.0,2
CPT,85732,Laboratory Services,554.76,360.59,48.68,48.68,2
CPT,85732,"THROMBOPLASTIN TIME, PARTIAL (PTT); SUBSTITUTION, PLASMA",554.76,360.59,56.5,89.99,2
CPT,85732,"THROMBOPLASTIN TIME, PARTIAL (PTT); SUBSTITUTION, PLASMA FRACTIONS, EACH",554.76,360.59,15.81,15.81,2
CPT,85810,HB MISC LAB SPECIAL TEST,87.42,56.82,13270.0,14761.0,4
CPT,85810,HB VISCOSITY SERUM,87.42,56.82,13270.0,14761.0,2
CPT,85810,Laboratory Services,87.42,56.82,87.86,87.87,2
CPT,85810,VISCOSITY,87.42,56.82,28.29,28.29,2
CPT,85810,VISCOSITY; BLOOD,87.42,56.82,102.01,162.46,2
CPT,85999,Laboratory Services,343.32,223.16,,,0
CPT,85999,UNLISTED HEMATOLOGY PROCEDURE,343.32,223.16,,,0
CPT,85999,Unlisted hematology and coagulation procedure,343.32,223.16,47.64,47.64,2
CPT,86000,"AGGLUTININS, FEBRILE (E.G., BRUCELLA, FRANCISELLA, MURINE TYPHUS, Q FEVEROCKY MOUNTAIN SPOTTED FEVER, SCRUB TYPHUS), EACH ANTIGEN",51.15,33.25,17.48,17.48,2
CPT,86000,"AGGLUTININS; FEBRILE, EACH ANTIGEN",51.15,33.25,55.03,87.64,2
CPT,86000,HB LAB TULAREMIA AGGLUTININ,51.15,33.25,13270.0,14761.0,2
CPT,86000,Laboratory Services,51.15,33.25,43.14,43.15,2
CPT,86001,"ALLERGEN SPECIFIC IGG QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN",,,19.13,72.66,4
CPT,86001,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,86001,Laboratory Services,,,39.24,39.25,2
CPT,86003,"ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN",6.45,4.19,12.48,12.48,2
CPT,86003,"ALLERGEN SPECIFIC IGE; QUUANTITIATIVE, OR SEMIQUANTITATIVE EACH ALLERGEN",6.45,4.19,138.05,219.86,2
CPT,86003,HB LAB SOUTH CA ALLERGY PANE,6.45,4.19,13270.0,14761.0,2
CPT,86003,HB MISC LAB SPECIAL TEST,6.45,4.19,13270.0,14761.0,2
CPT,86003,Laboratory Services,6.45,4.19,39.24,39.25,2
CPT,86005,"ALLERGEN SPECIFIC IGE; QUALITATIVE, MULTIALLERGEN SCREEEN",,,141.46,225.29,2
CPT,86005,"ALLERGEN SPECIFIC IGE; QUALITATIVE, MULTIALLERGEN SCREEN (DIPSTICK, PADDLE OR DISK)",,,19.97,19.97,2
CPT,86005,Laboratory Services,,,40.25,40.25,2
CPT,86008,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each",228.66,148.63,44.1,44.1,2
CPT,86008,Allg spec ige recomb ea,228.66,148.63,147.52,234.94,2
CPT,86008,HB MISC LAB SPECIAL TEST,228.66,148.63,,,0
CPT,86008,Laboratory Services,228.66,148.63,118.36,118.37,2
CPT,86015,"Actin (smooth muscle) antibody (ASMA), each",,,28.93,46.07,4
CPT,86015,HB MISC LAB SPECIAL TEST,868.53,564.54,13270.0,14761.0,4
CPT,86015,Laboratory Services,,,61.63,61.64,2
CPT,86021,ANTIBODY IDENTIFICATION; LEUKOCYTE ANTIBODIES,19.25,12.51,36.61,209.37,4
CPT,86021,HB LAB ANCA,19.25,12.51,13270.0,14761.0,2
CPT,86021,HB LAB NEUTROPHIL ANTIBODY,19.25,12.51,13270.0,14761.0,2
CPT,86021,Laboratory Services,19.25,12.51,102.83,102.84,2
CPT,86022,ANTIBODY IDENTIFICATION; PLATELET ANTIBODIES,274.0,178.1,44.93,216.77,4
CPT,86022,HB LAB PLT AB - HIT PF4-HEP EIA,274.0,178.1,13270.0,14761.0,2
CPT,86022,HB MISC LAB SPECIAL TEST,274.0,178.1,13270.0,14761.0,8
CPT,86022,Laboratory Services,274.0,178.1,138.17,138.19,2
CPT,86023,ANTIBODY IDENTIFICATION; PLATELET ASSOCIATED IMMUNOGLOBULIN ASSAY,33.78,21.96,30.79,149.35,4
CPT,86023,HB LAB PLATELET AB DIRECT,33.78,21.96,13270.0,14761.0,4
CPT,86023,Laboratory Services,33.78,21.96,93.71,93.72,2
CPT,86036,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody",549.35,357.08,29.95,48.22,4
CPT,86036,HB ANCA SCREEN EACH ANTIBODY,549.35,357.08,13270.0,14761.0,2
CPT,86036,Laboratory Services,549.35,357.08,64.4,64.41,2
CPT,86037,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody",554.76,360.59,29.95,48.22,4
CPT,86037,HB ANCA TITER EACH ANTIBODY,554.76,360.59,13270.0,14761.0,2
CPT,86037,Laboratory Services,554.76,360.59,64.4,64.41,2
CPT,86038,"ANTINUCLEAR ANTIBODIES (ANA), RIA",9.05,5.88,105.54,168.08,2
CPT,86038,ANTINUCLEAR ANTIBODIES (ANA);,9.05,5.88,29.95,29.95,2
CPT,86038,HB MISC LAB SPECIAL TEST,9.05,5.88,13270.0,14761.0,2
CPT,86038,Laboratory Services,9.05,5.88,90.94,90.95,2
CPT,86039,ANTIHUMAN GLOBULIN TEST;TITER,1022.51,664.63,97.36,155.06,2
CPT,86039,ANTINUCLEAR ANTIBODIES (ANA); TITER,1022.51,664.63,27.45,27.45,2
CPT,86039,HB LAB CENTROMERE ANTIBODY,1022.51,664.63,13270.0,14761.0,2
CPT,86039,Laboratory Services,1022.51,664.63,83.96,83.97,2
CPT,86051,Aquaporin-4 (neuromyelitis optica [NMO]) antibody; enzyme-linked immunosorbent immunoassay (ELISA),,,28.29,46.07,4
CPT,86052,"Aquaporin-4 (neuromyelitis optica [NMO]) antibody; cell-based immunofluorescence assay (CBA), each",,,29.95,48.22,4
CPT,86052,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,86052,Laboratory Services,,,64.4,64.41,2
CPT,86053,"Aquaporin-4 (neuromyelitis optica [NMO]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [FACS]), each",,,30.28,92.36,4
CPT,86053,HB MISC LAB SPECIAL TEST,868.53,564.54,13270.0,14761.0,4
CPT,86053,Laboratory Services,,,64.4,64.41,2
CPT,86060,ANTISTREPTOLYSIN 0; TITER,,,18.31,101.5,4
CPT,86060,Laboratory Services,,,54.9,54.91,2
CPT,86063,ANTISTREPTOLYSIN 0; SCREEN,14.48,9.41,14.14,80.43,4
CPT,86063,Laboratory Services,14.48,9.41,43.46,43.46,2
CPT,86077,"BLOOD BANK PHYSICIAN SERVICES; DIFFICULT CROSS MATCH AND/OR EVALUATION OF IRREGULAR ANTIBODY(S), INTERPRETATION AND WRITTEN REPORT",,,65.72,65.72,2
CPT,86077,"BLOOD BANK PHYSICIAN SERVICES; DIFFICULT CROSSMATCH AND/OR EVALUATION OF IRREGULAR ANTIBODY(S), INTERPRETATION AND",,,163.27,260.03,2
CPT,86077,Laboratory Services,,,277.04,277.06,2
CPT,86078,BLOOD BANK PHYSICIAN SERVICES; INVESTIGATION OF TRANSFUSION REACTION INCLUDING SUSPICION OF TRANSMISSIBLE DISEA,955.55,621.11,279.1,444.49,2
CPT,86078,"BLOOD BANK PHYSICIAN SERVICES; INVESTIGATION OF TRANSFUSION REACTION INCLUDING SUSPICION OF TRANSMISSIBLE DISEASE, INTERPRETATION AND WRITTEN REPORT",955.55,621.11,65.72,65.72,2
CPT,86078,HB TRANSFUSION REACT WORKUP,955.55,621.11,213.38,14761.0,20
CPT,86078,Laboratory Services,955.55,621.11,279.24,279.26,2
CPT,86079,"BLOOD BANK PHYSICIAN SERVICES; AUTHORIZATION FOR DEVIATION FROM STANDARD BLOOD BANKING PROCEDURES (EG, USE OF OUTDA",,,259.76,413.69,2
CPT,86079,"BLOOD BANK PHYSICIAN SERVICES; AUTHORIZATION FOR DEVIATION FROM STANDARDBLOOD BANKING PROCEDURES (E.G., USE OF OUTDATED BLOOD, TRANSFUSION OF RHINCOMPATIBLE UNITS), WITH WRITTEN REPORT",,,66.18,66.18,2
CPT,86079,Laboratory Services,,,279.24,279.26,2
CPT,86140,C-REACTIVE PROTEIN,204.6,132.99,45.15,71.91,2
CPT,86140,C-REACTIVE PROTEIN;,204.6,132.99,12.48,12.48,2
CPT,86140,HB IBDSGI CRP,204.6,132.99,13270.0,14761.0,4
CPT,86140,HB LAB C-REACT PROT CORD BL,204.6,132.99,13270.0,14761.0,2
CPT,86140,HB MISC LAB SPECIAL TEST,204.6,132.99,,,0
CPT,86140,Laboratory Services,204.6,132.99,38.93,38.93,2
CPT,86141,C-REACTIVE PROTEIN; HIGH SENSITIVITY,417.27,271.22,113.0,179.97,2
CPT,86141,C-reactive protein; high sensitivity (hsCRP),417.27,271.22,31.62,31.62,2
CPT,86141,HB LAB C-REACT PROT QT,417.27,271.22,13270.0,14761.0,2
CPT,86141,HB MISC LAB SPECIAL TEST,417.27,271.22,,,0
CPT,86141,Laboratory Services,417.27,271.22,97.42,97.43,2
CPT,86146,BETA 2 GLYCOPROTEIN 1 ANTIBODY; EACH,574.13,373.18,222.07,353.67,2
CPT,86146,"BETA 2 GLYCOPROTEIN I ANTIBODY, EACH",574.13,373.18,62.4,62.4,2
CPT,86146,HB LAB BETA 2 GLYCOPROTEIN1-IGM,574.13,373.18,13270.0,14761.0,2
CPT,86146,HB MISC LAB SPECIAL TEST,574.13,373.18,,,0
CPT,86146,Laboratory Services,574.13,373.18,191.38,191.4,2
CPT,86147,"CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS",226.9,147.49,62.4,62.4,2
CPT,86147,"CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH LG CLASS",226.9,147.49,126.12,200.85,2
CPT,86147,HB CARDIOLIPIN IGA AB,226.9,147.49,13270.0,14761.0,4
CPT,86147,HB LAB ANTIBD ANTICARDIOLIPIN,226.9,147.49,13270.0,14761.0,2
CPT,86147,HB MISC LAB SPECIAL TEST,226.9,147.49,,,0
CPT,86147,Laboratory Services,226.9,147.49,191.38,191.4,2
CPT,86148,ANTI-PHOSPHATIDYLSERINE (PHOSPHOLIPID) ANTIBODY,15.71,10.21,39.11,224.73,4
CPT,86148,HB PHOSPHATIDYLSERINE AB,15.71,10.21,,,0
CPT,86148,Laboratory Services,15.71,10.21,120.88,120.89,2
CPT,86152,CELL ENUMERATION USING IMMUNOLOGIC SELECTION AND IDENTIFICATION IN FLUID SPECIMEN (EG CIRCULATING TUMOR CELLS IN BLOOD);,503.73,327.42,760.81,1211.66,2
CPT,86152,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood);",503.73,327.42,615.71,615.71,2
CPT,86152,HB MISC LAB SPECIAL TEST,503.73,327.42,,,0
CPT,86152,Laboratory Services,503.73,327.42,4364.39,4364.83,2
CPT,86153,"CELL ENUMERATION USING IMMUNOLOGIC SELECTION AND IDENTIFICATION IN FLUID SPECIMEN; PHYSICIAN INTERPRETATION AND REPORT,",,,189.73,302.17,2
CPT,86153,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,86153,Laboratory Services,,,943.37,943.46,2
CPT,86155,"CHEMOTAXIS ASSAY, SPECIFY METHOD",,,39.11,214.99,4
CPT,86155,Laboratory Services,,,120.25,120.26,2
CPT,86156,COLD AGGLUTININ; SCREEN,32.0,20.8,19.97,92.42,4
CPT,86156,Laboratory Services,32.0,20.8,50.44,50.44,2
CPT,86157,COLD AGGLUTININ; TITER,44.4,28.86,19.97,112.18,4
CPT,86157,HB COLD HEMAGGLUTININS,44.4,28.86,13270.0,14761.0,2
CPT,86157,Laboratory Services,44.4,28.86,60.69,60.7,2
CPT,86160,"COMPLEMENT; ANTIGEN, EACH COMPONENT",31.97,20.78,29.12,166.95,4
CPT,86160,HB COMPLEMENT COMPONENT C5,31.97,20.78,13270.0,14761.0,2
CPT,86160,HB LAB COMPLMNT C4 ASSY,31.97,20.78,13270.0,14761.0,2
CPT,86160,HB MISC LAB SPECIAL TEST,31.97,20.78,13270.0,14761.0,4
CPT,86160,Laboratory Services,31.97,20.78,90.31,90.32,2
CPT,86161,"COMPLEMENT; FUNCTIONAL ACTIVITY, EACH COMPONENT",19.79,12.86,29.12,166.95,4
CPT,86161,"HB C1 INHIBITOR, FUNCTIONAL",19.79,12.86,13270.0,14761.0,2
CPT,86161,HB MISC LAB SPECIAL TEST,19.79,12.86,,,0
CPT,86161,Laboratory Services,19.79,12.86,90.31,90.32,2
CPT,86162,COMPLEMENT; TOTAL (CH 50),8.44,5.49,177.38,282.5,2
CPT,86162,COMPLEMENT; TOTAL HEMOLYTIC (CH50),8.44,5.49,49.92,49.92,2
CPT,86162,"HB COMPLEMENT, TOTAL (CH50)",8.44,5.49,13270.0,14761.0,4
CPT,86162,Laboratory Services,8.44,5.49,152.83,152.84,2
CPT,86171,"COMPLEMENT FIXATION TESTS, EACH ANTIGEN",12.63,8.21,24.96,139.33,4
CPT,86171,HB LAB HISTO YEAST AB - CF #,12.63,8.21,13270.0,14761.0,4
CPT,86171,Laboratory Services,12.63,8.21,75.41,75.41,2
CPT,86200,"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY",285.91,185.84,31.62,31.62,2
CPT,86200,"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY ï",285.91,185.84,110.59,176.13,2
CPT,86200,HB LAB CYCLIC CITRULINATD PEP IGG,285.91,185.84,13270.0,14761.0,2
CPT,86200,HB MISC LAB SPECIAL TEST,285.91,185.84,,,0
CPT,86200,Laboratory Services,285.91,185.84,97.42,97.43,2
CPT,86215,"DEOXYRIBONUCLEASE, ANTIBODY",15.44,10.04,32.45,184.28,4
CPT,86215,HB DNASE-B ANTIBODY,15.44,10.04,13270.0,14761.0,4
CPT,86215,HB MISC LAB SPECIAL TEST,15.44,10.04,,,0
CPT,86215,Laboratory Services,15.44,10.04,99.68,99.69,2
CPT,86225,DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY,65.0,42.25,120.0,191.11,2
CPT,86225,DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED,65.0,42.25,34.12,34.12,2
CPT,86225,HB LAB ANTIBD DNA 1F,65.0,42.25,13270.0,14761.0,2
CPT,86225,HB MISC LAB SPECIAL TEST,65.0,42.25,13270.0,14761.0,6
CPT,86225,Laboratory Services,65.0,42.25,103.33,103.34,2
CPT,86226,DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; SINGLE STRANDED,,,29.95,29.95,2
CPT,86226,DEOXYRIBONUCLEIC ACID ANTIBODY;SINGLE STRANDED,,,105.77,168.45,2
CPT,86226,HB TERM SINGLE STRANDED DNA,30.43,19.78,,,0
CPT,86226,Laboratory Services,,,91.07,91.08,2
CPT,86231,"Endomysial antibody (EMA), each immunoglobulin (Ig) class",23.0,14.95,29.95,48.32,4
CPT,86231,HB MISC LAB SPECIAL TEST,23.0,14.95,,,0
CPT,86231,Laboratory Services,23.0,14.95,64.65,64.66,2
CPT,86235,"ANTIBODY TO SPECIFIC NUCLEAR ANTIGEN, ANY METHOD, EACH",84.92,55.2,132.99,211.81,2
CPT,86235,"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (E.G., NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EACH ANTIBODY",84.92,55.2,44.1,44.1,2
CPT,86235,HB ANTI CHROMATIN AB IGG,84.92,55.2,13270.0,14761.0,2
CPT,86235,HB LAB SS-A ANTIBODIES,84.92,55.2,13270.0,14761.0,2
CPT,86235,HB MISC LAB SPECIAL TEST,84.92,55.2,13270.0,14761.0,6
CPT,86235,Laboratory Services,84.92,55.2,123.14,123.15,2
CPT,86255,FLUORESCENT ANTIBODY; SCREEN,57.9,37.63,105.3,167.7,2
CPT,86255,"FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY",57.9,37.63,29.95,29.95,2
CPT,86255,HB MISC LAB SPECIAL TEST,57.9,37.63,13270.0,14761.0,8
CPT,86255,Laboratory Services,57.9,37.63,90.69,90.7,2
CPT,86256,FLUORESCENT ANTIBODY; TITER,66.85,43.45,105.3,167.7,2
CPT,86256,"FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH ANTIBODY",66.85,43.45,29.95,29.95,2
CPT,86256,HB MISC LAB SPECIAL TEST,66.85,43.45,13270.0,14761.0,2
CPT,86256,HB SMOOTH MUSCLE ANTIBODY,66.85,43.45,13270.0,14761.0,2
CPT,86256,Laboratory Services,66.85,43.45,90.69,90.7,2
CPT,86258,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class",44.84,29.15,28.93,46.07,4
CPT,86258,HB MISC LAB SPECIAL TEST,44.84,29.15,,,0
CPT,86258,Laboratory Services,44.84,29.15,61.63,61.64,2
CPT,86277,"GROWTH HORMONE, HUMAN (HGH), ANTIBODY",104.22,67.74,38.27,38.27,2
CPT,86277,"GROWTH HORMONE, HUMAN (HGH), ANTIBODY, RIA",104.22,67.74,137.4,218.83,2
CPT,86277,Laboratory Services,104.22,67.74,118.42,118.44,2
CPT,86280,HEMAGGLUTINATION INHIBITION TEST (HAI),,,19.97,19.97,2
CPT,86280,"HEMAGGLUTINATION INHIBITION TEST (HAI), EACH (EG, RUBELLA, VIRAL)",,,71.44,113.77,2
CPT,86280,Laboratory Services,,,61.57,61.58,2
CPT,86294,"IMMUNOASSAY FOR TUMOR ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE (E.G., BLADDER TUMOR ANTIGEN)",,,62.4,62.4,2
CPT,86294,"IMMUNOASSAY FOR TUMOR ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE (EG, BLADDER TUMOR ANTIGEN)",,,144.64,230.35,2
CPT,86294,Laboratory Services,,,147.61,147.62,2
CPT,86300,HB CA27.29,247.63,160.96,13270.0,14761.0,2
CPT,86300,HB LAB CA 15-3,247.63,160.96,13270.0,14761.0,2
CPT,86300,HB MISC LAB SPECIAL TEST,247.63,160.96,,,0
CPT,86300,"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)",247.63,160.96,50.75,50.75,2
CPT,86300,"IMMUNOASSY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3",247.63,160.96,181.62,289.24,2
CPT,86300,Laboratory Services,247.63,160.96,156.6,156.61,2
CPT,86301,HB LAB CA 19-9,34.66,22.53,13270.0,14761.0,2
CPT,86301,HB LAB FLD CA 19-9 PLEURAL,34.66,22.53,13270.0,14761.0,2
CPT,86301,"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9",34.66,22.53,50.75,289.24,4
CPT,86301,Laboratory Services,34.66,22.53,156.6,156.61,2
CPT,86304,HB LAB CA125 IA,25.7,16.71,13270.0,14761.0,2
CPT,86304,"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125",25.7,16.71,50.75,289.24,4
CPT,86304,Laboratory Services,25.7,16.71,156.6,156.61,2
CPT,86305,HB HE4 OVARIAN CANCER MONITOR,96.5,62.73,,,0
CPT,86305,HUMAN EPIDIDYMIS PROTEIN 4 (HE4),96.5,62.73,236.89,377.26,2
CPT,86305,Human epididymis protien 4(HE4),96.5,62.73,50.75,50.75,2
CPT,86305,Laboratory Services,96.5,62.73,156.6,156.61,2
CPT,86308,HB LAB ANTIBD MONO S ER,554.76,360.59,13270.0,14761.0,2
CPT,86308,HB MISC LAB SPECIAL TEST,554.76,360.59,,,0
CPT,86308,HETEROPHILE ANTIBODIES; SCREENING,554.76,360.59,12.48,12.48,2
CPT,86308,HETEROPHILE ANTIBODIES;SCREENING,554.76,360.59,45.15,71.91,2
CPT,86308,Laboratory Services,554.76,360.59,38.93,38.93,2
CPT,86309,HETEROPHILE ANTIBODIES; TITER,,,15.81,15.81,2
CPT,86309,HETEROPHILE ANTIBODIES;TITER,,,56.5,89.99,2
CPT,86309,Laboratory Services,,,48.68,48.68,2
CPT,86310,HETEROPHILE ANTIBODIES; PLUS TITERS AFTER ABSORPTION WITH BEEF CELLS AND GUINEA PIG KIDNEY,,,64.38,102.53,2
CPT,86310,HETEROPHILE ANTIBODIES; TITERS AFTER ABSORPTION WITH BEEF CELLS AND GUINEA PIG KIDNEY,,,18.31,18.31,2
CPT,86310,Laboratory Services,,,55.41,55.41,2
CPT,86316,HB ANGTNSN II TYPE I REC ANTI AT1R,48.25,31.36,13270.0,14761.0,2
CPT,86316,HB CHROMAGRANIN A,48.25,31.36,13270.0,14761.0,4
CPT,86316,HB MISC LAB SPECIAL TEST,48.25,31.36,,,0
CPT,86316,"IMMUNOASSAY FOR TUMOR ANTIGEN (EG, PROSTATE SPECIFIC ANTIGEN, CANCER ANTIGEN 125)",48.25,31.36,181.74,289.43,2
CPT,86316,"IMMUNOASSAY FOR TUMOR ANTIGEN, OTHER ANTIGEN, QUANTITATIVE (E.G., CA 50,72-4, 549), EACH",48.25,31.36,50.75,50.75,2
CPT,86316,Laboratory Services,48.25,31.36,156.6,156.61,2
CPT,86317,HB MISC LAB SPECIAL TEST,11.64,7.57,13270.0,14761.0,4
CPT,86317,HB WEST NILE VIRUS IGM AB,11.64,7.57,13270.0,14761.0,4
CPT,86317,"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED",11.64,7.57,36.61,36.61,2
CPT,86317,"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIGEN OR ANTIBODY, EACH",11.64,7.57,130.94,208.53,2
CPT,86317,Laboratory Services,11.64,7.57,112.83,112.84,2
CPT,86318,IMMUNOASSAY FOR CHEMICAL CONSTITUENT,,,113.06,180.06,2
CPT,86318,"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUALITATIVE OR SEMIQUANTITATIVE, SINGLE STEP METHOD (E.G., REAGENT STRIP)",,,44.1,44.1,2
CPT,86318,Laboratory Services,,,97.42,97.43,2
CPT,86320,IMMUNOELECTROPHORESIS; SERUM,,,73.22,73.22,2
CPT,86320,"IMMUNOELECTROPHORESIS; SERUM, EACH SPECIMEN (PLATE)",,,195.73,311.72,2
CPT,86320,Laboratory Services,,,168.61,168.63,2
CPT,86325,"IMMUNOELECTROPHORESIS; OTHER FLUIDS (E.G., URINE, CEREBROSPINAL FLUID) WITH CONCENTRATION",,,56.58,56.58,2
CPT,86325,"IMMUNOELECTROPHORESIS; OTHER FLUIDS (EG, URINE) WITH CONCENTRATION, EACH SPECIMEN",,,195.26,310.97,2
CPT,86325,Laboratory Services,,,168.17,168.19,2
CPT,86327,IMMUNOELECTROPHORESIS; CROSSED (2 DIMENSIONAL ASSAY),,,191.67,305.26,2
CPT,86327,IMMUNOELECTROPHORESIS; CROSSED (2-DIMENSIONAL ASSAY),,,73.22,73.22,2
CPT,86327,Laboratory Services,,,170.69,170.7,2
CPT,86328,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disea",439.74,285.83,283.69,451.8,2
CPT,86328,Laboratory Services,439.74,285.83,284.46,284.48,2
CPT,86329,HB LAB C4 BINDING PROTEIN,19.3,12.55,13270.0,14761.0,2
CPT,86329,IMMUNODIFFUSION; NOT ELSEWHERE SPECIFIED,19.3,12.55,34.12,34.12,2
CPT,86329,"IMMUNODIFFUSION; QUANTITATIVE, EACH IGA, IGG, IGM, CERULOPLASMIN, TRANSFERRIN, ALPHA-2, MACROGLOBULIN, COMPL",19.3,12.55,112.0,178.38,2
CPT,86329,Laboratory Services,19.3,12.55,105.66,105.67,2
CPT,86331,HB LAB COCCI ID IGG & IGM,9.11,5.92,13270.0,14761.0,4
CPT,86331,"IMMUNODIFFUSION; GEL DIFFUSION, QUALITATIVE (OUCHTERLONY), EACH ANTIGEN OR ANTIBODY",9.11,5.92,29.12,166.67,4
CPT,86331,Laboratory Services,9.11,5.92,90.12,90.13,2
CPT,86332,HB MISC LAB SPECIAL TEST,85.84,55.8,13270.0,14761.0,6
CPT,86332,IMMUNE COMPLEX ASSAY,85.84,55.8,59.91,59.91,2
CPT,86332,IMMUNE COMPLEX ASSAY; C1Q BINDING CELL,85.84,55.8,212.84,338.97,2
CPT,86332,Laboratory Services,85.84,55.8,183.39,183.41,2
CPT,86334,"HB LAB PROTEIN IFE, SERUM",1925.37,1251.49,13270.0,14761.0,2
CPT,86334,HB MISC LAB SPECIAL TEST,1925.37,1251.49,,,0
CPT,86334,"IMMUNOFIXATION ELECTROPHORESIS, SERUM",1925.37,1251.49,195.08,310.69,2
CPT,86334,IMMUNOFIXATION ELECTROPHORESIS; SERUM,1925.37,1251.49,54.92,54.92,2
CPT,86334,Laboratory Services,1925.37,1251.49,168.04,168.06,2
CPT,86335,HB LAB BETA 2 TRANSFERRIN,1119.41,727.61,13270.0,14761.0,2
CPT,86335,"HB LAB PROTEIN IFE, URINE",1119.41,727.61,13270.0,14761.0,2
CPT,86335,IMMONOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION,1119.41,727.61,121.53,193.55,2
CPT,86335,"IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION (E.G., URINE, CSF)",1119.41,727.61,72.39,72.39,2
CPT,86335,Laboratory Services,1119.41,727.61,220.81,220.83,2
CPT,86336,INHIBIN A,,,197.55,314.62,2
CPT,86336,Inhibin A,,,38.27,38.27,2
CPT,86336,Laboratory Services,,,117.23,117.24,2
CPT,86337,HB INSULIN ANTIBODIES,35.0,22.75,13270.0,14761.0,4
CPT,86337,HB MISC LAB SPECIAL TEST,35.0,22.75,,,0
CPT,86337,INSULIN ANTIBODIES,35.0,22.75,52.42,52.42,2
CPT,86337,"INSULIN ANTIBODIES, RIA",35.0,22.75,158.75,252.82,2
CPT,86337,Laboratory Services,35.0,22.75,161.06,161.08,2
CPT,86340,HB INTRINSIC FACTOR ANTIBODY,20.0,13.0,13270.0,14761.0,4
CPT,86340,INTRINSIC FACTOR ANTIBODIES,20.0,13.0,37.44,37.44,2
CPT,86340,"INTRINSIC FACTOR ANTIBODIES, RIA",20.0,13.0,131.64,209.65,2
CPT,86340,Laboratory Services,20.0,13.0,113.39,113.4,2
CPT,86341,HB MISC LAB SPECIAL TEST,120.0,78.0,13270.0,14761.0,8
CPT,86341,ISLET CELL ANTIBODY,120.0,78.0,58.24,213.87,4
CPT,86341,Laboratory Services,120.0,78.0,124.96,124.98,2
CPT,86343,HB MISC LAB SPECIAL TEST,96.5,62.73,,,0
CPT,86343,LEUKOCYTE HISTAMINE RELEASE TEST (LHR),96.5,62.73,30.79,167.7,4
CPT,86343,Laboratory Services,96.5,62.73,93.77,93.78,2
CPT,86344,LEUKOCYTE PHAGOCYTOSIS,,,25.8,107.5,4
CPT,86344,Laboratory Services,,,60.06,60.07,2
CPT,86352,"CELLULAR FUNCTION ASSAY INVOLVING STIMULATION (EG, MITOGEN OR ANTIGEN) AND DETECTION OF BIOMARKER (EG, ATP)",150.41,97.77,631.81,1006.22,2
CPT,86352,"Cellular function assay involving stimulation (eg, mitogen or antigen ) and detection of biomarker (eg, ATP)",150.41,97.77,333.64,333.64,2
CPT,86352,HB LAB T CELL IMMUNE FUNCTION,150.41,97.77,13270.0,14761.0,4
CPT,86352,HB MISC LAB SPECIAL TEST,150.41,97.77,,,0
CPT,86352,Laboratory Services,150.41,97.77,1022.04,1022.15,2
CPT,86353,HB LYMPHOCYTE BLASTOGENESIS,1938.52,1260.03,13270.0,14761.0,2
CPT,86353,HB MISC LAB SPECIAL TEST,1938.52,1260.03,,,0
CPT,86353,"LYMPHOCYTE TRANSFORMATION, MITOGEN (PHYTOMITOGEN) OR ANTIGEN INDUCED BLASTOGENESIS",1938.52,1260.03,120.64,120.64,2
CPT,86353,"LYMPHOCYTE TRANSFORMATION, SPONTANEOUS BLASTOGENESIS OR PHYTOMITOGEN (PHYTOHEMOGLUTINATION, PHA) OR OTHER MITOG",1938.52,1260.03,428.09,681.77,2
CPT,86353,Laboratory Services,1938.52,1260.03,368.79,368.83,2
CPT,86355,"B CELLS, TOTAL COUNT",833.16,541.55,92.36,92.36,2
CPT,86355,"B CELLS, TOTAL COUNT ï",833.16,541.55,322.26,513.22,2
CPT,86355,HB LAB B LYMPH QUANTITATION,833.16,541.55,13270.0,14761.0,2
CPT,86355,HB MISC LAB SPECIAL TEST,833.16,541.55,,,0
CPT,86355,Laboratory Services,833.16,541.55,283.76,283.79,2
CPT,86356,HB MISC LAB SPECIAL TEST,12.33,8.01,13270.0,14761.0,2
CPT,86356,Laboratory Services,12.33,8.01,201.38,201.4,2
CPT,86356,"MONOCULCLEAR CELL ANTIGEN, QUANITATIVE(EG,FLOW CYTOMETRY)",12.33,8.01,233.83,372.39,2
CPT,86356,"MONONUCLEAR CELL ANTIGEN, QUANTITATIVE (EG, FLOW CYTOMETRY), NOT OTHERWISE SPECIFIED, EACH ANTIGEN",12.33,8.01,65.73,65.73,2
CPT,86357,HB LAB NK LYMPH QUANTITATION,833.16,541.55,13270.0,14761.0,2
CPT,86357,HB MISC LAB SPECIAL TEST,833.16,541.55,,,0
CPT,86357,Laboratory Services,833.16,541.55,283.76,283.79,2
CPT,86357,"NATURAL KILLER (NK) CELLS, TOTAL COUNT",833.16,541.55,92.36,92.36,2
CPT,86357,"NATURAL KILLER (NK) CELLS, TOTAL COUNT ï",833.16,541.55,322.26,513.22,2
CPT,86359,"HB LAB T CELLS, TOTAL COUNT",853.22,554.59,13270.0,14761.0,4
CPT,86359,HB MISC LAB SPECIAL TEST,853.22,554.59,,,0
CPT,86359,Laboratory Services,853.22,554.59,283.76,283.79,2
CPT,86359,T CELLS; TOTAL COUNT,853.22,554.59,92.36,525.58,4
CPT,86360,HB LAB CD4 AND CD8 T CELL COUNT,1134.0,737.1,13270.0,14761.0,4
CPT,86360,HB MISC LAB SPECIAL TEST,1134.0,737.1,,,0
CPT,86360,Laboratory Services,1134.0,737.1,353.45,353.48,2
CPT,86360,"T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO",1134.0,737.1,115.65,115.65,2
CPT,86360,"T4 AND T8, INCLUDING RATIO",1134.0,737.1,344.6,548.81,2
CPT,86361,Laboratory Services,,,201.38,201.4,2
CPT,86361,T CELLS; ABSOLUTE CD4 COUNT,,,65.73,374.55,4
CPT,86362,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,2
CPT,86362,Laboratory Services,,,64.4,64.41,2
CPT,86362,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each",,,29.95,48.22,4
CPT,86363,HB MISC LAB SPECIAL TEST,868.53,564.54,13270.0,14761.0,4
CPT,86363,Laboratory Services,,,64.4,64.41,2
CPT,86363,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [FACS]), each",,,30.28,92.36,4
CPT,86364,HB MISC LAB SPECIAL TEST,44.84,29.15,,,0
CPT,86364,Laboratory Services,44.84,29.15,61.63,61.64,2
CPT,86364,"Tissue transglutaminase, each immunoglobulin (Ig) class",44.84,29.15,28.29,46.07,4
CPT,86367,HB LAB CD34 STEM CELL QUANT,1134.0,737.1,13270.0,14761.0,2
CPT,86367,Laboratory Services,1134.0,737.1,283.76,283.79,2
CPT,86367,"STEM CELLS (I.E., CD34), TOTAL COUNT",1134.0,737.1,191.37,191.37,2
CPT,86367,"STEM CELLS, TOTAL COUNT ï",1134.0,737.1,322.26,513.22,2
CPT,86376,HB LIVER-KIDNEY MICROSOMAL AB,14.0,9.1,13270.0,14761.0,4
CPT,86376,HB MISC LAB SPECIAL TEST,14.0,9.1,,,0
CPT,86376,HB THYROID PEROXIDASE ANTIBODY,14.0,9.1,13270.0,14761.0,2
CPT,86376,Laboratory Services,14.0,9.1,109.49,109.5,2
CPT,86376,"MICROSOMAL ANTIBODIES (E.G., THYROID OR LIVER-KIDNEY), EACH",14.0,9.1,35.77,35.77,2
CPT,86376,MICROSOMAL ANTIBODY (THYROID); RIA,14.0,9.1,127.88,203.66,2
CPT,86381,HB MISC LAB SPECIAL TEST,868.53,564.54,13270.0,14761.0,4
CPT,86381,Laboratory Services,,,136.03,136.05,2
CPT,86381,"Mitochondrial antibody (eg, M2), each",,,62.4,144.39,4
CPT,86382,HB RABVQ VAC RESP END PNT TTR,412.5,268.13,,,0
CPT,86382,Laboratory Services,412.5,268.13,127.23,127.24,2
CPT,86382,"NEUTRALIZATION TEST, VIRAL",412.5,268.13,41.61,312.93,4
CPT,86384,Laboratory Services,,,85.66,85.67,2
CPT,86384,NITROBLUE TETRAZOLIUM DYE TEST (NTD),,,33.29,158.43,4
CPT,86386,Laboratory Services,,,120.88,120.89,2
CPT,86386,"NUCLEAR MATRIX PROTEIN 22 (NMP22), QUALITATIVE",,,116.16,185.0,2
CPT,86386,NUCLEAR MATRIX PROTIEN 22,,,53.25,53.25,2
CPT,86403,Laboratory Services,43.43,28.23,76.66,76.67,2
CPT,86403,"PARTICLE AGGLUTINATION, RAPID TEST FOR INFECTIOUS AGENT, EACH ANTIGEN",43.43,28.23,86.43,137.65,2
CPT,86403,"PARTICLE AGGLUTINATION; SCREEN, EACH ANTIBODY",43.43,28.23,28.29,28.29,2
CPT,86406,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,86406,Laboratory Services,,,80.0,80.01,2
CPT,86406,PARTICLE AGGLLUTINATION; TITER; EACH ANTIBODY,,,141.46,225.29,2
CPT,86406,"PARTICLE AGGLUTINATION; TITER, EACH ANTIBODY",,,25.8,25.8,2
CPT,86408,Laboratory Services,,,312.32,312.35,2
CPT,86408,PARTICLE AGGLLUTINATION; TITER; EACH ANTIBODY,,,187.2,298.14,2
CPT,86409,Laboratory Services,,,779.41,779.49,2
CPT,86409,PARTICLE AGGLLUTINATION; TITER; EACH ANTIBODY,,,124.88,198.88,2
CPT,86413,Laboratory Services,,,312.32,312.35,2
CPT,86413,PARTICLE AGGLLUTINATION; TITER; EACH ANTIBODY,,,124.88,198.88,2
CPT,86430,Laboratory Services,,,42.64,42.64,2
CPT,86430,"RHEUMATOID FACTOR, LATEX FIXATION",,,48.8,77.72,2
CPT,86430,RHEUMATOID FACTOR; QUALITATIVE,,,14.98,14.98,2
CPT,86431,HB LAB ANTIB RA QUANT,12.15,7.9,13270.0,14761.0,2
CPT,86431,"HB LAB RA, IGG, IGA, IGM",12.15,7.9,13270.0,14761.0,2
CPT,86431,HB MISC LAB SPECIAL TEST,12.15,7.9,,,0
CPT,86431,Laboratory Services,12.15,7.9,42.64,42.64,2
CPT,86431,RHEUMATOID FACTOR; QUANTITATIVE,12.15,7.9,14.14,77.72,4
CPT,86480,"HB LAB TB TEST CELL IMMUN, MEASUR",1368.83,889.74,13270.0,14761.0,2
CPT,86480,Laboratory Services,1368.83,889.74,466.27,466.32,2
CPT,86480,"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON",1368.83,889.74,529.45,843.2,2
CPT,86480,"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY MEASUREMENT OF GAMMA INTERFERON ANTIGEN RESPONSE",1368.83,889.74,152.26,152.26,2
CPT,86481,Laboratory Services,,,466.27,466.32,2
CPT,86481,"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFERON-PRODUCING T-CELL",,,438.34,698.1,2
CPT,86481,"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFERON-PRODUCING T-CELLS IN CELL SUSPENSION",,,245.45,245.45,2
CPT,86485,Laboratory Services,,,86.41,86.42,2
CPT,86485,SKIN TEST; CANDIDA,,,47.43,125.19,4
CPT,86486,Laboratory Services,,,32.33,32.33,2
CPT,86486,"SKIN TEST; UNLISTED ANTIGEN, EACH",,,15.49,142.8,4
CPT,86490,Laboratory Services,,,43.39,43.4,2
CPT,86490,SKIN TEST; COCCIDIOIDOMYCOSIS,,,71.73,193.55,4
CPT,86510,Laboratory Services,,,41.19,41.2,2
CPT,86510,SKIN TEST; HISTOPLASMOSIS,,,17.98,122.01,4
CPT,86580,Laboratory Services,486.73,316.37,47.86,47.86,2
CPT,86580,"SKIN TEST; TUBERCULOSIS, INTRADERMAL",486.73,316.37,24.64,98.97,4
CPT,86590,Laboratory Services,,,83.02,83.02,2
CPT,86590,"STREPTOKINASE, ANTIBODY",,,30.79,153.38,4
CPT,86592,HB LAB ANTIBD SY RPR QL,6.82,4.43,13270.0,14761.0,2
CPT,86592,HB MISC LAB SPECIAL TEST,6.82,4.43,,,0
CPT,86592,"HB VDRL, CSF",6.82,4.43,13270.0,14761.0,4
CPT,86592,Laboratory Services,6.82,4.43,32.14,32.14,2
CPT,86592,"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)",6.82,4.43,37.28,59.37,2
CPT,86592,"SYPHILIS TEST; QUALITATIVE (E.G., VDRL, RPR, ART)",6.82,4.43,10.82,10.82,2
CPT,86593,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,86593,Laboratory Services,,,33.08,33.08,2
CPT,86593,"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE",,,38.45,61.24,2
CPT,86593,SYPHILIS TEST; QUANTITATIVE,,,10.82,10.82,2
CPT,86596,HB MISC LAB SPECIAL TEST,200.0,130.0,13270.0,14761.0,6
CPT,86596,Laboratory Services,200.0,130.0,98.36,98.37,2
CPT,86596,"Voltage-gated calcium channel antibody, each",200.0,130.0,29.95,73.51,4
CPT,86602,ANTIBODY; ACTINOMYCES,,,24.96,141.49,4
CPT,86602,Laboratory Services,,,76.54,76.55,2
CPT,86603,ANTIBODY; ADENOVIRUS,10.62,6.9,31.62,179.03,4
CPT,86603,"HB ADENOVIRUS ANTIBODY,SERUM",10.62,6.9,13270.0,14761.0,2
CPT,86603,Laboratory Services,10.62,6.9,96.79,96.8,2
CPT,86606,ANTIBODY; ASPERGILLUS,11.29,7.34,36.61,36.61,2
CPT,86606,ASPIRGILLUS,11.29,7.34,131.47,209.37,2
CPT,86606,HB ASPERGILLUS AB,11.29,7.34,13270.0,14761.0,4
CPT,86606,HB MISC LAB SPECIAL TEST,11.29,7.34,,,0
CPT,86606,Laboratory Services,11.29,7.34,113.27,113.28,2
CPT,86609,"ANTIBODY; BACTERIUM, NOT ELSEWHERE SPECIFIED",9.65,6.27,31.62,31.62,2
CPT,86609,"BACTERIUM, NOT ELSEWHERE SPECIFIED",9.65,6.27,112.53,179.22,2
CPT,86609,HB MISC LAB SPECIAL TEST,9.65,6.27,,,0
CPT,86609,HB S. PNEUMO IGG AB,9.65,6.27,13270.0,14761.0,2
CPT,86609,Laboratory Services,9.65,6.27,96.92,96.92,2
CPT,86611,ANTIBODY; BARTONELLA,12.13,7.88,24.96,141.39,4
CPT,86611,"HB B HENSELAE IGG,M W/RFL",12.13,7.88,13270.0,14761.0,4
CPT,86611,Laboratory Services,12.13,7.88,76.54,76.55,2
CPT,86612,ANTIBODY; BLASTOMYCES,26.38,17.15,31.62,31.62,2
CPT,86612,BLASTOMYCES,26.38,17.15,115.18,183.43,2
CPT,86612,HB LAB BLASTOMYCOSIS - CF #,26.38,17.15,13270.0,14761.0,4
CPT,86612,Laboratory Services,26.38,17.15,97.1,97.11,2
CPT,86615,ANTIBODY; BORDETELLA,25.0,16.25,32.45,32.45,2
CPT,86615,BORDETELLA,25.0,16.25,115.18,183.43,2
CPT,86615,HB LAB B PERTUSSIS AB,25.0,16.25,13270.0,14761.0,2
CPT,86615,HB MISC LAB SPECIAL TEST,25.0,16.25,,,0
CPT,86615,Laboratory Services,25.0,16.25,99.24,99.25,2
CPT,86617,"ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE) CONFIRMATORY TEST (E.G., WESTERN BLOT OR IMMUNOBLOT)",10.62,6.9,38.27,38.27,2
CPT,86617,BORRELIA BURGDORFERI CONFIRMATORY TEST,10.62,6.9,188.61,300.39,2
CPT,86617,HB LAB LYME WESTERN BLOT IGG #,10.62,6.9,13270.0,14761.0,4
CPT,86617,HB MISC LAB SPECIAL TEST,10.62,6.9,13270.0,14761.0,2
CPT,86617,Laboratory Services,10.62,6.9,116.54,116.55,2
CPT,86618,ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE),11.23,7.3,41.61,41.61,2
CPT,86618,BORELLIA BUFGDORFERI(LYME DISEASE),11.23,7.3,140.7,224.07,2
CPT,86618,HB LYMR LYME DIS AB W/RFLX IB,11.23,7.3,13270.0,14761.0,4
CPT,86618,Laboratory Services,11.23,7.3,128.11,128.12,2
CPT,86619,ANTIBODY; BORRELIA (RELAPSING FEVER),69.58,45.23,32.45,32.45,2
CPT,86619,BORRELIA,69.58,45.23,115.18,183.43,2
CPT,86619,Laboratory Services,69.58,45.23,100.69,100.7,2
CPT,86622,ANTIBODY; BRUCELLA,9.42,6.12,21.63,21.63,2
CPT,86622,BRUCELLA,9.42,6.12,70.44,112.18,2
CPT,86622,HB BRUCELLA IGG/IGM,9.42,6.12,13270.0,14761.0,4
CPT,86622,HB MISC LAB SPECIAL TEST,9.42,6.12,,,0
CPT,86622,Laboratory Services,9.42,6.12,67.17,67.17,2
CPT,86625,ANTIBODY; CAMPYLOBACTER,,,32.45,32.45,2
CPT,86625,CAMPYLOBACTER,,,114.83,182.87,2
CPT,86625,Laboratory Services,,,98.68,98.69,2
CPT,86628,ANTIBODY; CANDIDA,32.79,21.31,29.12,29.12,2
CPT,86628,CANDIDA,32.79,21.31,108.18,172.29,2
CPT,86628,"HB CANDIDA ANTIBODY, ID",32.79,21.31,13270.0,14761.0,2
CPT,86628,Laboratory Services,32.79,21.31,90.37,90.38,2
CPT,86631,ANTIBODY; CHLAMYDIA,8.96,5.82,29.12,29.12,2
CPT,86631,CHLAMYDIA,8.96,5.82,112.71,179.5,2
CPT,86631,HB LAB CHLAMYDIA GROUP AB,8.96,5.82,13270.0,14761.0,2
CPT,86631,HB LAB LGVF CHLAMYDIA AB,8.96,5.82,13270.0,14761.0,2
CPT,86631,HB MISC LAB SPECIAL TEST,8.96,5.82,,,0
CPT,86631,Laboratory Services,8.96,5.82,88.93,88.94,2
CPT,86632,"ANTIBODY; CHLAMYDIA, IGM",8.97,5.83,30.79,30.79,2
CPT,86632,"CHLAMYDIA,IGM",8.97,5.83,112.71,179.5,2
CPT,86632,HB LAB LGVF CHLAMYDIA IGM AB,8.97,5.83,13270.0,14761.0,2
CPT,86632,HB LAB TWAR PNL AB CHLAMYDIA IGM,8.97,5.83,13270.0,14761.0,2
CPT,86632,HB MISC LAB SPECIAL TEST,8.97,5.83,,,0
CPT,86632,Laboratory Services,8.97,5.83,95.47,95.48,2
CPT,86635,ANTIBODY; COCCIDIOIDES,262.68,170.74,28.29,28.29,2
CPT,86635,COCCIDIOIDES,262.68,170.74,101.6,161.8,2
CPT,86635,HB LAB COCCI CF,262.68,170.74,13270.0,14761.0,2
CPT,86635,HB LAB COCCI IGG,262.68,170.74,13270.0,14761.0,2
CPT,86635,HB LAB COCCI TP AND F,262.68,170.74,13270.0,14761.0,2
CPT,86635,Laboratory Services,262.68,170.74,86.35,86.36,2
CPT,86638,ANTIBODY; COXIELLA BURNETII (Q FEVER),28.23,18.35,29.95,29.95,2
CPT,86638,COXIELLA BRUNETII (Q FEVER),28.23,18.35,110.24,175.57,2
CPT,86638,HB QFEVR Q FEVER ANTIBODY,28.23,18.35,13270.0,14761.0,4
CPT,86638,Laboratory Services,28.23,18.35,91.19,91.2,2
CPT,86641,ANTIBODY; CRYPTOCOCCUS,14.4,9.36,35.77,35.77,2
CPT,86641,CRYPTOCOCCUS,14.4,9.36,107.36,170.98,2
CPT,86641,HB LAB ANTIBD CRYPTO,14.4,9.36,13270.0,14761.0,2
CPT,86641,Laboratory Services,14.4,9.36,108.42,108.44,2
CPT,86644,ANTIBODY; CYTOMEGALOVIRUS (CMV),275.0,178.75,34.94,34.94,2
CPT,86644,CYTOMEGALOVIRUS(CMV),275.0,178.75,125.29,199.54,2
CPT,86644,"HB LAB CMV AB, IGG",275.0,178.75,13270.0,14761.0,2
CPT,86644,HB MISC LAB SPECIAL TEST,275.0,178.75,13270.0,14761.0,6
CPT,86644,Laboratory Services,275.0,178.75,108.24,108.25,2
CPT,86645,"ANTIBODY; CYTOMEGALOVIRUS (CMV), IGM",843.02,547.96,41.61,41.61,2
CPT,86645,"CYTOMEGALOVIRUS (CVM),IGM",843.02,547.96,140.87,224.35,2
CPT,86645,"HB LAB CMV AB, IGM",843.02,547.96,13270.0,14761.0,2
CPT,86645,Laboratory Services,843.02,547.96,126.73,126.74,2
CPT,86648,ANTIBODY; DIPHTHERIA,19.3,12.55,37.44,37.44,2
CPT,86648,DIPTHERIA,19.3,12.55,103.3,164.52,2
CPT,86648,HB LAB DIPHTHERIA ANTITOXOID #,19.3,12.55,,,0
CPT,86648,HB MISC LAB SPECIAL TEST,19.3,12.55,,,0
CPT,86648,Laboratory Services,19.3,12.55,114.46,114.47,2
CPT,86651,"ANTIBODY; ENCEPHALITIS, CALIFORNIA (LA CROSSE)",16.65,10.82,32.45,32.45,2
CPT,86651,"HB CALIFORNIA ENCEPH AB, IGG",16.65,10.82,13270.0,14761.0,4
CPT,86651,HB MISC LAB SPECIAL TEST,16.65,10.82,13270.0,14761.0,2
CPT,86651,Laboratory Services,16.65,10.82,99.24,99.25,2
CPT,86651,TREPONEMA ANTIBODIES; ENCEPHALITIS CALIFORNIA (LA CROSSE),16.65,10.82,115.18,183.43,2
CPT,86652,"ANTIBODY; ENCEPHALITIS, EASTERN EQUINE",16.65,10.82,32.45,32.45,2
CPT,86652,"HB EASTERN EQUINE AB, IGG",16.65,10.82,13270.0,14761.0,2
CPT,86652,HB MISC LAB SPECIAL TEST,16.65,10.82,13270.0,14761.0,4
CPT,86652,Laboratory Services,16.65,10.82,99.24,99.25,2
CPT,86652,"TREPONEMA ANTIBODIES; ENCEPHALITIS, EASTERN EQUINE",16.65,10.82,115.18,183.43,2
CPT,86653,"ANTIBODY; ENCEPHALITIS, ST. LOUIS",15.93,10.35,32.45,32.45,2
CPT,86653,HB MISC LAB SPECIAL TEST,15.93,10.35,13270.0,14761.0,2
CPT,86653,"HB ST. LOUIS ENCEPH AB, IGG",15.93,10.35,13270.0,14761.0,4
CPT,86653,Laboratory Services,15.93,10.35,99.24,99.25,2
CPT,86653,"TREPONEMA ANTIBODIES;ENCEPHALITIES,ST. LOUIS",15.93,10.35,115.18,183.43,2
CPT,86654,"ANTIBODY; ENCEPHALITIS, WESTERN EQUINE",15.92,10.35,32.45,32.45,2
CPT,86654,HB MISC LAB SPECIAL TEST,15.92,10.35,13270.0,14761.0,2
CPT,86654,HB WESTERN EQ ENCEPH IGG,15.92,10.35,13270.0,14761.0,2
CPT,86654,"HB WESTERN EQUINE AB, IGM",15.92,10.35,13270.0,14761.0,2
CPT,86654,Laboratory Services,15.92,10.35,99.24,99.25,2
CPT,86654,TREPONEMA ANTIBODIES,15.92,10.35,115.18,183.43,2
CPT,86658,"ANTIBODY; ENTEROVIRUS (E.G., COXSACKIE, ECHO, POLIO)",11.21,7.29,31.62,31.62,2
CPT,86658,"ENTEROVIRUS(EG, COXSACKIE, ECHO, POLIO)",11.21,7.29,115.18,183.43,2
CPT,86658,HB MISC LAB SPECIAL TEST,11.21,7.29,13270.0,14761.0,8
CPT,86658,Laboratory Services,11.21,7.29,98.05,98.06,2
CPT,86663,"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, EARLY ANTIGEN (EA)",6.76,4.39,32.45,32.45,2
CPT,86663,EPSTEIN-BARR VIRUS EARLY ANTIGEN,6.76,4.39,115.18,183.43,2
CPT,86663,HB EBV EA-D AB (IGG),6.76,4.39,13270.0,14761.0,4
CPT,86663,Laboratory Services,6.76,4.39,98.68,98.69,2
CPT,86664,"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)",9.36,6.08,37.44,37.44,2
CPT,86664,EPSTEIN-BARR VIRUS NUCLEAR ANTIGEN,9.36,6.08,135.58,215.93,2
CPT,86664,HB EBV EBNA AB (IGG),9.36,6.08,13270.0,14761.0,4
CPT,86664,HB MISC LAB SPECIAL TEST,9.36,6.08,,,0
CPT,86664,Laboratory Services,9.36,6.08,115.09,115.1,2
CPT,86665,"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)",843.02,547.96,44.93,44.93,2
CPT,86665,"EPSTEIN-BARR VIRUS, VIRAL CAPSID",843.02,547.96,140.81,224.26,2
CPT,86665,HB LAB ANTIBODY EBV IGG,843.02,547.96,13270.0,14761.0,2
CPT,86665,HB MISC LAB SPECIAL TEST,843.02,547.96,,,0
CPT,86665,Laboratory Services,843.02,547.96,136.47,136.49,2
CPT,86666,ANTIBODY; EHRLICHIA,12.07,7.85,24.96,141.39,4
CPT,86666,HB E. CHAFFEENSIS AB (M),12.07,7.85,,,0
CPT,86666,HB MISC LAB SPECIAL TEST,12.07,7.85,13270.0,14761.0,4
CPT,86666,Laboratory Services,12.07,7.85,76.54,76.55,2
CPT,86668,ANTIBODY; FRANCISELLA TULARENSIS,,,34.94,34.94,2
CPT,86668,FRANCISELLA TULARENSIS,,,90.84,144.67,2
CPT,86668,Laboratory Services,,,78.24,78.24,2
CPT,86671,"ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED",38.48,25.01,29.95,29.95,2
CPT,86671,"FUNGUS, NOT ELSEWHERE SPECIFIED",38.48,25.01,112.53,179.22,2
CPT,86671,"HB LAB IBD DIF PANEL, FUNGUS NOS",38.48,25.01,13270.0,14761.0,2
CPT,86671,Laboratory Services,38.48,25.01,92.2,92.21,2
CPT,86674,ANTIBODY; GIARDIA LAMBLIA,14.73,9.57,35.77,35.77,2
CPT,86674,GIARDIA LAMBLIA,14.73,9.57,127.0,202.26,2
CPT,86674,Laboratory Services,14.73,9.57,110.75,110.76,2
CPT,86677,ANTIBODY; HELICOBACTER PYLORI,174.53,113.44,41.61,41.61,2
CPT,86677,HB MISC LAB SPECIAL TEST,174.53,113.44,13270.0,14761.0,4
CPT,86677,HELICOBACTER PYLORI,174.53,113.44,130.05,207.13,2
CPT,86677,Laboratory Services,174.53,113.44,109.18,109.19,2
CPT,86682,"ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED",18.71,12.16,31.62,31.62,2
CPT,86682,HB LAB ANTIBD CYSTICER,18.71,12.16,13270.0,14761.0,4
CPT,86682,HB MISC LAB SPECIAL TEST,18.71,12.16,13270.0,14761.0,4
CPT,86682,"HELMINTH, NOT ELSEWHERE",18.71,12.16,114.65,182.59,2
CPT,86682,Laboratory Services,18.71,12.16,97.86,97.87,2
CPT,86684,ANTIBODY; HAEMOPHILUS INFLUENZA,,,39.11,39.11,2
CPT,86684,HEMOPHILUS INFLUENZA,,,135.58,215.93,2
CPT,86684,Laboratory Services,,,119.24,119.25,2
CPT,86687,ANTIBODY; HTLV-I,,,22.46,22.46,2
CPT,86687,"HTLV I, ANTIBODY DETECTION; IMMUNOASSAY",,,73.26,116.67,2
CPT,86687,Laboratory Services,,,63.14,63.15,2
CPT,86688,ANTIBODY; HTLV-II,,,34.12,34.12,2
CPT,86688,HTLV-II,,,116.12,184.93,2
CPT,86688,Laboratory Services,,,105.34,105.35,2
CPT,86689,"ANTIBODY; HTLV OR HIV ANTIBODY, CONFIRMATORY TEST (E.G., WESTERN BLOT)",49.1,31.91,47.43,47.43,2
CPT,86689,"HTLV I, ANTIBODY DETECTION; CONFIRMATORY TEST",49.1,31.91,169.04,269.21,2
CPT,86689,Laboratory Services,49.1,31.91,145.59,145.61,2
CPT,86692,"ANTIBODY; HEPATITIS, DELTA AGENT",44.44,28.89,42.43,42.43,2
CPT,86692,HB HEPATITIS D IGM AB,44.44,28.89,13270.0,14761.0,2
CPT,86692,HB LAB HEPATITIS DELTA ANTIBODY,44.44,28.89,13270.0,14761.0,2
CPT,86692,"HEPATITIS, DELTA AGENT",44.44,28.89,140.7,224.07,2
CPT,86692,Laboratory Services,44.44,28.89,129.12,129.13,2
CPT,86694,"ANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TEST",99.4,64.61,34.94,34.94,2
CPT,86694,HB LAB CSF MENIN PNL AB HSV NS,99.4,64.61,13270.0,14761.0,4
CPT,86694,"HERPES SIMPLEX, NON-SPECIFIC TYPE TEST",99.4,64.61,125.29,199.54,2
CPT,86694,Laboratory Services,99.4,64.61,108.24,108.25,2
CPT,86695,"ANTIBODY; HERPES SIMPLEX, TYPE 1",587.09,381.61,32.45,32.45,2
CPT,86695,HB CSF HSV 1 IGG,587.09,381.61,13270.0,14761.0,4
CPT,86695,HB LAB HERPES SIMPLEX TYP 1 IGG,587.09,381.61,13270.0,14761.0,2
CPT,86695,HB MISC LAB SPECIAL TEST,587.09,381.61,,,0
CPT,86695,"HERPES SIMPLEX, TYPE I",587.09,381.61,115.18,183.43,2
CPT,86695,Laboratory Services,587.09,381.61,99.24,99.25,2
CPT,86696,"ANTIBODY; HERPES SIMPLEX, TYPE 2",584.1,379.66,47.43,269.02,4
CPT,86696,HB CSF HSV 2 IGG,584.1,379.66,13270.0,14761.0,4
CPT,86696,HB LAB HERPES SIMPLEX TYP 2 IGG,584.1,379.66,13270.0,14761.0,2
CPT,86696,HB MISC LAB SPECIAL TEST,584.1,379.66,,,0
CPT,86696,Laboratory Services,584.1,379.66,145.59,145.61,2
CPT,86698,ANTIBODY; HISTOPLASMA,18.09,11.76,34.12,34.12,2
CPT,86698,HB HISTD HISTOPLASMA,18.09,11.76,13270.0,14761.0,4
CPT,86698,HISTOPLASMA,18.09,11.76,110.24,175.57,2
CPT,86698,Laboratory Services,18.09,11.76,94.02,94.03,2
CPT,86701,ANTIBODY; HIV-1,218.45,141.99,21.63,21.63,2
CPT,86701,HB AB;HIV1,218.45,141.99,13270.0,14761.0,2
CPT,86701,HIV-I,218.45,141.99,77.55,123.51,2
CPT,86701,Laboratory Services,218.45,141.99,66.85,66.86,2
CPT,86702,ANTIBODY; HIV-2,306.2,199.03,33.29,33.29,2
CPT,86702,HB AB;HIV2,306.2,199.03,13270.0,14761.0,2
CPT,86702,HIV-2,306.2,199.03,119.94,191.02,2
CPT,86702,Laboratory Services,306.2,199.03,101.76,101.77,2
CPT,86703,"ANTIBODY; HIV-1 AND HIV-2, SINGLE ASSAY",682.59,443.68,33.29,33.29,2
CPT,86703,"HIV-1 AND HIV-2, SINGLE ASSAY",682.59,443.68,123.41,196.54,2
CPT,86703,Laboratory Services,682.59,443.68,103.2,103.21,2
CPT,86704,HB LAB HEP ANTI-HBC,399.75,259.84,13270.0,14761.0,2
CPT,86704,"HEPATITIS B CORE ANTIBODY (HBCAB),TOTAL LGG AND LGM",399.75,259.84,101.89,162.27,2
CPT,86704,HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL,399.75,259.84,29.95,29.95,2
CPT,86704,Laboratory Services,399.75,259.84,90.69,90.7,2
CPT,86705,"HB LAB HEPATITIS B CORE AB, IGM",257.19,167.17,13270.0,14761.0,2
CPT,86705,HEPATITIS B CORE ANTIBODY (HBCAB); IGM ANTIBODY,257.19,167.17,29.12,29.12,2
CPT,86705,HEPATITIS B CORE ANTIBODY (HBCAB); LGM ANTIBODY,257.19,167.17,99.48,158.43,2
CPT,86705,Laboratory Services,257.19,167.17,88.55,88.56,2
CPT,86706,HB LAB ANTI-HEP B SURF ANTIBD,459.56,298.71,13270.0,14761.0,2
CPT,86706,HEPATITIS B SURFACE ANTIBODY (HBSAB),459.56,298.71,26.63,144.48,4
CPT,86706,Laboratory Services,459.56,298.71,80.82,80.82,2
CPT,86707,HB HEPATITIS BE ANTIBODY,7.72,5.02,13270.0,14761.0,4
CPT,86707,HEPATITIS B ANTIBODY (HBEAB),7.72,5.02,97.72,155.62,2
CPT,86707,HEPATITIS BE ANTIBODY (HBEAB),7.72,5.02,28.29,28.29,2
CPT,86707,Laboratory Services,7.72,5.02,87.04,87.05,2
CPT,86708,HEPATITIS A ANTIBODY (HAAB); TOTAL,270.58,175.88,30.79,30.79,2
CPT,86708,"HEPATITIS A ANTIBODY (HAAB);TOTAL, LGG AND LGM",270.58,175.88,104.66,166.67,2
CPT,86708,Laboratory Services,270.58,175.88,93.2,93.21,2
CPT,86709,HB LAB ANTI-HAV IGM,245.81,159.78,13270.0,14761.0,2
CPT,86709,HEPATITIS A ANTIBODY (HAAB); IGM ANTIBODY,245.81,159.78,27.45,27.45,2
CPT,86709,HEPATITIS A ANTIBODY (HAAB); LGM ANTIBODY,245.81,159.78,95.07,151.41,2
CPT,86709,Laboratory Services,245.81,159.78,84.65,84.66,2
CPT,86710,ANTIBODY; INFLUENZA VIRUS,10.71,6.96,33.29,33.29,2
CPT,86710,HB INFLUENZA VIRUS TYPES A & B,10.71,6.96,13270.0,14761.0,4
CPT,86710,INFLUENZA VIRUS,10.71,6.96,120.65,192.14,2
CPT,86710,Laboratory Services,10.71,6.96,102.01,102.02,2
CPT,86711,ANTIBODY; JC (JOHN CUNNINGHAM) VIRUS,,,101.66,161.9,2
CPT,86711,Antibody; JC (John Cunningham) virus,,,41.61,41.61,2
CPT,86711,Laboratory Services,,,105.78,105.79,2
CPT,86713,ANTIBODY; LEGIONELLA,23.74,15.43,37.44,37.44,2
CPT,86713,HB MISC LAB SPECIAL TEST,23.74,15.43,13270.0,14761.0,4
CPT,86713,LEGIONELLA,23.74,15.43,131.7,209.75,2
CPT,86713,Laboratory Services,23.74,15.43,115.09,115.1,2
CPT,86717,ANTIBODY; LEISHMANIA,94.69,61.55,29.95,29.95,2
CPT,86717,HB LEISHMANIA IGG,94.69,61.55,13270.0,14761.0,2
CPT,86717,LEISHMANIA,94.69,61.55,107.12,170.61,2
CPT,86717,Laboratory Services,94.69,61.55,92.14,92.14,2
CPT,86720,ANTIBODY; LEPTOSPIRA,30.4,19.76,39.94,39.94,2
CPT,86720,HB MISC LAB SPECIAL TEST,30.4,19.76,13270.0,14761.0,4
CPT,86720,LEPTOSPIRA,30.4,19.76,75.02,119.48,2
CPT,86720,Laboratory Services,30.4,19.76,99.24,99.25,2
CPT,86723,ANTIBODY; LISTERIA MONOCYTOGENES,,,32.45,32.45,2
CPT,86723,LISTERIA MONOCYTOGENES,,,115.18,183.43,2
CPT,86723,Laboratory Services,,,99.24,99.25,2
CPT,86727,ANTIBODY; LYMPHOCYTIC CHORIOMENINGITIS,15.0,9.75,31.62,31.62,2
CPT,86727,HB LAB ANTIBD LCM,15.0,9.75,13270.0,14761.0,2
CPT,86727,LYMPHOCYTIC,15.0,9.75,112.42,179.03,2
CPT,86727,Laboratory Services,15.0,9.75,96.79,96.8,2
CPT,86732,ANTIBODY; MUCORMYCOSIS,,,36.61,36.61,2
CPT,86732,Laboratory Services,,,99.24,99.25,2
CPT,86732,MUCORMYCOSIS,,,115.18,183.43,2
CPT,86735,ANTIBODY; MUMPS,16.65,10.82,32.45,32.45,2
CPT,86735,HB MUMPS IGG AB,16.65,10.82,13270.0,14761.0,4
CPT,86735,HB MUMPS IGG EIA,16.65,10.82,13270.0,14761.0,2
CPT,86735,Laboratory Services,16.65,10.82,98.17,98.18,2
CPT,86735,MUMPS,16.65,10.82,115.18,183.43,2
CPT,86738,ANTIBODY; MYCOPLASMA,14.48,9.41,32.45,32.45,2
CPT,86738,HB LAB MYCOPLASMA IGM ANTIBODY,14.48,9.41,13270.0,14761.0,4
CPT,86738,HB MISC LAB SPECIAL TEST,14.48,9.41,,,0
CPT,86738,Laboratory Services,14.48,9.41,99.62,99.63,2
CPT,86738,MYCOPLASMA,14.48,9.41,115.18,183.43,2
CPT,86741,ANTIBODY; NEISSERIA MENINGITIDIS,,,32.45,32.45,2
CPT,86741,Laboratory Services,,,99.24,99.25,2
CPT,86741,NEISSERIA MENINGITIDIS,,,115.18,183.43,2
CPT,86744,ANTIBODY; NOCARDIA,20.55,13.36,39.11,39.11,2
CPT,86744,HB NOCARDIA AB,20.55,13.36,13270.0,14761.0,4
CPT,86744,Laboratory Services,20.55,13.36,99.24,99.25,2
CPT,86744,NOCARDIA,20.55,13.36,115.18,183.43,2
CPT,86747,ANTIBODY; PARVOVIRUS,26.96,17.52,36.61,36.61,2
CPT,86747,HB PARVOVIRUS (B19) AB,26.96,17.52,13270.0,14761.0,4
CPT,86747,Laboratory Services,26.96,17.52,113.14,113.15,2
CPT,86747,PARVOVIRUS,26.96,17.52,131.47,209.37,2
CPT,86750,ANTIBODY; PLASMODIUM (MALARIA),,,32.45,32.45,2
CPT,86750,Laboratory Services,,,99.24,99.25,2
CPT,86750,PLASMODIUM,,,115.18,183.43,2
CPT,86753,"ANTIBODY; PROTOZOA, NOT ELSEWHERE SPECIFIED",17.62,11.45,30.79,30.79,2
CPT,86753,"HB B MICROTI AB (IGG, IGM)",17.62,11.45,13270.0,14761.0,2
CPT,86753,"HB ENTAMOEBA HIST. IGG, ELIS",17.62,11.45,13270.0,14761.0,2
CPT,86753,HB MISC LAB SPECIAL TEST,17.62,11.45,,,0
CPT,86753,Laboratory Services,17.62,11.45,93.2,93.21,2
CPT,86753,"PROTOZOA, NOT ELSEWHERE SPECIFIED",17.62,11.45,107.12,170.61,2
CPT,86756,ANTIBODY; RESPIRATORY SYNCYTIAL VIRUS,18.34,11.92,39.11,39.11,2
CPT,86756,HB LAB ANTIBD RESP SYN,18.34,11.92,13270.0,14761.0,2
CPT,86756,Laboratory Services,18.34,11.92,96.98,96.99,2
CPT,86756,RESPIRATORY SYNCYTIAL VIRUS,18.34,11.92,112.42,179.03,2
CPT,86757,ANTIBODY; RICKETTSIA,9.65,6.27,47.43,269.02,4
CPT,86757,HB MISC LAB SPECIAL TEST,9.65,6.27,,,0
CPT,86757,HB RICKETTSIA IGG TITER,9.65,6.27,13270.0,14761.0,2
CPT,86757,HB SPOTTED FEVER IGG AB,9.65,6.27,13270.0,14761.0,2
CPT,86757,Laboratory Services,9.65,6.27,145.59,145.61,2
CPT,86759,ANTIBODY; ROTAVIRUS,,,44.93,44.93,2
CPT,86759,Laboratory Services,,,99.24,99.25,2
CPT,86759,ROTAVIRUS,,,115.18,183.43,2
CPT,86762,ANTIBODY; RUBELLA,282.18,183.42,34.94,34.94,2
CPT,86762,HB LAB ANTIBD RUBELLA,282.18,183.42,13270.0,14761.0,2
CPT,86762,HB RUBELLA AB IGM,282.18,183.42,13270.0,14761.0,2
CPT,86762,HB RUBELLA IGM ANTIBODY,282.18,183.42,13270.0,14761.0,2
CPT,86762,Laboratory Services,282.18,183.42,108.24,108.25,2
CPT,86762,RUBELLA,282.18,183.42,125.29,199.54,2
CPT,86765,ANTIBODY; RUBEOLA,12.39,8.05,31.62,31.62,2
CPT,86765,HB LAB ANTIBD MEASLES IGG,12.39,8.05,13270.0,14761.0,2
CPT,86765,HB LAB CSF MENINGO PNL RUBELLA,12.39,8.05,13270.0,14761.0,4
CPT,86765,Laboratory Services,12.39,8.05,96.92,96.92,2
CPT,86765,RUBEOLA,12.39,8.05,112.53,179.22,2
CPT,86768,ANTIBODY; SALMONELLA,8.14,5.29,32.45,32.45,2
CPT,86768,HB FEB AGLUT AB; SALMONELLA,8.14,5.29,13270.0,14761.0,4
CPT,86768,Laboratory Services,8.14,5.29,99.24,99.25,2
CPT,86768,SALMONELLA,8.14,5.29,115.18,183.43,2
CPT,86769,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]),409.57,266.22,264.22,420.8,2
CPT,86769,HB MISC LAB SPECIAL TEST,409.57,266.22,,,0
CPT,86769,"HB SARS-COV-2 IGG, NUCLEOCAPSID",409.57,266.22,13270.0,14761.0,2
CPT,86769,HB SARS-COV-2-IGG QUANT II,409.57,266.22,13270.0,14761.0,2
CPT,86769,Laboratory Services,409.57,266.22,264.96,264.99,2
CPT,86771,ANTIBODY; SHIGELLA,,,59.91,59.91,2
CPT,86771,Laboratory Services,,,99.24,99.25,2
CPT,86771,SHIGELLA,,,196.49,312.93,2
CPT,86774,ANTIBODY; TETANUS,19.3,12.55,36.61,36.61,2
CPT,86774,HB LAB ANTIBD TETANUS ANTITOXID#,19.3,12.55,,,0
CPT,86774,HB MISC LAB SPECIAL TEST,19.3,12.55,,,0
CPT,86774,Laboratory Services,19.3,12.55,111.32,111.33,2
CPT,86774,TETANUS,19.3,12.55,130.05,207.13,2
CPT,86777,ANTIBODY; TOXOPLASMA,41.5,26.98,34.94,34.94,2
CPT,86777,HB CSF TOXO IGG,41.5,26.98,13270.0,14761.0,2
CPT,86777,HB LAB ANTIBD TOX IGG,41.5,26.98,13270.0,14761.0,2
CPT,86777,HB MISC LAB SPECIAL TEST,41.5,26.98,13270.0,14761.0,4
CPT,86777,Laboratory Services,41.5,26.98,108.24,108.25,2
CPT,86777,TOXOPLASMA,41.5,26.98,125.29,199.54,2
CPT,86778,"ANTIBODY; TOXOPLASMA, IGM",843.02,547.96,35.77,35.77,2
CPT,86778,"HB AB; TOXOPLASMA, IGM",843.02,547.96,13270.0,14761.0,2
CPT,86778,HB LAB ANTIBD TOXO IGM,843.02,547.96,13270.0,14761.0,2
CPT,86778,HB MISC LAB SPECIAL TEST,843.02,547.96,13270.0,14761.0,4
CPT,86778,Laboratory Services,843.02,547.96,108.36,108.37,2
CPT,86778,"TOXOPLASMA, IGM",843.02,547.96,130.05,207.13,2
CPT,86780,ANTIBODY; TREPONEMA PALLIDUM,13.0,8.45,154.75,246.45,2
CPT,86780,HB LAB ANTIBD SY FTA,13.0,8.45,13270.0,14761.0,2
CPT,86780,HB MISC LAB SPECIAL TEST,13.0,8.45,13270.0,14761.0,8
CPT,86780,Laboratory Services,13.0,8.45,99.62,99.63,2
CPT,86780,Treponema pallidum,13.0,8.45,32.45,32.45,2
CPT,86784,ANTIBODY; TRICHINELLA,36.91,23.99,30.79,30.79,2
CPT,86784,HB TRICHINELLA AB,36.91,23.99,13270.0,14761.0,4
CPT,86784,Laboratory Services,36.91,23.99,94.53,94.53,2
CPT,86784,TRICHINELLA,36.91,23.99,110.24,175.57,2
CPT,86787,ANTIBODY; VARICELLA-ZOSTER,9.89,6.43,31.62,31.62,2
CPT,86787,HB LAB VARICELLA ZOSTER IGG,9.89,6.43,13270.0,14761.0,2
CPT,86787,HB MISC LAB SPECIAL TEST,9.89,6.43,13270.0,14761.0,2
CPT,86787,HB VARICELLA ZOSTER ACIF,9.89,6.43,13270.0,14761.0,4
CPT,86787,Laboratory Services,9.89,6.43,96.92,96.92,2
CPT,86787,VAROCELLA-ZOSTER,9.89,6.43,112.53,179.22,2
CPT,86788,"ANTIBODY; WEST NILE VIRUS, IGM",19.4,12.61,41.61,41.61,2
CPT,86788,"ANTIBODY; WEST NILE VIRUS, IGM ï",19.4,12.61,143.93,229.22,2
CPT,86788,"HB LAB CSF MENN PL WNV AB, IGM",19.4,12.61,13270.0,14761.0,4
CPT,86788,Laboratory Services,19.4,12.61,126.73,126.74,2
CPT,86789,ANTIBODY; WEST NILE VIRUS,17.65,11.47,34.94,34.94,2
CPT,86789,ANTIBODY; WEST NILE VIRUS ï,17.65,11.47,122.94,195.79,2
CPT,86789,HB LAB CSF MENIN PNL WNV AB,17.65,11.47,13270.0,14761.0,4
CPT,86789,Laboratory Services,17.65,11.47,108.24,108.25,2
CPT,86790,"ANTIBODY; VIRUS, NOT ELSEWHERE SPECIFIED",27.02,17.56,31.62,31.62,2
CPT,86790,HB ANTI-HAV IGG,27.02,17.56,13270.0,14761.0,2
CPT,86790,HB HERPESVIRUS 7 IGM AB,27.02,17.56,13270.0,14761.0,2
CPT,86790,HB LAB HEPATITIS E IGM,27.02,17.56,13270.0,14761.0,2
CPT,86790,HB MISC LAB SPECIAL TEST,27.02,17.56,,,0
CPT,86790,Laboratory Services,27.02,17.56,96.92,96.92,2
CPT,86790,"VIRUS, NOT ELSEWHERE SPECIFIED",27.02,17.56,112.53,179.22,2
CPT,86793,ANTIBODY; YERSINIA,14.48,9.41,32.45,32.45,2
CPT,86793,HB Y ENTEROCOLITICA IGG/IGA,14.48,9.41,13270.0,14761.0,2
CPT,86793,Laboratory Services,14.48,9.41,99.24,99.25,2
CPT,86793,YERSINIA,14.48,9.41,115.18,183.43,2
CPT,86794,"Antibody; Zika virus, IgM",,,41.61,41.61,2
CPT,86794,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,86794,Laboratory Services,,,111.19,111.2,2
CPT,86794,Zika virus igm antibody,,,138.7,220.89,2
CPT,86800,HB MISC LAB SPECIAL TEST,42.0,27.3,,,0
CPT,86800,HB THYROGLOB PNL THYROGLOB AB,42.0,27.3,13270.0,14761.0,4
CPT,86800,HB THYROGLOBULIN ANTIBODY IGG,42.0,27.3,13270.0,14761.0,2
CPT,86800,Laboratory Services,42.0,27.3,119.62,119.63,2
CPT,86800,THYROGLOBULIN ANTIBODY,42.0,27.3,39.11,39.11,2
CPT,86800,"THYROGLOBULIN ANTIBODY, RIA",42.0,27.3,138.87,221.17,2
CPT,86803,HB LAB HEP C ANTIBD,399.75,259.84,13270.0,14761.0,2
CPT,86803,HB MISC LAB SPECIAL TEST,399.75,259.84,,,0
CPT,86803,HEPATITIS C ANTIBODY,399.75,259.84,120.65,192.14,2
CPT,86803,HEPATITIS C ANTIBODY;,399.75,259.84,34.94,34.94,2
CPT,86803,Laboratory Services,399.75,259.84,107.36,107.37,2
CPT,86804,"HEPATITIS C ANTIBODY; CONFIRMATORY TEST (E.G., IMMUNOBLOT)",125.0,81.25,38.27,38.27,2
CPT,86804,HEPATITIS C ANTIBODY; CONFIRMATORY TEST (EG. IMMUNOBLOT),125.0,81.25,130.88,208.44,2
CPT,86804,Laboratory Services,125.0,81.25,116.54,116.55,2
CPT,86805,HB T-CELL CYTOTOXIC CROSSMATCH,2167.36,1408.78,13270.0,14761.0,2
CPT,86805,"LYMPHOCYTOTOXICITY ASSAY, VISUAL CROSSMATCH; WITH TITRATION",2167.36,1408.78,314.32,500.58,4
CPT,86805,Laboratory Services,2167.36,1408.78,325.65,325.68,2
CPT,86806,"LYMPHOCYTOTOXICITY ASSAY, VISUAL CROSSMATCH; WITHOUT TITRATION",949.07,616.9,116.49,500.58,4
CPT,86806,Laboratory Services,949.07,616.9,162.83,162.84,2
CPT,86807,Laboratory Services,1420.92,923.6,297.73,297.76,2
CPT,86807,SERUM SCREENING FOR CYTOTOXIC PERCENT REACTIVE ANTIBODY (PRA); STANDARD METHOD,1420.92,923.6,193.04,475.58,4
CPT,86808,Laboratory Services,1389.29,903.04,162.83,162.84,2
CPT,86808,SERUM SCREENING FOR CYTOTOXIC PERCENT REACTIVE ANTIBODY (PRA); QUICK METHOD,1389.29,903.04,73.22,412.75,4
CPT,86812,HB HLA B27 ANTIGEN,27.0,17.55,13270.0,14761.0,4
CPT,86812,"HLA TYPING; A, B, OR C (E.G., A10, B7, B27), SINGLE ANTIGEN",27.0,17.55,63.24,63.24,2
CPT,86812,Laboratory Services,27.0,17.55,194.14,194.16,2
CPT,86812,"TISSUE TYPING; HLA TYPING, A, B, OR C (EG, A10, B7, B27), SINGLE ANTIGEN",27.0,17.55,207.49,330.44,2
CPT,86813,HB LAB HLA MATCHING LARC,383.0,248.95,13270.0,14761.0,4
CPT,86813,"HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS",383.0,248.95,142.27,142.27,2
CPT,86813,Laboratory Services,383.0,248.95,307.98,308.01,2
CPT,86813,"TISSUE TYPING; HLA TYPING, A, B, AND/OR C (EG, A10, B7, B27), MULTIPLE ANTIGENS",383.0,248.95,506.4,806.5,2
CPT,86816,"HLA TYPING; DR/DQ, SINGLE ANTIGEN",,,74.05,74.05,2
CPT,86816,Laboratory Services,,,209.62,209.64,2
CPT,86816,"TISSUE TYPING; HLA TYPING, DR, SINGLE ANTIGEN",,,235.77,375.48,2
CPT,86817,"HLA TYPING; DR/DQ, MULTIPLE ANTIGENS",2888.05,1877.23,260.43,260.43,2
CPT,86817,Laboratory Services,2888.05,1877.23,484.39,484.44,2
CPT,86817,"TISSUE TYPING; HLA TYPING, DR, MULTIPLE ANTIGENS",2888.05,1877.23,477.36,760.24,2
CPT,86821,"HLA TYPING; LYMPHOCYTE CULTURE, MIXED (MLC)",,,89.86,89.86,2
CPT,86821,Laboratory Services,,,424.7,424.75,2
CPT,86821,"TISSUE TYPING; LYMPHOCYTE CULTURE, MIXED (MLC)",,,477.12,759.86,2
CPT,86825,HB T-CELL FLOW CROSSMATCH 1ST SERUM,2888.05,1877.23,13270.0,14761.0,2
CPT,86825,"HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH, NON-CYTOTOXIC (EG, USING FLOW CYTOMETRY); FIRST SERUM SAMPLE OR DILUTION",2888.05,1877.23,632.75,1007.72,2
CPT,86825,"Human leukocyte antigen(HLA) crossmatch, noncytotoxic (eg, using flow cytometry); first serum sample or dilution",2888.05,1877.23,268.75,268.75,2
CPT,86825,Laboratory Services,2888.05,1877.23,604.26,604.32,2
CPT,86826,HB T-CELL FLOW CROSSMATCH-ADDLSERA/DIL,2888.05,1877.23,13270.0,14761.0,2
CPT,86826,"HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH, NON-CYTOTOXIC (EG, USING FLOW CYTOMETRY); EACH ADDITIONAL SERUM SAMPLE OR SAMP",2888.05,1877.23,210.96,335.97,2
CPT,86826,"Human leukocyte antigen(HLA) crossmatch, noncytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in additon to primary procedure)",2888.05,1877.23,89.86,89.86,2
CPT,86826,Laboratory Services,2888.05,1877.23,201.38,201.4,2
CPT,86828,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS,TO HLA CLASS I AND CLASS II HLA ANTIGENS",3358.38,2182.95,279.39,444.96,2
CPT,86828,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",3358.38,2182.95,157.25,157.25,2
CPT,86828,Laboratory Services,3358.38,2182.95,290.81,290.84,2
CPT,86829,ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS; TO HLA CLASS I OR CLASS II HLA ANTIGENS,1679.07,1091.4,209.55,333.72,2
CPT,86829,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",1679.07,1091.4,157.25,157.25,2
CPT,86829,Laboratory Services,1679.07,1091.4,218.11,218.13,2
CPT,86830,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS; ANTIBODY IDENTIFICATION BY QUALITATIVE PANEL, HLA CLASS I",2219.59,1442.73,458.78,730.65,2
CPT,86830,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",2219.59,1442.73,234.63,234.63,2
CPT,86830,HB PRA SCREENING HLA ANTIBODY CLASS I,2219.59,1442.73,13270.0,14761.0,2
CPT,86830,Laboratory Services,2219.59,1442.73,477.47,477.52,2
CPT,86831,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS; ANTIBODY IDENTIFICATION BY QUALITATIVE PANEL, HLA CLAS II",2219.59,1442.73,393.22,626.24,2
CPT,86831,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",2219.59,1442.73,201.36,201.36,2
CPT,86831,HB PRA SCREENING HLA ANTIBODY CLASS II,2219.59,1442.73,13270.0,14761.0,2
CPT,86831,Laboratory Services,2219.59,1442.73,409.3,409.34,2
CPT,86832,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS SOLID PHASE ASSAYS; HIGH DEFI QUALITATIVE PANEL FOR IDENTIFICATION, HLA CLASS I",2519.19,1637.47,720.89,1148.08,2
CPT,86832,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",2519.19,1637.47,794.6,794.6,2
CPT,86832,HB C1Q HLA ANTIBODY CLASS I - ARC,2519.19,1637.47,13270.0,14761.0,4
CPT,86832,HB SINGLE ANTIGEN HLA ANTIBODY CLASS I,2519.19,1637.47,13270.0,14761.0,2
CPT,86832,Laboratory Services,2519.19,1637.47,750.35,750.43,2
CPT,86833,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS SOLID PHASE ASSAYS; HIGH DEFI QUALITATIVE PANEL FOR IDENTIFICATION, HLA CLASS II",3206.05,2083.93,655.39,1043.77,2
CPT,86833,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",3206.05,2083.93,799.58,799.58,2
CPT,86833,HB SINGLE ANTIGEN HLA ANTIBODY CLASS II,3206.05,2083.93,13270.0,14761.0,2
CPT,86833,Laboratory Services,3206.05,2083.93,682.12,682.19,2
CPT,86834,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS SEMI QUANTATIVE PANEL (EG, TITER), HLA CLASS I",5252.79,3414.31,2031.72,3235.72,2
CPT,86834,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I",5252.79,3414.31,877.8,877.8,2
CPT,86834,HB SNGL ANTGN HLA ANTIBODY TITRATION CLASS I,5252.79,3414.31,13270.0,14761.0,2
CPT,86834,Laboratory Services,5252.79,3414.31,2114.59,2114.8,2
CPT,86835,"ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA) SOLID PHASE ASSAYS SEMI QUANTATIVE PANEL (EG, TITER), HLA CLASS II",4744.48,3083.91,1835.11,2922.6,2
CPT,86835,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II",4744.48,3083.91,792.93,792.93,2
CPT,86835,HB SNGL ANTGN HLA ANTIBODY TITRATION CLASS II,4744.48,3083.91,13270.0,14761.0,2
CPT,86835,Laboratory Services,4744.48,3083.91,1909.94,1910.13,2
CPT,86849,Laboratory Services,5095.46,3312.05,,,0
CPT,86849,UNLISTED IMMUNOLOGY,5095.46,3312.05,,,0
CPT,86849,Unlisted immunology procedure,5095.46,3312.05,47.64,47.64,2
CPT,86850,"ANTIBODY SCREEN, RBC EACH SERUM",868.53,564.54,94.31,150.19,2
CPT,86850,"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE",868.53,564.54,24.13,24.13,2
CPT,86850,HB AB SCREEN FICIN (EZ),868.53,564.54,66.53,14761.0,10
CPT,86850,"HB AB SCREEN, GEL",868.53,564.54,66.53,14761.0,10
CPT,86850,HB ANTIBODY SCR EA TECH (ARC),868.53,564.54,66.53,14761.0,10
CPT,86850,Laboratory Services,868.53,564.54,106.35,106.36,2
CPT,86860,"ANTIBODY ELUTION (RBC), EACH ELUTION",640.53,416.34,75.71,75.71,2
CPT,86860,"ANTIBODY ELUTION RBC, EACH ELUTION",640.53,416.34,235.77,375.48,2
CPT,86860,HB ANTIBODY ELUTION (RBC),640.53,416.34,213.38,14761.0,20
CPT,86860,HB ANTIBODY ELUTION (RBC)-ARC,640.53,416.34,13270.0,14761.0,2
CPT,86860,Laboratory Services,640.53,416.34,137.35,137.37,2
CPT,86870,"ANTIBODY IDENTIFICATION, RBC ANTIBODIES, EACH PANEL FOR EACH SERUM TECHNIQUE",1825.31,1186.45,104.0,104.0,2
CPT,86870,"ANTIBODY IDENTIFICATION, RBC ANTIBODIES,EACH PANEL FOR EACH SERUM TECHNIQUE",1825.31,1186.45,196.49,312.93,2
CPT,86870,HB ANTIBODY I.D. LISS,1825.31,1186.45,447.92,14761.0,10
CPT,86870,HB ANTIBODY ID EACH TECH (ARC),1825.31,1186.45,447.92,14761.0,10
CPT,86870,Laboratory Services,1825.31,1186.45,188.36,188.38,2
CPT,86880,"ANTIHUMAN GLOBULIN TEST (COOMBS TEST); DIRECT, EACH ANTISERUM",714.96,464.72,13.31,13.31,2
CPT,86880,"ANTIHUMAN GLOBULIN TEST; DIRECT, EACH ANTISERUM",714.96,464.72,46.92,74.72,2
CPT,86880,HB CORD BLOOD SCREEN,714.96,464.72,73.96,14761.0,10
CPT,86880,HB DAT EACH ANTISERA (ARC),714.96,464.72,73.96,14761.0,20
CPT,86880,"HB DAT, POLYSPECIFIC",714.96,464.72,73.96,14761.0,10
CPT,86880,Laboratory Services,714.96,464.72,40.44,40.44,2
CPT,86885,"ANTIHUMAN GLOBULIN TEST (COOMBS TEST); INDIRECT, QUALITATIVE, EACH ANTISERUM",10.0,6.5,14.14,14.14,2
CPT,86885,Laboratory Services,10.0,6.5,43.08,43.08,2
CPT,86885,"T CELLS; INDIRECT, QUALTITIATIVE, EACH ANTISERUM",10.0,6.5,49.98,79.59,2
CPT,86886,"ANTIHUMAN GLOBULIN TEST (COOMBS TEST); INDIRECT, TITER, EACH ANTISERUM",955.55,621.11,12.48,12.48,2
CPT,86886,"ANTIHUMAN GLOBULIN TEST; INDIRECT,TITER, EACH ANTISERUM",955.55,621.11,45.15,71.91,2
CPT,86886,HB ANTIBODY RBC TITRE,955.55,621.11,213.38,14761.0,10
CPT,86886,HB TITRATION EACH,955.55,621.11,213.38,14761.0,10
CPT,86886,Laboratory Services,955.55,621.11,38.93,38.93,2
CPT,86890,"AUTOLOGOUS BLOOD OR COMPONENT, COLLECTION PROCESSING AND STORAGE; PREDEPOSITED",955.55,621.11,237.96,625.78,4
CPT,86890,HB PROCESS AUTOLOGUS UNIT,955.55,621.11,213.38,245.38,8
CPT,86890,Laboratory Services,955.55,621.11,434.33,434.37,2
CPT,86891,"AUTOLOGOUS BLOOD OR COMPONENT, COLLECTION PROCESSING AND STORAGE; INTRA- OR POSTOPERATIVE SALVAGE",,,336.14,336.14,2
CPT,86891,"AUTOLOGOUS BLOOD OR COMPONENT, COLLECTION PROCESSING AND STORAGE; INTRAOR POSTOPERATIVE SALVAGE",,,392.93,625.78,2
CPT,86891,Laboratory Services,,,611.55,611.61,2
CPT,86900,BLOOD TYPING; ABO,1074.29,698.29,26.05,41.48,2
CPT,86900,BLOOD TYPING;ABO,1074.29,698.29,7.49,7.49,2
CPT,86900,HB PATIENT ABO TYPE,1074.29,698.29,160.5,14761.0,20
CPT,86900,HB PT ABO TYPE (ARC),1074.29,698.29,160.5,14761.0,10
CPT,86900,Laboratory Services,1074.29,698.29,22.45,22.45,2
CPT,86901,BLOOD TYPING; RH (D),180.5,117.33,7.49,7.49,2
CPT,86901,HB ALLO BM/PBSC DONOR RH (D),180.5,117.33,48.87,14761.0,10
CPT,86901,HB PATIENT RH TYPE,180.5,117.33,48.87,14761.0,10
CPT,86901,HB PT RH TYPE (ARC),180.5,117.33,48.87,14761.0,10
CPT,86901,Laboratory Services,180.5,117.33,22.45,22.45,2
CPT,86901,RH (D),180.5,117.33,55.03,87.64,2
CPT,86902,"BLOOD TYPING; ANTIGEN TESTING OF DONOR BLOOD USING REAGENT SERUM, EACH ANTIGEN TEST",673.5,437.78,15.81,43.06,4
CPT,86902,HB AG TYPE /UNIT/AG,673.5,437.78,447.92,14761.0,10
CPT,86902,Laboratory Services,673.5,437.78,28.74,28.74,2
CPT,86904,"ANTIGEN SCREENING FOR COMPATIBLE UNIT USING PATIENT SERUM, PER UNIT SCREENED",168.54,109.55,83.02,132.22,2
CPT,86904,"BLOOD TYPING; ANTIGEN SCREENING FOR COMPATIBLE UNIT USING PATIENT SERUM, PER UNIT SCREENED",168.54,109.55,39.94,39.94,2
CPT,86904,Laboratory Services,168.54,109.55,71.51,71.51,2
CPT,86905,"BLOOD TYPING; RBC ANTIGENS, OTHER THAN ABO OR RH (D), EACH",651.5,423.48,9.15,9.15,2
CPT,86905,HB MISC LAB SPECIAL TEST,651.5,423.48,447.92,515.11,8
CPT,86905,HB PT RBC PHENOTYPE EACH (ARC),651.5,423.48,447.92,14761.0,10
CPT,86905,HB RBC PHENO PT/BLD GRP AG,651.5,423.48,447.92,14761.0,10
CPT,86905,Laboratory Services,651.5,423.48,28.74,28.74,2
CPT,86905,"RBC ANTIGENS, OTHER THAN ABO OR RH (D), EACH",651.5,423.48,33.4,53.19,2
CPT,86906,"BLOOD TYPING; RH PHENOTYPING, COMPLETE",137.55,89.41,19.13,19.13,2
CPT,86906,HB RH PHENOTYPE,137.55,89.41,48.87,14761.0,10
CPT,86906,HB RH PHENOTYPE (ARC),137.55,89.41,48.87,14761.0,10
CPT,86906,Laboratory Services,137.55,89.41,58.3,58.31,2
CPT,86906,"RH PHENOTYPING, COMPLETE",137.55,89.41,67.67,107.78,2
CPT,86910,"BLOOD TYPING, FOR PATERNITY TESTING, PER INDIVIDUAL; ABO, RH AND MN",,,61.57,61.57,2
CPT,86910,Laboratory Services,,,113.02,113.03,2
CPT,86911,"BLOOD TYPING, FOR PATERNITY TESTING, PER INDIVIDUAL; EACH ADDITIONAL ANTIGEN SYSTEM",,,53.25,53.25,2
CPT,86911,Laboratory Services,,,97.48,97.49,2
CPT,86911,T CELLS; EACH ADDITIONAL ANTIGEN SYSTEM,,,45.68,72.76,2
CPT,86920,COMPATIBILITY TEST EACH UNIT; IMMEDIATE SPIN TECHNIQUE,0.01,0.01,84.04,500.58,4
CPT,86920,HB I. S. CROSSMATCH,0.01,0.01,213.38,14761.0,30
CPT,86920,Laboratory Services,0.01,0.01,152.89,152.9,2
CPT,86921,COMPATIBILITY TEST EACH UNIT; INCUBATION TECHNIQUE,557.34,362.27,75.71,75.71,2
CPT,86921,INCUBATION TECHNIQUE,557.34,362.27,314.32,500.58,2
CPT,86921,Laboratory Services,557.34,362.27,137.35,137.37,2
CPT,86922,COMPATIBILITY TEST EACH UNIT;,0.01,0.01,314.32,500.58,2
CPT,86922,COMPATIBILITY TEST EACH UNIT; ANTIGLOBULIN TECHNIQUE,0.01,0.01,89.86,89.86,2
CPT,86922,HB AHG CROSSMATCH,0.01,0.01,213.38,14761.0,10
CPT,86922,Laboratory Services,0.01,0.01,163.96,163.97,2
CPT,86923,COMPATIBILITY TEST EACH UNIT; ELECTRONIC,0.01,0.01,67.39,67.39,2
CPT,86923,COMPATIBILITY TEST EACH UNIT; ELECTRONIC ï,0.01,0.01,74.08,117.98,2
CPT,86923,HB LAB ELECTRONIC CROSSMATCH,0.01,0.01,213.38,14761.0,10
CPT,86923,Laboratory Services,0.01,0.01,121.88,121.9,2
CPT,86927,"FRESH FROZEN PLASMA, THAWING, EACH UNIT",955.55,621.11,47.43,125.19,4
CPT,86927,HB PLASMA THAW FFP,955.55,621.11,213.38,14761.0,12
CPT,86927,Laboratory Services,955.55,621.11,86.41,86.42,2
CPT,86930,"FROZEN BLOOD, EACH UNIT; FREEZING (INCL PREPARATION)",1281.0,832.65,314.32,500.58,2
CPT,86930,"FROZEN BLOOD, EACH UNIT; FREEZING (INCLUDES PREPARATION)",1281.0,832.65,280.39,280.39,2
CPT,86930,HB HLA LYMPHOCYTE PREP,1281.0,832.65,213.38,14761.0,20
CPT,86930,Laboratory Services,1281.0,832.65,509.67,509.72,2
CPT,86931,"FROZEN BLOOD, EACH UNIT; THAWING",,,210.5,210.5,2
CPT,86931,"FROZEN BLOOD, EACH UNIT; THAWING THAWING",,,471.54,750.97,2
CPT,86931,Laboratory Services,,,383.32,383.36,2
CPT,86932,"FROZEN BLOOD, EACH UNIT; FREEZING (INCL PREP) AND THAWING",,,352.77,561.82,2
CPT,86932,"FROZEN BLOOD, EACH UNIT; FREEZING (INCLUDES PREPARATION) AND THAWING",,,237.96,237.96,2
CPT,86932,Laboratory Services,,,434.33,434.37,2
CPT,86940,"HEMOLYSINS AND AGGLUTININS; AUTO, SCREEN, EACH",,,21.63,21.63,2
CPT,86940,"HEMOYSINS AND AGGLUTININS,AUTO, SCREEN, EACH;",,,71.49,113.86,2
CPT,86940,Laboratory Services,,,61.7,61.7,2
CPT,86941,"HB DONATH LANDSTEINER, BLOOD",804.45,522.89,13270.0,14761.0,2
CPT,86941,HEMOLYSINS AND AGGLUTININS; INCUBATED,804.45,522.89,29.95,29.95,2
CPT,86941,"HEMOYSINS AND AGGLUTININS, AUTO, SCREEN, EACH; INCUBATED",804.45,522.89,105.77,168.45,2
CPT,86941,Laboratory Services,804.45,522.89,91.07,91.08,2
CPT,86945,HB IRRADIATION OF BLOOD PRODUCT,341.42,221.92,48.87,14761.0,20
CPT,86945,"IRRADIATION OF BLOOD PRODUCT, EACH UNIT",341.42,221.92,69.89,250.29,4
CPT,86945,Laboratory Services,341.42,221.92,128.55,128.56,2
CPT,86950,LEUKOCYTE TRANSFUSION,,,182.21,665.85,4
CPT,86950,Laboratory Services,,,332.38,332.41,2
CPT,86960,Laboratory Services,,,141.82,141.83,2
CPT,86960,"VOLUME REDUCTION OF BLOOD OR BLOOD PRODUCT (E.G., RED BLOOD CELLS OR PLATELETS), EACH UNIT",,,78.21,78.21,2
CPT,86960,VOLUME REDUCTION OF BLOOD OR BLOOD PRODUCT ï,,,96.42,153.56,2
CPT,86965,HB PROCESS OUTSIDE POOL CRYO,955.55,621.11,213.38,14761.0,20
CPT,86965,Laboratory Services,955.55,621.11,141.82,141.83,2
CPT,86965,POOLING OF PLATELETS OR OTHER BLOOD PRODUCTS,955.55,621.11,78.21,78.21,2
CPT,86965,POOLING PLATELETS OR OTHER BLOOD PRODUCTS,955.55,621.11,157.16,250.29,2
CPT,86970,HB CELLS PRE TREATMENT W/PRON,273.21,177.59,73.96,14761.0,10
CPT,86970,Laboratory Services,273.21,177.59,128.55,128.56,2
CPT,86970,"PRETREATMENT OF RBC'S FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION AND /OR COMPATIBLITY TESTING; INCUBATION WITH",273.21,177.59,125.76,200.29,2
CPT,86970,"PRETREATMENT OF RBCS FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TESTING; INCUBATION WITH CHEMICAL AGENTS OR DRUGS, EACH",273.21,177.59,69.89,69.89,2
CPT,86971,HB PRETREAT RBC'S ENZM EA-ARC,650.5,422.82,213.38,14761.0,10
CPT,86971,"INCUBATION WITH ENZYMES, EACH",650.5,422.82,125.76,200.29,2
CPT,86971,Laboratory Services,650.5,422.82,101.95,101.96,2
CPT,86971,"PRETREATMENT OF RBCS FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TESTING; INCUBATION WITH ENZYMES, EACH",650.5,422.82,55.75,55.75,2
CPT,86972,BY DENSITY GRADIENT SEPARATION,,,157.16,250.29,2
CPT,86972,Laboratory Services,,,179.49,179.51,2
CPT,86972,"PRETREATMENT OF RBCS FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TESTING; BY DENSITY GRADIENT SEPARATION",,,98.18,98.18,2
CPT,86975,HB PRETREAT RBC'S/DRUGS - ARC,739.73,480.82,13270.0,14761.0,2
CPT,86975,HB SERUM PRE TREATMENT,739.73,480.82,496.88,14761.0,10
CPT,86975,Laboratory Services,739.73,480.82,137.35,137.37,2
CPT,86975,"PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; INCUBATION WITH DRUGS, EACH",739.73,480.82,75.71,75.71,2
CPT,86975,"PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATIONINCUBATION WITH DRUGS, EACH",739.73,480.82,125.76,200.29,2
CPT,86976,BY DILUTION,,,125.76,200.29,2
CPT,86976,Laboratory Services,,,152.89,152.9,2
CPT,86976,PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; BY DILUTION,,,84.04,84.04,2
CPT,86977,"INCUBATION W/ INHIBITORS, EACH",712.58,463.18,125.76,200.29,2
CPT,86977,Laboratory Services,712.58,463.18,152.89,152.9,2
CPT,86977,"PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; INCUBATION WITH INHIBITORS, EACH",712.58,463.18,84.04,84.04,2
CPT,86978,"BY DIFFERENTIAL RED CELL ABSORPTION USING PATIENT RBC'S OR RBC'S OF KNOWN PHENOTYPE, EACH ABSORPTION",350.85,228.05,157.16,250.29,2
CPT,86978,HB PT.SERA DIFF ABSORPTION-ARC,350.85,228.05,13270.0,14761.0,2
CPT,86978,Laboratory Services,350.85,228.05,152.89,152.9,2
CPT,86978,"PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; BY DIFFERENTIAL RED CELL ABSORPTION USING PATIENT RBCS OR RBCS OF KNOWN PHENOTYPE, EACH ABSORPTION",350.85,228.05,84.04,84.04,2
CPT,86985,HB LAB SPLIT BLD PRODUCT EA UN,655.88,426.32,213.38,14761.0,10
CPT,86985,Laboratory Services,655.88,426.32,113.02,113.03,2
CPT,86985,"SPLITTING OF BLOOD OR BLOOD PRODUCTS, EACH UNIT",655.88,426.32,61.57,280.91,4
CPT,86999,HB WASHING BLOOD PRODUCTS,346.31,225.1,13270.0,14761.0,2
CPT,86999,Laboratory Services,346.31,225.1,,,0
CPT,86999,UNLISTED TRANSFUSION MEDICINE PROCEDURE,346.31,225.1,,,0
CPT,86999,Unlisted transfusion medicine procedure,346.31,225.1,33.61,33.61,2
CPT,87003,"ANIMAL INOCULATION, SMALL ANIMAL; WITH OBSERVATION AND DISSECTION",,,41.61,234.09,4
CPT,87003,Laboratory Services,,,126.66,126.68,2
CPT,87015,"CONCENTRATION (ANY TYPE), FOR INFECTIOUS AGENTS",150.81,98.03,16.64,16.64,2
CPT,87015,"CONCENTRATION (ANY TYPE),FOR INFECTIOUS AGENTS PARASITES,OVAOR TUBERCLE BACILLUS (TB,AFB)",150.81,98.03,58.32,92.89,2
CPT,87015,HB CONCENTRATION - ANY TYPE,150.81,98.03,13270.0,14761.0,2
CPT,87015,HB MISC LAB SPECIAL TEST,150.81,98.03,13270.0,14761.0,4
CPT,87015,Laboratory Services,150.81,98.03,50.25,50.26,2
CPT,87040,"CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES ANAEROBIC CLUTUR",1185.71,770.71,90.13,143.55,2
CPT,87040,"CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES ANAEROBIC CULTURE, IF APPROPRIATE)",1185.71,770.71,24.96,24.96,2
CPT,87040,HB LAB CULT BAC BLOOD,1185.71,770.71,13270.0,14761.0,2
CPT,87040,HB VIRAL RESPIRATORY PANEL WITH COVID19 - 22 TARGETS,535.86,348.31,,,0
CPT,87040,Laboratory Services,1185.71,770.71,77.67,77.68,2
CPT,87045,"CULTURE, BACTERIAL; STOOL, AEROBIC, WITH ISOLATION AND PRELIMINARY EXAMINATION (E.G., KIA, LIA), SALMONELLA AND SHIGELLA SPECIES",489.51,318.18,23.3,23.3,2
CPT,87045,"CULTURRE, BACTERIAL, DEFINITIVE; STOOL, AEROBIC, WITH ISOLATION AND PRELIMINARY EXAMINATION, (EG, KIA, LIA), SALMONELLA",489.51,318.18,82.37,131.19,2
CPT,87045,"HB CULTURE, BACT FECAL ROUTINE",489.51,318.18,13270.0,14761.0,2
CPT,87045,Laboratory Services,489.51,318.18,71.0,71.01,2
CPT,87046,"CULTURE, BACTERIAL; STOOL, AEROBIC, ADDITIONAL PATHOGENS, ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, EACH PLA",237.95,154.66,20.58,32.77,2
CPT,87046,"CULTURE, BACTERIAL; STOOL, AEROBIC, ADDITIONAL PATHOGENS, ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, EACH PLATE",237.95,154.66,23.3,23.3,2
CPT,87046,HB SRN VRE C. DIFF TOX POS STOOL,237.95,154.66,13270.0,14761.0,2
CPT,87046,Laboratory Services,237.95,154.66,71.0,71.01,2
CPT,87070,"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",641.8,417.17,20.8,20.8,2
CPT,87070,"CULTURE,BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD, OR STOOL, AEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION",641.8,417.17,75.14,119.67,2
CPT,87070,HB LAB CULTURE ABSCESS,641.8,417.17,13270.0,14761.0,2
CPT,87070,HB MISC LAB SPECIAL TEST,641.8,417.17,,,0
CPT,87070,Laboratory Services,641.8,417.17,64.78,64.78,2
CPT,87071,"CULTURE, BACTERIAL; QUANTITATIVE, AEROBIC WITH ISOLATION AND PRESUMPTIVEIDENTIFICATION OF ISOLATES, ANY SOURCE EXCEPT URINE, BLOOD OR STOOL",,,24.13,24.13,2
CPT,87071,"CULTURE, QUANTITATIVE, AREOBIC W/ISOLATION AND PRESUMPTIVE IDENTIFICATION ISOLATES,ANY SOURCE EXCEPT,BLOOD,URINE,STOOL",,,41.16,65.55,2
CPT,87071,Laboratory Services,,,71.0,71.01,2
CPT,87073,"CULTURE, BACTERIAL; QUANTITATIVE, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, ANY SOURCE EXCEPT URINE, BLOOD OR STOOL",,,24.13,24.13,2
CPT,87073,"CULTURE, QUANTITATIVE, ANAEROBIC W/ISOLATION AND PRESUMPTIVE IDENTIFICATION ISOLATES,ANY SOURCE EXCEPT,BLOOD,URINE,STOOL",,,41.16,65.55,2
CPT,87073,Laboratory Services,,,71.0,71.01,2
CPT,87075,"CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",1887.3,1226.75,23.3,23.3,2
CPT,87075,"CULTURE, BACTERIAL; ANY SOURCE; EXCEPT BLOOD ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",1887.3,1226.75,82.61,131.56,2
CPT,87075,HB LAB CULT BAC-ANAROB,1887.3,1226.75,13270.0,14761.0,2
CPT,87075,Laboratory Services,1887.3,1226.75,71.13,71.14,2
CPT,87076,"CULTURE, BACTERIAL, ANY SOURCE; DEFINITIVE IDENTIFICATION, EACH ANAEROBIC ORGANISM, INCLUDING GAS CHROMATOGRAPHY",284.41,184.87,110.01,175.19,2
CPT,87076,"CULTURE, BACTERIAL; ANAEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH ISOLATE",284.41,184.87,19.97,19.97,2
CPT,87076,HB LAB CHLAMYDIA ADNL WORK,284.41,184.87,13270.0,14761.0,2
CPT,87076,Laboratory Services,284.41,184.87,60.75,60.76,2
CPT,87077,"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH ISOLATE",182.28,118.48,19.97,19.97,2
CPT,87077,"CULTURE; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH ISOLATE",182.28,118.48,70.5,112.27,2
CPT,87077,"HB LAB BACTI ADDNL. ID, EACH",182.28,118.48,13270.0,14761.0,2
CPT,87077,Laboratory Services,182.28,118.48,60.75,60.76,2
CPT,87081,"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;",543.92,353.55,16.64,16.64,2
CPT,87081,"CULTURE,BACTERIAL,PRESUMPTIVE,PATHOGENIC ORGANISMS,SCREENING ONLY; FOR SINGLE ORGANISMS",543.92,353.55,57.44,91.48,2
CPT,87081,HB LAB CULT LEGIONELLA,543.92,353.55,13270.0,14761.0,2
CPT,87081,HB LAB MRSA+MSSA SCREEN,543.92,353.55,13270.0,14761.0,2
CPT,87081,Laboratory Services,543.92,353.55,49.87,49.88,2
CPT,87084,"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY, BY COMMERCIAL KIT (SPECIFY TYPE); WITH COLONY ESTIMATION FRO",,,75.14,119.67,2
CPT,87084,"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY; WITH COLONY ESTIMATION FROM DENSITY CHART",,,66.56,66.56,2
CPT,87084,Laboratory Services,,,64.78,64.78,2
CPT,87086,"CULTURE, BACTERIAL, URINE; QUANTITATIVE, COLONY COUNT,URINE",,,69.5,110.68,2
CPT,87086,"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE",,,19.97,19.97,2
CPT,87086,Laboratory Services,,,60.75,60.76,2
CPT,87088,"CULTURE, BACTERIAL; COLONY COUNT; W/ISOLATION AND PRESUMPTIVE IDENTIFICATION EACH ISOLATE, URINE",1237.32,804.26,62.85,100.1,2
CPT,87088,"CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE",1237.32,804.26,19.97,19.97,2
CPT,87088,"HB CULTURE, URINE",1237.32,804.26,13270.0,14761.0,2
CPT,87088,Laboratory Services,1237.32,804.26,49.31,49.31,2
CPT,87090,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,87101,"CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; SKIN, HAIR, OR NAIL",,,19.13,19.13,2
CPT,87101,"CULTURE, FUNGI,(MOLD OR YEAST)ISOLATION,W/PRESUMPTIVE IDENTIFICATION OF ISOLATES;SKIN,HAIR OR NAIL",,,67.32,107.21,2
CPT,87101,Laboratory Services,,,58.05,58.05,2
CPT,87102,"CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; OTHER SOURCE (EXCEPT BLOOD)",1256.37,816.64,20.8,20.8,2
CPT,87102,"CULTURE, FUNGI, ISOLATION (WITH OR WITHOUT PRESUMPTIVE IDENTIFICATION); OTHER SOURCE (EXCEPT BLOOD)",1256.37,816.64,73.38,116.86,2
CPT,87102,HB LAB CULT FUNG UNSPCF,1256.37,816.64,13270.0,14761.0,2
CPT,87102,Laboratory Services,1256.37,816.64,63.27,63.27,2
CPT,87103,"CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; BLOOD",1256.37,816.64,49.92,49.92,2
CPT,87103,"CULTURE, FUNGI, ISOLATION (WITH OR WITHOUT PRESUMPTIVE IDENTIFICATION); BLOOD",1256.37,816.64,78.73,125.38,2
CPT,87103,HB LAB CULT FUNG BLOOD,1256.37,816.64,13270.0,14761.0,2
CPT,87103,Laboratory Services,1256.37,816.64,67.86,67.87,2
CPT,87106,"CULTURE, FUNGI, DEFINITIVE IDENTIFICATION, EACH ORGANISM; YEAST",233.04,151.48,24.96,24.96,2
CPT,87106,"CULTURE,FUNGI,DEFINITIVE IDENTIFICATION EACH ORGANISM;YEAST",233.04,151.48,90.13,143.55,2
CPT,87106,"HB LAB FUNG DEFIN. ID, 1ST ORG",233.04,151.48,13270.0,14761.0,2
CPT,87106,Laboratory Services,233.04,151.48,77.67,77.68,2
CPT,87107,"CULTURE, FUNGI, DEFINITIVE IDENTIFICATION EACH ORGANISM; MOLD",233.04,151.48,90.13,143.55,2
CPT,87107,"CULTURE, FUNGI, DEFINITIVE IDENTIFICATION, EACH ORGANISM; MOLD",233.04,151.48,24.96,24.96,2
CPT,87107,HB MALDI MOLD ID ORGS 1,233.04,151.48,13270.0,14761.0,2
CPT,87107,HB MISC LAB SPECIAL TEST,233.04,151.48,13270.0,14761.0,4
CPT,87107,Laboratory Services,233.04,151.48,77.67,77.68,2
CPT,87109,"CULTURE, MYCOPLASMA, ANY SOURCE",1177.51,765.38,37.44,213.96,4
CPT,87109,HB LAB CULT BLOOD MYCOPLASMA,1177.51,765.38,13270.0,14761.0,2
CPT,87109,HB MISC LAB SPECIAL TEST,1177.51,765.38,,,0
CPT,87109,Laboratory Services,1177.51,765.38,115.72,115.73,2
CPT,87110,"CULTURE, CHLAMYDIA, ANY SOURCE",518.08,336.75,48.26,48.26,2
CPT,87110,"CULTURE, CHLAMYDIA,ANY SOURCE",518.08,336.75,171.15,272.58,2
CPT,87110,HB LAB CHLAMYDIA CULTURE,518.08,336.75,13270.0,14761.0,2
CPT,87110,HB MISC LAB SPECIAL TEST,518.08,336.75,13270.0,14761.0,2
CPT,87110,Laboratory Services,518.08,336.75,147.35,147.37,2
CPT,87116,"CULTURE, TUBERCLE OR OTHER ACID-FAST BACILLI (E.G., TB, AFB, MYCOBACTERIANY SOURCE, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",1256.37,816.64,26.63,26.63,2
CPT,87116,"CULTURE,TUBERCLE OR OTHER ACID-FAST BACILLI(EG,TB,AFB,MYCOBACTERIA);ANY SOURCE,WITH ISOLATION AND PRESUMPTIVE OF ISOLATE",1256.37,816.64,94.19,150.01,2
CPT,87116,HB LAB CULT AFB BLOOD,1256.37,816.64,13270.0,14761.0,2
CPT,87116,Laboratory Services,1256.37,816.64,73.96,73.97,2
CPT,87118,"CULTURE, MYCOBACTERIA, DEFINITIVE IDENTIFICATION EACH ISOLATES",1332.5,866.13,95.6,152.25,2
CPT,87118,"CULTURE, MYCOBACTERIAL, DEFINITIVE IDENTIFICATION, EACH ISOLATE",1332.5,866.13,35.77,35.77,2
CPT,87118,HB LAB AFB ID,1332.5,866.13,13270.0,14761.0,2
CPT,87118,Laboratory Services,1332.5,866.13,82.32,82.33,2
CPT,87140,"CULTURE, TYPING; IMMUNOFLUORESCENT METHOD, EACH ANTISERUM",,,13.31,13.31,2
CPT,87140,"CULTURE, TYPING;IMMUNOFLUORESCENT METHOD, EACH ANTISERUM",,,48.74,77.63,2
CPT,87140,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,87140,Laboratory Services,,,41.89,41.89,2
CPT,87143,"CULTURE, TYPING; GAS LIQUID CHROMATOGRAPHY (GLC) OR HIGH PRESSURE LIQUIDCHROMATOGRAPHY (HPLC) METHOD",52.21,33.94,30.79,30.79,2
CPT,87143,"CULTURE, TYPING; GAS LIQUID CHROMATOGRAPHY (GLC)OR HIGH PRESSURE LIQUID CHROMATOGRAPHY (HPLC) METHOD",52.21,33.94,109.42,174.26,2
CPT,87143,Laboratory Services,52.21,33.94,94.27,94.28,2
CPT,87147,"CULTURE, TYPING; IMMUNOLOGIC METHOD, OTHER THAN IMMUNOFLUORESENCE (E.G.,AGGLUTINATION GROUPING), PER ANTISERUM",116.92,75.99,12.48,12.48,2
CPT,87147,"CULTURE,TYPING;IMMUNOLOGIC METHHOD,OTHER THAN IMMUNOFLUORESCENCE(EG,AGGLUTION GROUPING)PER ANTISERUM",116.92,75.99,40.86,65.08,2
CPT,87147,HB MRSA CONFIRMATION,116.92,75.99,13270.0,14761.0,2
CPT,87147,Laboratory Services,116.92,75.99,36.92,36.92,2
CPT,87149,"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, DIRECT PROBE TECHNIQUE, PER CULTURE OR ISOLATE, EACH",446.7,290.35,174.97,278.66,2
CPT,87149,"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID PROBE",446.7,290.35,49.09,49.09,2
CPT,87149,HB LAB GRAM NEG BLD CULT NA,446.7,290.35,13270.0,14761.0,2
CPT,87149,Laboratory Services,446.7,290.35,150.88,150.89,2
CPT,87150,"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, AMPLIFIED PROBE TECHNIQUE, PER CULTURE OR ISOLATE, E",1000.14,650.09,384.28,612.01,2
CPT,87150,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed",1000.14,650.09,86.54,86.54,2
CPT,87150,Laboratory Services,1000.14,650.09,264.02,264.04,2
CPT,87152,"CULTURE, TYPING; IDENTIFICATION BY PULSE FIELD GEL TYPING",,,19.13,19.13,2
CPT,87152,"CULTURE, TYPING; IMMUNOLOGIC METHOD IDENTIFICATION BY PULSE FIELD GEL TYPING",,,45.68,72.76,2
CPT,87152,Laboratory Services,,,39.37,39.37,2
CPT,87153,"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID SEQUENCING METHOD, EACH ISOLATE (EG, SEQUENCING OF THE 16S RRNA GENE)",,,908.74,1447.25,2
CPT,87153,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene)",,,282.89,282.89,2
CPT,87153,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
CPT,87153,Laboratory Services,,,867.77,867.86,2
CPT,87154,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",5473.54,3557.8,535.0,871.11,4
CPT,87154,HB CULT TYPE ID BLOOD PATHOGEN 6+ TARGET,5473.54,3557.8,13270.0,14761.0,2
CPT,87154,Laboratory Services,5473.54,3557.8,1165.69,1165.8,2
CPT,87158,"CULTURE, TYPING; OTHER METHODS",,,19.13,72.76,4
CPT,87158,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,87158,Laboratory Services,,,39.37,39.37,2
CPT,87164,"DARK FIELD EXAMINATION, ANY SOURCE (E.G., PENILE, VAGINAL, ORAL, SKIN); INCLUDES SPECIMEN COLLECTION",,,26.63,26.63,2
CPT,87164,"DARK FIELD EXAMINATION, ANY SOURCE (EG, PENILE, VAGINAL, ORAL, SKIN); INCLUDES SPECIMEN COLLECTION",,,93.78,149.35,2
CPT,87164,Laboratory Services,,,80.82,80.82,2
CPT,87166,"DARK FIELD EXAMINATION, ANY SOURCE (E.G., PENILE, VAGINAL, ORAL, SKIN); WITHOUT COLLECTION",,,27.45,27.45,2
CPT,87166,"DARK FIELD EXAMINATION, ANY SOURCE (EG, PENILE, VAGINAL, ORAL, SKIN); WITHOUT COLLECTION",,,98.6,157.03,2
CPT,87166,Laboratory Services,,,85.03,85.04,2
CPT,87168,Laboratory Services,,,32.14,32.14,2
CPT,87168,MACROSCOPIC EXAMINATION; ARTHROPOD,,,10.82,59.37,4
CPT,87169,Laboratory Services,,,32.14,32.14,2
CPT,87169,MACROSCOPIC EXAMINATION; PARASITE,,,10.82,59.37,4
CPT,87172,HB LAB MICRO PINWORMS,424.23,275.75,,,0
CPT,87172,Laboratory Services,424.23,275.75,32.14,32.14,2
CPT,87172,"PINWORM EXAM (E.G., CELLOPHANE TAPE PREP)",424.23,275.75,10.82,10.82,2
CPT,87172,"PINWORM EXAM (EG, CELLOPHANE TAPE PREP)",424.23,275.75,37.28,59.37,2
CPT,87176,"ENDOTOXIN, BACTERIAL (PYROGENS); HOMOGENIZATION, TISSUE, FOR CULTURE",418.77,272.2,51.39,81.84,2
CPT,87176,HB MISC LAB SPECIAL TEST,418.77,272.2,,,0
CPT,87176,HB TISSUE GRINDING,418.77,272.2,13270.0,14761.0,2
CPT,87176,"HOMOGENIZATION, TISSUE, FOR CULTURE",418.77,272.2,14.14,14.14,2
CPT,87176,Laboratory Services,418.77,272.2,44.28,44.28,2
CPT,87177,HB LAB O & P DIRECT WET MOUNT,252.88,164.37,13270.0,14761.0,2
CPT,87177,HB MISC LAB SPECIAL TEST,252.88,164.37,13270.0,14761.0,4
CPT,87177,Laboratory Services,252.88,164.37,66.92,66.92,2
CPT,87177,"OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION",252.88,164.37,21.63,123.13,4
CPT,87181,"HB LAB ETEST MIC, EACH DRUG",27.89,18.13,13270.0,14761.0,2
CPT,87181,Laboratory Services,27.89,18.13,12.26,12.26,2
CPT,87181,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; AGAR DILUTION METHOD, PER AGENT (E.G., ANTIBIOTIC GRADIENT STRIP)",27.89,18.13,11.64,11.64,2
CPT,87181,"SUSCEPTIBILITY STUDIES,ANTIMICROBIAL AGENT;AGAR DILUTION METHOD,PER AGENT (EG,ANTIBIOTIC GRADIENT STRIP)",27.89,18.13,19.7,31.37,2
CPT,87184,HB CLIND INDUCED RES.TEST,462.56,300.66,13270.0,14761.0,2
CPT,87184,Laboratory Services,462.56,300.66,51.89,51.89,2
CPT,87184,"SENSITIVITY STUDIES, ANTIBIOTIC; DISK METHOD, PER PLATE (12 OR LESS AGENTS)",462.56,300.66,60.15,95.79,2
CPT,87184,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; DISK METHOD, PER PLATE (12 OR FEWER AGENTS)",462.56,300.66,18.31,18.31,2
CPT,87185,HB BETA LAC ENZ DETECT,130.53,84.84,13270.0,14761.0,2
CPT,87185,HB MISC LAB SPECIAL TEST,130.53,84.84,13270.0,14761.0,2
CPT,87185,Laboratory Services,130.53,84.84,12.26,12.26,2
CPT,87185,"SUSCEPTIBIILITY STUDIES, ANTIMICROBIAL AGENT; ENZYME DETECTION, PER ENZYME",130.53,84.84,25.16,40.08,2
CPT,87185,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; ENZYME DETECTION (E.G., BETLACTAMASE), PER ENZYME",130.53,84.84,11.64,11.64,2
CPT,87186,HB LAB SUSCEPT MIC,192.75,125.29,13270.0,14761.0,2
CPT,87186,HB MISC LAB SPECIAL TEST,192.75,125.29,13270.0,14761.0,4
CPT,87186,Laboratory Services,192.75,125.29,65.03,65.04,2
CPT,87186,"SENSITIVITY STUDIES,ANTIBIOTIC;MICRODILUTION OR AGAR DILUTION,(MIC),OR BREAK POINT EACH MULTI-ANTIMICROBIAL,PER PLATE",192.75,125.29,75.49,120.23,2
CPT,87186,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONCENTRATION (MIC) OR BREAKPOINT), EACH MULTI-ANTIMICROBIAL, PER PLATE",192.75,125.29,21.63,21.63,2
CPT,87187,Laboratory Services,,,77.98,77.99,2
CPT,87187,"SENSITIVITY STUDIES, ANTIBIOTIC; MINIMUM BACTERICIDAL CONCENTRATION (MBC) (USE IN ADDITION TO 87186 OR 87188)",,,77.02,122.66,2
CPT,87187,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION, MINIMUM LETHAL CONCENTRATION (MLC), EACH PLATE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,99.01,99.01,2
CPT,87188,HB MISC LAB SPECIAL TEST,868.53,564.54,13270.0,14761.0,4
CPT,87188,Laboratory Services,,,49.94,49.94,2
CPT,87188,"SENSITIVITY STUDIES, ANTIBIOTIC; MACROBROTH DILUTION METHOD, EACH AGENT",,,57.91,92.23,2
CPT,87188,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MACROBROTH DILUTION METHOD,EACH AGENT",,,16.64,16.64,2
CPT,87190,"HB AFB TB SUSCEPT, EACH DRU",14.25,9.26,13270.0,14761.0,2
CPT,87190,Laboratory Services,14.25,9.26,36.92,36.92,2
CPT,87190,"SENSITIVITY STUDIES, ANTIBIOTIC;MYCOBACTERIA, PROPORTION METHOD, EACH AGENT",14.25,9.26,47.15,75.1,2
CPT,87190,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MYCOBACTERIA, PROPORTION METHOD, EACH AGENT",14.25,9.26,18.31,18.31,2
CPT,87197,Laboratory Services,,,113.02,113.03,2
CPT,87197,SERUM BACTERICIDAL TITER (SCHLICTER TEST),,,36.61,162.74,4
CPT,87205,HB LAB GRAM STAIN FOR BV SCREEN,341.31,221.85,13270.0,14761.0,2
CPT,87205,Laboratory Services,341.31,221.85,32.14,32.14,2
CPT,87205,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYPES",341.31,221.85,10.82,10.82,2
CPT,87205,"SMEAR, PRIMARY SOURCE, WITH INTERPRETATION;GRAM OR GIEMSA STAIN FOR BACTERIA,FUNGI, OR CELL TYPES",341.31,221.85,37.28,59.37,2
CPT,87206,HB MISC LAB SPECIAL TEST,160.46,104.3,,,0
CPT,87206,HB ZIEHL-NEELSEN STAIN-CONF,160.46,104.3,13270.0,14761.0,2
CPT,87206,Laboratory Services,160.46,104.3,40.44,40.44,2
CPT,87206,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; FLUORESCENT AND/OR ACID FAST STAIN FOR BACTERIA, FUNGI, PARASITES, VIRUSES OR CELL TYPES",160.46,104.3,13.31,13.31,2
CPT,87206,"SMEAR,PRIMARY SOURCE,W/INTERPRETATION;FLUORESCENT AND/OR ACID FAST STAIN FOR BACTERIA,FUNGI,PARASITE,VIRUS,CELL TYPES",160.46,104.3,46.92,74.72,2
CPT,87207,HB LAB MICRO MALARIA BL,333.12,216.53,13270.0,14761.0,2
CPT,87207,HB MISC LAB SPECIAL TEST,333.12,216.53,13270.0,14761.0,4
CPT,87207,Laboratory Services,333.12,216.53,45.09,45.1,2
CPT,87207,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; SPECIAL STAIN FOR INCLUSION BODIES OR PARASITES (E.G., MALARIA, COCCIDIA, MICROSPORIDIA, TRYPANOSOMES, HERPES VIRUSES)",333.12,216.53,14.98,14.98,2
CPT,87207,"SMEAR,PRIMARY SOURCE W/INTERP; SPECIAL STAIN FOR INCLUSION BODIES OR PARASITES (EG, MALARIA, COCCIDIA, MICROSPORIDIA, T",333.12,216.53,52.33,83.34,2
CPT,87209,HB LAB O&P TRICHROME STAIN,505.81,328.78,13270.0,14761.0,4
CPT,87209,HB MISC LAB SPECIAL TEST,505.81,328.78,13270.0,14761.0,4
CPT,87209,Laboratory Services,505.81,328.78,135.22,135.23,2
CPT,87209,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; COMPLEX SPECIAL STAIN (E.G., TRICHROME, IRON HEMOTOXYLIN) FOR OVA AND PARASITES",505.81,328.78,44.1,44.1,2
CPT,87209,"SMEAR, PRIMARY SOURCE WITH INTERPRETATIONS; COMPLEX SPECIAL STAIN FOR OVA AND PARASITES ï",505.81,328.78,153.51,244.49,2
CPT,87210,HB LAB WETMT FUNG UNSPC,429.64,279.27,13270.0,14761.0,2
CPT,87210,Laboratory Services,429.64,279.27,32.14,32.14,2
CPT,87210,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; WET MOUNT FOR INFECTIOUS AGENTS (E.G., SALINE, INDIA INK, KOH PREPS)",429.64,279.27,14.14,14.14,2
CPT,87210,"SMEAR,PRIMARY SOURCE,WITH INTERPRETATION;WET MOUNT FOR INFECTIOUS AGENTS(EG,SALINE,INDIAINK,KOH PREPS)",429.64,279.27,37.28,59.37,2
CPT,87220,Laboratory Services,,,32.14,32.14,2
CPT,87220,"TISSUE EXAMINATION BY KOH SLIDE OF SAMPLES FROM SKIN, HAIR, OR NAILS FORFUNGI OR ECTOPARASITE OVA OR MITES (E.G., SCABIES)",,,10.82,10.82,2
CPT,87220,"TISSUE EXAMINATION BY KOH SLIDE)OF SAMPLES FROM SKIN, HAIR OR NAILS FOR FUNGI,ECTOPARASITE OVA OR MITES(EG, SCABIES)",,,37.28,59.37,2
CPT,87230,Laboratory Services,,,148.55,148.56,2
CPT,87230,"TOXIN OR ANTITOXIN ASSAY, TISSUE CULTURE (E.G., CLOSTRIDIUM DIFFICILE TOXIN)",,,48.26,48.26,2
CPT,87230,"TOXIN OR ANTITOXIN ASSAY, TISSUE CULTURE (EG, CLOSTRIDIUM DIFFICILE TOXIN)",,,172.45,274.64,2
CPT,87250,Laboratory Services,,,147.1,147.12,2
CPT,87250,"VIRUS ISOLATION; INOCULATION OF EMBRYONATED EGGS, OR SMALL ANIMAL, INCLUDES OBSERVATION AND DISSECTION",,,48.26,48.26,2
CPT,87250,"VIRUS ISOLATION;INOCULATION OF EMBRYONATED EGGS, OR SMALL ANIMAL,INCLUDES OBSERVATION AND DISSECTION",,,170.74,271.92,2
CPT,87252,"HB LAB VIRUS INOCULATION, TISSUE",251.0,163.15,13270.0,14761.0,2
CPT,87252,HB MISC LAB SPECIAL TEST,251.0,163.15,13270.0,14761.0,2
CPT,87252,Laboratory Services,251.0,163.15,196.09,196.11,2
CPT,87252,VIRUS IDENTIFICATION; TISSUE CULTURE INOCULATION OBSERVATIONAND PRESUMPTIVE IDENTIFICATION BY CYTOPATHIC EFFECT,251.0,163.15,227.65,362.56,2
CPT,87252,"VIRUS ISOLATION; TISSUE CULTURE INOCULATION, OBSERVATION, AND PRESUMPTIVE IDENTIFICATION BY CYTOPATHIC EFFECT",251.0,163.15,64.07,64.07,2
CPT,87253,HB POLIOVIRUS INNOC STUDY,89.0,57.85,,,0
CPT,87253,Laboratory Services,89.0,57.85,151.94,151.96,2
CPT,87253,"VIRUS IDENTIFICATION; TISSUE CULTURE, ADDITIONAL STUDIES OR IDENTIFICATION(EG,HEMABSORPTION,NEUTRALIZATION)EACH ISOLATE",89.0,57.85,74.14,118.08,2
CPT,87253,"VIRUS ISOLATION; TISSUE CULTURE, ADDITIONAL STUDIES OR DEFINITIVE IDENTIFICATION (E.G., HEMABSORPTION, NEUTRALIZATION, IMMUNOFLUORESENCE STAIN), EACH ISOLATE",89.0,57.85,49.92,49.92,2
CPT,87254,"HB LAB VIRUS INOCULATION, SHELL V",418.77,272.2,13270.0,14761.0,2
CPT,87254,HB MISC LAB SPECIAL TEST,418.77,272.2,13270.0,14761.0,2
CPT,87254,Laboratory Services,418.77,272.2,147.1,147.12,2
CPT,87254,"VIRUS ISOLATION; CENTRIFUGE ENHANCED (SHELL VIAL) TECHNIQUE, INCLUDES IDENTIFICATION WITH IMMUNOFLUORESCENCE STAIN, EACH VIRUS",418.77,272.2,48.26,48.26,2
CPT,87254,"VIRUS ISOLATION; CENTRIFUGE ENHANCED (SHELL VIAL) TECHNIQUE,INCL IDENTIFICATION W/ IMMUNOFLUORESCENCE STAIN, EACH VIRUS",418.77,272.2,42.69,67.98,2
CPT,87255,Laboratory Services,764.44,496.89,254.77,254.8,2
CPT,87255,"VIRUS ISOLATION, INCLUDING IDENTIFICATION BY NON IMMUNOLOGICOTHER THAN BY CYTOPATHIC EFFECT",764.44,496.89,295.68,470.9,2
CPT,87255,"VIRUS ISOLATION; INCLUDING IDENTIFICATION BY NON-IMMUNOLOGIC METHOD, OTHER THAN BY CYTOPATHIC EFFECT (E.G., VIRUS SPECIFIC ENZYMATIC ACTIVITY",764.44,496.89,83.2,83.2,2
CPT,87260,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; ADENOVIRUS,189.94,123.46,35.77,125.01,4
CPT,87260,Laboratory Services,189.94,123.46,69.87,69.88,2
CPT,87265,INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE BORDETELLA PERTUSSIS/PARAPERTUSSIS,,,78.49,125.01,2
CPT,87265,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; BORDETELLA PERTUSSIS/PARAPERTUSSIS,,,29.12,29.12,2
CPT,87265,Laboratory Services,,,69.87,69.88,2
CPT,87267,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHENTEROVIRUS,",,,79.37,126.41,2
CPT,87267,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA)",,,33.29,33.29,2
CPT,87267,Laboratory Services,,,69.87,69.88,2
CPT,87269,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; GIARDIA,293.73,190.92,33.29,33.29,2
CPT,87269,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUOROSCENT TECHNIQUE; GIARDIA,293.73,190.92,81.43,129.69,2
CPT,87269,Laboratory Services,293.73,190.92,69.87,69.88,2
CPT,87270,INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE CHLAMYDIA TRACHOMATIS,,,78.49,125.01,2
CPT,87270,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; CHLAMYDIA TRACHOMATIS,,,29.12,29.12,2
CPT,87270,Laboratory Services,,,69.87,69.88,2
CPT,87271,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE: CYTOMEGALOVIRUS,",205.17,133.36,79.37,126.41,2
CPT,87271,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA)",205.17,133.36,33.29,33.29,2
CPT,87271,Laboratory Services,205.17,133.36,69.87,69.88,2
CPT,87272,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; CRYPTOSPORIDIUM,293.73,190.92,29.12,125.01,4
CPT,87272,Laboratory Services,293.73,190.92,69.87,69.88,2
CPT,87273,HERPES SIMPLEX VIRUS TYPE 2,386.15,251.0,81.08,129.13,2
CPT,87273,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; HERPES SIMPLEX VIRUS TYPE 2,386.15,251.0,29.12,29.12,2
CPT,87273,Laboratory Services,386.15,251.0,69.87,69.88,2
CPT,87274,INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE HERPES SIMPLEX VIRUS TYPE 1,386.15,251.0,78.49,125.01,2
CPT,87274,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; HERPES SIMPLEX VIRUS TYPE 1,386.15,251.0,29.12,29.12,2
CPT,87274,Laboratory Services,386.15,251.0,69.87,69.88,2
CPT,87275,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS,,,29.95,29.95,2
CPT,87275,INFLUENZA B VIRUS,,,81.08,129.13,2
CPT,87275,Laboratory Services,,,69.87,69.88,2
CPT,87276,INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE INFLUENZE A VIRUS,202.93,131.9,78.49,125.01,2
CPT,87276,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA A VIRUS,202.93,131.9,39.11,39.11,2
CPT,87276,Laboratory Services,202.93,131.9,69.87,69.88,2
CPT,87278,INFACTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE; LEGIONELLA PNEUMOPHILA,,,78.49,125.01,2
CPT,87278,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; LEGIONELLA PNEUMOPHILA,,,38.27,38.27,2
CPT,87278,Laboratory Services,,,69.87,69.88,2
CPT,87279,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PARAINFLUENZA VIRUS, EACH TYPE",,,39.94,39.94,2
CPT,87279,Laboratory Services,,,69.87,69.88,2
CPT,87279,"PARAINFLUENZA VIRUS, EACH TYPE",,,81.08,129.13,2
CPT,87280,INFACTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE; RESPIRATORY SYNCYTIAL VIRUS,202.93,131.9,78.49,125.01,2
CPT,87280,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; RESPIRATORY SYNCYTIAL VIRUS,202.93,131.9,33.29,33.29,2
CPT,87280,Laboratory Services,202.93,131.9,69.87,69.88,2
CPT,87281,HB LAB PNEUMOCYSTIS DFA,707.09,459.61,13270.0,14761.0,2
CPT,87281,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PNEUMOCYSTIS CARINII,707.09,459.61,29.12,29.12,2
CPT,87281,Laboratory Services,707.09,459.61,69.87,69.88,2
CPT,87281,PNEUMOCYSTIS CARINII,707.09,459.61,81.08,129.13,2
CPT,87283,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; RUBEOLA,,,148.94,148.94,2
CPT,87283,Laboratory Services,,,69.87,69.88,2
CPT,87283,RUBEOLA,,,81.08,129.13,2
CPT,87285,"INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE, TREPONEMA PALLIDUM",,,78.49,125.01,2
CPT,87285,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; TREPONEMA PALLIDUM,,,29.95,29.95,2
CPT,87285,Laboratory Services,,,69.87,69.88,2
CPT,87290,HB LAB VARICELLA ZOSTER DFA,486.26,316.07,,,0
CPT,87290,INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLOURESCENT ANTIBODY TECHNIQUE; VARICELLA ZOSTER VIRUS,486.26,316.07,78.49,125.01,2
CPT,87290,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; VARICELLA ZOSTER VIRUS,486.26,316.07,33.29,33.29,2
CPT,87290,Laboratory Services,486.26,316.07,69.87,69.88,2
CPT,87299,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; NOT OTHERWISE SPECIFIED, EACH ORGANISM",231.26,150.32,39.94,39.94,2
CPT,87299,Laboratory Services,231.26,150.32,69.87,69.88,2
CPT,87299,"NOT OTHERWISE SPECIFIED, EACH ORGANISM",231.26,150.32,78.49,125.01,2
CPT,87300,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE, POLYVALENT FOR MULTIPLE ORGANISMS, EACH POLYVALENT ANTISERUM",,,29.12,29.12,2
CPT,87300,"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHPOLYVALENT FOR MULTIPLE ORGANISMS,EA POLYVALENT ANTISERUM",,,40.57,64.61,2
CPT,87300,Laboratory Services,,,69.87,69.88,2
CPT,87301,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, MULTIPLE STEP METHOD; ADENOVIRUS ENTERIC TYPES 40/41",,,78.49,125.01,2
CPT,87301,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ADENOVIRUS ENTERIC TYPES 40/41",,,29.12,29.12,2
CPT,87301,Laboratory Services,,,69.87,69.88,2
CPT,87305,HB ASPERGILLUS ANTIGEN,45.0,29.25,13270.0,14761.0,4
CPT,87305,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE-STEP METHO",45.0,29.25,79.37,126.41,2
CPT,87305,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE-STEP METHOD; ASPERGILLUS",45.0,29.25,29.12,29.12,2
CPT,87305,Laboratory Services,45.0,29.25,69.87,69.88,2
CPT,87320,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHO",,,78.49,125.01,2
CPT,87320,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CHLAMYDIA TRACHOMATIS",,,36.61,36.61,2
CPT,87320,Laboratory Services,,,69.87,69.88,2
CPT,87324,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CLOSTRIDIUM DIFFICILE TOXIN(S)",,,29.12,29.12,2
CPT,87324,INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE; CLOSTRIDIUM DIFFICILE TOXIN,,,78.49,125.01,2
CPT,87324,Laboratory Services,,,69.87,69.88,2
CPT,87327,CYRPTOCOCCUS NEOFORMANS,676.2,439.53,81.08,129.13,2
CPT,87327,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CRYPTOCOCCUS NEOFORMANS",676.2,439.53,33.29,33.29,2
CPT,87327,Laboratory Services,676.2,439.53,69.87,69.88,2
CPT,87328,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUALITATIVE, CRYPTOSPORIDUM",943.63,613.36,78.49,125.01,2
CPT,87328,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CRYPTOSPORIDIUM",943.63,613.36,34.12,34.12,2
CPT,87328,Laboratory Services,943.63,613.36,69.87,69.88,2
CPT,87329,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,87329,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP ME",,,81.43,129.69,2
CPT,87329,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; GIARDIA",,,29.12,29.12,2
CPT,87329,Laboratory Services,,,69.87,69.88,2
CPT,87332,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, CRYTOMEGALOVIRUS",,,78.49,125.01,2
CPT,87332,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CYTOMEGALOVIRUS",,,29.12,29.12,2
CPT,87332,Laboratory Services,,,69.87,69.88,2
CPT,87335,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, ESCHERICHIA COLI",,,78.49,125.01,2
CPT,87335,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ESCHERICHIA COLI 157",,,30.79,30.79,2
CPT,87335,Laboratory Services,,,69.87,69.88,2
CPT,87336,ETANMOEBA HISTOLTICA DISPAR GROUP,,,81.08,129.13,2
CPT,87336,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ENTAMOEBA HISTOLYTICA DISPAR GROUP",,,39.11,39.11,2
CPT,87336,Laboratory Services,,,69.87,69.88,2
CPT,87337,ENTAMOEBA HISTOLYTICA GROUP,32.81,21.33,81.08,129.13,2
CPT,87337,HB E. HISTOLYTICA AG,32.81,21.33,13270.0,14761.0,2
CPT,87337,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ENTAMOEBA HISTOLYTICA GROUP",32.81,21.33,29.12,29.12,2
CPT,87337,Laboratory Services,32.81,21.33,69.87,69.88,2
CPT,87338,HB LAB H. PYLORI STOOL AG EIA,438.61,285.1,13270.0,14761.0,2
CPT,87338,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHO",438.61,285.1,139.23,221.73,2
CPT,87338,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HELICOBACTER PYLORI, STOOL",438.61,285.1,34.94,34.94,2
CPT,87338,Laboratory Services,438.61,285.1,108.17,108.18,2
CPT,87339,HELICOBACTER PYLORI,209.6,136.24,81.08,129.13,2
CPT,87339,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HELICOBACTER PYLORI",209.6,136.24,39.11,39.11,2
CPT,87339,Laboratory Services,209.6,136.24,69.87,69.88,2
CPT,87340,HB LAB HEP B S ANTIG,350.83,228.04,13270.0,14761.0,2
CPT,87340,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HEPATITIS B SURFACE",350.83,228.04,87.25,138.96,2
CPT,87340,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS B SURFACE ANTIGEN (HBSAG)",350.83,228.04,24.96,24.96,2
CPT,87340,Laboratory Services,350.83,228.04,77.67,77.68,2
CPT,87341,HB LAB HBSAG CONFIRMATION,1204.7,783.06,13270.0,14761.0,2
CPT,87341,HEPATITIS B SURFACE ANTIGEN NEUTRALIZATION,1204.7,783.06,90.13,143.55,2
CPT,87341,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS B SURFACE ANTIGEN (HBSAG) NEUTRALIZATION",1204.7,783.06,24.96,24.96,2
CPT,87341,Laboratory Services,1204.7,783.06,77.67,77.68,2
CPT,87350,HB HEPATITIS BE ANTIGEN,7.72,5.02,13270.0,14761.0,4
CPT,87350,HB MISC LAB SPECIAL TEST,7.72,5.02,,,0
CPT,87350,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS BE ANTIGEN (HBEAG)",7.72,5.02,28.29,28.29,2
CPT,87350,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOSSAT TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HEPATITIS B ANTIGEN",7.72,5.02,97.36,155.06,2
CPT,87350,Laboratory Services,7.72,5.02,86.73,86.74,2
CPT,87380,HB HEPATITIS DELTA ANTIGEN,125.0,81.25,13270.0,14761.0,2
CPT,87380,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HEPATITIS, DELTA AGT",125.0,81.25,138.76,220.98,2
CPT,87380,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS, DELTA AGENT",125.0,81.25,44.93,44.93,2
CPT,87380,Laboratory Services,125.0,81.25,123.52,123.53,2
CPT,87385,HB MISC LAB SPECIAL TEST,58.13,37.78,13270.0,14761.0,8
CPT,87385,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HISTOPLASMA CAPSULAT",58.13,37.78,78.49,125.01,2
CPT,87385,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HISTOPLASMA CAPSULATUM",58.13,37.78,32.45,32.45,2
CPT,87385,Laboratory Services,58.13,37.78,69.87,69.88,2
CPT,87389,HB LAB HIV AG/AB COMBO,453.25,294.61,13270.0,14761.0,2
CPT,87389,HB MISC LAB SPECIAL TEST,453.25,294.61,,,0
CPT,87389,HIV-1 AG W/HIV-1 & HIV-2 AB,453.25,294.61,59.07,59.07,2
CPT,87389,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE-STEP",453.25,294.61,175.31,279.2,2
CPT,87389,Laboratory Services,453.25,294.61,182.38,182.4,2
CPT,87390,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HIV-1",,,149.1,237.46,2
CPT,87390,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HIV-1",,,59.07,59.07,2
CPT,87390,Laboratory Services,,,132.76,132.78,2
CPT,87391,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HIV-2",,,149.1,237.46,2
CPT,87391,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HIV-2",,,54.08,54.08,2
CPT,87391,Laboratory Services,,,132.76,132.78,2
CPT,87400,HB LAB INFLUENZA B MEMBRANE EIA,481.37,312.89,13270.0,14761.0,4
CPT,87400,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; INFLUENZA, A OR B, EACH",481.37,312.89,34.94,34.94,2
CPT,87400,"INFLUENZA, A OR B, EACH",481.37,312.89,40.57,64.61,2
CPT,87400,Laboratory Services,481.37,312.89,69.87,69.88,2
CPT,87420,HB LAB RSVMEMBRANE EIA,788.64,512.62,13270.0,14761.0,4
CPT,87420,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, RESPIRATORY SYNCYTIA",788.64,512.62,78.49,125.01,2
CPT,87420,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; RESPIRATORY SYNCYTIAL VIRUS",788.64,512.62,34.12,34.12,2
CPT,87420,Laboratory Services,788.64,512.62,69.87,69.88,2
CPT,87425,HB MISC LAB SPECIAL TEST,1011.63,657.56,,,0
CPT,87425,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENQYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, ROTAVIRUS",1011.63,657.56,78.49,125.01,2
CPT,87425,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ROTAVIRUS",1011.63,657.56,29.12,29.12,2
CPT,87425,Laboratory Services,1011.63,657.56,69.87,69.88,2
CPT,87426,HB SARSCOV2 ANTIGEN TEST RESPIRATORY,879.8,571.87,13270.0,14761.0,2
CPT,87426,"Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantita",879.8,571.87,158.69,252.73,2
CPT,87426,Laboratory Services,879.8,571.87,284.46,284.48,2
CPT,87427,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; SHIGA-LIKE TOXIN",500.4,325.26,29.12,29.12,2
CPT,87427,Laboratory Services,500.4,325.26,69.87,69.88,2
CPT,87427,SHIGA-LIKE TOXIN,500.4,325.26,81.08,129.13,2
CPT,87428,"Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IM",,,200.37,319.11,2
CPT,87430,HB LAB RAPID STREP GROUP A,263.8,171.47,13270.0,14761.0,2
CPT,87430,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE; STREPTOCOCCUS GRP A",263.8,171.47,78.49,125.01,2
CPT,87430,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; STREPTOCOCCUS, GROUP A",263.8,171.47,41.61,41.61,2
CPT,87430,Laboratory Services,263.8,171.47,69.87,69.88,2
CPT,87449,HB MISC LAB SPECIAL TEST,70.0,45.5,13270.0,14761.0,8
CPT,87449,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE STEP METHOD, NOT OTHERWISE SPECIFIED, EACH ORGANISM",70.0,45.5,29.12,29.12,2
CPT,87449,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, MULTIPLE STEP METHOD",70.0,45.5,78.49,125.01,2
CPT,87449,Laboratory Services,70.0,45.5,69.87,69.88,2
CPT,87450,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, SINGLE STEP METHOD",,,63.32,100.85,2
CPT,87451,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE STEP METHOD, POLYVALENT FOR MULTIPLE ORGANISMS, EACH POLYVALENT ANTISERUM",,,25.8,25.8,2
CPT,87451,INFECTIOUS AGENT DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEIMQUANTITATIVE;EACH POLYVALENT ANTISERUM,,,65.44,104.22,2
CPT,87451,Laboratory Services,,,25.66,25.66,2
CPT,87467,"Hepatitis B surface antigen (HBsAg), quantitative",,,36.61,36.61,2
CPT,87467,"Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IM",,,84.78,135.02,2
CPT,87468,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique",,,86.54,314.71,4
CPT,87469,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique",,,86.54,314.71,4
CPT,87471,HB LAB BARTONELLA PCR,120.63,78.41,13270.0,14761.0,4
CPT,87471,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA AND RNA) BARTONELLA HENSELAE AND QUINTANA, AMPLIFIED PROBE TECH",120.63,78.41,296.56,472.31,2
CPT,87471,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); BARTONELLA HENSELAE AND BARTONELLA QUINTANA, AMPLIFIED PROBE TECHNIQUE",120.63,78.41,86.54,86.54,2
CPT,87471,Laboratory Services,120.63,78.41,264.02,264.04,2
CPT,87472,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA AND RNA) BARTONELLA HENSELAE AND QUINTANA, QUANTIFICATION",,,225.95,359.85,2
CPT,87472,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); BARTONELLA HENSELAE AND BARTONELLA QUINTANA, QUANTIFICATION",,,104.83,104.83,2
CPT,87472,Laboratory Services,,,322.25,322.29,2
CPT,87475,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA AND RNA) BORRELIA BURGDORFERI, DIRECT PROBE TECHNIQUE",,,169.45,269.86,2
CPT,87475,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); BORRELIA BURGDORFERI, DIRECT PROBE TECHNIQUE",,,49.09,49.09,2
CPT,87475,Laboratory Services,,,150.88,150.89,2
CPT,87476,HB BORRELIA BURGDORFERI DNA,226.78,147.41,13270.0,14761.0,4
CPT,87476,HB MISC LAB SPECIAL TEST,226.78,147.41,,,0
CPT,87476,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNIQUE",226.78,147.41,296.56,472.31,2
CPT,87476,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNIQUE",226.78,147.41,86.54,86.54,2
CPT,87476,Laboratory Services,226.78,147.41,264.02,264.04,2
CPT,87478,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique",,,86.54,314.71,4
CPT,87480,HB LAB DNA PROBE CANDIDA SP,438.11,284.77,13270.0,14761.0,2
CPT,87480,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CANDIDA SPECIES DIRECT PROBE TECHNIQUE,438.11,284.77,169.45,269.86,2
CPT,87480,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, DIRECT PROBE TECHNIQUE",438.11,284.77,49.09,49.09,2
CPT,87480,Laboratory Services,438.11,284.77,150.88,150.89,2
CPT,87481,HB MISC LAB SPECIAL TEST,535.86,348.31,,,0
CPT,87481,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CANDIDA SPECIFIES AMPLIFIED PROBE TECHNIQUE,535.86,348.31,296.56,472.31,2
CPT,87481,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE",535.86,348.31,86.54,86.54,2
CPT,87481,Laboratory Services,535.86,348.31,264.02,264.04,2
CPT,87482,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CANDIDA SPECIES QUANTIFICATION,,,225.95,359.85,2
CPT,87482,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, QUANTIFICATION",,,136.45,136.45,2
CPT,87482,Laboratory Services,,,314.08,314.11,2
CPT,87483,HB MENINGITIS ENCEPHALITIS PCR PANEL,7361.88,4785.22,13270.0,14761.0,2
CPT,87483,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenza, E. Coli, Streptococcus ",7361.88,4785.22,3112.2,4956.49,2
CPT,87483,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",7361.88,4785.22,1023.41,1023.41,2
CPT,87483,Laboratory Services,7361.88,4785.22,3056.26,3056.56,2
CPT,87484,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique",,,86.54,314.71,4
CPT,87485,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA PNEUMONIAE DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87485,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, DIRECT PROBE TECHNIQUE",,,49.09,49.09,2
CPT,87485,Laboratory Services,,,150.88,150.89,2
CPT,87486,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TECHNIQUE,597.23,388.2,296.56,472.31,2
CPT,87486,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE",597.23,388.2,86.54,86.54,2
CPT,87486,Laboratory Services,597.23,388.2,264.02,264.04,2
CPT,87487,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA PNEUMONIAE QUANTIFICATION,,,225.95,359.85,2
CPT,87487,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, QUANTIFICATION",,,104.83,104.83,2
CPT,87487,Laboratory Services,,,322.25,322.29,2
CPT,87490,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA TRACHOMATIS DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87490,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, DIRECT PROBE TECHNIQUE",,,55.75,55.75,2
CPT,87490,Laboratory Services,,,150.88,150.89,2
CPT,87491,HB CHLAMYDIA BY AMPLIFICATION,532.58,346.17,13270.0,14761.0,2
CPT,87491,"HB LAB C TRACH/GC, TMA A",532.58,346.17,,,0
CPT,87491,HB MISC LAB SPECIAL TEST,532.58,346.17,,,0
CPT,87491,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TECHNIQUE,532.58,346.17,296.56,472.31,2
CPT,87491,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE",532.58,346.17,86.54,86.54,2
CPT,87491,Laboratory Services,532.58,346.17,264.02,264.04,2
CPT,87492,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA TRACHOMATIS QUANTIFICATION,,,225.95,359.85,2
CPT,87492,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, QUANTIFICATION",,,131.46,131.46,2
CPT,87492,Laboratory Services,,,263.01,263.04,2
CPT,87493,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID ( DNA OR RNA); CLOSTRIDIUM DIFFICILE, TOXIN GENE(S), AMPLIFIED PROBE TECHNIQUE",,,91.52,91.52,2
CPT,87493,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CLOSTRIDIUM DIFFICILE, TOXIN GENE(S), AMPLIFIED PROBE TECHNIQUE",,,383.93,611.45,2
CPT,87493,Laboratory Services,,,264.02,264.04,2
CPT,87495,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CYTOMEGALOVIRUS DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87495,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CYTOMEGALOVIRUS, DIRECT PROBE TECHNIQUE",,,74.05,74.05,2
CPT,87495,Laboratory Services,,,150.88,150.89,2
CPT,87496,"HB CYTOMEGALOVIRUS (CMV)-PCR, QUAL",1607.36,1044.78,13270.0,14761.0,2
CPT,87496,HB MISC LAB SPECIAL TEST,1607.36,1044.78,13270.0,14761.0,4
CPT,87496,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CYTOMEGALOVIRUS AMPLIFIED PROBE TECHNIQUE,1607.36,1044.78,296.56,472.31,2
CPT,87496,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CYTOMEGALOVIRUS, AMPLIFIED PROBE TECHNIQUE",1607.36,1044.78,86.54,86.54,2
CPT,87496,Laboratory Services,1607.36,1044.78,264.02,264.04,2
CPT,87497,"HB CYTOMEGALOVIRUS (CMV)-PCR, QUANT",2226.24,1447.05,13270.0,14761.0,2
CPT,87497,HB MISC LAB SPECIAL TEST,2226.24,1447.05,13270.0,14761.0,2
CPT,87497,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CYTOMEGALOVIRUS QUANTIFICATION,2226.24,1447.05,225.95,359.85,2
CPT,87497,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CYTOMEGALOVIRUS, QUANTIFICATION",2226.24,1447.05,104.83,104.83,2
CPT,87497,Laboratory Services,2226.24,1447.05,322.25,322.29,2
CPT,87498,HB LAB ENTEROVIRUS AMP PROBE,791.27,514.32,13270.0,14761.0,2
CPT,87498,HB MISC LAB SPECIAL TEST,791.27,514.32,13270.0,14761.0,8
CPT,87498,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); ENTEROVIRUS, AMPLIFIED PROBE TECHNIQUE",791.27,514.32,86.54,86.54,2
CPT,87498,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); ENTEROVIRUS, AMPLIFIED PROBE TECHNIQUE ï",791.27,514.32,299.85,477.55,2
CPT,87498,Laboratory Services,791.27,514.32,264.02,264.04,2
CPT,87499,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,87500,HB RIF MARKER,740.56,481.36,13270.0,14761.0,2
CPT,87500,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); VANCOMYCIN RESISTANCE (EG, ENTEROCOCCUS SPECIES VAN A, VAN B), AMPLIFIED PROBE TECHNIQUE",740.56,481.36,86.54,86.54,2
CPT,87500,"INFECTIOUS AGENT DETECTION, BY NUCLEIC ACID (DNA OR RNA); VANCOMYCIN RESISTENCE",740.56,481.36,306.5,488.13,2
CPT,87500,Laboratory Services,740.56,481.36,264.02,264.04,2
CPT,87501,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECH",,,362.93,578.0,2
CPT,87501,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE, EACH TYPE OR SUBTYPE",,,125.64,125.64,2
CPT,87501,Laboratory Services,,,386.09,386.13,2
CPT,87502,HB LAB INFLUENZA A-B PCR,91.68,59.59,13270.0,14761.0,2
CPT,87502,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, REVERSE TRANS",91.68,59.59,601.8,958.42,2
CPT,87502,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE, FIRST 2 TYPES OR SUB-TYPES",91.68,59.59,235.46,235.46,2
CPT,87502,Laboratory Services,91.68,59.59,640.17,640.23,2
CPT,87503,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, AMPLIFIED PR",379.54,246.7,146.81,233.81,2
CPT,87503,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, MULTIPLEX REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE, EACH ADDITIONAL INFLUENZA VIRU",379.54,246.7,71.56,71.56,2
CPT,87503,Laboratory Services,379.54,246.7,156.22,156.24,2
CPT,87505,HB LAB ENTERIC BACTERIA PCR,2157.44,1402.34,13270.0,14761.0,2
CPT,87505,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",2157.44,1402.34,315.34,315.34,2
CPT,87505,Laboratory Services,2157.44,1402.34,933.24,933.33,2
CPT,87505,Nfct agent detection gi,2157.44,1402.34,858.41,1367.1,2
CPT,87506,HB EXT ENTERIC BACT PCR 8 TARGET,3363.94,2186.56,13270.0,14761.0,2
CPT,87506,Iadna-dna/rna probe tq 6-11,3363.94,2186.56,1428.07,2274.35,2
CPT,87506,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",3363.94,2186.56,645.67,645.67,2
CPT,87506,Laboratory Services,3363.94,2186.56,1552.66,1552.81,2
CPT,87507,Iadna-dna/rna probe tq 12-25,,,2788.76,4441.39,2
CPT,87507,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,1023.41,1023.41,2
CPT,87507,Laboratory Services,,,3031.98,3032.28,2
CPT,87510,HB LAB DNA PROBE GARD VAGINALIS,438.11,284.77,13270.0,14761.0,2
CPT,87510,"INFECTIOUS AGENT DETECTION BY NUCIECI ACID; GARDNERELLA VAGINALIS, DIRECT PROBE TECHNIQUE",438.11,284.77,169.45,269.86,2
CPT,87510,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, DIRECT PROBE TECHNIQUE",438.11,284.77,49.09,49.09,2
CPT,87510,Laboratory Services,438.11,284.77,150.88,150.89,2
CPT,87511,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID GARDNERELLA VAGINALIS; AMPLIFIED PROBE TECHNIQUE,,,296.56,472.31,2
CPT,87511,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, AMPLIFIED PROBE TECHNIQUE",,,86.54,86.54,2
CPT,87511,Laboratory Services,,,264.02,264.04,2
CPT,87512,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID GARDNERELLA VAGINALIS; QUANTIFICATION,,,225.95,359.85,2
CPT,87512,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, QUANTIFICATION",,,102.34,102.34,2
CPT,87512,Laboratory Services,,,314.08,314.11,2
CPT,87516,INFECTIOUS AGENT ANTIGEN BY NUCIECI ACID; HEPATITIS B VIRUS AMPLIFIED,91.68,59.59,296.56,472.31,2
CPT,87516,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS B VIRUS, AMPLIFIED PROBE TECHNIQUE",91.68,59.59,86.54,86.54,2
CPT,87516,Laboratory Services,91.68,59.59,264.02,264.04,2
CPT,87517,HB LAB HEP B RT PCR QUANT,1479.36,961.58,13270.0,14761.0,2
CPT,87517,HB MISC LAB SPECIAL TEST,1479.36,961.58,,,0
CPT,87517,"INFECTIOUS AGENT DETECTION BY NUCIECI ACID; HEPATITIS B VIRUS, QUANTIFICATION",1479.36,961.58,225.95,359.85,2
CPT,87517,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS B VIRUS, QUANTIFICATION",1479.36,961.58,104.83,104.83,2
CPT,87517,Laboratory Services,1479.36,961.58,322.25,322.29,2
CPT,87520,INFECTIOUS AGENT DETECTION BY NUCIECI ACID; HEPATITIS C VIRUS; AMPLIFIED PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87520,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, DIRECT PROBE TECHNIQUE",,,76.55,76.55,2
CPT,87520,Laboratory Services,,,150.88,150.89,2
CPT,87521,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, AMPLIFIED PROBE TECHNIQUE",56.94,37.01,86.54,86.54,2
CPT,87521,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID; HEPATITIS C, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE",56.94,37.01,296.56,472.31,2
CPT,87521,Laboratory Services,56.94,37.01,264.02,264.04,2
CPT,87522,HB LAB HEP C VIR QUANT NUC ACID,1446.73,940.37,13270.0,14761.0,2
CPT,87522,HB MISC LAB SPECIAL TEST,1446.73,940.37,,,0
CPT,87522,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION",1446.73,940.37,104.83,104.83,2
CPT,87522,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID; HEPATITIS C, REVERSE TRANSCRIPTION AND QUANTIFICATION",1446.73,940.37,225.95,359.85,2
CPT,87522,Laboratory Services,1446.73,940.37,322.25,322.29,2
CPT,87525,INFECTIOUS AGENT ASNTIGEN DETECTION BY NUCIECI ACID; HEPATITIS G VIRUS DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87525,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS G, DIRECT PROBE TECHNIQUE",,,73.22,73.22,2
CPT,87525,Laboratory Services,,,150.88,150.89,2
CPT,87526,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HEPATITIS G VIRUS AMPLIFIED PROBE TECHNIQUE,,,296.56,472.31,2
CPT,87526,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS G, AMPLIFIED PROBE TECHNIQUE",,,96.51,96.51,2
CPT,87526,Laboratory Services,,,264.02,264.04,2
CPT,87527,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HEPATITIS G VIRUS, QUANTIFICATION",,,225.95,359.85,2
CPT,87527,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS G, QUANTIFICATION",,,102.34,102.34,2
CPT,87527,Laboratory Services,,,314.08,314.11,2
CPT,87528,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HERPES SIMPLEX VIRUS, DIRECT PROBE TECHNIQUE",,,169.45,269.86,2
CPT,87528,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, DIRECT PROBE TECHNIQUE",,,49.09,49.09,2
CPT,87528,Laboratory Services,,,150.88,150.89,2
CPT,87529,HB LAB HSV PCR 1+2,744.33,483.81,13270.0,14761.0,2
CPT,87529,HB MISC LAB SPECIAL TEST,744.33,483.81,13270.0,14761.0,4
CPT,87529,"INFECTIOUS AENT ANTIGEN DETECTION BY NUCIECI ACID; HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHNIQUE",744.33,483.81,296.56,472.31,2
CPT,87529,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHNIQUE",744.33,483.81,86.54,86.54,2
CPT,87529,Laboratory Services,744.33,483.81,264.02,264.04,2
CPT,87530,"HB HERPES SIMPLEX VIRUS TYPE 1&2-PCR, QUANT",4086.82,2656.43,13270.0,14761.0,2
CPT,87530,HB MISC LAB SPECIAL TEST,4086.82,2656.43,13270.0,14761.0,4
CPT,87530,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HERPES SIMPLEX VIRUS, QUANTIFICATION",4086.82,2656.43,225.95,359.85,2
CPT,87530,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, QUANTIFICATION",4086.82,2656.43,104.83,104.83,2
CPT,87530,Laboratory Services,4086.82,2656.43,322.25,322.29,2
CPT,87531,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HERPES VIRUS -6, DIRECT PROBE TECHNIQUE",,,169.45,269.86,2
CPT,87531,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6,DIRECT PROBE TECHNIQUE",,,142.27,142.27,2
CPT,87531,Laboratory Services,,,150.88,150.89,2
CPT,87532,"HB HERPESVIRUS 6 DNA, PCR",175.44,114.04,13270.0,14761.0,4
CPT,87532,HB MISC LAB SPECIAL TEST,175.44,114.04,13270.0,14761.0,2
CPT,87532,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID HERPES VIRUS-6 AMPLIFIED PROBE TECHNIQUE,175.44,114.04,296.56,472.31,2
CPT,87532,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6,AMPLIFIED PROBE TECHNIQUE",175.44,114.04,86.54,86.54,2
CPT,87532,Laboratory Services,175.44,114.04,264.02,264.04,2
CPT,87533,"HB HV6PQ HHV-6, DNA, QUANT",265.38,172.5,13270.0,14761.0,4
CPT,87533,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HERPES VIRUS-6 QUANTIFICATION,265.38,172.5,225.95,359.85,2
CPT,87533,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6,QUANTIFICATION",265.38,172.5,102.34,102.34,2
CPT,87533,Laboratory Services,265.38,172.5,314.08,314.11,2
CPT,87534,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, DIRECT PROBE TECHNIQUE",,,54.08,54.08,2
CPT,87534,INFECTIOUS ANTIGEN DETECTION BY NUCIECI ACID; HIV-1 DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87534,Laboratory Services,,,150.88,150.89,2
CPT,87535,"HB HIV-1 PROVIRAL DNA, PCR",98.92,64.29,13270.0,14761.0,4
CPT,87535,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, AMPLIFIED PROBE TECHNIQUE",98.92,64.29,86.54,86.54,2
CPT,87535,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID; HIV-1, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE",98.92,64.29,296.56,472.31,2
CPT,87535,Laboratory Services,98.92,64.29,264.02,264.04,2
CPT,87536,"HB HIV-1 RNA, QN PCR, CSF",630.4,409.76,13270.0,14761.0,2
CPT,87536,HB LAB HIV QUANTITATION BY PCR,630.4,409.76,13270.0,14761.0,4
CPT,87536,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION",630.4,409.76,208.84,208.84,2
CPT,87536,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, REVERSE TRANSCRIPTION AND QUANTIFICATION",630.4,409.76,225.95,359.85,2
CPT,87536,Laboratory Services,630.4,409.76,640.17,640.23,2
CPT,87537,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; HIV-2 DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87537,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-2, DIRECT PROBE TECHNIQUE",,,54.08,54.08,2
CPT,87537,Laboratory Services,,,150.88,150.89,2
CPT,87538,HB LAB HIV-2 DNA/RNA PCR QL,84.92,55.2,13270.0,14761.0,2
CPT,87538,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-2, AMPLIFIED PROBE TECHNIQUE",84.92,55.2,86.54,86.54,2
CPT,87538,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-2, REVERSE TRANSCRIPTIONS AND AMPLIFIED PROBE TECHNIQUE",84.92,55.2,296.56,472.31,2
CPT,87538,Laboratory Services,84.92,55.2,264.02,264.04,2
CPT,87539,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-2, QUANTIFICATION",,,143.94,143.94,2
CPT,87539,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-2, REVERSE TRANSCRIPTIONS AND QUANTIFICATION",,,225.95,359.85,2
CPT,87539,Laboratory Services,,,322.25,322.29,2
CPT,87540,HB LAB LEGIONELLA DIRECT,682.59,443.68,13270.0,14761.0,2
CPT,87540,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID LEGIONELLA PNEUMOPHILA, DIRECT PROBE TECHNIQUE",682.59,443.68,169.45,269.86,2
CPT,87540,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, DIRECT PROBE TECHNIQUE",682.59,443.68,49.09,49.09,2
CPT,87540,Laboratory Services,682.59,443.68,150.88,150.89,2
CPT,87541,HB MISC LAB SPECIAL TEST,39.58,25.73,,,0
CPT,87541,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; LEGIONELLA PNEUMOPHILA, AMPLIFIED TECHNIQUE",39.58,25.73,296.56,472.31,2
CPT,87541,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, AMPLIFIED PROBE TECHNIQUE",39.58,25.73,86.54,86.54,2
CPT,87541,Laboratory Services,39.58,25.73,264.02,264.04,2
CPT,87542,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID LEGIONELLA PNEUMOPHILA, QUANTIFICATION",,,225.95,359.85,2
CPT,87542,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, QUANTIFICATION",,,102.34,102.34,2
CPT,87542,Laboratory Services,,,314.08,314.11,2
CPT,87550,"HB LAB AFB DNA PROBE, 1ST ID",438.11,284.77,13270.0,14761.0,4
CPT,87550,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA SPECIES AMPLIFIED PROBE TECHNIQUE,438.11,284.77,169.45,269.86,2
CPT,87550,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, DIRECT PROBE TECHNIQUE",438.11,284.77,49.09,49.09,2
CPT,87550,Laboratory Services,438.11,284.77,150.88,150.89,2
CPT,87551,HB MISC LAB SPECIAL TEST,535.86,348.31,13270.0,14761.0,4
CPT,87551,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA SPECIES AMPLIFIED PROBE TECHNIQUE,535.86,348.31,296.56,472.31,2
CPT,87551,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, AMPLIFIED PROBE TECHNIQUE",535.86,348.31,118.15,118.15,2
CPT,87551,Laboratory Services,535.86,348.31,264.02,264.04,2
CPT,87552,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA SPECIES QUANTIFICATION,,,225.95,359.85,2
CPT,87552,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, QUANTIFICATION",,,104.83,104.83,2
CPT,87552,Laboratory Services,,,322.25,322.29,2
CPT,87555,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; MYCOBACTERIA TUBERCULOSIS, DIRECT PROBE TECHNIQUE",,,169.45,269.86,2
CPT,87555,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOSIS, DIRECT PROBE TECHNIQUE",,,65.73,65.73,2
CPT,87555,Laboratory Services,,,150.88,150.89,2
CPT,87556,HB MISC LAB SPECIAL TEST,535.86,348.31,13270.0,14761.0,8
CPT,87556,HB MTB CMPLX RIFAMPIN PCR RESP,535.86,348.31,13270.0,14761.0,2
CPT,87556,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA TUBERCULOSIS AMPLIFIED PROBE TECHNIQUE,535.86,348.31,296.56,472.31,2
CPT,87556,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOSIS, AMPLIFIED PROBE TECHNIQUE",535.86,348.31,102.34,102.34,2
CPT,87556,Laboratory Services,535.86,348.31,264.02,264.04,2
CPT,87557,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA TUBERCULOSIS QUANTIFICATION,,,225.95,359.85,2
CPT,87557,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOSIS, QUANTIFICATION",,,104.83,104.83,2
CPT,87557,Laboratory Services,,,322.25,322.29,2
CPT,87560,"INFECTIOUS AGENT ANTIFEN DETECTIONBY NUCIECI ACID MYCOBACTERIA AVIUMINTRACELLULARE, DIRECT PROBE TECHNIQUE",,,169.45,269.86,2
CPT,87560,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, DIRECT PROBE TECHNIQUE",,,67.39,67.39,2
CPT,87560,Laboratory Services,,,150.88,150.89,2
CPT,87561,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID; MYCOBACTERIA AVIUMINTRACELLULARE, AMPLIFIED PROBE TECHNIQUE",535.86,348.31,296.56,472.31,2
CPT,87561,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, AMPLIFIED PROBE TECHNIQUE",535.86,348.31,86.54,86.54,2
CPT,87561,Laboratory Services,535.86,348.31,264.02,264.04,2
CPT,87562,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOBACTERIA AVIUMINTRACELLULARE QUANTIFICATION,,,225.95,359.85,2
CPT,87562,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, QUANTIFICATION",,,104.83,104.83,2
CPT,87562,Laboratory Services,,,322.25,322.29,2
CPT,87563,HB MISC LAB SPECIAL TEST,75.0,48.75,13270.0,14761.0,4
CPT,87563,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique",75.0,48.75,86.54,176.69,4
CPT,87563,Laboratory Services,75.0,48.75,187.6,187.62,2
CPT,87580,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOPLASMA PNEUMONIAE DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87580,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, DIRECT PROBE TECHNIQUE",,,49.09,49.09,2
CPT,87580,Laboratory Services,,,150.88,150.89,2
CPT,87581,HB MISC LAB SPECIAL TEST,427.73,278.02,13270.0,14761.0,4
CPT,87581,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOPLASMA PNEUMONIAE AMPLIFIED PROBE TECHNIQUE,427.73,278.02,296.56,472.31,2
CPT,87581,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE",427.73,278.02,86.54,86.54,2
CPT,87581,Laboratory Services,427.73,278.02,264.02,264.04,2
CPT,87582,"INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID MYCOPLASMA PNEUMONIAE, QUANTIFICATION",,,225.95,359.85,2
CPT,87582,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, QUANTIFICATION",,,743.01,743.01,2
CPT,87582,Laboratory Services,,,314.08,314.11,2
CPT,87590,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID NEISSERIA GONORRHOEAE; DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87590,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, DIRECT PROBE TECHNIQUE",,,65.73,65.73,2
CPT,87590,Laboratory Services,,,150.88,150.89,2
CPT,87591,HB GC BY AMPLIFICATION,532.58,346.17,13270.0,14761.0,4
CPT,87591,"HB LAB C TRACH/GC, TMA B",532.58,346.17,,,0
CPT,87591,HB MISC LAB SPECIAL TEST,532.58,346.17,,,0
CPT,87591,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID NEISSERIA GONORRHOEAE AMPLIFIED PROB TECHNIQUE,532.58,346.17,296.56,472.31,2
CPT,87591,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE",532.58,346.17,86.54,86.54,2
CPT,87591,Laboratory Services,532.58,346.17,264.02,264.04,2
CPT,87592,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID NEISSERIA GONORRHOEAE QUANTIFICATION,,,225.95,359.85,2
CPT,87592,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, QUANTIFICATION",,,104.83,104.83,2
CPT,87592,Laboratory Services,,,322.25,322.29,2
CPT,87593,HB MISC LAB SPECIAL TEST,965.69,627.7,,,0
CPT,87593,HB ORTHOPOXVIRUS PCR,965.69,627.7,13270.0,14761.0,2
CPT,87593,"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each",965.69,627.7,125.64,125.64,2
CPT,87593,Laboratory Services,965.69,627.7,322.69,322.73,2
CPT,87623,Hpv low-risk types,,,234.83,373.99,2
CPT,87623,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44)",,,86.54,86.54,2
CPT,87623,Laboratory Services,,,255.34,255.36,2
CPT,87624,HB HPV HIGH-RISK TYPES,535.86,348.31,13270.0,14761.0,2
CPT,87624,Hpv high-risk types,,,234.83,373.99,2
CPT,87624,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)",,,86.54,86.54,2
CPT,87624,Laboratory Services,,,255.34,255.36,2
CPT,87625,Hpv types 16 & 18 only,,,234.83,373.99,2
CPT,87625,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed",,,99.85,99.85,2
CPT,87625,Laboratory Services,,,255.34,255.36,2
CPT,87631,HB RANDOM VIRUSES OF RESPIRATORY TRACT PANEL FLEX,1808.08,1175.25,13270.0,14761.0,2
CPT,87631,"INFECTIOUS AGENT DETECTION BY NUCLEAIC ACID; RESPIRATORY VIRUS, MULTIPLE TYPES OR SUBTYPES, 3-5 TARGETS",1808.08,1175.25,905.74,1442.48,2
CPT,87631,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",1808.08,1175.25,350.29,350.29,2
CPT,87631,Laboratory Services,1808.08,1175.25,942.67,942.77,2
CPT,87632,"INFECTIOUS AGENT DETECTION BY NUCLEAIC ACID; RESPIRATORY VIRUS, MULTIPLE TYPES OR SUBTYPES, 6-11 TARGETS",5147.63,3345.96,1506.86,2399.82,2
CPT,87632,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",5147.63,3345.96,535.0,535.0,2
CPT,87632,Laboratory Services,5147.63,3345.96,1568.25,1568.41,2
CPT,87633,"INFECTIOUS AGENT DETECTION BY NUCLEAIC ACID; RESPIRATORY VIRUS, MULTIPLE TYPES OR SUBTYPES, 12-25 TARGETS",7714.52,5014.44,2942.63,4686.44,2
CPT,87633,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",7714.52,5014.44,1023.41,1023.41,2
CPT,87633,Laboratory Services,7714.52,5014.44,3062.61,3062.91,2
CPT,87634,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique",,,172.24,172.24,2
CPT,87634,Laboratory Services,,,463.26,463.3,2
CPT,87634,Rsv dna/rna amp probe,,,577.78,920.17,2
CPT,87635,HB RAPID COVID-19 PCR ASSAY,508.8,330.72,13270.0,14761.0,2
CPT,87635,HB SARS-COVID-19 DETECTION BY NUCLEIC ACID,508.8,330.72,13270.0,14761.0,4
CPT,87635,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique",508.8,330.72,321.79,512.48,2
CPT,87635,Laboratory Services,508.8,330.72,322.69,322.73,2
CPT,87636,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex ampl",615.82,400.28,397.28,632.71,2
CPT,87637,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, and respirator",879.8,571.87,397.28,632.71,2
CPT,87640,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECHNIQUE",,,86.54,86.54,2
CPT,87640,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECHNIQUE. ï",,,299.85,477.55,2
CPT,87640,Laboratory Services,,,264.02,264.04,2
CPT,87641,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREAUS, METHICILLIN RESISTANT, AMPLIFIED PROBE",,,299.85,477.55,2
CPT,87641,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, METHICILLIN RESISTANT, AMPLIFIED PROBE TECHNIQUE",,,86.54,86.54,2
CPT,87641,Laboratory Services,,,264.02,264.04,2
CPT,87650,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID STEPTOCOCCUS GROUP A DIRECT PROBE TECHNIQUE,,,169.45,269.86,2
CPT,87650,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, DIRECT PROBE TECHNIQUE",,,49.09,49.09,2
CPT,87650,Laboratory Services,,,150.88,150.89,2
CPT,87651,"HB STREP A, PCR IDNOW",949.07,616.9,13270.0,14761.0,2
CPT,87651,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID STREPTOCOCCUS GROUP A AMPLIFIED PROBE TECHNIQUE,949.07,616.9,296.56,472.31,2
CPT,87651,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, AMPLIFIED PROBE TECHNIQUE",949.07,616.9,86.54,86.54,2
CPT,87651,Laboratory Services,949.07,616.9,264.02,264.04,2
CPT,87652,INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID STREPTOCOCCUS GROUP A,,,225.95,359.85,2
CPT,87652,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, QUANTIFICATION",,,102.34,102.34,2
CPT,87652,Laboratory Services,,,314.08,314.11,2
CPT,87653,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TECHNIQUE",,,86.54,86.54,2
CPT,87653,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TECHNIQUE. ï",,,299.85,477.55,2
CPT,87653,Laboratory Services,,,264.02,264.04,2
CPT,87660,HB LAB DNA PROBE TRICH VAGINALIS,454.34,295.32,13270.0,14761.0,2
CPT,87660,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, DIRECT PROBE TECHNIQUE",454.34,295.32,49.09,49.09,2
CPT,87660,Laboratory Services,454.34,295.32,150.88,150.89,2
CPT,87660,"TRICHOMONAS VAGINALIS, DIRECT PROBE TECHNIQUE",454.34,295.32,175.74,279.88,2
CPT,87661,HB MISC LAB SPECIAL TEST,449.47999999999996,292.15999999999997,,,0
CPT,87661,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECHNIQUE",,,86.54,299.7,4
CPT,87661,Laboratory Services,,,255.9,255.93,2
CPT,87662,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique",,,125.64,125.64,2
CPT,87662,Laboratory Services,,,338.67,338.7,2
CPT,87662,Zika virus dna/rna amp probe,,,422.32,672.59,2
CPT,87797,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
CPT,87797,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; DIRECT PROBE TECHNIQUE, EACH ORGANISM",,,74.05,74.05,2
CPT,87797,"INFECTIOUS AGENT DETECTION BY UCIECI ACID NOT OTHERWISE SPECIFIED DIRECT PROBE TECHNIQUE, EACH ORGANISM",,,169.45,269.86,2
CPT,87797,Laboratory Services,,,150.88,150.89,2
CPT,87798,HB C.DIFFICILE TOXIN B PCR,258.02,167.71,13270.0,14761.0,2
CPT,87798,HB MISC LAB SPECIAL TEST,258.02,167.71,13270.0,14761.0,8
CPT,87798,"INFECTIOUS AGENT DETECTION BY NUCIECI ACID AMPLIFIED PROBE TECHNIQUE, EACH ORGANISM",258.02,167.71,296.56,472.31,2
CPT,87798,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE TECHNIQUE, EACH ORGANISM",258.02,167.71,86.54,86.54,2
CPT,87798,Laboratory Services,258.02,167.71,264.02,264.04,2
CPT,87799,"HB EPSTEIN-BARR VIRUS (EBV)-PCR, QUANT",365.65,237.67,13270.0,14761.0,2
CPT,87799,HB MISC LAB SPECIAL TEST,365.65,237.67,13270.0,14761.0,8
CPT,87799,"INFECTIOUS AGENT DETECTION BY NUCIECI ACID, QUANTIFICATION, EACH ORGANISM",365.65,237.67,225.95,359.85,2
CPT,87799,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; QUANTIFICATION, EACH ORGANISM",365.65,237.67,104.83,104.83,2
CPT,87799,Laboratory Services,365.65,237.67,322.25,322.29,2
CPT,87800,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS,DIRECT PROBE TECHNIQUE",,,174.97,278.66,2
CPT,87800,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; DIRECT PROBE(S) TECHNIQUE",,,107.33,107.33,2
CPT,87800,Laboratory Services,,,301.69,301.72,2
CPT,87801,HB MISC LAB SPECIAL TEST,161.12,104.72,13270.0,14761.0,4
CPT,87801,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS, AMPLIFIED PROBE TECHNIQUE",161.12,104.72,306.32,487.85,2
CPT,87801,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECHNIQUE",161.12,104.72,172.24,172.24,2
CPT,87801,Laboratory Services,161.12,104.72,528.03,528.09,2
CPT,87802,"INFECTIOUS AGENT ANTIGENDETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GROUP B",,,78.49,125.01,2
CPT,87802,"Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B",,,31.62,31.62,2
CPT,87802,Laboratory Services,,,69.87,69.88,2
CPT,87803,INFECTIOUS AGENT ANTIGENDETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; CLOSTRIDIUM DIFFICILE TOXIN A,,,78.49,125.01,2
CPT,87803,Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A,,,39.11,39.11,2
CPT,87803,Laboratory Services,,,69.87,69.88,2
CPT,87804,INFECTIOUS AGENT ANTIGENDETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA,353.02,229.46,78.49,125.01,2
CPT,87804,Infectious agent antigen detection by immunoassay with direct optical observation; Influenza,353.02,229.46,40.77,40.77,2
CPT,87804,Laboratory Services,353.02,229.46,69.87,69.88,2
CPT,87806,Hiv antigen w/hiv antibodies,,,161.1,256.57,2
CPT,87806,"Infectious agent antigen detection by immunoassay with direct optical observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies",,,80.7,80.7,2
CPT,87806,Laboratory Services,,,175.15,175.17,2
CPT,87807,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; RESPIRATORY SYNCYTIAL VIRUS,,,32.45,32.45,2
CPT,87807,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH WITH DIRECT OPTICAL OBSERVATION; RESPIRATORY SYNCYTIAL VIRUS,,,79.49,126.6,2
CPT,87807,Laboratory Services,,,69.87,69.88,2
CPT,87808,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; TRICHOMONAS VAGINALIS,,,37.44,37.44,2
CPT,87808,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; TRICHOMONAS VAGINALIS ï,,,79.37,126.41,2
CPT,87808,Laboratory Services,,,69.87,69.88,2
CPT,87809,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; ADENOVIRUS,,,53.25,53.25,2
CPT,87809,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION;ADENOVIRUS,,,81.14,129.22,2
CPT,87809,Laboratory Services,,,69.87,69.88,2
CPT,87810,CHLAMYDIA TRACHOMATIS,,,78.49,125.01,2
CPT,87810,INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; CHLAMYDIA TRACHOMATIS,,,86.54,86.54,2
CPT,87810,Laboratory Services,,,69.87,69.88,2
CPT,87811,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19])",,,37.16,59.18,2
CPT,87850,INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; NEISSERIA GONORRHOEAE,,,59.91,125.01,4
CPT,87850,Laboratory Services,,,69.87,69.88,2
CPT,87880,"INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GROUP A",459.56,298.71,40.77,40.77,2
CPT,87880,INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAOBSERVATION; STREPTOCCUS GROUP A,459.56,298.71,78.49,125.01,2
CPT,87880,Laboratory Services,459.56,298.71,69.87,69.88,2
CPT,87899,HB LAB BINAXNOW MALARIA ANTIGN,200.39,130.25,13270.0,14761.0,2
CPT,87899,INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; NOT OTHERWISE SPECIFIED,200.39,130.25,39.11,125.01,4
CPT,87899,Laboratory Services,200.39,130.25,69.87,69.88,2
CPT,87900,HB LAB HIV PHENO INFECT AG DRG,216.89,140.98,13270.0,14761.0,4
CPT,87900,HB MISC LAB SPECIAL TEST,216.89,140.98,,,0
CPT,87900,INFECTIOUS AGENT DRUG SUSCEPTIBILITY PHENOTYPE PREDICTION USING REGULARLY UPDATED GENOTYPIC BIOINFORMATICS,216.89,140.98,320.33,320.33,2
CPT,87900,INFECTIOUS AGENT DRUG SUSCEPTIBILITY PHENOTYPE PREDICTION USING REGULARLY UPDATED GENOTYPIC BIONFORMATICS ï,216.89,140.98,1113.52,1773.39,2
CPT,87900,Laboratory Services,216.89,140.98,980.53,980.63,2
CPT,87901,HB LAB GENOTYPE DNA HIV REVERSE T,398.44,258.99,13270.0,14761.0,4
CPT,87901,HB MISC LAB SPECIAL TEST,398.44,258.99,,,0
CPT,87901,"INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HIV 1, REVERSE TRANSCRIPTASE AND PROTEASE",398.44,258.99,632.35,632.35,2
CPT,87901,"INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HIV-1, REVERSE TRANSCRIPTASE AND PROTEASE REGIONS",398.44,258.99,2246.85,3578.34,2
CPT,87901,Laboratory Services,398.44,258.99,1936.67,1936.86,2
CPT,87902,HB HCV GENOTYPING,607.95,395.17,13270.0,14761.0,2
CPT,87902,HB HEP C VIR RNA NS3 GENO,607.95,395.17,13270.0,14761.0,4
CPT,87902,INFECTIOUS AGENT GENOTYPEANALYSIS BY NUCLEIC ACID; HEPATITIS C VIRUS,607.95,395.17,2246.85,3578.34,2
CPT,87902,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus,607.95,395.17,632.35,632.35,2
CPT,87902,Laboratory Services,607.95,395.17,1936.67,1936.86,2
CPT,87903,HB LAB PHENOTYPE DNA HIV W/CULT,767.04,498.58,13270.0,14761.0,4
CPT,87903,"INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NEUCLEIC ACID(RNA/DNAWITH DRUG RESISTANCE TISSUE CULTURE ANALYSIS,HIV1,10 DRUGS",767.04,498.58,4264.7,6791.96,2
CPT,87903,"INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA) WITH DRUG RESISTANCE TISSUE CULTURE ANALYSIS, HIV 1; FIRST THROUGH 10 DRUGS TESTED",767.04,498.58,1199.8,1199.8,2
CPT,87903,Laboratory Services,767.04,498.58,3675.92,3676.29,2
CPT,87904,HB LAB PHENOTYPE DNA HIV W/CLT AD,41.14,26.74,13270.0,14761.0,4
CPT,87904,"INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA) WITH DRUG RESISTANCE TISSUE CULTURE ANALYSIS, HIV 1; EACH ADDITIONAL DRUG TESTED (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCE",41.14,26.74,64.07,64.07,2
CPT,87904,INFECTIOUS AGENT PHENOTYPE ANALYSIS; EACH ADDITIONAL DRUG TESTED; BY NUCLEIC ACID WITH DRUG RESISTANCE TISSUE CULTURE AN,41.14,26.74,227.48,362.28,2
CPT,87904,Laboratory Services,41.14,26.74,196.09,196.11,2
CPT,87905,"INFECTIOUS AGENT ENZYMATIC ACTIVITY OTHER THAN VIRUS (EG, SIALIDASE ACTIVITY IN VAGINAL FLUID)",,,29.95,173.04,4
CPT,87905,Laboratory Services,,,91.95,91.96,2
CPT,87906,HB INF AGNT GEN NUC ACID HIV-1,419.86,272.91,13270.0,14761.0,4
CPT,87906,HB MISC LAB SPECIAL TEST,419.86,272.91,,,0
CPT,87906,"INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HIV-1, OTHER REGION (EG, INTEGRASE, FUSION)",419.86,272.91,316.18,1449.77,4
CPT,87906,Laboratory Services,419.86,272.91,968.33,968.43,2
CPT,87910,HB MISC LAB SPECIAL TEST,292.34,190.02,13270.0,14761.0,4
CPT,87910,INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); CYTOMEGALOVIRUS,292.34,190.02,1817.65,2894.79,2
CPT,87910,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus,292.34,190.02,632.35,632.35,2
CPT,87910,Laboratory Services,292.34,190.02,1891.76,1891.95,2
CPT,87912,HB LAB HB5GQ GENOTYPE DNA HEPB,125.0,81.25,13270.0,14761.0,2
CPT,87912,INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HEPATITIS B VIRUS,125.0,81.25,1817.65,2894.79,2
CPT,87912,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus,125.0,81.25,632.35,632.35,2
CPT,87912,Laboratory Services,125.0,81.25,1891.76,1891.95,2
CPT,87913,INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID(DNA/RNA) SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2(SARS-COV-2),,,1449.88,2309.09,2
CPT,87999,Laboratory Services,1960.0,1274.0,,,0
CPT,87999,UNLISTED MICROBIOLOGY PROCEDURE,1960.0,1274.0,,,0
CPT,87999,Unlisted microbiology procedure,1960.0,1274.0,47.64,47.64,2
CPT,88000,Laboratory Services,,,1267.51,1267.63,2
CPT,88000,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITHOUT CNS",,,8.39,8.39,2
CPT,88005,Laboratory Services,,,1480.2,1480.35,2
CPT,88005,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITH BRAIN",,,9.8,9.8,2
CPT,88007,Laboratory Services,,,1551.08,1551.24,2
CPT,88007,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITH BRAIN AND SPINAL CORD",,,10.26,10.26,2
CPT,88012,Laboratory Services,,,1267.51,1267.63,2
CPT,88012,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; INFANT WITH BRAIN",,,8.39,8.39,2
CPT,88014,Laboratory Services,,,1163.36,1163.48,2
CPT,88014,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; STILLBORN OR NEWBORN WITH BRAIN",,,7.69,7.69,2
CPT,88016,Laboratory Services,,,1619.82,1619.99,2
CPT,88016,"NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; MACERATED STILLBORN",,,10.71,10.71,2
CPT,88020,Laboratory Services,,,2184.84,2185.06,2
CPT,88020,"NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITHOUT CNS",,,14.44,14.44,2
CPT,88025,Laboratory Services,,,2113.96,2114.17,2
CPT,88025,"NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITH BRAIN",,,13.99,13.99,2
CPT,88027,Laboratory Services,,,2255.78,2256.0,2
CPT,88027,"NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITH BRAIN AND SPINAL CORD",,,14.92,14.92,2
CPT,88028,Laboratory Services,,,1267.51,1267.63,2
CPT,88028,"NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; INFANT WITH BRAIN",,,8.39,8.39,2
CPT,88029,Laboratory Services,,,1267.51,1267.63,2
CPT,88029,"NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; STILLBORN OR NEWBORN WITH BRAIN",,,8.39,8.39,2
CPT,88036,Laboratory Services,,,633.75,633.82,2
CPT,88036,"NECROPSY (AUTOPSY), LIMITED, GROSS AND/OR MICROSCOPIC; REGIONAL",,,4.19,4.19,2
CPT,88037,Laboratory Services,,,562.81,562.87,2
CPT,88037,"NECROPSY (AUTOPSY), LIMITED, GROSS AND/OR MICROSCOPIC; SINGLE ORGAN",,,3.73,3.73,2
CPT,88040,Laboratory Services,,,3523.22,3523.58,2
CPT,88040,NECROPSY (AUTOPSY); FORENSIC EXAMINATION,,,23.31,23.31,2
CPT,88045,Laboratory Services,,,352.32,352.35,2
CPT,88045,NECROPSY (AUTOPSY); CORONER'S CALL,,,2.32,2.32,2
CPT,88099,Unlisted necropsy (autopsy) procedure,,,47.64,47.64,2
CPT,88104,"CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS WITH INTERPRETATION",543.85,353.5,105.02,105.02,2
CPT,88104,"CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, WITH CENTRIFUGATION EXCEPT CERVICAL OR VAGINAL; SMEARS WITH INTERPRET",543.85,353.5,55.38,88.21,2
CPT,88104,"HB PATHOLOGY FLUID, SMEAR",543.85,353.5,48.87,14761.0,10
CPT,88104,Laboratory Services,543.85,353.5,405.21,405.25,2
CPT,88106,"CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SIMPLE FILTER METHOD W/INTERPRETATION",,,47.86,76.22,2
CPT,88106,"CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SIMPLE FILTER METHOD WITH INTERPRETATION",,,126.14,126.14,2
CPT,88106,Laboratory Services,,,500.49,500.54,2
CPT,88108,"CYTOPATHOLOGY, CONCENTRATION TECHNIQUE, SMEARS AND INTERPRETATION (E.G.,SACCOMANNO TECHNIQUE)",669.5,435.18,109.51,109.51,2
CPT,88108,"CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, WITH CENTRIFUGATION EXCEPT CERVICAL OR VAGINAL; CONCENTRATION TECHNIQ",669.5,435.18,57.56,91.67,2
CPT,88108,"HB PATHOLOGY FLUID, CONCENTRATE",669.5,435.18,48.87,14761.0,10
CPT,88108,Laboratory Services,669.5,435.18,471.68,471.73,2
CPT,88112,"CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (E.G., LIQUID BASED SLIDE PREPARATION METHOD), EXCEPT CERVICAL OR VAGINAL",868.53,564.54,98.69,98.69,2
CPT,88112,"CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITHINTERPRETATION, EXCEPT CERVICAL OR VAGINAL",868.53,564.54,386.11,614.91,2
CPT,88112,"HB PATHOLOGY FLUID, SUREPATH",868.53,564.54,66.53,14761.0,10
CPT,88112,Laboratory Services,868.53,564.54,625.89,625.95,2
CPT,88120,"CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES",,,2645.19,4212.73,2
CPT,88120,"CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL",,,1340.78,1340.78,2
CPT,88120,Laboratory Services,,,2931.04,2931.33,2
CPT,88121,"CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES",3936.51,2558.73,2220.04,3535.64,2
CPT,88121,"CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; USING COMPUTER-ASSISTED TECHNOLOGY",3936.51,2558.73,924.9,924.9,2
CPT,88121,HB LAB UROVYSION,3936.51,2558.73,213.38,14761.0,10
CPT,88121,Laboratory Services,3936.51,2558.73,2476.34,2476.59,2
CPT,88125,"CYTOPATHOLOGY, FORENSIC (E.G., SPERM)",,,36.29,36.29,2
CPT,88125,"CYTOPATHOLOGY, FORENSIC (EG, SPERM)",,,10.17,16.2,2
CPT,88125,Laboratory Services,,,133.71,133.72,2
CPT,88130,Laboratory Services,,,113.2,113.22,2
CPT,88130,SEX CHROMATIN IDENTIFICATION; BARR BODIES,,,44.1,209.28,4
CPT,88140,Laboratory Services,,,60.12,60.13,2
CPT,88140,"SEX CHROMATIN IDENTIFICATION; PERIPHERAL BLOOD SMEAR, POLYMORPHONUCLEAR ''DRUMSTICKS''",,,69.79,111.15,2
CPT,88140,"SEX CHROMATIN IDENTIFICATION; PERIPHERAL BLOOD SMEAR, POLYMORPHONUCLEAR DRUMSTICKS",,,19.97,19.97,2
CPT,88141,"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), REQUIRING INTERPRETATION BY PHYSICIAN",,,31.04,31.04,2
CPT,88141,"CYTOPATHOLOGY, CERVICAL OR VAGINAL;REQUIRING INTERPRETATION BY PHYSICIAN(LIST SPARATELY IN ADDITION TO CODE FOR TECH SER",,,161.75,257.6,2
CPT,88141,Laboratory Services,,,171.82,171.84,2
CPT,88142,"CYTOPATHOLGY, CERVICAL OR VAGINAL COLLECTED IN PRESERVATIVE FLUID AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTEC",319.21,207.49,123.47,196.64,2
CPT,88142,"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION; MANUAL SCREENING UNDER PHYSICIAN SUPERVISION",319.21,207.49,49.92,49.92,2
CPT,88142,HB MISC LAB SPECIAL TEST,319.21,207.49,,,0
CPT,88142,HB PATHOLOGY GYN LIQUID/MAN SCR,319.21,207.49,13270.0,14761.0,2
CPT,88142,Laboratory Services,319.21,207.49,152.39,152.4,2
CPT,88143,"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION; WITH MANUAL SCREENING AND RESCREENING UNDER PHYSICIAN SUPERVISION",,,56.58,56.58,2
CPT,88143,"CYTOPATHOLOGY,CERVICAL/VAGINAL(ANY REPORTING SYSTEM)COLLECT IN PRESERVATIVE FLUID,AUTO THIN LAYER PREP;W MANUAL/RESCREEN",,,135.23,215.37,2
CPT,88143,Laboratory Services,,,114.34,114.35,2
CPT,88147,"CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL; SCREENING BY AUTOMATED SYSTEMUNDER PHYSICIAN SUPERVISION",,,123.98,123.98,2
CPT,88147,"CYTOPATHOLOGY SMEARS,CERVICAL OR VAGINAL;SCREENING BY AUTOMATED SYSTEM UNDER PHYSICIAN SUPERVISION",,,82.31,131.09,2
CPT,88147,Laboratory Services,,,85.66,85.67,2
CPT,88148,"CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL; SCREENING BY AUTOMATED SYSTEMWITH MANUAL RESCREENING UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
CPT,88148,"CYTOPATHOLOGY,SMEARS,CERVICAL OR VAGINAL;SCREENED BY AUTO SYSTEM WITH MANUAL RESCREENING",,,94.07,149.82,2
CPT,88148,Laboratory Services,,,114.34,114.35,2
CPT,88150,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL; MANUAL SCREENING UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
CPT,88150,"CYTOPATHOLOGY, SMEARS, CERVICAL OR VAGINAL (EG, PAPANICOLAOU), UP TO THREE SMEARS; SCREENING BY TECHNICIAN UNDER PHYS",,,45.15,71.91,2
CPT,88150,Laboratory Services,,,79.49,79.5,2
CPT,88152,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL; WITH MANUAL SCREENING AND COMPUTER-ASSISTED RESCREENING UNDER PHYSICIAN SUPERVISION",,,68.23,68.23,2
CPT,88152,"CYTOPATHOLOGY, SMEARS, CERVICAL OR VAGINAL, UP TO THREE SMEARS,W/MANUAL CYTOTECH SCREENING AND AUTOMATED RESCREENING",,,56.91,90.64,2
CPT,88152,Laboratory Services,,,79.49,79.5,2
CPT,88153,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL; WITH MANUAL SCREENING AND RESCREENING UNDER PHYSICIAN SUPERVISION",,,59.07,59.07,2
CPT,88153,"CYTOPATHOLOGY,SLIDES,CERVICAL OR VAGINAL;WITH MANUAL SCREENING AND RESCREENING UNDER PHYSICIAN SUPERVISION",,,56.91,90.64,2
CPT,88153,Laboratory Services,,,79.49,79.5,2
CPT,88155,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL, DEFINITIVE HORMONAL EVALUATION (E.G., MATURATION INDEX, KARYOPYKNOTIC INDEX, ESTROGENIC INDEX) (LIST SEPARATELY IN ADDITION TO CODE(S) FOR OTHER TECHNICAL A",,,35.77,35.77,2
CPT,88155,"CYTOPATHOLOGY, SMEARS, CERVICAL OR VAGINAL (EG, PAPANICOLAOU), UP TO THREE SMEARS; WITH DEFINITIVE HORMONAL EVALUATIO",,,52.33,83.34,2
CPT,88155,Laboratory Services,,,45.09,45.1,2
CPT,88160,"CYTOPATHOLOGY, ANY OTHER SOURCE; SCREENING AND INTERPRETATION",,,42.04,66.95,2
CPT,88160,"CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; SCREENING AND INTERPRETATION",,,123.33,123.33,2
CPT,88160,Laboratory Services,,,336.28,336.31,2
CPT,88161,"CYTOPATHOLOGY, ANY OTHER SOURCE; PREPARATION, SCREENING AND INTERPRETATION",486.73,316.37,45.27,72.1,2
CPT,88161,"CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; PREPARATION, SCREENING AND INTERPRETATION",486.73,316.37,128.32,128.32,2
CPT,88161,HB PATHOLOGY SMEAR PREP/SCR/INT,486.73,316.37,30.49,35.07,8
CPT,88161,Laboratory Services,486.73,316.37,336.28,336.31,2
CPT,88162,"CYTOPATHOLOGY, ANY OTHER SOURCE; EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/OR MULTIPLE STAINS",,,90.07,143.45,2
CPT,88162,"CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/OR MULTIPLE STAINS",,,199.05,199.05,2
CPT,88162,Laboratory Services,,,481.05,481.1,2
CPT,88164,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL (THE BETHESDA SYSTEM); MANUALSCREENING UNDER PHYSICIAN SUPERVISION",350.83,228.04,42.43,42.43,2
CPT,88164,"CYTOPATHOLOGY,SLIDES,CERVICAL OR VAGINAL( BETHESDA SYSTEM) WITH MANUAL SCREENING UNDER PHYSICIAN SUPERVISION",350.83,228.04,45.15,71.91,2
CPT,88164,Laboratory Services,350.83,228.04,79.49,79.5,2
CPT,88165,"CYTOPATHOLOGY, SLIDES CERVICAL OR VAGINAL(BETHESDA SYSTEM) W/MANUAL SCREENING & RESCREENING UNDER PHYSICIAN SUPERVISION",,,56.91,90.64,2
CPT,88165,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL (THE BETHESDA SYSTEM); WITH MANUAL SCREENING AND RESCREENING UNDER PHYSICIAN SUPERVISION",,,104.0,104.0,2
CPT,88165,Laboratory Services,,,79.49,79.5,2
CPT,88166,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL (THE BETHESDA SYSTEM); WITH MANUAL SCREENING AND COMPUTER-ASSISTED RESCREENING UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
CPT,88166,"CYTOPATHOLOGY,SLIDES,CERVICAL OR VAGINAL(BETHESDA SYSTEM); W MANUAL SCREENING&COMPUTER-ASSISTED RESCREEN UNDER PHYS SUP",,,56.91,90.64,2
CPT,88166,Laboratory Services,,,79.49,79.5,2
CPT,88167,"CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL (THE BETHESDA SYSTEM); WITH MANUAL SCREENING AND COMPUTER-ASSISTED RESCREENING USING CELL SELECTION AND REVIEW UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
CPT,88167,"CYTOPATHOLOGY,SLIDES,CERVICAL OR VAGINAL(BETHESDA SYSTEM) W MANUAL SCREENING AND COMPUTER-ASST RESCREEN USING CELL SEL",,,56.91,90.64,2
CPT,88167,Laboratory Services,,,79.49,79.5,2
CPT,88172,"CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY FOR DIAGNOSIS, F",955.55,621.11,90.84,144.67,2
CPT,88172,"CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY OF SPECIMEN(S)",955.55,621.11,51.26,51.26,2
CPT,88172,HB CYTO QUICK STAIN,955.55,621.11,213.38,14761.0,10
CPT,88172,Laboratory Services,955.55,621.11,308.61,308.64,2
CPT,88173,"CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; INTERPRETATION AND REPORT",868.53,564.54,230.01,230.01,2
CPT,88173,EVALUATION OF FINE NEEDLE ASPIRATE WITH OR WITHOUT PREPARATION OF SMEARS; INTERPRETATION AND REPORT,868.53,564.54,95.48,152.07,2
CPT,88173,HB PATHOLOGY FNA INTERP & RPT,868.53,564.54,66.53,14761.0,10
CPT,88173,Laboratory Services,868.53,564.54,847.21,847.29,2
CPT,88174,"CYTOPATHOLOGY, CERVICAL OR VAGINAL COLLECTED IN PRESERVATIVEFLUID, AUTOMATED THIN LAYER PREPARATION; SCREENING BY AUTOMA",,,130.17,207.31,2
CPT,88174,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision",,,62.4,62.4,2
CPT,88174,Laboratory Services,,,160.69,160.7,2
CPT,88175,"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION; WITH SCREENING BY AUTOMATED SYSTEM AND MANUAL RESCREENING OR REVIEW, UNDER",,,65.73,65.73,2
CPT,88175,"CYTOPATHOLOGY, CERVICAL OR VAGINAL; WITH SCREENING BY AUTOMATED SYSTEM AND MANUAL RESCREENING OR REVIEW, UNDER PHYSICIAN",,,176.8,281.57,2
CPT,88175,Laboratory Services,,,199.3,199.32,2
CPT,88177,"CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY FOR DIAGNOSIS, E",178.24,115.86,41.1,65.45,2
CPT,88177,"CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY FOR DIAGNOSIS, EACH SEPARATE ADDITIONAL EVALUATION EPISODE, SAME SITE (LIST SEPARATELY IN ADDITI",178.24,115.86,19.97,19.97,2
CPT,88177,HB CYTOPATH FNA - ADQC 2 SM ST,178.24,115.86,13270.0,14761.0,2
CPT,88177,Laboratory Services,178.24,115.86,166.1,166.11,2
CPT,88182,"FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS",868.53,564.54,302.4,302.4,2
CPT,88182,FLOW CYTOMETRY; CELL CYCLE OR DNA ANALYSIS,868.53,564.54,104.36,166.21,2
CPT,88182,"HB LAB DNA ANAL, TISSUE",868.53,564.54,66.53,14761.0,10
CPT,88182,Laboratory Services,868.53,564.54,647.34,647.4,2
CPT,88184,"FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; FIRST MARKER",1281.0,832.65,184.07,184.07,2
CPT,88184,"FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKERTECHNICAL COMPONENT ONLY; FIRST MARKER",1281.0,832.65,340.66,542.53,2
CPT,88184,HB FLOW CYTOM- 1ST MARKER,1281.0,832.65,447.92,14761.0,10
CPT,88184,"HB FLOW CYTOMETRY, FIRST MARKER",1281.0,832.65,447.92,14761.0,10
CPT,88184,HB MISC LAB SPECIAL TEST,1281.0,832.65,447.92,14761.0,20
CPT,88184,Laboratory Services,1281.0,832.65,546.4,546.45,2
CPT,88185,"FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; EACH ADDITIONAL MARKER (LIST SEPARATELY IN ADDITION TO CODE FOR FIRST MARKER)",432.77,281.3,59.07,59.07,2
CPT,88185,"FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKERTECHNICAL COMPONENT ONLY; EACH ADDITIONAL MARKER",432.77,281.3,167.39,266.58,2
CPT,88185,"HB FACS, ADDL MARKER 3",432.77,281.3,13270.0,14761.0,2
CPT,88185,"HB FACS, INTERP 2-8 MARKERS",1121.69,729.1,,,0
CPT,88185,HB LAB FLOW CYTOM-ADDL MARKERS,432.77,281.3,13270.0,14761.0,2
CPT,88185,HB MISC LAB SPECIAL TEST,432.77,281.3,13270.0,14761.0,4
CPT,88185,Laboratory Services,432.77,281.3,327.03,327.07,2
CPT,88187,"FLOW CYTOMETRY, INTERPRETATION; 2 TO 8 MARKERS",1121.69,729.1,47.47,690.95,4
CPT,88187,"HB FACS, INTERP 2-8 MARKERS",1121.69,729.1,13270.0,14761.0,2
CPT,88187,HB MISC LAB SPECIAL TEST,1121.69,729.1,13270.0,14761.0,2
CPT,88187,HB PROF INTERP 2-8 MARKERS,1121.69,729.1,13270.0,14761.0,2
CPT,88187,Laboratory Services,1121.69,729.1,389.04,389.08,2
CPT,88188,"FLOW CYTOMETRY, INTERPRETATION; 9 TO 15 MARKERS",1399.5,909.68,83.07,862.12,4
CPT,88188,"HB FACS, INTERP 9-15 MARKERS",1399.5,909.68,13270.0,14761.0,2
CPT,88188,HB MISC LAB SPECIAL TEST,1399.5,909.68,13270.0,14761.0,4
CPT,88188,HB PROF INTERP 9-15 MARKERS,1399.5,909.68,13270.0,14761.0,2
CPT,88188,Laboratory Services,1399.5,909.68,482.69,482.74,2
CPT,88189,"FLOW CYTOMETRY, INTERPRETATION; 16 OR MORE MARKERS",1843.56,1198.31,112.28,1135.63,4
CPT,88189,HB MISC LAB SPECIAL TEST,1843.56,1198.31,13270.0,14761.0,4
CPT,88189,HB PROF INTERP >=16 MARKERS,1843.56,1198.31,13270.0,14761.0,2
CPT,88189,Laboratory Services,1843.56,1198.31,589.48,589.54,2
CPT,88199,HB PATHOLOGY FNA CYTOTECH ASST,868.53,564.54,66.53,76.51,8
CPT,88199,Laboratory Services,868.53,564.54,,,0
CPT,88199,UNLISTED CYTOPATHOLOGY PROCEDURE,868.53,564.54,,,0
CPT,88199,Unlisted cytopathology procedure,868.53,564.54,67.53,67.53,2
CPT,88230,HB LAB CBK-BLOOD TISSUE CULTURE,2233.17,1451.56,13270.0,14761.0,2
CPT,88230,HB LAB CFKS-TISSUE CULTURE LYMPH,2233.17,1451.56,,,0
CPT,88230,Laboratory Services,2233.17,1451.56,876.39,876.48,2
CPT,88230,TISSUE CULTURE FOR CHROMOSOME ANALYSIS; LYMPHOCYTE,2233.17,1451.56,863.76,1375.62,2
CPT,88230,TISSUE CULTURE FOR NON-NEOPLASTIC DISORDERS; LYMPHOCYTE,2233.17,1451.56,286.23,286.23,2
CPT,88233,HB LAB CTK-TIS CULT SOLID TISSUE,2697.35,1753.28,13270.0,14761.0,4
CPT,88233,Laboratory Services,2697.35,1753.28,1058.65,1058.75,2
CPT,88233,TISSUE CULTURE FOR CHROMOSOME ANALYSIS; SKIN OR OTHER SOLID TISSUE BIOPSY,2697.35,1753.28,1043.32,1661.59,2
CPT,88233,TISSUE CULTURE FOR NON-NEOPLASTIC DISORDERS; SKIN OR OTHER SOLID TISSUE BIOPSY,2697.35,1753.28,345.3,345.3,2
CPT,88235,HB LAB CAK-TISSUE CULTURE AMNIO,2492.94,1620.41,,,0
CPT,88235,HB LAB CCCK-TISSUE CULTURE CVS,2492.94,1620.41,13270.0,14761.0,2
CPT,88235,HB MISC LAB SPECIAL TEST,2492.94,1620.41,13270.0,14761.0,2
CPT,88235,Laboratory Services,2492.94,1620.41,1107.76,1107.87,2
CPT,88235,TISSUE CULTURE FOR CHROMOSOME ANALYSIS; AMNIOTIC FLUID OR CHORIONIC VILLUS CELLS,2492.94,1620.41,964.24,1535.65,2
CPT,88235,TISSUE CULTURE FOR NON-NEOPLASTIC DISORDERS; AMNIOTIC FLUID OR CHORIONICVILLUS CELLS,2492.94,1620.41,369.43,369.43,2
CPT,88237,HB LAB CCBK-TIS CULT CANCER/HEM,2421.03,1573.67,13270.0,14761.0,4
CPT,88237,HB MISC LAB SPECIAL TEST,2421.03,1573.67,13270.0,14761.0,4
CPT,88237,Laboratory Services,2421.03,1573.67,950.16,950.25,2
CPT,88237,TISSUE CULTURE FOR CHROMOSOME ANALYSIS; BONE MARROW (MYELOID) CELLS,2421.03,1573.67,936.43,1491.36,2
CPT,88237,"TISSUE CULTURE FOR NEOPLASTIC DISORDERS; BONE MARROW, BLOOD CELLS",2421.03,1573.67,352.79,352.79,2
CPT,88239,HB LAB CMS-BLOOD TISSUE CULTURE,3223.14,2095.04,13270.0,14761.0,4
CPT,88239,Laboratory Services,3223.14,2095.04,1109.78,1109.89,2
CPT,88239,TISSUE CULTURE FOR CHROMOSOME ANALYSIS; OTHER TISSUE,3223.14,2095.04,1246.69,1985.48,2
CPT,88239,TISSUE CULTURE FOR NEOPLASTIC DISORDERS; SOLID TUMOR,3223.14,2095.04,361.94,361.94,2
CPT,88240,"CRYOPRESERVATION, FREEZING AND STORAGE OF CELLS, EACH CELL LINE",328.42,213.47,32.45,32.45,2
CPT,88240,"CRYOPRESERVATION,FREEZING AND STORAGE OF CELLS,EACH CELL LINE",328.42,213.47,39.86,63.49,2
CPT,88240,HB CELL CRYOPRESERVE/STORE,328.42,213.47,13270.0,14761.0,2
CPT,88240,Laboratory Services,328.42,213.47,76.04,76.04,2
CPT,88241,HB FROZEN CELL/THAW,477.72,310.52,13270.0,14761.0,2
CPT,88241,Laboratory Services,477.72,310.52,76.04,76.04,2
CPT,88241,"THAWING AND EXPANSION OF FROZEN CELLS, EACH ALIQUOT",477.72,310.52,29.95,29.95,2
CPT,88241,"THAWING AND EXPANSION OF FROZEN CELLS,EACH ALIQUOT",477.72,310.52,39.86,63.49,2
CPT,88245,"CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; BASELINE SISTER CHROMATID EXCHANGE (SCE), 20-25 CELLS",,,425.17,425.17,2
CPT,88245,"CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; SCORE 25 CELLS (SCE STUDY), COUNT 5 CELLS, 1 KARYOTYPE, WITH BANDING (EG, BL",,,1257.92,2003.36,2
CPT,88245,Laboratory Services,,,976.95,977.05,2
CPT,88248,"CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; BASELINE BREAKAGE, SCORE 50-100 CELLS, COUNT 20 CELLS, 2 KARYOTYPES (E.G., FOR ATAXIA TELANGIECTASIA, FANCONI ANEMIA, FRAGILE X)",,,425.17,425.17,2
CPT,88248,"CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; SCORE 100 CELLS, COUNT 20 CELLS, 2 KARYOTYPES, WITH BANDING (EG, ATAXIA TEL",,,1463.35,2330.53,2
CPT,88248,Laboratory Services,,,1302.79,1302.92,2
CPT,88249,"CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; SCORE 100 CELLS, CLASTOGEN STRESS (E.G., DIEPOXYBUTANE, MITOMYCIN C, IONIZING RADIATION, UV RADIATION)",,,425.17,425.17,2
CPT,88249,CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES;SCORE 100 CELLS CLASTOGEN STRESS,,,1505.56,2397.76,2
CPT,88249,Laboratory Services,,,1302.79,1302.92,2
CPT,88261,"CHROMOSOME ANALYSIS; COUNT 5 CELLS, 1 KARYOTYPE, WITH BANDING",3387.47,2201.86,648.99,2086.7,4
CPT,88261,HB LAB CFKS-CHROM ANL 5 CELLS/1K,3387.47,2201.86,,,0
CPT,88261,Laboratory Services,3387.47,2201.86,1329.52,1329.65,2
CPT,88262,"CHROMOSOME ANALYSIS; COUNT 15-20 CELLS, 2 KARYOTYPES, WITH BANDING",2814.12,1829.18,307.86,1733.5,4
CPT,88262,HB LAB CBK-CYT BL 15-20 CLS 2K,2814.12,1829.18,13270.0,14761.0,2
CPT,88262,HB LAB CTK-TIS CHROM AN 20 CELLS,2814.12,1829.18,13270.0,14761.0,2
CPT,88262,Laboratory Services,2814.12,1829.18,937.64,937.74,2
CPT,88263,"CHROMOSOME ANALYSIS; COUNT 45 CELLS FOR MOSAICISM, 2 KARYOTYPES, WITH BANDING",,,369.43,2022.37,4
CPT,88263,Laboratory Services,,,781.55,781.63,2
CPT,88264,CHROMOSOME ANALYSIS; ANALYZE 20-25 CELLS,2801.64,1821.07,355.29,355.29,2
CPT,88264,CHROMOSOME ANALYSIS;ANALYZE 20-25 CELLS,2801.64,1821.07,1083.65,1725.82,2
CPT,88264,HB LAB CCBK-ANALYZE 20-25 CELLS,2801.64,1821.07,13270.0,14761.0,4
CPT,88264,HB LAB CKST-ANALYZE 20-25 CELLS,2801.64,1821.07,13270.0,14761.0,2
CPT,88264,Laboratory Services,2801.64,1821.07,937.64,937.74,2
CPT,88267,"CHROMOSOME ANALYSIS, AMNIOTIC FLUID OR CHORIONIC VILLUS, COUNT 15 CELLS, 1 KARYOTYPE, WITH BANDING",4058.91,2638.29,1569.94,2500.3,2
CPT,88267,"CHROMOSOME ANALYSIS, AMNIOTIC FLUID OR CHORIONIC VILLUS, COUNT 15 CELLS,1 KARYOTYPE, WITH BANDING",4058.91,2638.29,462.62,462.62,2
CPT,88267,HB LAB CCCK-ANALYSIS 15 CELLS/1K,4058.91,2638.29,13270.0,14761.0,2
CPT,88267,Laboratory Services,4058.91,2638.29,1352.35,1352.48,2
CPT,88269,"CHROMOSOME ANALYSIS, IN SITU FOR AMNIOTIC FLUID CELLS, COUNT CELLS FROM 6-12 COLONIES, 1 KARYOTYPE, WITH BANDING",3755.05,2440.78,426.0,2313.11,4
CPT,88269,HB LAB CAK-IN SITU ANL 15 CL/1K,3755.05,2440.78,,,0
CPT,88269,Laboratory Services,3755.05,2440.78,1251.16,1251.28,2
CPT,88271,"HB LAB ANEU-FISH PROBE, EACH",584.89,380.18,,,0
CPT,88271,"HB LAB IISH2-FISH PROBE, EACH",584.89,380.18,13270.0,14761.0,2
CPT,88271,HB MISC LAB SPECIAL TEST,584.89,380.18,13270.0,14761.0,6
CPT,88271,Laboratory Services,584.89,380.18,161.13,161.14,2
CPT,88271,"MOLECULAR CYTOGENETICS; DNA PROBE, EACH (E.G., FISH)",584.89,380.18,52.42,52.42,2
CPT,88271,"MOLECULAR CYTOGENETICS; DNA PROBE,EACH (EG FISH)",584.89,380.18,1481.63,2359.65,2
CPT,88272,Laboratory Services,,,201.38,201.4,2
CPT,88272,MOLECULAR CYTOGENETICS; CHROMOSOMAL IN SITU HYBRIDIZATION ANALYZE 3-5 CELLS,,,1557.83,2481.01,2
CPT,88272,"MOLECULAR CYTOGENETICS; CHROMOSOMAL IN SITU HYBRIDIZATION, ANALYZE 3-5 CELLS (E.G., FOR DERIVATIVES AND MARKERS)",,,99.85,99.85,2
CPT,88273,Laboratory Services,,,241.69,241.71,2
CPT,88273,"MOLECULAR CYTOGENETICS; CHROMOSOMAL IN SITU HYBRIDIZATION, ANALYZE 10-30 CELLS",,,1659.43,2642.81,2
CPT,88273,"MOLECULAR CYTOGENETICS; CHROMOSOMAL IN SITU HYBRIDIZATION, ANALYZE 10-30CELLS (E.G., FOR MICRODELETIONS)",,,85.7,85.7,2
CPT,88274,"HB INTERPHASES, 25-99",2227.5,1447.88,,,0
CPT,88274,HB LAB IISH1-ANALYZE 25-99 CELLS,2227.5,1447.88,,,0
CPT,88274,Laboratory Services,2227.5,1447.88,261.88,261.9,2
CPT,88274,"MOECULAR CYTOGENTICS;INTERPHASE IN SITU HYBRIDIZATION, ANALYZE 25-99 CELLS",2227.5,1447.88,1828.76,2912.49,2
CPT,88274,"MOLECULAR CYTOGENETICS; INTERPHASE IN SITU HYBRIDIZATION, ANALYZE 25-99 CELLS",2227.5,1447.88,104.0,104.0,2
CPT,88275,HB LAB IISH2-ANALYZE100-300 CELLS,2833.17,1841.56,13270.0,14761.0,2
CPT,88275,HB LAB MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL,2833.17,1841.56,,,0
CPT,88275,HB MISC LAB SPECIAL TEST,2833.17,1841.56,13270.0,14761.0,6
CPT,88275,Laboratory Services,2833.17,1841.56,302.07,302.1,2
CPT,88275,"MOLECULAR CYTOGENETICS; INTERPHASE IN SITU HYBRIDIZATION, ANALYZE 100-300 CELLS",2833.17,1841.56,125.64,125.64,2
CPT,88275,MOLECULAR CYTOGENETICS;INTERPHASE IN SITU HYBRIDIZATION ANALYZE 100-300 CELLS,2833.17,1841.56,2285.95,3640.61,2
CPT,88280,"CHROMOSOME ANALYSIS; ADDITIONAL KARYOTYPES, EACH STUDY",566.68,368.34,82.37,349.08,4
CPT,88280,"HB CHROMOSOME ANALYSIS, ADDL KARYOTYPE",566.68,368.34,,,0
CPT,88280,HB LAB CCBK-1 CHROM ADD KARYOTYPE,566.68,368.34,13270.0,14761.0,4
CPT,88280,HB LAB CKST-ADDITIONAL KARYTYPE,566.68,368.34,13270.0,14761.0,2
CPT,88280,Laboratory Services,566.68,368.34,188.8,188.82,2
CPT,88283,"CHROMOSOME ANALYSIS; ADDITIONAL SPECIALIZED BANDING TECHNIQUE (E.G., NORC-BANDING)",,,168.07,168.07,2
CPT,88283,"CHROMOSOME ANALYSIS; ADDITIONAL SPECIALIZED BANDING TECHNIQUE (EG, NOR, C-BANDING)",,,77.55,123.51,2
CPT,88283,Laboratory Services,,,65.03,65.04,2
CPT,88285,"CHROMOSOME ANALYSIS; ADDITIONAL CELLS COUNTED, EACH STUDY",364.35,236.83,65.73,224.45,4
CPT,88285,HB LAB CCCK-AD CELLS CNT/KARY,364.35,236.83,,,0
CPT,88285,Laboratory Services,364.35,236.83,142.95,142.97,2
CPT,88289,CHROMOSOME ANALYSIS; ADDITIONAL HIGH RESOLUTION STUDY,,,77.55,123.51,4
CPT,88289,Laboratory Services,,,97.73,97.74,2
CPT,88291,"CYTOGENETICS AND MOLECULAR CYTOGENETICS, INTERPRETATION AND REPORT",279.81,181.88,43.82,43.82,2
CPT,88291,"CYTOGENETICS AND MOLECULAR CYTOGENTICS, INTERPRETATION AND REPORT",279.81,181.88,163.16,259.84,2
CPT,88291,HB MISC LAB SPECIAL TEST,279.81,181.88,13270.0,14761.0,6
CPT,88291,HB PROF CBK-INTERP & REPORT,279.81,181.88,13270.0,14761.0,2
CPT,88291,Laboratory Services,279.81,181.88,170.75,170.77,2
CPT,88295,HB MISC LAB SPECIAL TEST,30.43,19.78,13270.0,14761.0,2
CPT,88299,HB FAMIL. MEDITERRANEAN FEVE,241.25,156.81,66.53,14761.0,10
CPT,88299,Laboratory Services,241.25,156.81,,,0
CPT,88299,UNLISTED CYTOGENETIC STUDY,241.25,156.81,,,0
CPT,88299,Unlisted cytogenetic study,241.25,156.81,67.53,67.53,2
CPT,88300,HB PATHOLOGY LEVEL I SURGICAL,361.02,234.66,30.49,14761.0,20
CPT,88300,"LEVEL I - SURGICAL PATHOLOGY, GROSS EXAMINATION ONLY",361.02,234.66,28.8,28.8,2
CPT,88300,Laboratory Services,361.02,234.66,170.62,170.64,2
CPT,88300,"SURGICAL PATHOLOGY, GROSS EXAMINATION ONLY",361.02,234.66,24.75,39.42,2
CPT,88302,HB PATHOLOGY LEVEL II SURGICAL,630.66,409.93,48.87,14761.0,20
CPT,88302,"LEVEL II - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION APPENDIX, INCIDENTAL FALLOPIAN TUBE, STERILIZATION FINGERS/TOES, AMPUTATION, TRAUMATIC FORESKIN, NEWBORN HERNIA SAC, ANY LOCATION HYDRO",630.66,409.93,64.57,64.57,2
CPT,88302,Laboratory Services,630.66,409.93,341.81,341.85,2
CPT,88302,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION OF PRESUMPTIVELY NORMAL TISSUE(S), FOR IDENTIFICATION AND RECORD P",630.66,409.93,61.03,97.2,2
CPT,88304,HB PATHOLOGY LEVEL III SURGICAL,868.53,564.54,66.53,14761.0,20
CPT,88304,"LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION, INDUCED ABSCESS ANEURYSM - ARTERIAL/VENTRICULAR ANUS, TAG APPENDIX, OTHER THAN INCIDENTAL ARTERY, ATHEROMATOUS PLAQUE BARTHO",868.53,564.54,77.89,77.89,2
CPT,88304,"LEVEL III SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION",868.53,564.54,85.84,136.71,2
CPT,88304,Laboratory Services,868.53,564.54,398.67,398.71,2
CPT,88305,HB LAB TISSUE GR M 7,868.53,564.54,66.53,14761.0,20
CPT,88305,"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION",868.53,564.54,86.21,86.21,2
CPT,88305,"LEVEL IV SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION",868.53,564.54,117.83,187.65,2
CPT,88305,Laboratory Services,868.53,564.54,664.88,664.95,2
CPT,88307,HB PATHOLOGY LEVEL V SURGICAL,1281.0,832.65,447.92,14761.0,20
CPT,88307,"LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ADRENAL, RESECTION BONE - BIOPSY/CURETTINGS BONE FRAGMENT(S), PATHOLOGIC FRACTURE BRAIN, BIOPSY BRAIN/MENINGES, TUMOR RESECTION BREAST, ",1281.0,832.65,518.73,518.73,2
CPT,88307,Laboratory Services,1281.0,832.65,1418.95,1419.09,2
CPT,88307,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION OF PRESUMPTIVELY ABNORMAL TISSUE(S); SINGLE COMPLICATED SPE",1281.0,832.65,175.09,278.85,2
CPT,88309,HB PATHOLOGY LEVEL VI SURGICAL,3579.96,2326.97,1017.19,14761.0,20
CPT,88309,"LEVEL VI - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION BONE RESECTION BREAST, MASTECTOMY - WITH REGIONAL LYMPH NODES COLON, SEGMENTAL RESECTION FOR TUMOR COLON, TOTAL RESECTION ESOPHAGUS, PA",3579.96,2326.97,733.39,733.39,2
CPT,88309,Laboratory Services,3579.96,2326.97,2133.83,2134.05,2
CPT,88309,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION OF PRESUMPTIVELY ABNORMAL TISSUE(S); COMPLEX DIAGNOSTIC PRO",3579.96,2326.97,238.94,380.54,2
CPT,88311,DECALCIFICATION PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION),165.9,107.84,20.48,34.93,4
CPT,88311,HB PATHOLOGY DECALICIFICATION,165.9,107.84,13270.0,14761.0,4
CPT,88311,Laboratory Services,165.9,107.84,112.2,112.21,2
CPT,88312,HB LAB RHODAMINE AUROMN,868.53,564.54,66.53,14761.0,10
CPT,88312,HB PATHOLOGY TISSUE STAIN GR I,868.53,564.54,66.53,14761.0,20
CPT,88312,Laboratory Services,868.53,564.54,676.2,676.27,2
CPT,88312,"SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE); GROUP I FOR MICROORGANISMS (E.G., GRIDLEY, ACID FAST, METHENAMINE SILVER), EACH",868.53,564.54,214.34,214.34,2
CPT,88312,"SPECIAL STAINS; GROUP I FOR MICROORGANISMS (EG, GRIDLEY, ACID FAST, METHENAMINE SILVER), INCLUDING INTERPRETATION AND RE",868.53,564.54,25.99,41.39,2
CPT,88313,HB MISC LAB SPECIAL TEST,310.79,202.01,160.5,14761.0,10
CPT,88313,HB PATHOLOGY TISS STN GR II - BM,310.79,202.01,160.5,14761.0,20
CPT,88313,Laboratory Services,310.79,202.01,497.72,497.77,2
CPT,88313,"SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE); GROUP II, ALL OTHER, (E.G., IRON, TRICHROME), EXCEPT IMMUNOCYTOCHEMISTRY AND IMMUNOPEROXIDASE STAINS, EACH",310.79,202.01,173.57,173.57,2
CPT,88313,"SPECIAL STAINS; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT IMMUNOCYTOCHEMISTRY AND IMMUNOPEROXIDASE STAINS, INCLU",310.79,202.01,25.4,40.45,2
CPT,88314,"HB PATHOLOGY TISSUE STAIN, FROZ",1237.32,804.26,13270.0,14761.0,4
CPT,88314,Laboratory Services,1237.32,804.26,570.61,570.67,2
CPT,88314,SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE); HISTOCHEMICAL STAINING WITH FROZEN SECTION(S),1237.32,804.26,174.4,174.4,2
CPT,88314,"SPECIAL STAINS; HISTOCHEMICAL STAINING WITH FROZEN SECTION(S), INCL INTERPRETATION & REPORT (LIST SEPARATELY IN ADDITION",1237.32,804.26,72.02,114.71,2
CPT,88319,"DETERMINATIVE HISTOCHEMISTRY OR CYTOCHEMISTRY TO IDENTIFY ENZYME CONSTITUENTS, EACH",3579.96,2326.97,62.62,270.59,4
CPT,88319,"HB PATHOLOGY TISSUE STAIN, ENZ",3579.96,2326.97,1017.19,14761.0,12
CPT,88319,Laboratory Services,3579.96,2326.97,934.0,934.09,2
CPT,88321,CONSULTATION AND REPORT ON REFERRED SLIDES PREPARED ELSEWHERE,,,111.83,543.56,4
CPT,88321,HB PROF HB OUTSIDE CONS SLIDES,,,48.87,14761.0,10
CPT,88321,Laboratory Services,,,466.97,467.01,2
CPT,88323,CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREPARATION OF SLIDES,868.53,564.54,69.57,120.04,4
CPT,88323,"HB OUTSIDE CONSULT, WITH PREP",868.53,564.54,66.53,76.51,8
CPT,88323,Laboratory Services,868.53,564.54,866.01,866.1,2
CPT,88325,"CONSULTATION, COMPREHENSIVE, WITH REVIEW OF RECORDS AND SPECIMENS, WITH REPORT ON REFERRED MATERIAL",,,178.9,842.83,4
CPT,88325,"HB PROF OUTSIDE CONS, COMPR",,,213.38,245.38,8
CPT,88325,Laboratory Services,,,740.1,740.18,2
CPT,88329,CONSULTATION DURING SURGERY;,549.1,356.92,252.76,402.55,2
CPT,88329,HB PATHOLOGY INTRAOPERATIVE CON,549.1,356.92,73.96,14761.0,12
CPT,88329,Laboratory Services,549.1,356.92,198.17,198.19,2
CPT,88329,PATHOLOGY CONSULTATION DURING SURGERY;,549.1,356.92,47.47,47.47,2
CPT,88331,"CONSULTATION DURING SURGERY;FIRST TISSUE BLOCK, W/FRZEN SECTION(S), SINGLE SPECIMEN",955.55,621.11,139.05,221.45,2
CPT,88331,"HB PATH CON INTRAOP FZS, 1 BLOC",955.55,621.11,213.38,14761.0,10
CPT,88331,Laboratory Services,955.55,621.11,555.14,555.2,2
CPT,88331,"PATHOLOGY CONSULTATION DURING SURGERY; FIRST TISSUE BLOCK, WITH FROZEN SECTION(S), SINGLE SPECIMEN",955.55,621.11,102.01,102.01,2
CPT,88332,"HB PATH CON INTRAOP FZS, ADDL",198.51,129.03,13270.0,14761.0,4
CPT,88332,Laboratory Services,198.51,129.03,242.51,242.53,2
CPT,88332,PATHOLOGY CONSULTATION DURING SURGERY; EACH ADDITIONAL TISSUE BLOCK WITH FROZEN SECTION(S),198.51,129.03,61.25,61.25,2
CPT,88332,PATHOLOGY CONSULTATION DURING SURGERY; EACH ADDITIONAL TISSUE BLOCK WITH FROZEN SECTION(S) (LIST SEPARATELY IN ADDITION,198.51,129.03,72.85,116.02,2
CPT,88333,Laboratory Services,3579.96,2326.97,576.46,576.52,2
CPT,88333,"PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION (E.G., TOUCPREP, SQUASH PREP), INITIAL SITE",3579.96,2326.97,79.55,79.55,2
CPT,88333,"PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION, INITIAL SITE ï",3579.96,2326.97,143.34,228.29,2
CPT,88334,"HB PATH INTROP TCH PRP, ADDL",226.64,147.32,13270.0,14761.0,2
CPT,88334,Laboratory Services,226.64,147.32,355.71,355.75,2
CPT,88334,"PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION (E.G., TOUCPREP, SQUASH PREP), EACH ADDITIONAL SITE",226.64,147.32,48.26,48.26,2
CPT,88334,"PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION (EG, TOUCH PREP, SQUASH PREP), EACH ADDITIONAL SITE (LIST S",226.64,147.32,87.66,139.61,2
CPT,88341,HB IMMUNOHISTO ANTIBODY SLIDE ADDL,1036.18,673.52,13270.0,14761.0,2
CPT,88341,HB IMMUNOHISTOCHEMICAL STAIN ADDL',1036.18,673.52,13270.0,14761.0,2
CPT,88341,Immunohisto antibody slide,1036.18,673.52,405.27,645.44,2
CPT,88341,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)",1036.18,673.52,145.61,145.61,2
CPT,88341,Laboratory Services,1036.18,673.52,409.3,409.34,2
CPT,88342,HB LAB IMMUNOHISTOCHEMISTRY EA AB,481.76,313.14,213.38,14761.0,10
CPT,88342,HB MISC LAB SPECIAL TEST,481.76,313.14,213.38,14761.0,32
CPT,88342,"IMMUNOHISTOCHEMISTRY (INCLUDING TISSUE IMMUNOPEROXIDASE), EACH ANTIBODY",481.76,313.14,83.25,163.58,4
CPT,88342,Laboratory Services,481.76,313.14,646.52,646.59,2
CPT,88344,"HB IMMUNO CYTOCHEM, EA ADDTL",1281.0,832.65,447.92,14761.0,10
CPT,88344,Immunohisto antibody slide,1281.0,832.65,681.85,1085.91,2
CPT,88344,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure",1281.0,832.65,324.17,324.17,2
CPT,88344,Laboratory Services,1281.0,832.65,707.9,707.97,2
CPT,88346,HB IMMUNOFLUOR ANTB INITIAL STAIN,150.0,97.5,213.38,14761.0,20
CPT,88346,HB IMMUNOFLUOR ANTIBODY INITIAL STAIN,150.0,97.5,213.38,14761.0,10
CPT,88346,HB MISC LAB SPECIAL TEST,150.0,97.5,213.38,14761.0,20
CPT,88346,"IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; DIRECT METHOD",150.0,97.5,65.91,290.06,4
CPT,88346,Laboratory Services,150.0,97.5,634.7,634.76,2
CPT,88348,ELECTRON MICROSCOPY; DIAGNOSTIC,3579.96,2326.97,290.21,984.21,4
CPT,88348,HB MISC LAB SPECIAL TEST,3579.96,2326.97,1017.19,1169.77,8
CPT,88348,"HB PATHOLOGY EM, DIAGNOSTIC",3579.96,2326.97,1017.19,14761.0,20
CPT,88348,Laboratory Services,3579.96,2326.97,4380.11,4380.55,2
CPT,88350,HB IBDSGI IF DNASE SEN,166.25,108.06,13270.0,14761.0,2
CPT,88350,HB IMMUNOFLUOR ANTB ADDL STAIN,166.25,108.06,13270.0,14761.0,2
CPT,88350,HB MISC LAB SPECIAL TEST,166.25,108.06,13270.0,14761.0,4
CPT,88350,Immunofluor antb addl stain,166.25,108.06,506.4,806.5,2
CPT,88350,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)",166.25,108.06,218.5,218.5,2
CPT,88350,Laboratory Services,166.25,108.06,436.15,436.19,2
CPT,88355,Laboratory Services,,,1327.57,1327.7,2
CPT,88355,MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE,,,149.95,323.33,4
CPT,88356,Laboratory Services,,,1730.26,1730.43,2
CPT,88356,MORPHOMETRIC ANALYSIS; NERVE,,,277.44,497.49,4
CPT,88358,Laboratory Services,,,452.63,452.67,2
CPT,88358,"MORPHOMETRIC ANALYSIS; TUMOR (E.G., DNA PLOIDY)",,,225.15,225.15,2
CPT,88358,MORPHOMETRIC ANALYSIS; TUMOR (EG. DNA),,,286.51,456.29,2
CPT,88360,HB LAB TUMOR IHC QUANT MAN,955.55,621.11,213.38,14761.0,10
CPT,88360,Laboratory Services,955.55,621.11,764.57,764.64,2
CPT,88360,"MORPHOMETRIC ANALYSIS, TUMOR IMMUNOHISTOCHEMISTRY (E.G., HER-2/NEU, ESTROGEN RECEPTOR/PROGESTERONE RECEPTOR), QUANTITATIVE OR SEMIQUANTITATIVE, EACH ANTIBODY; MANUAL",955.55,621.11,191.88,191.88,2
CPT,88360,"MORPHOMETRIC ANALYSIS, TUMOR IMMUNOHISTOCHEMISTRY (EG, HER-2ESTROGEN RECEPTOR/PROGESTERONE RECEPTOR), QUANTITATIVE OR SE",955.55,621.11,325.37,518.19,2
CPT,88361,HB LAB ESTROGEN RECEPTOR,1281.0,832.65,447.92,14761.0,10
CPT,88361,HB LAB HER2/NEU RECEPTOR,1281.0,832.65,447.92,14761.0,10
CPT,88361,Laboratory Services,1281.0,832.65,944.94,945.03,2
CPT,88361,"MORPHOMETRIC ANALYSIS, TUMOR IMMUNOHISTOCHEMISTRY (E.G., HER-2/NEU, ESTROGEN RECEPTOR/PROGESTERONE RECEPTOR), QUANTITATIVE OR SEMIQUANTITATIVE, EACH ANTIBODY; USING COMPUTER-ASSISTED TECHNOLOGY",1281.0,832.65,186.88,186.88,2
CPT,88361,"MORPHOMETRIC ANALYSIS, USING COMPUTER-ASSISTED TECHNOLOGY",1281.0,832.65,578.66,921.58,2
CPT,88362,HB NERVE TEASING PREPARATION,3579.96,2326.97,13270.0,14761.0,2
CPT,88362,Laboratory Services,3579.96,2326.97,1757.37,1757.54,2
CPT,88362,NERVE TEASING PREPARATIONS,3579.96,2326.97,238.47,379.79,4
CPT,88363,"EXAMINATION AND SELECTION OF RETRIEVED ARCHIVAL (IE, PREVIOUSLY DIAGNOSED) TISSUE(S) FOR MOLECULAR ANALYSIS (EG, KRAS MU",,,230.77,367.53,2
CPT,88363,"EXAMINATION AND SELECTION OF RETRIEVED ARCHIVAL (IE, PREVIOUSLY DIAGNOSED) TISSUE(S) FOR MOLECULAR ANALYSIS (EG, KRAS MUTATIONAL ANALYSIS)",,,26.02,26.02,2
CPT,88363,Laboratory Services,,,95.91,95.92,2
CPT,88364,HB INSITU HYBRIDIZATION (FISH),1606.85,1044.45,13270.0,14761.0,2
CPT,88364,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)",1606.85,1044.45,255.94,255.94,2
CPT,88364,Insitu hybridization (fish),1606.85,1044.45,621.52,989.84,2
CPT,88364,Laboratory Services,1606.85,1044.45,591.05,591.11,2
CPT,88365,HB LAB HPV HIGH RISK IN SITU,955.55,621.11,213.38,14761.0,20
CPT,88365,HB MISC LAB SPECIAL TEST,955.55,621.11,13270.0,14761.0,2
CPT,88365,"IN SITU HYBRIDIZATION (E.G., FISH), EACH PROBE",955.55,621.11,342.99,342.99,2
CPT,88365,"IN SITU HYBRIDIZATION (EG, FISH), EACH PROBE",955.55,621.11,84.49,134.56,2
CPT,88365,Laboratory Services,955.55,621.11,1036.07,1036.17,2
CPT,88366,HB MISC LAB SPECIAL TEST,30.43,19.78,213.38,14761.0,10
CPT,88366,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure",,,541.01,541.01,2
CPT,88366,Insitu hybridization (fish),,,767.75,1222.71,2
CPT,88366,Laboratory Services,,,899.59,899.68,2
CPT,88367,Laboratory Services,,,1622.59,1622.75,2
CPT,88367,"MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, (QUANTITATIVE EACH PROBE; USING COMPUTER ASSISTED TECHNOLOGY",,,922.55,1469.26,2
CPT,88367,"MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, (QUANTITATIVE OR SEMI-QUANTITATIVE) EACH PROBE; USING COMPUTER-ASSISTED TECHNOLOGY",,,201.03,201.03,2
CPT,88368,HB LAB MDS FISH PROBES,1281.0,832.65,447.92,14761.0,10
CPT,88368,HB MISC LAB SPECIAL TEST,1281.0,832.65,13270.0,14761.0,2
CPT,88368,Laboratory Services,1281.0,832.65,1383.1,1383.24,2
CPT,88368,"MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, (QUANTITATIVE OR SEMI-QUANTITATIVE EACH PROBE; MANUAL",1281.0,832.65,751.75,1197.24,2
CPT,88368,"MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, (QUANTITATIVE OR SEMI-QUANTITATIVE) EACH PROBE; MANUAL",1281.0,832.65,251.46,251.46,2
CPT,88369,HB MISC LAB SPECIAL TEST,1643.59,1068.33,13270.0,14761.0,2
CPT,88369,HB MORPHO ANAL ADDTL PROBE FISH ALK,1643.59,1068.33,13270.0,14761.0,4
CPT,88369,Laboratory Services,1643.59,1068.33,444.64,444.68,2
CPT,88369,M/phmtrc alysishquant/semiq,1643.59,1068.33,430.79,686.08,2
CPT,88369,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",1643.59,1068.33,222.67,222.67,2
CPT,88371,Laboratory Services,,,167.16,167.18,2
CPT,88371,"PROTEIN ANALYSIS OF TISSUE BY WESTERN BLOT, WITH INTERPRETATION AND REPORT;",,,54.92,299.08,4
CPT,88372,"IMMUNOLOGICAL PROBE FOR BAND IDENTIFICATION, EACH",,,192.26,306.19,2
CPT,88372,Laboratory Services,,,171.13,171.14,2
CPT,88372,"PROTEIN ANALYSIS OF TISSUE BY WESTERN BLOT, WITH INTERPRETATION AND REPORT; IMMUNOLOGICAL PROBE FOR BAND IDENTIFICATION, EACH",,,64.07,64.07,2
CPT,88373,Laboratory Services,,,364.71,364.74,2
CPT,88373,M/phmtrc alys ishquant/semiq,,,348.01,554.24,2
CPT,88373,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,109.0,109.0,2
CPT,88374,Laboratory Services,,,1248.07,1248.2,2
CPT,88374,M/phmtrc alys ishquant/semiq,,,1416.2,2255.43,2
CPT,88374,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure",,,648.67,648.67,2
CPT,88375,Laboratory Services,,,362.25,362.29,2
CPT,88375,"OPTICAL ENDOMICROSCOPIC IMAGE(S), INTERPRETATION AND REPORT,REAL-TIME OR REFERRED, EACH ENDOSCOPIC SESSION",,,353.06,562.29,2
CPT,88375,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session",,,63.9,63.9,2
CPT,88377,HB MISC LAB SPECIAL TEST,955.55,621.11,213.38,14761.0,12
CPT,88377,HB MORPHO ANALYSIS FISH MULTIPLEX PROBE,955.55,621.11,213.38,14761.0,10
CPT,88377,Laboratory Services,955.55,621.11,1295.56,1295.69,2
CPT,88377,M/phmtrc alys ishquant/semiq,955.55,621.11,1317.65,2098.5,2
CPT,88377,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure",955.55,621.11,828.06,828.06,2
CPT,88380,HB AMYLOID PROTEIN MICRODISSECTION LASER,940.71,611.46,13270.0,14761.0,2
CPT,88380,Laboratory Services,940.71,611.46,1085.37,1085.48,2
CPT,88380,MICRODISSECTION,940.71,611.46,317.49,505.64,2
CPT,88380,"MICRODISSECTION (E.G., MECHANICAL, LASER CAPTURE)",940.71,611.46,175.75,175.75,2
CPT,88381,HB EGFR MICRODISECTION MAN,1402.75,911.79,13270.0,14761.0,2
CPT,88381,HB SLIDE REVIEW,1402.75,911.79,13270.0,14761.0,4
CPT,88381,Laboratory Services,1402.75,911.79,1158.58,1158.7,2
CPT,88381,"MICRODISSECTION (IE, SAMPLE PREPARATION OF MICROSCOPICALLY IDENTIFIED TARGET); MANUAL",1402.75,911.79,442.19,442.19,2
CPT,88381,"MICRODISSECTION (IE,SAMPLE PREPARTATION OF MICROSCOPICALLY IDENTIFIED TARGET);MANUAL",1402.75,911.79,1056.13,1682.0,2
CPT,88387,Laboratory Services,,,241.5,241.53,2
CPT,88387,"MACROSCOPIC EXAM, DISSECTION, & PREP OF TISSUE FOR NON-MICROSCOPIC ANALYTICAL STUDIES (EG, NUCLEIC ACID-BASED MOLECULAR",,,55.5,88.39,2
CPT,88387,"MACROSCOPIC EXAMINATION, DISSECTION, AND PREPARATION OF TISSUE FOR NON-MICROSCOPIC ANALYTICAL STUDIES (EG, NUCLEIC ACID-BASED MOLECULAR STUDIES); EACH TISSUE PREPARATION (EG, A SINGLE LYMPH NODE)",,,18.81,18.81,2
CPT,88388,Laboratory Services,,,136.28,136.3,2
CPT,88388,"MACROSCOPIC EXAM, DISSECTION, & PREP OF TISSUE FOR NON-MICROSCOPIC ANALYTICAL STUDIES; IN CONJUNCTION W/TOUCH IMPRINT,",,,27.05,43.07,2
CPT,88388,"MACROSCOPIC EXAMINATION, DISSECTION, AND PREPARATION OF TISSUE FOR NON-MICROSCOPIC ANALYTICAL STUDIES (EG, NUCLEIC ACID-BASED MOLECULAR STUDIES); IN CONJUNCTION WITH A TOUCH IMPRINT, INTRAOPERATIVE CO",,,33.79,33.79,2
CPT,88399,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,,67.53,67.53,2
CPT,88720,"BILIRUBIN, TOTAL TRANSCUTANEOUS",,,44.63,71.07,2
CPT,88720,"BILIRUBIN, TOTAL, TRANSCUTANEOUS",,,12.48,12.48,2
CPT,88720,Laboratory Services,,,37.73,37.74,2
CPT,88738,"HEMOGLOBIN (HGB), QUANTITATIVE, TRANSCUTANEOUS",,,12.48,78.84,4
CPT,88738,Laboratory Services,,,37.73,37.74,2
CPT,88740,"HEMOGLOBIN, QUANTITATIVE, TRANCUTANEOUS, PER DAY; CARBOXYHEMOGOLBIN",,,44.63,71.07,2
CPT,88740,"HEMOGLOBIN, QUANTITATIVE, TRANSCUTANEOUS, PER DAY; CARBOXYHEMOGLOBIN",,,23.3,23.3,2
CPT,88740,Laboratory Services,,,37.73,37.74,2
CPT,88741,"HEMOGLOBIN, QUANTITATIVE, TRANCUTANEOUS, PER DAY; METHEMOGLOBIN",,,44.63,71.07,2
CPT,88741,"HEMOGLOBIN, QUANTITATIVE, TRANSCUTANEOUS, PER DAY; METHEMOGLOBIN",,,23.3,23.3,2
CPT,88741,Laboratory Services,,,37.73,37.74,2
CPT,88749,"Unlisted in vivo (eg, transcutaneous) laboratory service",,,47.64,47.64,2
CPT,89049,"CAFFEINE HALOTHANE CONTRACTURE TEST (CHCT) FOR MALIGNANT HYPERTHERMIA SUSCEPTIBILITY, INCLUDING INTERPRETATION AND REPORT",,,83.52,83.52,2
CPT,89049,"CAFFEINE HALOTHANE CONTRACTURE TEST FOR MALIGNANT HYPERTHERMIA SUSCEPTIBILITY, INCLUDING INTERPRETATION AND REPORT ï",,,1197.54,1907.2,2
CPT,89049,Laboratory Services,,,377.03,377.07,2
CPT,89050,"CELL COUNT, MISCELLANEOUS BODY FLUIDS (E.G., CEREBROSPINAL FLUID, JOINT FLUID), EXCEPT BLOOD;",307.19,199.67,11.64,11.64,2
CPT,89050,"CELL COUNT, MISCELLANEOUS BODY FLUIDS (EG, CSF, JOINT FLUID), EXCEPT BLOOD;",307.19,199.67,41.33,65.83,2
CPT,89050,HB LAB MICRO EOSINOPHILS URN,307.19,199.67,13270.0,14761.0,2
CPT,89050,Laboratory Services,307.19,199.67,35.53,35.54,2
CPT,89051,"CELL COUNT, MISCELLANEOUS BODY FLUIDS (E.G., CEREBROSPINAL FLUID, JOINT FLUID), EXCEPT BLOOD; WITH DIFFERENTIAL COUNT",593.64,385.87,14.14,14.14,2
CPT,89051,"CELL COUNT, MISCELLANEOUS BODY FLUIDS (EG, CSF, JOINT FLUID), EXCEPT BLOOD; WITH DIFFERENTIAL COUNT",593.64,385.87,48.15,76.69,2
CPT,89051,HB LAB CELL CT TOTAL & DIFF,593.64,385.87,13270.0,14761.0,2
CPT,89051,Laboratory Services,593.64,385.87,41.45,41.45,2
CPT,89055,"LEUKOCYTE ASSESSMENT, FECAL, QUALITATIVE OR SEMIQUANTITATIVE",,,10.82,59.37,4
CPT,89055,Laboratory Services,,,32.14,32.14,2
CPT,89060,"CRYSTAL ID BY LIGHT MICROSCOPY W/WO POLARIZING LENS ANALYSIS, TISSUE OR ANY BODY FLUID (EXCEPT URINE)",558.79,363.21,62.38,99.35,2
CPT,89060,"CRYSTAL IDENTIFICATION BY LIGHT MICROSCOPY WITH OR WITHOUT POLARIZING LENS ANALYSIS, TISSUE OR ANY BODY FLUID (EXCEPT URINE)",558.79,363.21,18.31,18.31,2
CPT,89060,HB LAB MICRO CRYSTL UNS,558.79,363.21,13270.0,14761.0,2
CPT,89060,Laboratory Services,558.79,363.21,53.77,53.78,2
CPT,89125,"FAT STAIN, FECES, URINE, OR RESPIRATORY SECRETIONS",24.4,15.86,14.14,14.14,2
CPT,89125,"FAT STAIN, FECES, URINE, OR RESPIRATORY SECTIONS",24.4,15.86,37.69,60.02,2
CPT,89125,Laboratory Services,24.4,15.86,32.51,32.52,2
CPT,89160,Laboratory Services,,,27.73,27.74,2
CPT,89160,"MEAT FIBERS, FECES",,,11.64,51.31,4
CPT,89190,HB LAB MICRO EOSINO,307.19,199.67,13270.0,14761.0,2
CPT,89190,Laboratory Services,307.19,199.67,35.72,35.73,2
CPT,89190,NASAL SMEAR FOR EOSINOPHILS,307.19,199.67,14.14,66.01,4
CPT,89220,Laboratory Services,,,103.27,103.28,2
CPT,89220,"SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE",,,94.6,150.66,2
CPT,89220,"SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE (SEPARATE PROCEDURE)",,,44.61,44.61,2
CPT,89230,Laboratory Services,868.53,564.54,19.06,19.06,2
CPT,89230,SWEAT COLLECTION BY IONTOPHORESIS,868.53,564.54,6.33,175.19,4
CPT,89240,HB MISC LAB SPECIAL TEST,30.43,19.78,66.53,76.51,8
CPT,89240,UNLISTED MISCELLANEOUS PATHOLOGY TEST,,,67.53,67.53,2
CPT,89250,"CULTURE OF OOCYTE(S)/EMBRYO(S), LESS THAN 4 DAYS;",,,2670.85,6273.68,4
CPT,89250,Laboratory Services,,,6397.22,6397.86,2
CPT,89251,"CULTURE OF OOCYTE(S)/EMBRYO(S), LESS THAN 4 DAYS; WITH CO- COCULTURE OF OOCYTE(S)/EMBRYOS",,,1293.49,2060.01,2
CPT,89251,"CULTURE OF OOCYTE(S)/EMBRYO(S), LESS THAN 4 DAYS; WITH CO-CULTURE OF OOCYTE(S)/EMBRYOS",,,2778.18,2778.18,2
CPT,89251,Laboratory Services,,,6654.25,6654.92,2
CPT,89253,ASSISTED EMBRYO HATCHING MICROTHECHIQUES (ANY METHOD),,,1175.9,1872.74,2
CPT,89253,"ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)",,,211.78,211.78,2
CPT,89253,Laboratory Services,,,2281.81,2282.04,2
CPT,89254,Laboratory Services,,,1820.07,1820.25,2
CPT,89254,OOCYTE IDENTIFICATION FROM FOLLICULAR FLUID,,,211.78,211.78,2
CPT,89254,OOCYTE IDENTIFICATION FROM IDENTIFICATION FROM FOLLICULAR FLUID,,,587.95,936.37,2
CPT,89255,Laboratory Services,,,1282.92,1283.04,2
CPT,89255,PREPARATION OF EMBRYO FOR TRANSFER (ANY METHOD),,,67.53,1123.64,4
CPT,89257,Laboratory Services,,,2861.54,2861.83,2
CPT,89257,SPERM IDENTIFICATION FROM ASPIRATION (OTHER THAN SEMINAL FLUID),,,67.53,262.18,4
CPT,89258,CRYOPRESERVATION; EMBRYO(S),,,505.64,1045.8,4
CPT,89258,Laboratory Services,,,1954.65,1954.85,2
CPT,89259,CRYOPRESERVATION; SPERM,,,211.78,211.78,2
CPT,89259,CRYOPRESERVATION;SPEM,,,505.64,805.28,2
CPT,89259,Laboratory Services,,,705.64,705.71,2
CPT,89260,Laboratory Services,868.53,564.54,796.96,797.04,2
CPT,89260,"SPERM ISOLATION; SIMPLE PREP (E.G., SPERM WASH AND SWIM-UP) FOR INSEMINATION OR DIAGNOSIS WITH SEMEN ANALYSIS",868.53,564.54,67.53,67.53,2
CPT,89260,"SPERM ISOLATION;SIMPLE PEP(EG,SPEM WASH AND SWIM-UP)FOR INSEMINATION OR DIAGNOSIS WITH SEMEN ANALYSIS",868.53,564.54,282.22,449.46,2
CPT,89261,HB SEMEN PREP FOR IUI - FRESH SAMPLE,896.58,582.78,66.53,76.51,8
CPT,89261,Laboratory Services,896.58,582.78,512.69,512.74,2
CPT,89261,"SPEM ISOLATION,COMLEX PREP(EG,PER COL GRADIENT,ALBUMIN GRADIENT)FOR INSEMINATION OR DIAGNOSIS WITH SEMEN ANALYSIS",896.58,582.78,505.64,805.28,2
CPT,89261,"SPERM ISOLATION; COMPLEX PREP (E.G., PERCOLL GRADIENT, ALBUMIN GRADIENT)FOR INSEMINATION OR DIAGNOSIS WITH SEMEN ANALYSIS",896.58,582.78,67.53,67.53,2
CPT,89264,Laboratory Services,,,2089.05,2089.26,2
CPT,89264,"SPERM IDENTIFICATION FROM TESTIS TISSUE, FRESH OR CRYOPRESERVED",,,67.53,67.53,2
CPT,89264,"SPERM IDENTIFICATION FROM TESTIS TISSUE,FRESH OR CRYOPRESERVED",,,505.64,805.28,2
CPT,89268,INSEMINATION OF OOCYTES,,,211.78,10300.07,4
CPT,89268,Laboratory Services,,,2115.91,2116.12,2
CPT,89272,"EXTENDED CULTURE OF OOCYTE(S)/EMBRYO(S), 4-7 DAYS",,,1045.8,1045.8,2
CPT,89272,"EXTENDED CULTURE OF OOCYTES(S)/EMBRYO(S), 4-7 DAYS",,,4997.58,7959.15,2
CPT,89272,Laboratory Services,,,2834.31,2834.6,2
CPT,89280,"ASSISTED OOCYTE FERTILIZATION, MICROTECHNIQUE; LESS THAN OR EQUAL TO 10 OOCYTES",,,1045.8,1045.8,2
CPT,89280,"ASSISTED OOCYTES FERTILIZATION, MICROTECHNIQUE; LESS THAN OREQUAL TO 10 OOCYTES",,,4527.92,7211.17,2
CPT,89280,Laboratory Services,,,3990.57,3990.97,2
CPT,89281,"ASSISTED OOCYTE FERTILIZATION, MICROTECHNIQUE; GREATER THAN 10 OOCYTES",,,211.78,211.78,2
CPT,89281,"ASSISTED OOCYTES FERTILIZATION, MICROTECHNIQUE; GREATER THAN10 OOCYTES",,,4997.58,7959.15,2
CPT,89281,Laboratory Services,,,5108.58,5109.09,2
CPT,89290,"BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQLESS THAN OR EQUAL TO 5 EMBRYOS",,,5585.53,8895.52,2
CPT,89290,"BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS",,,211.78,211.78,2
CPT,89290,Laboratory Services,,,6583.82,6584.48,2
CPT,89291,"BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQGREATER THAN 5 EMBRYOS",,,6173.48,9831.89,2
CPT,89291,"BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS",,,211.78,211.78,2
CPT,89291,Laboratory Services,,,5660.2,5660.77,2
CPT,89300,Laboratory Services,,,67.1,67.11,2
CPT,89300,SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM INCLUDING HUHNER TEST,,,75.14,119.67,2
CPT,89300,SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM INCLUDING HUHNER TEST (POST COITAL),,,24.13,24.13,2
CPT,89310,HB SEMEN CRYO WASHED (IUI) - SPERM COUNT AND MOTILITY ONLY,467.75,304.04,,,0
CPT,89310,Laboratory Services,467.75,304.04,64.71,64.72,2
CPT,89310,SEMEN ANALYSIS; MOTILITY AND COUNT (NOT INCL HUHNER TEST),467.75,304.04,75.08,119.57,2
CPT,89310,SEMEN ANALYSIS; MOTILITY AND COUNT (NOT INCLUDING HUHNER TEST),467.75,304.04,20.8,20.8,2
CPT,89320,HB SEMEN ANALYSIS,467.75,304.04,,,0
CPT,89320,Laboratory Services,467.75,304.04,90.69,90.7,2
CPT,89320,"SEMEN ANALYSIS; COMPLETE (VOLUME, COUNT, MOTILITY AND DIFFERENTIAL)",467.75,304.04,130.82,208.34,2
CPT,89320,"SEMEN ANALYSIS; COMPLETE (VOLUME, COUNT, MOTILITY, AND DIFFERENTIAL)",467.75,304.04,29.95,29.95,2
CPT,89321,HB SEMEN ANAL POST VASECTOMY,338.25,219.86,,,0
CPT,89321,Laboratory Services,338.25,219.86,90.69,90.7,2
CPT,89321,"SEMAN ANALYSIS, PRESENCE AND/OR MOTILITY OF SPERM",338.25,219.86,105.18,167.52,2
CPT,89321,"SEMEN ANALYSIS, PRESENCE AND/OR MOTILITY OF SPERM",338.25,219.86,29.95,29.95,2
CPT,89322,Laboratory Services,,,116.66,116.67,2
CPT,89322,"SEMEN ANALYSIS; VOLUME, COUNT, MOTILITY, AND DIFFERENTIAL USING STRICT MORPHOLOGIC CRITERIA",,,135.29,215.46,2
CPT,89322,"SEMEN ANALYSIS; VOLUME, COUNT, MOTILITY, AND DIFFERENTIAL USING STRICT MORPHOLOGIC CRITERIA (EG, KRUGER)",,,38.27,38.27,2
CPT,89325,Laboratory Services,33.81,21.98,80.31,80.32,2
CPT,89325,SPERM ANTIBODIES,33.81,21.98,25.8,148.41,4
CPT,89329,Laboratory Services,,,157.73,157.75,2
CPT,89329,SPERM EVALUATION; HAMSTER PENETRATION TEST,,,48.26,291.59,4
CPT,89330,Laboratory Services,,,74.46,74.47,2
CPT,89330,"SPERM EVALUATION; CERVICAL MUCUS PENETRATION TEST, WITH OR WITHOUT SPINNBARKEIT TEST",,,25.8,137.65,4
CPT,89331,HB RETROGRADE EJACULATION URINANALYSIS,518.08,336.75,,,0
CPT,89331,Laboratory Services,518.08,336.75,147.35,147.37,2
CPT,89331,"SPERM EVALUATION, FOR RETROGRADE EJACULATION, URINE",518.08,336.75,171.03,272.39,2
CPT,89331,"SPERM EVALUATION, FOR RETROGRADE EJACULATION, URINE (SPERM CONCENTRATION, MOTILITY, AND MORPHOLOGY, AS INDICATED)",518.08,336.75,48.26,48.26,2
CPT,89335,"CRYOPRESERVATION, REPRODUCTIVE TISSUE, TESTICULAR",,,67.53,5166.23,4
CPT,89335,Laboratory Services,,,6984.5,6985.2,2
CPT,89337,"Cryopreservation, mature oocyte(s)",,,211.78,987.4,4
CPT,89337,Laboratory Services,,,3459.01,3459.36,2
CPT,89342,Laboratory Services,,,691.8,691.87,2
CPT,89342,"STORAGE, (PER YEAR); EMBRYO",,,1175.9,1872.74,2
CPT,89342,"STORAGE, (PER YEAR); EMBRYO(S)",,,211.78,211.78,2
CPT,89343,Laboratory Services,,,594.45,594.51,2
CPT,89343,"STORAGE, (PER YEAR); SPERM/SEMEN",,,211.78,1872.74,4
CPT,89344,Laboratory Services,,,933.18,933.27,2
CPT,89344,"STORAGE, (PER YEAR); REPRODUCTIVE TISSUE, TESTICULAR/OVARIAN",,,211.78,1872.74,4
CPT,89346,Laboratory Services,,,1358.45,1358.58,2
CPT,89346,"STORAGE, (PER YEAR); OOCYTE(S)",,,436.51,1872.74,4
CPT,89352,Laboratory Services,,,125.78,125.79,2
CPT,89352,THAWING OF CRYOPERSERVED; EMBRYO(S),,,705.54,1123.64,2
CPT,89352,THAWING OF CRYOPRESERVED; EMBRYO(S),,,211.78,211.78,2
CPT,89353,Laboratory Services,,,125.78,125.79,2
CPT,89353,"THAWING OF CRYOPERSERVED; SPERM/SEMEN, EACH ALIQUOT",,,705.54,1123.64,2
CPT,89353,"THAWING OF CRYOPRESERVED; SPERM/SEMEN, EACH ALIQUOT",,,67.53,67.53,2
CPT,89354,Laboratory Services,,,66.54,66.55,2
CPT,89354,"THAWING OF CRYOPRESERVED; REPRODUCTIVE TISSUE, TESTICULAR/OVARIAN",,,211.78,1123.64,4
CPT,89356,Laboratory Services,,,59.31,59.31,2
CPT,89356,"THAWING OF CRYOPRESERVED; OOCYTES, EACH ALIQUOT",,,211.78,1123.64,4
CPT,89398,Laboratory Services,437.5,284.38,,,0
CPT,89398,UNLISTED REPRODUCTIVE MEDICINE LABORATORY PROCEDURE,437.5,284.38,313.61,499.46,2
CPT,89398,Unlisted reproductive medicine laboratory procedure,437.5,284.38,67.53,67.53,2
CPT,90281,IMMUNE GLOBULIN (IG) HUMAN FOR INTRAMUSCULAR USE,,,49.06,52.38,2
CPT,90281,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.54,36.75,2
CPT,90283,"IMMUNE GLOBULIN (IGIV) HUMAN, FOR INTRAVENOUS USE",,,245.27,261.87,2
CPT,90283,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,162.67,183.69,2
CPT,90284,"IMMUNE GLOBULIN, HUMAN, FOR USE IN SUBCUTANEOUS INFUSION,100MG,EACH",,,39.61,42.29,2
CPT,90284,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.27,29.67,2
CPT,90288,"BOTULISM IMMUNE GLOBULIN, HUMAN, FOR INTRAVENOUS USE",,,1295.7,1383.38,2
CPT,90288,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,859.32,970.41,2
CPT,90291,"CYTOMEGALOVIRUS IMMUNE GLOBULIN (CMV-IGIV), HUMAN, FOR INTRAVENOUS USE",,,1645.54,1756.89,2
CPT,90291,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1091.34,1232.42,2
CPT,90371,"HEPATITIS B IMMUNE GLOBIN (HBIG), HUMAN, FOR INTRAMUSCULAR USE",,,456.83,487.74,2
CPT,90371,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",8711.68,5662.59,174.24,14761.0,25
CPT,90371,HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN,1917.42,1246.32,174.24,14761.0,6
CPT,90371,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,302.97,342.14,2
CPT,90375,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,15263.48,9921.26,358.25,14761.0,30
CPT,90375,"RABIES IMMUNE GLOBULIN (RIG) HUMAN, FOR INTRAMUSCULAR AND/OR SUBCUTANEOUS USE",,,205.09,218.97,2
CPT,90375,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,136.02,153.6,2
CPT,90376,"RABIES IMMUNE GLOBULIN, HEAT-TREATED (RIG-HT) HUMAN FOR INTRAMUSCULAR AND/OR SUBCUTANEOUS USE",,,202.33,216.02,2
CPT,90376,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,134.18,151.53,2
CPT,90377,"Rabies immune globulin, heat- and solvent/detergent-treated (RIg-HT S/D), human, for intramuscular and/or subcutaneous use",,,1018.25,1087.15,2
CPT,90377,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,675.31,762.61,2
CPT,90378,PALIVIZUMAB 50 MG/0.5 ML IM SOLN,23663.61,15381.345000000001,896.37,14761.0,6
CPT,90378,"RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, RECOMBINANT, FOR INTRAMUSCULAR USE, 50 MG, EACH",,,1653.14,1765.0,2
CPT,90378,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1096.38,1238.11,2
CPT,90384,"RHO(D) IMMUNE GLOBULIN(RHIG), HUMAN, FULL-DOSE, FOR INTRAMUSCULAR USE",,,293.57,313.43,2
CPT,90384,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,194.7,219.87,2
CPT,90385,"RHO(D) IMMUNE GLOBLIN (RHIG) HUMAN, MINI-DOSE FOR INTRAMUSCULAR USE",,,103.66,110.67,2
CPT,90385,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,68.75,77.63,2
CPT,90386,"RHO(D) IMMUNE GLOBULINE (RHIGIV), HUMAN, FOR INTRAVENOUS USE",,,375.58,400.99,2
CPT,90386,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,249.09,281.29,2
CPT,90389,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,13270.0,14761.0,4
CPT,90389,TETANUS IMMUNE GLOBULIN(TIG) HUMAN FOR INTRAMUSCULAR USE,,,285.62,304.95,2
CPT,90389,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,189.43,213.92,2
CPT,90396,"VARICELLA-ZOSTER IMMUNE GLOBULIN, HUMAN, FOR INTRAMUSCULAR",,,340.58,363.63,2
CPT,90396,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,225.88,255.08,2
CPT,90460,HB TERM IMMUNIZATION ADM ANY ROUTE 1ST VAC/TOX,4567.325,2968.7599999999998,,,0
CPT,90471,HB ADMIN HEPATITIS B VACCINE,396.14,257.49,88.62,101.91,8
CPT,90471,HB ADMIN INFLUENZA VACCINE,396.14,257.49,88.62,101.91,8
CPT,90471,HB ADMIN PNEUMOCOCCAL VACCINE,455.565,296.115,88.62,14761.0,10
CPT,90471,HB IMMUNIZATION ADM;1 VACCINE,455.565,296.115,88.62,14761.0,76
CPT,90472,HB IMMUNIZATION ADM;1 VACCINE,380.335,247.215,88.62,101.91,16
CPT,90472,HB TERM IMMUNIZATION ADM ANY ROUTE 1ST VAC/TOX,396.14,257.49,,,0
CPT,90472,"HB THER/PROPH/DIAG INJ, SC/IM",412.24,267.96,88.62,101.91,8
CPT,90472,"HB VACCINE ADMIN, EA ADD'L",419.205,272.48,13270.0,14761.0,4
CPT,90581,"ANTHRAX VACCINE, FOR SUBCUTANEOUS USE",,,282.66,301.79,2
CPT,90581,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,187.46,211.7,2
CPT,90585,BACILLU CALMETTE-GUERIN VACCINE(BCG) FOR TUBERCULOSIS LIVE FOR PERCUTANEOUS USE,,,486.07,518.96,2
CPT,90585,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,322.37,364.04,2
CPT,90586,BACILLUS CALMETTE-GUERIN VACCINE (BCG) FOR BLADDER CANCER LIVE FOR INTRAVESICAL USE,,,486.07,518.96,2
CPT,90586,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,322.37,364.04,2
CPT,90587,Drug - Vaccines Toxoids Immune Globulins,,,282.66,301.79,2
CPT,90587,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,187.46,211.7,2
CPT,90619,"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use",,,376.64,402.13,2
CPT,90619,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,249.79,282.08,2
CPT,90620,"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG",2556.08,1661.45,13270.0,14761.0,4
CPT,90620,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), 2 dose schedule, for intramuscular use (Code Price is per 0.5 mL = 1 dose)",,,510.75,545.31,2
CPT,90620,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,338.74,382.53,2
CPT,90621,"Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use (Code Price is per dose = 0.5 mL)",,,2311.53,2467.94,2
CPT,90621,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1533.03,1731.21,2
CPT,90625,"Cholera vaccine , live, adult dosage, 1 dose schedule for oral use",,,599.72,640.31,2
CPT,90625,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,397.74,449.16,2
CPT,90626,"TICK-BORNE ENCEPHALITIS VIRUS VACCINE, INACTIVATED; 0.25 ML DOSAGE, FOR INTRAMUSCULAR USE",,,802.42,856.72,2
CPT,90626,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,532.17,600.97,2
CPT,90627,Drug - Vaccines Toxoids Immune Globulins,,,802.42,856.72,2
CPT,90627,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,532.17,600.97,2
CPT,90630,"Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative-free, for intradermal use (Code Price is per 0.1 mL)",,,52.94,56.52,2
CPT,90630,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.11,39.65,2
CPT,90632,HEPATITIS A VACCINE ADULT DOSAGE FOR INTRAMUSCULAR,,,173.25,184.98,2
CPT,90632,HEPATITIS A VIRUS VACCINE (PF) 1440 UNITS IM SUSP,1024.22,665.74,,,0
CPT,90632,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,,,0
CPT,90632,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,114.9,129.76,2
CPT,90633,"HEPATITIS A VACCINE, PEDIATRIC/ADOLESCENT DOSAGE-2 DOSE SCHEDULE, FOR INTRAMUSCULAR",,,82.75,88.35,2
CPT,90633,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.88,61.98,2
CPT,90634,"HEPATITS A VACCINE PEDIATRIC/ADOLESCENT DOSAGE-3 DOSE SCHEDULE, FOR INTRAMUSCULAR USE",,,82.75,88.35,2
CPT,90634,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.88,61.98,2
CPT,90636,HEPATITS A AND HEPATITIS B VACCINE(HEPA-HEPB) ADULT DOSAGE FOR INTRAMUSCULAR USE,,,259.71,277.28,2
CPT,90636,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,172.24,194.51,2
CPT,90644,"MENINGOCOCCAL CONJUGATE VACCINE SEROGROUPS C & Y & HEMOPHILUS INFLUENZA B VACCINE, TETANUS TOIXOID CONJUGATE (HIB-MENCY-",,,296.16,316.2,2
CPT,90644,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,196.42,221.81,2
CPT,90647,HEMOPHILUS INFLUENZA B VACCINE (HIB) PRP-OMP CONJUGATE (3 DOSE SCHEDULE) FOR INTRAMUSCULAR USE,,,141.61,151.2,2
CPT,90647,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.92,106.06,2
CPT,90648,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,10386.4,6751.16,13270.0,14761.0,2
CPT,90648,HEMOPHILUS INFLUENZA B VACCINCE (HIB) PRP-T CONJUGATE (4 DOSE SCHEDULE) FOR INTRAMUSCULAR,,,67.01,71.54,2
CPT,90648,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,44.44,50.18,2
CPT,90649,"HUMAN PAPILLOMA VIRUS (HPV) VACCINE, TYPES 6, 11, 16, 18; 3 DOSE SCHEDULE, FOR INTRAMUSCULAR USE",,,357.07,381.23,2
CPT,90649,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,236.81,267.43,2
CPT,90650,"HUMAN PAPILLOMA VIRUS (HPV) VACCINE, TYPES 16, 18, BIVALENT, 3 DOSE SCHEDULE, FOR INTRAMUSCULAR USE",,,367.44,392.3,2
CPT,90650,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,243.69,275.19,2
CPT,90651,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",4586.35,2981.13,,,0
CPT,90651,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 3 dose schedule, for intramuscular use (Code Price is per one dose = 0.5 mL) (Gardasil 9 is only indicated for",,,465.34,496.83,2
CPT,90651,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,308.62,348.52,2
CPT,90653,"Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use",,,139.2,148.61,2
CPT,90653,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,92.32,104.25,2
CPT,90654,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS PRESERVATIVE FREE, FOR INTRADERMAL USE",,,47.39,50.59,2
CPT,90654,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.43,35.49,2
CPT,90655,"INFLUENZA VIRUS VACCINE, TRIVALENT, SPLIT VIRUS, PRESERVATIVE FREE, WHEN ADMINISTERED TO CHILDREN 6-35 MONTHS OF AGE FOR",,,39.61,42.29,2
CPT,90655,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.27,29.67,2
CPT,90656,"INFLUENZA VIRUS VACCINE, TRIVALENT, SPLIT VIRUS, PRESERVATIVE FREE, WHEN ADMINISTERED TO CHILDREN 3 YEARS AND OLDER FOR",,,40.55,43.29,2
CPT,90656,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.89,30.37,2
CPT,90657,"INFLUENZA VIRUS VACCINE, TRIVALENT, SPLIT VIRUS, WHEN ADMINISTERED TO CHILDREN 6-35 MONTHS OF AGE, FOR INTRAMUSCULAR USE",,,11.67,12.46,2
CPT,90657,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.74,8.74,2
CPT,90658,"INFLUENZA VIRUS VACCINE, TRIVALENT, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSC",,,23.15,24.72,2
CPT,90658,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.35,17.34,2
CPT,90660,"INFLUENZA VIRUS VACCINE, TRIVALENT, FOR INTRANASAL USE",,,152.15,162.45,2
CPT,90660,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,100.91,113.95,2
CPT,90662,FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
CPT,90662,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, PRESERVATIVE FREE, ENCHANCED IMMUNOGENICITY VIA INCREASED ANTIGEN CONTENT, FOR INT",,,77.2,82.42,2
CPT,90662,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.2,57.82,2
CPT,90670,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,11912.71,7743.26,13270.0,14761.0,2
CPT,90670,"Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use (Code Price is per dose = 0.5 mL)",,,327.45,349.61,2
CPT,90670,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,217.17,245.25,2
CPT,90671,Drug - Vaccines Toxoids Immune Globulins,,,616.75,658.49,2
CPT,90671,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,409.04,461.92,2
CPT,90672,"INFLUENZA VIRUS VACCINE, QUADRIVALENT, LIVE, FOR INTRANASAL USE",,,61.65,65.82,2
CPT,90672,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.89,46.17,2
CPT,90673,"INFLUENZA VIRUS VACCINE, TRIVALENT, DERIVED FROM RECOMBINANT DNA (RIV3), HEMAGGLUTNIN (HA) PROTEIN ONLY, PRESERVATIVE AND ANTIBIOTIC FREE, FOR INTRAMUSCULAR USE",,,93.11,99.41,2
CPT,90673,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,61.75,69.73,2
CPT,90674,FLU VAC QS 2022(6 MS UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
CPT,90674,"Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use",,,57.38,61.26,2
CPT,90674,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,38.06,42.98,2
CPT,90675,RABIES VACCINE FOR INTRAMUSCULAR USE,,,408.33,435.96,2
CPT,90675,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",4835.6,3143.1400000000003,435.99,14761.0,30
CPT,90675,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,270.81,305.82,2
CPT,90676,RABIES VACCINE FOR INTRADERMAL USE,,,239.72,255.94,2
CPT,90676,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,158.98,179.54,2
CPT,90677,Drug - Vaccines Toxoids Immune Globulins,,,665.08,710.08,2
CPT,90677,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3861.76,2510.14,13270.0,14761.0,2
CPT,90677,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,441.08,498.11,2
CPT,90680,"ROTAVIRUS VACCINE, PENTAVALENT, 3 DOSE SCHEDULE, LIVE FOR ORAL USE`",,,187.89,200.6,2
CPT,90680,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,124.61,140.72,2
CPT,90681,"ROTAVIRUS VACCINE,HUMAN,ATTENTUATED, 2 DOSE SCHEDULE, LIVE, FOR ORAL USE",,,304.5,325.11,2
CPT,90681,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,201.95,228.06,2
CPT,90682,"Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use",,,239.47,381.38,2
CPT,90685,"INFLUENZA VIRIS VACCINE, QUADRIVALENT SPLIT VIRUS, PRESERVATIVE FREE, WHEN ADMINISTERED TO CHILDREN 6-35 MONTHS OF AGE,",,,60.91,65.03,2
CPT,90685,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.4,45.62,2
CPT,90686,FLU VAC QS2022-23 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
CPT,90686,FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
CPT,90686,"INFLUENZA VIRUS VACCINE, QUADRIVALENT, SPLIT VIRUS, PRESERVATIVE FREE, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE I",,,50.17,53.57,2
CPT,90686,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.28,37.58,2
CPT,90687,"Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL, for intramuscular use",,,22.41,23.93,2
CPT,90687,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.86,16.78,2
CPT,90688,"INFLUENZA VIRUS VACCINE, QUADRIVALENT, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAM",,,42.2,45.06,2
CPT,90688,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.99,31.61,2
CPT,90689,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,90689,Vacc iiv4 no prsrv 0.25ml im,,,60.71,64.82,2
CPT,90689,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.27,45.47,2
CPT,90690,TYPHOID VACCINE LIVE ORAL,,,25.54,27.27,2
CPT,90690,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.94,19.13,2
CPT,90691,TYPHOID VACCINE VI CAPSULAR POLYSACCARIDE (VICPS) FOR INTRAMUSCULAR USE,,,122.54,130.83,2
CPT,90691,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,20482.8,13313.82,,,0
CPT,90691,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.27,91.77,2
CPT,90694,"Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use",,,52.94,56.52,2
CPT,90694,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.11,39.65,2
CPT,90696,"PERTUSSIS VACCINE AND POLIOVIRUS VACCINE, INACTIVATED (DTAP-IPV),WHEN ADMIN TO CHILDRN 4 THRU 6 YRS OF AGE,FOR INTRMUSC",,,141.05,150.59,2
CPT,90696,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.54,105.64,2
CPT,90697,"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intra",,,351.89,375.7,2
CPT,90697,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,233.37,263.54,2
CPT,90698,"DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HAEMOPHILUS INFLUENZA TYPE B, AND POLIOVIRUS VACCINE, INACTI",,,136.06,145.27,2
CPT,90698,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,90.24,101.9,2
CPT,90700,"DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG",10974.18,7133.215,13270.0,14761.0,2
CPT,90700,"DIPTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE (DTAP), WHEN ADMINISTERED TO YOUNGER THAN 7 YEARS, FOR INTRA",,,54.62,58.31,2
CPT,90700,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,36.22,40.91,2
CPT,90702,"DIPTHERIA AND TETANUS TOXOIDS (DT) ADSORBED WHEN ADMINISTERED TO YOUNGER THAN 7 YEARS, FOR INTRAMUSCULAR USE",,,36.11,38.55,2
CPT,90702,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.95,27.04,2
CPT,90707,"MEASLES, MUMPS AND RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCTUANEOUS USE",,,115.87,123.71,2
CPT,90707,"MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR",1352.35,879.03,13270.0,14761.0,4
CPT,90707,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,76.85,86.78,2
CPT,90710,"IMMUNIZATION, ACTIVE; MEASLES, MUMPS, RUBELLA, AND VARICELLAVACCINE",,,311.17,332.22,2
CPT,90710,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,206.37,233.05,2
CPT,90713,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP,10974.18,7133.215,13270.0,14761.0,2
CPT,90713,"POLIOVIRUS VACCINE, INACTIVATED, (IPV), FOR SUBCUTANEOUS OR INTRAMUSCULAR USE",,,77.2,82.42,2
CPT,90713,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.2,57.82,2
CPT,90714,TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG,10542.56,6852.665,13270.0,14761.0,2
CPT,90714,"Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use (Code Price is per 0.5 mL)",,,57.01,60.87,2
CPT,90714,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,37.81,42.7,2
CPT,90715,"DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG",20482.8,13313.82,,,0
CPT,90715,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",647.655,420.975,13270.0,14761.0,4
CPT,90715,"TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINISTERED TO 7 YRS OR OLDER, FOR IM USE",,,115.13,122.92,2
CPT,90715,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,76.36,86.23,2
CPT,90716,"IMMUNIZATON, ACTIVE; VARICELLA(CHICKEN POX) VACCINE",,,180.86,193.09,2
CPT,90716,VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SC SUSR,10974.18,7133.215,,,0
CPT,90716,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,119.94,135.45,2
CPT,90717,"IMMUNIZATION, ACTIVE; YELLOW FEVER VACCINE",,,199.91,213.44,2
CPT,90717,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,132.58,149.72,2
CPT,90723,"DIPTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HEPATITIS B AND POLIO VIRUS VACCINE,INACTIVATED,FOR IM USE",,,183.62,196.04,2
CPT,90723,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,121.78,137.52,2
CPT,90732,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
CPT,90732,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SYRG,1745.28,1134.43,,,0
CPT,90732,"PNEUMOCOCCAL POLYSACCHARIDE VACCINE, 23-VALENT, ADULT OR IMMUNOSUPPRESSED PT DOSAGE, WHEN ADMINISTERED TO 2 YRS OR OLDER",,,48.69,51.99,2
CPT,90732,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.29,36.47,2
CPT,90733,"MENINGOCOCCAL POLYSACCHARIDE VACCINE (ANY GROUP(S)), FOR SUBCUTANEOUS USE",,,208.42,222.53,2
CPT,90733,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,138.23,156.1,2
CPT,90734,"MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR",1650.59,1072.88,13270.0,14761.0,2
CPT,90734,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",1650.59,1072.88,,,0
CPT,90734,"MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN",20482.8,13313.82,,,0
CPT,90734,"MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS A,C,Y AND W-135,FOR INTRAMUSCULAR USE",,,212.49,226.87,2
CPT,90734,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,140.93,159.15,2
CPT,90736,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,318.68,359.88,2
CPT,90736,"Zoster (shingles) vaccine (HZV), live, for subcutaneous injection (Code Price is per single dose)",,,480.52,513.03,2
CPT,90738,"Japanese encephalitis virus vaccine, inactivated, for intramuscular use (Code Price is per 0.5 mL = 1 dose)",,,556.98,594.67,2
CPT,90738,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,369.39,417.15,2
CPT,90739,HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG,1948.67,1266.64,13270.0,14761.0,2
CPT,90739,"Hepatitis B vaccine (HepB), adult dosage, 2 dose schedule, for intramuscular use (Code Price is per 0.5 mL = 1 dose)",,,337.18,359.99,2
CPT,90739,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,223.62,252.53,2
CPT,90740,"HEPATITIS B VACCINE, DIALYSIS OR IMMUNOSUPPRESSED PATIENT DOSAGE (3 DOSE SCHEDULE),FOR IM USE",,,548.46,585.58,2
CPT,90740,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP,684.02,444.61,13270.0,14761.0,2
CPT,90740,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,363.75,410.77,2
CPT,90743,"HEPATITIS B VACCINE, ADOLESCENT (2 DOSE SCHEDULE), FOR IM USE",,,196.95,210.27,2
CPT,90743,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,130.62,147.5,2
CPT,90744,HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG,296.96,193.02,13270.0,14761.0,2
CPT,90744,"IMMUNIZATION, ACTIVE, HEPATITUS B VACCINE; PEDIATRIC ADOLESCENT DOSAGE(3 DOSE SCHEDULE) FOR INTRAMUSCULARE USE",,,80.16,85.58,2
CPT,90744,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.16,60.04,2
CPT,90746,"HEPATITIS B VACCINE, ADULT DOSAGE (3 DOSE SCHEDULE), FOR INTRAMUSCULAR USE",,,149.56,159.68,2
CPT,90746,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,13270.0,14761.0,2
CPT,90746,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,99.19,112.01,2
CPT,90747,IMMUINZATION ACTIVE HEPATITUS DIALYSIS OR IMMUNOSUPPRESSED PATIENT ANY AGE(4 DOSE SCHEDULE)INTRAMUSCULAR USE,,,548.46,585.58,2
CPT,90747,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,363.75,410.77,2
CPT,90748,"IMMUNIZATION,ACTIVE,HEPATITIS B AND HEMOPILUS INFLUENZA B (HIB) VACCINE",,,131.42,140.31,2
CPT,90748,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,87.16,98.43,2
CPT,90750,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,11627.93,7558.155,,,0
CPT,90750,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,265.16,299.44,2
CPT,90750,"ZOSTER (SHINGLES) VACCINE (HZV), RECOMBINANT, SUB-UNIT, ADJUVANTED, FOR INTRAMUSCULAR INJECTION",,,399.82,426.87,2
CPT,90756,"Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5mL dosage, for intramuscular use",,,57.01,60.87,2
CPT,90756,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,37.81,42.7,2
CPT,90765,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90766,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90767,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90768,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90772,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90773,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90774,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90775,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90779,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,90791,HB DIAG INTERVIEW EXAM 60 MINUTES,1397.19,908.17,200.06,230.07,8
CPT,90791,HB PSYCH DIAGNOSTIC EVALUATION,1397.19,908.17,200.06,230.07,8
CPT,90792,HB PSYCH DIAG EVAL W/MED SRVCS,873.24,567.61,200.06,230.07,8
CPT,90832,HB PSYCHOTHERAPY 30 MINUTES,1047.89,681.13,200.06,230.07,8
CPT,90834,HB PSYCHOTHERAPY 45 MINUTES,1222.54,794.65,200.06,230.07,8
CPT,90837,HB PSYCHOTHERAPY 60 MINUTES,1397.19,908.17,200.06,230.07,8
CPT,90838,HB PSYCHOTHERAPY W/E&M 60 MIN,1588.26,1032.37,,,0
CPT,90867,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,90867,THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; PLANNING,,,19475.14,31016.13,2
CPT,90868,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,90868,"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; DELIVERY AND MANAGEMENT, PER SESSION",,,9402.2,14973.96,2
CPT,90869,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,90912,HB BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,3712.18,2412.92,,,0
CPT,90913,HB BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,3712.18,2412.92,,,0
CPT,90935,HB ACUTE HEMODIALYSIS INPATIENT,10688.3,6947.39,871.28,14761.0,18
CPT,90940,HEMODIALYSIS ACCESS FLOW STUDY TO DETERMINE BLOOD FLOW IN GRAFTS AND ARTERIOVENOUS FISTULAE BY AN INDICATOR,,,366.0,582.89,2
CPT,90945,HB CRRT VENOUS HEMODIALYSIS,22619.1,14702.41,13270.0,14761.0,2
CPT,90945,HB PERITONEAL DIALYSIS,22619.1,14702.41,530.23,14761.0,18
CPT,91010,ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY WITH INTERPRETATION AND R,10088.0,6557.2,274.75,437.57,2
CPT,91010,HB ESOPHAGEAL MANOMTRY W/INTER RPT 2D,10088.0,6557.2,660.7,14761.0,18
CPT,91010,Outpatient Grouper - 0,10088.0,6557.2,9059.94,9827.82,24
CPT,91013,"ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS, STUDY WITH INTERPRETATION AND REPORT; WITH STIMULATION OR PERFU",8558.16,5562.8,90.43,144.01,2
CPT,91013,Outpatient Grouper - 0,8558.16,5562.8,9059.94,9827.82,24
CPT,91020,ESOPHAGOGASTRIC MANOMETRIC STUDIES,6052.84,3934.35,211.25,336.44,2
CPT,91020,HB ANTRODUODENAL MANOMETRY,6052.84,3934.35,660.7,759.8,8
CPT,91020,Outpatient Grouper - 0,6052.84,3934.35,9059.94,9827.82,24
CPT,91022,DUODENAL MOTILITY (MANOMETRIC) STUDY ï,16460.4,10699.26,178.62,284.47,2
CPT,91022,HB DUODENAL MOTILITY STUDY,16460.4,10699.26,660.7,759.8,8
CPT,91022,Outpatient Grouper - 0,16460.4,10699.26,9059.94,9827.82,24
CPT,91030,"ESOPHAGUS, ACID PERFUSION (BERNSTEIN) TEST FOR ESOPHAGITIS",,,72.79,115.92,2
CPT,91030,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91034,"ESOPHAGUS, GASTROESOPHAGEAL REFLUX TEST; WITH NASAL CATHETERPH ELECTRODE(S) PLACEMENT, RECORDING, ANALYSIS AND INTERPRET",6052.84,3934.35,1728.57,2752.93,2
CPT,91034,HB 24 HR ESOPHAGEAL PH STUDY,6052.84,3934.35,660.7,759.8,8
CPT,91034,Outpatient Grouper - 0,6052.84,3934.35,9059.94,9827.82,24
CPT,91035,"ESOPHAGUS, GASTROESOPHAGEAL REFLUX TEST; WITH MUCOSAL ATTACHTELEMETRY PH ELECTRODE PLACEMENT, RECORDING, ANALYSIS AND IN",10106.0,6568.9,3637.94,5793.79,2
CPT,91035,Outpatient Grouper - 0,10106.0,6568.9,9059.94,9827.82,24
CPT,91037,"ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST WITH USUAL CATHETER INTRALUMINAL IMPEDANCE ELECTRODE(S) PLACEMENT",3969.24,2580.01,892.1,1420.75,2
CPT,91037,HB ESOPH IMPED FUNCTION TEST,3969.24,2580.01,387.75,14761.0,10
CPT,91037,Outpatient Grouper - 0,3969.24,2580.01,9059.94,9827.82,24
CPT,91038,"ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST WITH USUAL CATHETER INTRALUMINAL IMPEDANCE ELECTRODE(S) PLACEMENT",6052.84,3934.35,618.23,984.59,2
CPT,91038,HB IMPEDANCE PH REFLUX,6052.84,3934.35,660.7,759.8,8
CPT,91038,Outpatient Grouper - 0,6052.84,3934.35,9059.94,9827.82,24
CPT,91040,ESOPHAGEAL BALLOON DISTENSION PROVOCATION STUDY,,,3887.53,6191.28,2
CPT,91040,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91065,"BREATH HYDROGEN TEST (EG, FOR DETECTION OF LACTASE DEFICIENCY), FRUCTOSE INTOLERANCE, BACTERIAL OVERGROWTH, OR ORO-CECAL",3283.21,2134.09,153.93,245.14,2
CPT,91065,HB LACT/GLUC/FRUC HYDROGEN OR METHANE BREATH TEST,3283.21,2134.09,194.82,224.05,16
CPT,91065,Outpatient Grouper - 0,3283.21,2134.09,9059.94,9827.82,24
CPT,91110,"GASTROINTESTINAL TRACT IMAGING, INTRALUMINAL ESOPHAGUS THROUGH ILEUM, WITH INTERPRETATION AND REPORT",11922.5,7749.63,6723.8,10708.33,2
CPT,91110,Outpatient Grouper - 2,11922.5,7749.63,13036.88,14143.2,24
CPT,91111,"GASTROINTESTINAL TRACT IMAGING, INTRALUMINAL ESOPHAGUS WITH INTERPRETATION AND REPORT",,,5428.72,8645.79,2
CPT,91111,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,91112,"GASTROINTESTINAL TRANSIT AND PRESSURE MEASUREMENT, STOMACH THROUGH COLON WIRELESS CAPSULE, WITH INTERPRETATION/REPORT",14513.0,9433.45,8184.73,13035.02,2
CPT,91112,HB GI WIRELESS CAPSULE MEASURE,14513.0,9433.45,1167.44,1342.55,8
CPT,91112,Outpatient Grouper - 2,14513.0,9433.45,13036.88,14143.2,24
CPT,91112,Outpatient Surgical Group 2,14513.0,9433.45,12162.28,18056.43,50
CPT,91113,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report",5552.49,3609.12,4660.09,7421.67,2
CPT,91117,"COLON MOTILITY (MANOMETRIC) STUDY, MIN 6 HOURS CONTINUOUS RECORDING (INCLUDING PROVOCATION TESTS, EG, MEAL, INTRACOLONIC",,,829.89,1321.69,2
CPT,91117,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91120,HB RECTAL SENSATION TEST,6786.19,4411.02,387.75,445.91,8
CPT,91120,Outpatient Grouper - 0,6786.19,4411.02,9059.94,9827.82,24
CPT,91120,"RECTAL SENSATION, TONE, AND COMPLIANCE TEST",6786.19,4411.02,3827.14,6095.11,2
CPT,91122,ANORECTAL MANOMETRY,4202.01,2731.31,274.75,437.57,2
CPT,91122,HB ANORECTAL MANOMETRY,4202.01,2731.31,387.75,445.91,24
CPT,91122,Outpatient Grouper - 0,4202.01,2731.31,9059.94,9827.82,24
CPT,91132,"ELECTROGASTROGRAPHY, DIAGNOSTIC, TRANSCUTANEOUS;",,,970.12,1545.01,2
CPT,91132,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91133,"ELECTROGASTROGRAPHY, DIAGNOSTIC, TRANSCUTANEOUS; WITH PROVOCATIVE TESTING",,,1058.31,1685.47,2
CPT,91133,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91200,HB FIBROSCAN,3283.21,2134.09,194.82,224.05,16
CPT,91200,Liver elastography,3283.21,2134.09,274.28,436.82,2
CPT,91299,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,91305,"COVID-19 VAC, TRIS(PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",10974.18,7133.215,13270.0,14761.0,4
CPT,91312,"COVID-19 VAC, BV (PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",10974.18,7133.215,13270.0,14761.0,2
CPT,92002,HB EYE EXAM INTERMEDIATE NEW PATIENT,1669.54,1085.2,160.47,184.54,24
CPT,92012,HB EYE EXAM INTERMEDIATE EST PATIENT,1669.54,1085.2,160.47,184.54,8
CPT,92012,HB EYE EXAM INTERMEDIATE NEW PATIENT,1669.54,1085.2,160.47,184.54,24
CPT,92014,HB EYE EXAM & TREATMENT EST PATIENT 1+VISITS,1669.54,1085.2,160.47,184.54,8
CPT,92018,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92018,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,92019,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92019,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
CPT,92066,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,92082,HB PERIMETRY VFS INTMD,1037.19,674.17,73.96,85.06,16
CPT,92083,HB PERIMETRY VFS COMPR,1074.29,698.29,160.5,184.58,16
CPT,92100,SERIAL TONOMETRY (SEPARATE PROCEDURE) WITH MULTIPLE MEASUREMENTS OF INTRAOCULAR PRESSURE OVER AN EXTENDED TIME,,,279.57,445.24,2
CPT,92132,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,92133,HB CMPTRZD OPHTH IMG OPTIC NERVE,1037.19,674.17,73.96,85.06,16
CPT,92133,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,92134,HB CMPTRZD OPHTH IMG RETINA,1037.19,674.17,73.96,85.06,16
CPT,92134,Outpatient Surgical Group 0,1037.19,674.17,2806.68,4166.87,50
CPT,92136,HB LENSTAR,1074.29,698.29,160.5,184.58,8
CPT,92136,OPHTHALMIC BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY WITH INTRAOCULAR LENS POWER CALCULATION,1074.29,698.29,359.83,573.06,2
CPT,92145,Corneal hysteresis deter,,,56.91,90.64,2
CPT,92227,"REMOTE IMAGING FOR DETECTION OF RETINAL DISEASE (EG, RETINOPATHY IN A PATIENT WITH DIABETES) WITH ANALYSIS AND REPORT U",,,67.03,106.75,2
CPT,92228,"REMOTE IMAGING FOR MONITORING AND MANAGEMENT OF ACTIVE RETINAL DISEASE (EG, DIABETIC RETINOPATHY) WITH PHYSICIAN REVIEW,",,,73.2,116.58,2
CPT,92229,"Imaging of retina for detection or monitoring of disease; point-of-care automated analysis and report, unilateral or bilateral",1037.19,674.17,140.33,140.33,2
CPT,92235,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92240,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92242,"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral",,,1525.32,2429.22,2
CPT,92250,HB RETINAL FUNDUS,1074.29,698.29,160.5,184.58,16
CPT,92250,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,92260,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92265,"OCULOELECTROMYOGRAPHY, ONE OR MORE EXTRAOCULAR MUSCLES, ONE OR BOTH EYES, WITH MEDICAL DIAGNOSTIC EVALUATION",,,141.99,226.13,2
CPT,92270,"ELECTRO-OCULOGRAPHY, WITH MEDICAL DIAGNOSTIC EVALUATION",,,85.14,135.59,2
CPT,92273,Full field erg w/i&r,,,641.63,1021.86,2
CPT,92274,Multifocal erg w/i&r,,,381.46,607.52,2
CPT,92283,"COLOR VISION EXAMINATION, EXTENDED, EG, ANOMALOSCOPE OR EQUIVALENT",,,39.69,63.2,2
CPT,92284,"DARK ADAPTATION EXAMINATION, WITH MEDICAL DIAGNOSTIC EVALUATION",,,50.74,80.81,2
CPT,92285,"EXTERNAL OCULAR PHOTOGRAPHY WITH MEDICAL DIAGNOSTIC EVALUATION FOR DOCUMENTATION OF MEDICAL PROGRESS (EG, CLO",1037.19,674.17,36.16,57.59,2
CPT,92286,ANTERIOR SEGMENT PHOTOGRAPHY WITH INTERPRETATIONA ND REPORT; WITH SPECULAR ENDOTHELIAL MICROSCOPY AND CELL COUNT,1074.29,698.29,116.0,184.75,2
CPT,92287,ANTERIOR SEGMENT PHOTOGRAPHY WITH INTERPRETATION AND REPORT; WITH FLUORESCEIN ANGIOGRAPHY,1176.03,764.42,638.1,1016.24,2
CPT,92499,HB FIBERLAYER PHO OPTHAL NERVE,486.73,316.37,30.49,35.07,16
CPT,92502,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92502,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,92507,HB SP LANG VC SPCH IND TRT (4) EXT,1706.895,1109.485,13270.0,14761.0,2
CPT,92511,OUTPATIENT SURGERY CPT GROUP 1,1600.66,1040.43,6417.0,7038.0,2
CPT,92520,HB SP LARYN FUNC STUDY - (2) INT,862.57,560.67,160.5,184.58,8
CPT,92521,HB SP FLUENCY EVAL (3) MOD,1413.39,918.7,,,0
CPT,92522,HB SP SOUND PROD EVAL (1) BRF,1413.39,918.7,,,0
CPT,92523,HB SP LANG/COGNITIVE EVALUATION,1837.4,1194.31,13270.0,14761.0,2
CPT,92523,HB SP SOUND PROD W/LAN EVAL (2) INT,1625.395,1056.505,13270.0,14761.0,2
CPT,92524,HB VOICE RESN BEH QLT ANL(3)MOD,2111.895,1372.73,13270.0,14761.0,2
CPT,92526,HB SWALLOW THERAPY (2) INT,1924.1550000000002,1250.6999999999998,13270.0,14761.0,2
CPT,92537,Caloric vstblr test w/rec,,,72.32,115.17,2
CPT,92537,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,92538,Caloric vstblr test w/rec,,,38.8,61.8,2
CPT,92538,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,92549,"Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), incl",,,108.95,173.51,2
CPT,92551,HB HEARING SCREENING,770.66,500.93,13270.0,14761.0,2
CPT,92597,HB SP VOICE PROSTH DEVICE EVAL,2598.83,1689.2399999999998,13270.0,14761.0,4
CPT,92607,HB EVAL SGD 1HR,2259.41,1468.62,,,0
CPT,92608,HB EVAL SGD EACH ADD 30 MIN.,1129.73,734.32,,,0
CPT,92610,HB SWALLOW EVAL (2) INT,1624.92,1056.1950000000002,13270.0,14761.0,4
CPT,92610,HB SWALLOW EVAL (3) MOD,1624.92,1056.1950000000002,13270.0,14761.0,2
CPT,92611,HB VIDEO SWALLOW EVAL,3359.67,2183.785,13270.0,14761.0,4
CPT,92612,HB SP ENDOSCOPIC SWALLOW EVAL,2457.835,1597.59,13270.0,14761.0,4
CPT,92620,"EVALUATION OF CENTRAL AUDITORY FUNCTION, WITH REPORT; INITIAL 60 MINUTES",,,430.38,685.42,2
CPT,92621,"EVALUATION OF CENTRAL AUDITORY FUNCTION, WITH REPORT; EACH ADDITIONAL 15 MINUTES",,,101.89,162.27,2
CPT,92622,Outpatient Surgical Group 0,3189.86,2073.41,2806.68,4166.87,50
CPT,92623,Outpatient Surgical Group 0,808.8,525.72,2806.68,4166.87,50
CPT,92625,"ASSESSMENT OF TINNITUS (INCLUDING PITCH, LOUDNESS MATCHING, AND MASKING)",,,422.91,673.53,2
CPT,92650,HB NEWBORN HEARING SCREEN TST-IP,4427.19,2877.67,13270.0,14761.0,4
CPT,92653,HB AEP NEURODIAGOSTIC I&R,4564.63,2967.01,387.75,14761.0,10
CPT,92920,HB PTCA RC ARTERY SINGLE,61034.1,39672.17,7099.46,14761.0,20
CPT,92920,Outpatient Grouper - 6,61034.1,39672.17,28632.25,34209.93,24
CPT,92920,Outpatient Surgery Group 9 Global Rate,61034.1,39672.17,36365.0,36365.0,1
CPT,92920,Outpatient Surgical Group 5,61034.1,39672.17,19539.84,29009.34,50
CPT,92921,HB PTCA LD ARTERY EACH ADDL,47616.9,30950.99,13270.0,14761.0,4
CPT,92921,Outpatient Grouper - 6,47616.9,30950.99,28632.25,34209.93,24
CPT,92921,Outpatient Surgery Group 3 Global Rate,47616.9,30950.99,22055.0,22787.0,2
CPT,92921,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,50
CPT,92924,HB PTC ATHER/ANGIO ARTERY CIRCUMFLEX,102328.0,66513.2,13270.0,14761.0,2
CPT,92924,HB PTC ATHER/ANGIO LAD ARTERY SINGLE,102328.0,66513.2,14121.14,16239.31,8
CPT,92924,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
CPT,92924,Outpatient Surgery Group 9 Global Rate,102328.0,66513.2,36365.0,36365.0,1
CPT,92924,Outpatient Surgical Group 5,102328.0,66513.2,19539.84,29009.34,50
CPT,92925,Outpatient Grouper - 7,84912.1,55192.87,32948.13,35744.6,24
CPT,92925,Outpatient Surgery Group 3 Global Rate,84912.1,55192.87,22055.0,22787.0,2
CPT,92925,Outpatient Surgical Group 5,84912.1,55192.87,19539.84,29009.34,50
CPT,92928,"HB STENT, PLACE LC RX-ELUT",84349.5,54827.175,13270.0,16239.31,28
CPT,92928,Outpatient Grouper - 6,131492.0,85469.8,28632.25,34209.93,24
CPT,92928,Outpatient Surgery Group 9 Global Rate,131492.0,85469.8,36365.0,36365.0,1
CPT,92928,Outpatient Surgical Group 5,131492.0,85469.8,19539.84,29009.34,50
CPT,92929,"HB STENT, PLACE LC RX ADDL VSL",102585.0,66680.25,13270.0,14761.0,4
CPT,92929,Outpatient Grouper - 6,102585.0,66680.25,28632.25,34209.93,24
CPT,92929,Outpatient Surgery Group 3 Global Rate,102585.0,66680.25,22055.0,22787.0,2
CPT,92929,Outpatient Surgical Group 5,102585.0,66680.25,19539.84,29009.34,50
CPT,92933,HB PTC ATHER/STENT/ANGIO SINGLE,114605.0,74493.25,13270.0,25713.42,10
CPT,92933,Outpatient Grouper - 6,114605.0,74493.25,28632.25,34209.93,24
CPT,92933,Outpatient Surgery Group 9 Global Rate,114605.0,74493.25,36365.0,36365.0,1
CPT,92933,Outpatient Surgical Group 5,114605.0,74493.25,19539.84,29009.34,50
CPT,92934,HB PTC ATHER/STENT/ANGIO EA ADDL,109344.0,71073.6,13270.0,14761.0,2
CPT,92934,Outpatient Grouper - 6,109344.0,71073.6,28632.25,34209.93,24
CPT,92934,Outpatient Surgery Group 3 Global Rate,109344.0,71073.6,22055.0,22787.0,2
CPT,92934,Outpatient Surgical Group 5,109344.0,71073.6,19539.84,29009.34,50
CPT,92937,HB REVASC BYP GRAFT 1 VSL W DES,91583.6,59529.34,13270.0,16239.31,20
CPT,92937,Outpatient Grouper - 6,91583.6,59529.34,28632.25,34209.93,24
CPT,92937,Outpatient Surgery Group 9 Global Rate,91583.6,59529.34,36365.0,36365.0,1
CPT,92937,Outpatient Surgical Group 5,91583.6,59529.34,19539.84,29009.34,50
CPT,92938,HB REVASC BYP GRAFT ADDL W DES,76004.3,49402.8,13270.0,14761.0,2
CPT,92938,Outpatient Grouper - 6,76004.3,49402.8,28632.25,34209.93,24
CPT,92938,Outpatient Surgery Group 3 Global Rate,76004.3,49402.8,22055.0,22787.0,2
CPT,92938,Outpatient Surgical Group 5,76004.3,49402.8,19539.84,29009.34,50
CPT,92941,HB CARD REVASC MI 1 VSL W DES,105135.1,68337.815,13270.0,14761.0,6
CPT,92941,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
CPT,92941,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,92941,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,92943,HB REVSC CTO INI VSL W DES,76744.5,49883.925,13270.0,16239.31,38
CPT,92943,Outpatient Grouper - 6,116282.0,75583.3,28632.25,34209.93,24
CPT,92943,Outpatient Surgery Group 9 Global Rate,116282.0,75583.3,36365.0,36365.0,1
CPT,92943,Outpatient Surgical Group 5,116282.0,75583.3,19539.84,29009.34,50
CPT,92944,HB REVSC CTO ADDL W DES,96514.0,62734.1,13270.0,14761.0,4
CPT,92944,Outpatient Grouper - 6,96514.0,62734.1,28632.25,34209.93,24
CPT,92944,Outpatient Surgery Group 3 Global Rate,96514.0,62734.1,22055.0,22787.0,2
CPT,92944,Outpatient Surgical Group 5,96514.0,62734.1,19539.84,29009.34,50
CPT,92950,HB CARDIOPULMONARY RESUSCITAT,4564.63,2967.01,387.75,14761.0,30
CPT,92950,OUTPATIENT SURGERY CPT GROUP 1,3969.24,2580.01,6417.0,7038.0,2
CPT,92950,Outpatient Grouper - 0,3969.24,2580.01,9059.94,9827.82,24
CPT,92953,HB TRANSCUTANEOUS PACE TEMP,6108.68,3970.64,13270.0,14761.0,2
CPT,92953,OUTPATIENT SURGERY CPT GROUP 1,4698.97,3054.33,6417.0,7038.0,2
CPT,92953,Outpatient Grouper - 1,4698.97,3054.33,10495.38,11385.92,24
CPT,92960,HB ECG CARDIOVERSION,5403.825000000001,3512.4849999999997,814.83,14761.0,30
CPT,92960,OUTPATIENT SURGERY CPT GROUP 1,4698.97,3054.33,6417.0,7038.0,2
CPT,92960,Outpatient Grouper - 1,4698.97,3054.33,10495.38,11385.92,24
CPT,92961,"HB CARDIOVERSION, INTERNAL",4698.97,3054.33,814.83,937.05,8
CPT,92961,OUTPATIENT SURGERY CPT GROUP 1,4698.97,3054.33,6417.0,7038.0,2
CPT,92961,Outpatient Grouper - 1,4698.97,3054.33,10495.38,11385.92,24
CPT,92970,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92970,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,92971,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,92972,Outpatient Surgical Group 0,26636.3,17313.6,2806.68,4166.87,50
CPT,92973,HB PTC THROMBECTOMY MECHANICAL,29392.0,19104.8,13270.0,14761.0,2
CPT,92973,Outpatient Grouper - 0,29392.0,19104.8,9059.94,9827.82,24
CPT,92973,Outpatient Surgery Group 5 Global Rate,29392.0,19104.8,32992.0,34883.0,2
CPT,92974,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,92975,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,92975,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,92977,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,92977,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
CPT,92978,HB IVUS/OCT CORONARY GRAFT/VESSEL INITIAL,25816.5,16780.73,13270.0,14761.0,4
CPT,92978,OUTPATIENT SURGERY CPT GROUP 1,25816.5,16780.73,6417.0,7038.0,2
CPT,92978,Outpatient Grouper - 0,25816.5,16780.73,9059.94,9827.82,24
CPT,92979,HB IVUS/OCT CORONARY GRAFT/VESSEL EA ADDL,25737.9,16729.64,13270.0,14761.0,4
CPT,92979,OUTPATIENT SURGERY CPT GROUP 1,25737.9,16729.64,6417.0,7038.0,2
CPT,92979,Outpatient Grouper - 0,25737.9,16729.64,9059.94,9827.82,24
CPT,92986,HB AORTIC VALVUOPLASTY,47896.9,31132.99,7099.46,14761.0,12
CPT,92986,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
CPT,92986,Outpatient Surgery Group 6 Global Rate,47896.9,31132.99,34526.0,35549.0,2
CPT,92986,Outpatient Surgical Group 9,47896.9,31132.99,36513.58,54208.97,50
CPT,92987,HB VALVULOPLASTY MITRAL,102328.0,66513.2,13270.0,16239.31,10
CPT,92987,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,92987,Outpatient Surgery Group 6 Global Rate,102328.0,66513.2,34526.0,35549.0,2
CPT,92987,Outpatient Surgical Group 9,102328.0,66513.2,36513.58,54208.97,50
CPT,92990,HB VALVULOPLASTY PULM VALVE,102328.0,66513.2,13270.0,16239.31,12
CPT,92990,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,92990,Outpatient Surgery Group 8 Global Rate,102328.0,66513.2,41579.0,42988.0,2
CPT,92990,Outpatient Surgical Group 9,102328.0,66513.2,36513.58,54208.97,50
CPT,92992,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,92993,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,92997,HB PULM ART ANGIOPLASTY,102328.0,66513.2,13270.0,14761.0,2
CPT,92997,Outpatient Grouper - 6,102328.0,66513.2,28632.25,34209.93,24
CPT,92997,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
CPT,92997,Outpatient Surgical Group 7,102328.0,66513.2,27131.25,40279.73,50
CPT,92998,Outpatient Grouper - 6,27280.6,17732.39,28632.25,34209.93,24
CPT,92998,Outpatient Surgery Group 2 Global Rate,27280.6,17732.39,14322.0,15354.0,2
CPT,92998,Outpatient Surgical Group 7,27280.6,17732.39,27131.25,40279.73,50
CPT,93000,"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT",,,250.47,398.89,2
CPT,93005,"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT",1037.19,674.17,144.64,230.35,2
CPT,93005,HB ROUTINE ECG,1192.76,775.29,73.96,14761.0,10
CPT,93010,"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY",,,105.83,168.55,2
CPT,93015,CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE; CONTINUOUS ELECTROCARDIOGRAPHIC,,,1033.62,1646.14,2
CPT,93016,"CARDIOVASCULAR STRESS TEST; PHYSICIAN SUPERVISION ONLY, WITHOUT INTERPRETATION AND REPORT",,,270.75,431.2,2
CPT,93017,"CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE; TRACING ONLY, WITHOUT INTERPRETA",3969.24,2580.01,475.36,757.06,2
CPT,93017,HB CARDIAC STRESS TEST CL,4564.63,2967.01,387.75,14761.0,20
CPT,93018,CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE; INTERPRETATION AND REPORT ONLY,,,221.36,352.54,2
CPT,93024,ERGONOVINE PROVOCATION TEST,739.73,480.82,312.67,497.96,2
CPT,93025,Microvolt T-wave alternans for assessment of ventricular arrhythmias,10010.6,6506.89,2289.07,3645.57,2
CPT,93040,"RHYTHM ECG, ONE TO THREE LEADS; WITH INTERPRETATION AND REPORT",,,137.58,219.11,2
CPT,93041,"RHYTHM ECG, ONE TO THREE LEADS; TRACING ONLY WITHOUT INTERPRETATION AND REPORT",1037.19,674.17,47.21,75.19,2
CPT,93042,"RHYTHM ECG, ONE TO THREE LEADS; INTERPRETATION AND REPORT ONLY",,,138.93,221.26,2
CPT,93050,Art pressure waveform analys,,,142.46,226.88,2
CPT,93050,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93150,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93151,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93152,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93153,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93224,"EXTERNAL ELECTROCARDIOGRAPHIC RECORDING UP TO 48 HOURS BY CONTINUOUS RHYTHM RECORDING AND STORAGE; INCLUDES RECORDING, R",,,1500.15,2389.15,2
CPT,93225,EXTERNAL ELECTROCARDIOGRAPHIC RECORDING UP TO 48 HOURS BY CONTINUOUS RHYTHM RECORDING AND STORAGE; RECORDING (INCLUDES C,1074.29,698.29,399.51,636.26,2
CPT,93225,HB ECG UP TO 48HRS RECORDING,1235.425,803.025,160.5,14761.0,10
CPT,93226,EXTERNAL ELECTROCARDIOGRAPHIC RECORDING UP TO 48 HOURS BY CONTINUOUS RHYTHM RECORDING AND STORAGE; SCANNING ANALYSIS WIT,1298.72,844.17,704.66,1122.24,2
CPT,93226,HB ECG UP TO 48HRS SCAN ANLYS RPT,1493.525,970.79,73.96,14761.0,10
CPT,93227,EXTERNAL ELECTROCARDIOGRAPHIC RECORDING UP TO 48 HOURS BY CONTINUOUS RHYTHM RECORDING AND STORAGE; REVIEW AND INTERPRETA,,,395.98,630.65,2
CPT,93228,"EXTERNAL MOBILE CARDIOVASCULAR TELEMETRY W/ECG RECORDING, REAL TIME DATA ANALYSIS MORE THAN 24HRS UP TO 30 DAYS; REVIEW",,,198.43,316.02,2
CPT,93229,"EXTERNAL MOBILE CV TELEMETRY W/ECG RECORDING; TECHSUPPORT FOR CONNECT & PT INSTRUCT FOR USE, ANALYSIS AND TRANSMISSION O",7295.99,4742.39,4114.65,6553.0,2
CPT,93242,External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording),1037.19,674.17,135.82,216.3,2
CPT,93242,HB EXT REC >48HRS <7DAYS RECORDING,1192.76,775.29,48.87,14761.0,10
CPT,93243,HB EXT ECG REC >48HR <7DAYS SCAN ANAL W/ REP,1235.425,803.025,160.5,14761.0,10
CPT,93244,External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation,,,203.72,324.45,2
CPT,93246,External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording),1037.19,674.17,135.82,216.3,2
CPT,93246,HB EXT REC >7DAYS <15DAYS RECORDING,1192.76,775.29,48.87,14761.0,10
CPT,93247,HB EXT REC >7DAYS <15DAYS SCAN ANAL W/ REP,1235.425,803.025,160.5,14761.0,10
CPT,93248,External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation,,,224.48,357.51,2
CPT,93260,HB IMPLT SUBQ DEFB SYS DEV EVL,1440.95,936.62,46.43,14761.0,10
CPT,93260,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",1440.95,936.62,253.58,403.86,2
CPT,93261,HB IMPLT SUBQ DEFB INTEROGAT,1440.95,936.62,46.43,53.4,8
CPT,93261,"Interrogation device evaluation (in person) with analysis, review and report, by a physician or other qualified health care professional, includes connection, recording and disconnection per patient e",1440.95,936.62,253.58,403.86,2
CPT,93264,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,93264,Rem mntr wrls p-art prs snr,,,434.79,692.45,2
CPT,93268,"EXTRNL PT & WHEN PRFMED,AUTO ACTIVATED ECG RHYTHM DERIVED EVENTRECDNG W/SYMPTOM-RELATED MEM LOOP W /REMOTE DWNLD CAPBLT",,,2337.98,3723.48,2
CPT,93270,"EXTERNAL PATIENT AND WHEN PERFORMED AUTO ACTIVATED ECG EVENT RECORDING W/SYMPTOM-RELATED; DOWNLOAD CAPABILITY 30 DAYS, 2",1440.95,936.62,396.87,632.05,2
CPT,93271,"EXTERNAL PATIENT, WHEN PERFORMED AUTO ACTIVATED ELECTROCARDIOGRAPHIC RHYTHM DERV EVENT RECORING; REMOTE DOWNLOAD CAPABIL",3679.48,2391.66,1676.54,2670.06,2
CPT,93272,"EXTERNAL PATIENT AND, WHEN PERFORMED, AUTO ACTIVATED ELECTROCARDIOGRAPHIC RHYTHM DERIVED EVENT RECORDING UP TO 30 DYS, 2",,,264.58,421.37,2
CPT,93278,"SIGNAL-AVERAGED ELECTROCARDIOGRAPHY (SAECG), WITH OR WITHOUTECG",1115.91,725.34,605.47,964.27,2
CPT,93279,HB PROG SNG LEAD OR LEADLESS ONE CHAMBR,1657.105,1077.12,46.43,14761.0,18
CPT,93279,PROGRAMMING DEV EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEVICE TO TEST FUNC OF DEVICE & SELECT OPTIMAL PERM PROGR,1440.95,936.62,173.33,276.04,2
CPT,93280,HB PROGRAMMING DUAL LEAD PPM,1657.105,1077.12,46.43,14761.0,20
CPT,93280,PROGRAMMING DEV EVAL (IN PERSON) W/ITERATIVE ADJUSTT OF IMPLANT DEVICE TO TEST FUNCTION OF DEVICE & SELECT OPTIMAL PERM,1440.95,936.62,173.33,276.04,2
CPT,93281,HB PROGRAMMING MULT LEAD PPM,1657.105,1077.12,46.43,14761.0,12
CPT,93281,PROGRAMMING DEVICE EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEVICE TO TEST FUNCTION OF DEVICE & SELECT OPTIMAL PER,1440.95,936.62,202.84,323.05,2
CPT,93282,HB PROGRAMMING SNG LEAD ICD,1657.105,1077.12,46.43,14761.0,20
CPT,93282,PROGRAMMING DEV EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEVICE TO TEST FUNC OF DEVICE & SELECT OPTIMAL PERM PROGR,1440.95,936.62,183.03,291.49,2
CPT,93283,HB PROGRAMMING DUAL LEAD ICD,1657.105,1077.12,46.43,14761.0,20
CPT,93283,PROGRAMMING DEVICE EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEV TO TEST FUNC OF DEVICE & SELECT OPTIMAL PERM PROGR,1440.95,936.62,208.13,331.47,2
CPT,93284,HB PROGRAMMING MULT LEAD ICD,1657.105,1077.12,46.43,14761.0,20
CPT,93284,PROGRAMMING DEV EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEV TO TEST FUNC OF DEV & SELECT OPTIMAL PERM PROGRAMMED,1440.95,936.62,236.36,376.42,2
CPT,93285,HB PROG SQ CARD RHYTH PACEMAKER SYSTEM,1657.105,1077.12,46.43,14761.0,10
CPT,93285,PROGRAMMING DEVICE EVAL (IN PERSON) W/ITERATIVE ADJUST OF IMPLANT DEVICE TO TEST FUNCTION OF DEVICE & SELECT OPTIMAL PER,1440.95,936.62,140.23,223.32,2
CPT,93286,HB PERI-PROC PRG DEV EVAL LEAD OR LEADLS,823.13,535.035,13270.0,14761.0,4
CPT,93286,"PERI-PROCEDURAL DEVICE EVAL (IN PERSON) & PROGRAMMING OF DEVICE SYS PARAMETERS BEFORE OR AFTER SURGERY, PROC, OR TEST W/",714.92,464.7,93.07,148.23,2
CPT,93287,HB PERI-PROC PRG DEV EVAL ICD,1906.9050000000002,1239.49,13270.0,14761.0,4
CPT,93287,"PERI-PROC DEV EVAL (IN PERSON) & PROGRAMMING OF DEV SYS PARAMETERS BEFORE OR AFTER SURGERY, PROC, OR TEST W/PHYSICIAN AN",1659.3,1078.55,103.66,165.08,2
CPT,93288,HB INTERROGATION IN PERSON LEAD OR LEADLS,1657.105,1077.12,46.43,14761.0,18
CPT,93288,"INTERROGATION DEVICE EVALUATION (IN PERSON) WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; SINGLE DUAL, OR MULTIPLE LEAD PA",1440.95,936.62,143.34,228.29,2
CPT,93289,HB INTERROGATION IN PERSON ICD,1657.105,1077.12,46.43,14761.0,10
CPT,93289,"INTERROGATION DEVICE EVAL (IN PERSON) W/PHYS ANALYSIS, REVIEW AND REPORT; SINGLE DUAL, OR MULTIPLE LEAD IMPLANTABLE CAR",1440.95,936.62,173.33,276.04,2
CPT,93290,"INTERROGATION DEV EVAL (IN PERSON) W/PHYS ANALYSIS, REV & REP; IMPLANTABLE CV MONITOR SYSTEM, INCL ANALYSIS OF 1> RECOR",1440.95,936.62,78.08,124.35,2
CPT,93291,HB INTER IN PERSON SQ CARD RHYTH PACE SYS,559.745,363.83000000000004,30.49,14761.0,18
CPT,93291,"INTERROGATION DEVICE EVAL (IN PERSON) W/PHYSICIAN ANALYSIS, REVIEW AND REPORT; IMPLANTABLE LOOP RECORDER SYSTEM, INCL HE",486.73,316.37,128.35,204.41,2
CPT,93292,"INTERROGATION DEVICE EVALUATION (IN PERSON) WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; WEARABLE DEFIB SYSTEM",1440.95,936.62,97.89,155.91,2
CPT,93293,"TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL(S) SINGLE, DUAL OR MULTIPLE LEAD PACEMAKER, INCL RECORDING W/ & W/O MAGNET",1440.95,936.62,318.37,507.04,2
CPT,93294,"INTERROGATION DEVICE EVAL(S) (REMOTE), UP TO 90 DAYS; SINGLE, DUAL OR MULTIPLE LEAD PACEMAKER W/INTERIM PHYSICIAN ANALYS",,,250.06,398.24,2
CPT,93295,"INTERROGATION DEVICE EVAL(S) (REMOTE), UP TO 90 DAYS; SINGLE, DUAL OR MULTIPLE LEAD IMPLANTABLE CARDIOVERTER-DEFIB SYSTE",,,452.9,721.29,2
CPT,93296,HB INTERRO REM 90DAYS PPM/ICD,1657.105,1077.12,46.43,14761.0,20
CPT,93296,"INTERROGATION DEVICE EVAL(S) (REMOTE), UP TO 90 DAYS; SINGLE, DUAL OR MULTIPLE LEAD PACEMAKER SYSTEM OR IMPLANTABLE CARD",1440.95,936.62,283.98,452.27,2
CPT,93297,"INTERROGATION DEV EVAL(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE CV MONITOR SYS, INCL ANAL OF 2 OR MORE RECORDED PHYSIOLOG",1606.4,1044.16,170.68,271.83,2
CPT,93298,HB REM INTERROG SCRMS <30 D PHYS/QHP,1606.4,1044.16,46.43,14761.0,26
CPT,93298,"INTERROGATION DEVICE EVAL(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE LOOP RECORDER SYS, INCL ANALYSIS OF RECORDED HEART RHY",1606.4,1044.16,201.55,320.99,2
CPT,93303,HB TTE CONG CARD ANOM COMPLETE W/O CONT,6403.97,4162.58,682.74,14761.0,20
CPT,93303,TRANSHORACIC ECHOCARDIOLGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE,6403.97,4162.58,1123.57,1789.4,2
CPT,93304,HB TTE CONG CARD ANOM F/U LIMITED W/O CONT,5065.27,3292.43,682.74,14761.0,20
CPT,93304,TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY,5065.27,3292.43,567.08,903.13,2
CPT,93306,"ECHOCARDIOGRAPHY, TRANTHORACIC, REAL-TIME W/IMAGE DOC (2D), INCLS M-MODE REC, WHEN PERFORMED, COMPLETE W/SPECTRAL DOPPLE",8120.55,5278.36,2084.46,3319.71,2
CPT,93306,HB TTE/2D ECHO W/SPEC COLOR FLW DOPP W/O CONT,9339.17,6070.46,682.74,14761.0,28
CPT,93307,"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COM",4847.52,3150.89,1258.98,2005.05,2
CPT,93308,"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOL",8363.32,5436.16,635.46,1012.03,2
CPT,93308,HB TTE/2D ECHO F/U LIMITED W/O CONT,9617.82,6251.58,300.99,14761.0,28
CPT,93312,"ECHOCARDIOGRAPHY, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING), TRANSESOPHAGEAL",10460.4,6799.26,1064.48,1695.3,2
CPT,93312,HB TEE WITHOUT CONTRAST,12030.01,7819.505,682.74,14761.0,20
CPT,93313,PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY,,,522.57,832.25,2
CPT,93314,HB ECHO TRNSPHGL IMAG I&R ONLY,2459.52,1598.69,13270.0,14761.0,4
CPT,93314,"IMAGE ACQUISITION, INTERPRETATION AND REPORT ONLY",2459.52,1598.69,1068.89,1702.32,2
CPT,93315,HB TEE CONGENITAL;GLOBAL W/O CONT,5065.27,3292.43,682.74,14761.0,20
CPT,93315,"TRANSEOPHAGEAL ECHCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALINCLUDING PROBE PLACEMENT, IMAGE ACCQUISTION, INTERPRETATION",5065.27,3292.43,963.06,1533.77,2
CPT,93316,"TRANSEOPAGEAL ECHOCARDIOLGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; IMAGE ACQUISTION, INTERPRETATION AND REPORT ONLY",,,440.96,702.28,2
CPT,93317,HB TEE CONGENITAL; INT & REP,2604.93,1693.2,13270.0,14761.0,4
CPT,93317,TRANSEOPHAGEAL ECHOCARDIIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; IMAGE ACQUISTION INTERPRETATION AND REPORT ONLY,2604.93,1693.2,888.98,1415.79,2
CPT,93318,"ECHOCARDIOGRAPHY,TRANSESOPHAGEAL (TEE) MONITORING,INCLUDING PROBE PLACEMENT,REAL TIME AND INTERPRETATION",,,1993.15,3174.29,2
CPT,93319,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",1472.06,956.84,530.04,844.14,2
CPT,93319,HB 3D ECHO IMG TEE/TTE CONG CAR ANOM,1472.06,956.84,13270.0,14761.0,4
CPT,93320,"DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; COMPLETE",3212.51,2088.13,560.9,893.3,2
CPT,93320,HB PULSE WAVE DOPPLER COMPLETE,3694.3900000000003,2401.355,13270.0,14761.0,4
CPT,93321,"DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; FOLLOW-UP OR LIMITED STUDY",2587.01,1681.56,314.85,501.43,2
CPT,93321,HB PULSE WAVE DOPPLER LIMITED,2975.07,1933.795,13270.0,14761.0,4
CPT,93325,"DOPPLER COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR ECHOCARDIOGRAPHY 93307, 93308, 93320, 9332",2846.48,1850.21,825.07,1314.01,2
CPT,93325,HB DOPPLER COLOR FLOW,3272.76,2127.295,13270.0,14761.0,4
CPT,93350,"ECHCARDGRPHY, TRANSTHRACIC, REALTIME W/ IMG DOCMNTN (2D), INCL M-MOD RECRD, PERFRM DUR REST & CARDIOVSCLR STRSS TEST US",5283.6,3434.34,580.78,924.95,2
CPT,93351,"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W/IMAGE DOC(2D), INCLS M-MODE REC, WHEN PERFORMED, W/INTERPRET & REPORT",8120.55,5278.36,1901.9,3028.97,2
CPT,93351,HB TTE/2D ECHO STRESS W/ ECG W/O CONT,9339.24,6070.504999999999,682.74,14761.0,20
CPT,93352,USE OF ECHOCARDIOGRAPHIC CONTRAST AGENT DURING STRESS ECHOCARDIOGRAPHY,,,286.21,455.82,2
CPT,93355,Echo transesophageal (tee),18079.1,11751.41,1740.92,2772.59,2
CPT,93355,HB ECHO TRANSESOPHAGEAL (TEE),18079.1,11751.41,13270.0,14761.0,4
CPT,93356,HB MYOCRD STRAIN IMG SPECKLE TRCK ASSMT,3268.3,2124.39,13270.0,14761.0,4
CPT,93356,Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging),3268.3,2124.39,356.3,567.44,2
CPT,93451,HB RIGHT HEART CATH,36962.1,24025.37,4005.04,14761.0,20
CPT,93451,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93451,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93451,Outpatient Surgery Group 3 Global Rate,36962.1,24025.37,22055.0,22787.0,2
CPT,93451,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93452,HB LHC +/- LV GRAM,36962.1,24025.37,4005.04,14761.0,12
CPT,93452,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93452,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93452,Outpatient Surgery Group 8 Global Rate,36962.1,24025.37,41579.0,42988.0,2
CPT,93452,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93453,HB R/LHC +/- LV GRAM,36962.1,24025.37,4005.04,14761.0,12
CPT,93453,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93453,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93453,Outpatient Surgery Group 8 Global Rate,36962.1,24025.37,41579.0,42988.0,2
CPT,93453,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93454,HB COR ANGIO W/INJ S & I,36962.1,24025.37,4005.04,14761.0,20
CPT,93454,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93454,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93454,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93455,HB COR ANGIO W/GRFT INJ S & I,36962.1,24025.37,4005.04,14761.0,12
CPT,93455,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93455,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93455,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93456,HB RHC W/COR INJ S & I,36962.1,24025.37,4005.04,14761.0,20
CPT,93456,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93456,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93456,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93456,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93457,HB RHC W/COR + GRFT INJ S & I,36962.1,24025.37,4005.04,14761.0,10
CPT,93457,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93457,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93457,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93457,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93458,HB LHC W/COR +/- LV GRAM,36962.1,24025.37,4005.04,14761.0,20
CPT,93458,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93458,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93458,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93458,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93459,HB LHC W/COR +/- LV GRM W/GRFT,36962.1,24025.37,4005.04,14761.0,12
CPT,93459,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93459,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93459,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93459,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93460,HB R/LHC+/-LV GRAM W/COR,36962.1,24025.37,4005.04,14761.0,20
CPT,93460,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93460,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93460,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93460,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93461,HB R/LHC +/- LV GRM W/COR+GRFT,36962.1,24025.37,4005.04,14761.0,10
CPT,93461,Outpatient Catheter Lab,36962.1,24025.37,,,0
CPT,93461,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93461,Outpatient Surgery Group 9 Global Rate,36962.1,24025.37,36365.0,36365.0,1
CPT,93461,Outpatient Surgical Group 7,36962.1,24025.37,27131.25,40279.73,50
CPT,93462,HB TRNSPTL TRNSAP PUNCTURE,28044.6,18228.99,13270.0,14761.0,4
CPT,93462,Outpatient Catheter Lab,28044.6,18228.99,,,0
CPT,93462,Outpatient Grouper - 0,28044.6,18228.99,9059.94,9827.82,24
CPT,93462,Outpatient Surgery Group 9 Global Rate,28044.6,18228.99,36365.0,36365.0,1
CPT,93463,HB NITRIC OXIDE/HEMO MEAS,2986.5,1941.23,13270.0,14761.0,2
CPT,93463,Outpatient Grouper - 0,2986.5,1941.23,9059.94,9827.82,24
CPT,93464,HB EXERCISE W/HEMODYNAMIC MEAS,4482.42,2913.57,,,0
CPT,93464,Outpatient Grouper - 0,4482.42,2913.57,9059.94,9827.82,24
CPT,93464,Outpatient Surgical Group 0,4482.42,2913.57,2806.68,4166.87,50
CPT,93464,"PHYSIOLOGIC EXERCISE STUDY (EG, BICYCLE OR ARM ERGOMETRY) INCLUDING ASSESSING HEMODYNAMIC MEASUREMENTS BEFORE AND AFTER",4482.42,2913.57,1737.86,2767.72,2
CPT,93503,HB INSERT SWAN GANZ CATH,10614.89,6899.68,13270.0,14761.0,2
CPT,93503,Outpatient Grouper - 1,8165.3,5307.45,10495.38,11385.92,24
CPT,93503,Outpatient Surgery Group 3 Global Rate,8165.3,5307.45,22055.0,22787.0,2
CPT,93503,Outpatient Surgical Group 1,8165.3,5307.45,9088.3,13492.72,50
CPT,93505,HB ENDOMYOCARDIAL BIOPSY,14909.4,9691.11,3919.23,14761.0,20
CPT,93505,Outpatient Grouper - 4,14909.4,9691.11,19724.25,21397.98,24
CPT,93505,Outpatient Surgery Group 3 Global Rate,14909.4,9691.11,22055.0,22787.0,2
CPT,93505,Outpatient Surgical Group 1,14909.4,9691.11,9088.3,13492.72,50
CPT,93530,Outpatient Catheter Lab,37207.0,24184.55,,,0
CPT,93530,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,93531,Outpatient Catheter Lab,37207.0,24184.55,,,0
CPT,93531,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,93531,Outpatient Surgical Group 7,7503.89,4877.53,27131.25,40279.73,50
CPT,93532,Outpatient Catheter Lab,37207.0,24184.55,,,0
CPT,93532,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,93533,Outpatient Catheter Lab,37207.0,24184.55,,,0
CPT,93533,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
CPT,93563,HB INJ CNGNTL COR ANGIO W/S&I,1577.29,1025.24,13270.0,14761.0,2
CPT,93563,Outpatient Grouper - 0,1577.29,1025.24,9059.94,9827.82,24
CPT,93563,Outpatient Surgery Group 2 Global Rate,1577.29,1025.24,14322.0,15354.0,2
CPT,93564,Outpatient Grouper - 0,1688.85,1097.75,9059.94,9827.82,24
CPT,93564,Outpatient Surgery Group 2 Global Rate,1688.85,1097.75,14322.0,15354.0,2
CPT,93565,HB INJ CNGNTL LV/LA W/S&I,1131.36,735.38,13270.0,14761.0,2
CPT,93565,Outpatient Grouper - 0,1131.36,735.38,9059.94,9827.82,24
CPT,93565,Outpatient Surgery Group 2 Global Rate,1131.36,735.38,14322.0,15354.0,2
CPT,93566,HB INJ RV/RA W/S&I,1131.36,735.38,13270.0,14761.0,2
CPT,93566,Outpatient Grouper - 0,1131.36,735.38,9059.94,9827.82,24
CPT,93566,Outpatient Surgery Group 2 Global Rate,1131.36,735.38,14322.0,15354.0,2
CPT,93567,HB INJ AORTO W/S&I,993.63,645.86,13270.0,14761.0,2
CPT,93567,Outpatient Grouper - 0,993.63,645.86,9059.94,9827.82,24
CPT,93567,Outpatient Surgery Group 2 Global Rate,993.63,645.86,14322.0,15354.0,2
CPT,93568,HB INJ PULM ART W/S&I,937.9,609.63,13270.0,14761.0,2
CPT,93568,Outpatient Grouper - 0,937.9,609.63,9059.94,9827.82,24
CPT,93568,Outpatient Surgery Group 2 Global Rate,937.9,609.63,14322.0,15354.0,2
CPT,93569,Outpatient Grouper - 0,10874.7,7068.56,9059.94,9827.82,24
CPT,93571,HB DOPPLER FLOW WIRE INITL VESSL,24591.5,15984.48,13270.0,14761.0,4
CPT,93571,Outpatient Grouper - 0,24591.5,15984.48,9059.94,9827.82,24
CPT,93572,HB DOPPLER FLOW WIRE ADDL VESSL,14065.0,9142.25,13270.0,14761.0,4
CPT,93572,Outpatient Grouper - 0,14065.0,9142.25,9059.94,9827.82,24
CPT,93573,"HB PULM ART ANGIO W/INJ HEART CATH, BIL",10874.7,7068.56,13270.0,14761.0,2
CPT,93573,Outpatient Grouper - 0,10874.7,7068.56,9059.94,9827.82,24
CPT,93574,HB PULM VEN ANGIO W/INJ HEART CATH,10874.7,7068.56,13270.0,14761.0,2
CPT,93574,Outpatient Grouper - 0,10874.7,7068.56,9059.94,9827.82,24
CPT,93575,HB PULM ANGIO W/INJ MAPCA W/CHD HEART CATH,10874.7,7068.56,13270.0,14761.0,2
CPT,93575,Outpatient Grouper - 0,10874.7,7068.56,9059.94,9827.82,24
CPT,93580,HB CLOSURE CONGENITAL ATRIAL DEFECT,114605.0,74493.25,13270.0,25713.42,20
CPT,93580,Outpatient Grouper - 8,114605.0,74493.25,34726.75,37674.38,24
CPT,93580,Outpatient Surgery Group 6 Global Rate,114605.0,74493.25,34526.0,35549.0,2
CPT,93581,HB CLOSURE VENTRICULR DEFECT,114605.0,74493.25,13270.0,25713.42,12
CPT,93581,Outpatient Grouper - 8,114605.0,74493.25,34726.75,37674.38,24
CPT,93581,Outpatient Surgery Group 6 Global Rate,114605.0,74493.25,34526.0,35549.0,2
CPT,93582,HB PERQ TRANSCATH CLOSURE PDA,114605.0,74493.25,13270.0,25713.42,10
CPT,93582,Outpatient Grouper - 8,114605.0,74493.25,34726.75,37674.38,24
CPT,93582,Outpatient Surgery Group 6 Global Rate,114605.0,74493.25,34526.0,35549.0,2
CPT,93583,HB PERQ TRANSCATH SEPTL REDUXN,134163.35,87206.18,13270.0,14761.0,2
CPT,93583,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
CPT,93583,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
CPT,93584,Outpatient Surgical Group 0,15113.8,9823.97,2806.68,4166.87,50
CPT,93585,Outpatient Surgical Group 0,34028.9,22118.79,2806.68,4166.87,50
CPT,93586,Outpatient Surgical Group 0,36421.6,23674.04,2806.68,4166.87,50
CPT,93587,Outpatient Surgical Group 0,15113.8,9823.97,2806.68,4166.87,50
CPT,93588,Outpatient Surgical Group 0,24005.5,15603.58,2806.68,4166.87,50
CPT,93590,HB PERQ TRANSCATH CLOSURE MITRAL,114605.0,74493.25,13270.0,25713.42,10
CPT,93590,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,93590,Outpatient Surgery Group 6 Global Rate,114605.0,74493.25,34526.0,35549.0,2
CPT,93590,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitrial valve",114605.0,74493.25,9977.69,15890.48,2
CPT,93591,HB PERQ TRANSCATH CLOSURE AORTIC,114605.0,74493.25,13270.0,25713.42,10
CPT,93591,Outpatient Grouper - 9,114605.0,74493.25,38279.75,41528.61,24
CPT,93591,Outpatient Surgery Group 6 Global Rate,114605.0,74493.25,34526.0,35549.0,2
CPT,93591,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve",114605.0,74493.25,8282.63,13190.93,2
CPT,93592,HB PERQ TRANSCATH CLOSURE EA ADDL,57033.9,37072.04,13270.0,14761.0,2
CPT,93592,Outpatient Grouper - 0,57033.9,37072.04,9059.94,9827.82,24
CPT,93592,Outpatient Surgery Group 6 Global Rate,57033.9,37072.04,34526.0,35549.0,2
CPT,93592,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (list separately in addition to code for primary service).,57033.9,37072.04,3643.23,5802.22,2
CPT,93593,HB RHC CHD W/ IMG GUID NORM NATV CONN,36962.1,24025.37,4005.04,14761.0,10
CPT,93593,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93593,Outpatient Surgery Group 6 Global Rate,36962.1,24025.37,34526.0,35549.0,2
CPT,93594,HB RHC CHD W/ IMG GUID ABNORM NATV CONN,36962.1,24025.37,13270.0,14761.0,2
CPT,93594,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93594,Outpatient Surgery Group 6 Global Rate,36962.1,24025.37,34526.0,35549.0,2
CPT,93595,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93595,Outpatient Surgery Group 6 Global Rate,36962.1,24025.37,34526.0,35549.0,2
CPT,93596,HB RHC/LHC CHD W/ IMG GUID NORM NATV CONN,36962.1,24025.37,4005.04,14761.0,10
CPT,93596,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93596,Outpatient Surgery Group 6 Global Rate,36962.1,24025.37,34526.0,35549.0,2
CPT,93597,HB RHC/LHC CHD W/ IMG GUID ABNORM NATV CONN,36962.1,24025.37,4005.04,14761.0,10
CPT,93597,Outpatient Grouper - 5,36962.1,24025.37,25486.19,27649.53,24
CPT,93597,Outpatient Surgery Group 6 Global Rate,36962.1,24025.37,34526.0,35549.0,2
CPT,93598,Outpatient Grouper - 0,11235.5,7303.07,9059.94,9827.82,24
CPT,93600,Outpatient Grouper - 2,37999.5,24699.67,13036.88,14143.2,24
CPT,93600,Outpatient Surgery Group 2 Global Rate,37999.5,24699.67,14322.0,15354.0,2
CPT,93602,Outpatient Grouper - 2,37999.5,24699.67,13036.88,14143.2,24
CPT,93602,Outpatient Surgery Group 2 Global Rate,37999.5,24699.67,14322.0,15354.0,2
CPT,93603,Outpatient Grouper - 2,7159.1,4653.41,13036.88,14143.2,24
CPT,93603,Outpatient Surgery Group 2 Global Rate,7159.1,4653.41,14322.0,15354.0,2
CPT,93609,Outpatient Grouper - 0,37207.0,24184.55,9059.94,9827.82,24
CPT,93609,Outpatient Surgery Group 5 Global Rate,37207.0,24184.55,32992.0,34883.0,2
CPT,93610,OUTPATIENT SURGERY CPT GROUP 1,37999.5,24699.67,6417.0,7038.0,2
CPT,93610,Outpatient Grouper - 2,37999.5,24699.67,13036.88,14143.2,24
CPT,93612,OUTPATIENT SURGERY CPT GROUP 1,37999.5,24699.67,6417.0,7038.0,2
CPT,93612,Outpatient Grouper - 2,37999.5,24699.67,13036.88,14143.2,24
CPT,93613,Outpatient Grouper - 0,30054.7,19535.56,9059.94,9827.82,24
CPT,93613,Outpatient Surgery Group 2 Global Rate,30054.7,19535.56,14322.0,15354.0,2
CPT,93615,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,93615,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,93616,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,93616,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
CPT,93618,OUTPATIENT SURGERY CPT GROUP 1,7159.1,4653.41,6417.0,7038.0,2
CPT,93618,Outpatient Grouper - 2,7159.1,4653.41,13036.88,14143.2,24
CPT,93619,HB COMP EP EVAL W/O ARRHYT INDUCT,37999.5,24699.67,9448.61,14761.0,10
CPT,93619,Outpatient Grouper - 6,37999.5,24699.67,28632.25,34209.93,24
CPT,93619,Outpatient Surgery Group 5 Global Rate,37999.5,24699.67,32992.0,34883.0,2
CPT,93620,HB COMP EP EVAL W/ARRHYT INDUCT,37999.5,24699.67,9448.61,14761.0,12
CPT,93620,Outpatient Grouper - 6,37999.5,24699.67,28632.25,34209.93,24
CPT,93620,Outpatient Surgery Group 5 Global Rate,37999.5,24699.67,32992.0,34883.0,2
CPT,93621,HB COMP EP EVAL LFT ATRIAL PACE,32029.0,20818.85,,,0
CPT,93621,Outpatient Grouper - 0,32029.0,20818.85,9059.94,9827.82,24
CPT,93621,Outpatient Surgery Group 5 Global Rate,32029.0,20818.85,32992.0,34883.0,2
CPT,93622,HB COMP EP EVAL LFT VNTRC PACE,33091.5,21509.48,,,0
CPT,93622,Outpatient Grouper - 0,33091.5,21509.48,9059.94,9827.82,24
CPT,93622,Outpatient Surgery Group 5 Global Rate,33091.5,21509.48,32992.0,34883.0,2
CPT,93623,HB EP STIM+PACE POST DRUG INFUSN,37207.0,24184.55,13270.0,14761.0,2
CPT,93623,Outpatient Grouper - 0,37207.0,24184.55,9059.94,9827.82,24
CPT,93623,Outpatient Surgery Group 3 Global Rate,37207.0,24184.55,22055.0,22787.0,2
CPT,93624,Outpatient Grouper - 6,37999.5,24699.67,28632.25,34209.93,24
CPT,93624,Outpatient Surgery Group 5 Global Rate,37999.5,24699.67,32992.0,34883.0,2
CPT,93631,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,93631,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,93640,Outpatient Grouper - 0,9831.36,6390.38,9059.94,9827.82,24
CPT,93640,Outpatient Surgery Group 7 Global Rate,9831.36,6390.38,36188.0,39001.0,2
CPT,93641,HB EP EVAL ICD GEN & LEADS,15511.2,10082.28,13270.0,14761.0,2
CPT,93641,Outpatient Grouper - 0,15511.2,10082.28,9059.94,9827.82,24
CPT,93641,Outpatient Surgery Group 5 Global Rate,15511.2,10082.28,32992.0,34883.0,2
CPT,93642,HB EP EVAL ICD W/PROGRAMMING,7159.1,4653.41,1511.65,1738.39,8
CPT,93642,Outpatient Grouper - 2,7159.1,4653.41,13036.88,14143.2,24
CPT,93642,Outpatient Surgery Group 2 Global Rate,7159.1,4653.41,14322.0,15354.0,2
CPT,93644,Outpatient Grouper - 0,15546.3,10105.09,9059.94,9827.82,24
CPT,93644,Outpatient Surgery Group 2 Global Rate,15546.3,10105.09,14322.0,15354.0,2
CPT,93650,HB ABLATION ATRIOVENTRC NODE,37999.5,24699.67,9448.61,14761.0,10
CPT,93650,Outpatient Grouper - 6,37999.5,24699.67,28632.25,34209.93,24
CPT,93650,Outpatient Surgery Group 9 Global Rate,37999.5,24699.67,36365.0,36365.0,1
CPT,93653,HB COMP EP & SVT ABLATION 3D MAP,168429.0,109478.85,13270.0,35129.42,20
CPT,93653,Outpatient Grouper - 8,168429.0,109478.85,34726.75,37674.38,24
CPT,93653,Outpatient Surgery Group 9 Global Rate,168429.0,109478.85,36365.0,36365.0,1
CPT,93653,Outpatient Surgical Group 7,168429.0,109478.85,27131.25,40279.73,50
CPT,93654,Catheter Ablation,168429.0,109478.85,8550.0,8550.0,1
CPT,93654,HB COMP EP & VT ABLATION 3D MAP,168429.0,109478.85,13270.0,35129.42,20
CPT,93654,Outpatient Grouper - 8,168429.0,109478.85,34726.75,37674.38,24
CPT,93654,Outpatient Surgery Group 9 Global Rate,168429.0,109478.85,36365.0,36365.0,1
CPT,93654,Outpatient Surgical Group 7,168429.0,109478.85,27131.25,40279.73,50
CPT,93655,HB ABLATE ARRHYTHMIA ADD ON,41994.8,27296.62,13270.0,14761.0,2
CPT,93655,Outpatient Grouper - 0,41994.8,27296.62,9059.94,9827.82,24
CPT,93655,Outpatient Surgery Group 9 Global Rate,41994.8,27296.62,36365.0,36365.0,1
CPT,93655,Outpatient Surgical Group 7,41994.8,27296.62,27131.25,40279.73,50
CPT,93656,Catheter Ablation,185272.0,120426.8,8550.0,8550.0,1
CPT,93656,HB COMP ATRIAL FIB PULM VEIN ISL 3D MAP S&I,185272.0,120426.8,13270.0,35129.42,18
CPT,93656,Outpatient Grouper - 8,185272.0,120426.8,34726.75,37674.38,24
CPT,93656,Outpatient Surgery Group 9 Global Rate,185272.0,120426.8,36365.0,36365.0,1
CPT,93656,Outpatient Surgical Group 7,185272.0,120426.8,27131.25,40279.73,50
CPT,93657,HB TX L/R ATRIAL FIB ADDL,41994.8,27296.62,13270.0,14761.0,2
CPT,93657,Outpatient Grouper - 0,41994.8,27296.62,9059.94,9827.82,24
CPT,93657,Outpatient Surgery Group 9 Global Rate,41994.8,27296.62,36365.0,36365.0,1
CPT,93657,Outpatient Surgical Group 7,41994.8,27296.62,27131.25,40279.73,50
CPT,93660,HB TILT TABLE TEST,4731.09,3075.21,660.7,759.8,8
CPT,93660,Outpatient Grouper - 0,4731.09,3075.21,9059.94,9827.82,24
CPT,93662,HB INTRACARDIAC ECHO,25650.8,16673.02,13270.0,14761.0,4
CPT,93662,"INTRACARDIAC ECHOCARDIOGRAPHY DURING THERAPEUTIC/DIAGNOSTIC INTERVENTION,INCLUDING, IMAGING, SUPERVISION AND INTERP",25650.8,16673.02,610.29,971.95,2
CPT,93662,Outpatient Grouper - 0,25650.8,16673.02,9059.94,9827.82,24
CPT,93701,BIOIMPEDANCE-DERIVED PHYSIOLOGIC CARDIOVASCULAR ANALYSIS,,,185.67,295.71,2
CPT,93702,Bis xtracell fluid analysis,3283.21,2134.09,984.23,1567.48,2
CPT,93724,HB EA ANTITACHY PACEMAKER SYS,1496.02,972.41,373.44,14761.0,10
CPT,93724,Outpatient Surgery Group 5 Global Rate,1496.02,972.41,32992.0,34883.0,2
CPT,93740,TEMPERATURE GRADIENT STUDIES,,,42.8,68.17,2
CPT,93745,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,93750,"HB INTERROGATION VAD,IN PERSON",1314.09,854.16,114.3,14761.0,18
CPT,93750,"INTERROGATION OF VENTRICULAR ASSIST DEVICE, IN PERSON, W/PHYSICIAN ANALYSIS OF DEVICE PARAMETERS, REVIEW OF DEVICE FUNCT",1314.09,854.16,380.58,606.11,2
CPT,93750,Outpatient Grouper - 0,1314.09,854.16,9059.94,9827.82,24
CPT,93770,DETERMINATION OF VENOUS PRESSURE,,,10.17,16.2,2
CPT,93784,"AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS; I",,,1147.85,1828.08,2
CPT,93786,"AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS; R",1074.29,698.29,374.82,596.94,2
CPT,93786,"HB BPM 24HR OR >,RECORD",1074.29,698.29,160.5,184.58,16
CPT,93788,"AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS; S",1074.29,698.29,352.77,561.82,2
CPT,93788,"HB BPM 24HR OR >, SCAN ANAL W",1074.29,698.29,160.5,184.58,16
CPT,93790,"AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS; P",,,352.77,561.82,2
CPT,93797,HB CARDIAC REHAB; WO CONT ECG,1555.78,1011.26,156.78,180.3,8
CPT,93797,PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITHOUT CONTINUOUS ECG MONITORING (PER SESSION),1555.78,1011.26,156.1,248.61,2
CPT,93798,HB CONT CARD EXERC #,1555.78,1011.26,156.78,14761.0,18
CPT,93798,PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITH CONTINUOUS ECG MONITORING (PER SESSION),1555.78,1011.26,246.53,392.62,2
CPT,93799,Ambulatory Surgery: Default Rate,3283.21,2134.09,,,0
CPT,93799,HB CATH UNLISTED PROCEDURES,20245.105,13159.32,194.82,14761.0,66
CPT,93799,HB ILIAC ANGIO W/HEART CATH,3283.21,2134.09,13270.0,14761.0,2
CPT,93799,Outpatient Grouper - 0,3283.21,2134.09,9059.94,9827.82,24
CPT,93799,UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE,3283.21,2134.09,,,0
CPT,93880,DUPLEX SCAN OF EXTRACRANIAL ARTERIER; COMPLETE BILATERAL STUDY,4663.64,3031.37,1254.1,1997.28,2
CPT,93880,DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY,4663.64,3031.37,381.44,381.44,2
CPT,93880,HB VAS DUPLEX CAROTIDS BILAT,5363.1900000000005,3486.075,300.99,14761.0,20
CPT,93882,DUPLEX SCAN OF EXTRACRANIAL ARTERIES; UNILATERAL OR LIMITED STUDY,4663.64,3031.37,249.8,249.8,2
CPT,93882,DUPLEX SCAN OF EXTRACRANIAL ARTERIES;FOLLOW-UP OR LIMITED STUDY,4663.64,3031.37,832.54,1325.9,2
CPT,93882,HB VAS DUPLEX CAROTID LTD UNI,6062.74,3940.78,13270.0,14761.0,4
CPT,93886,HB VAS DUPLEX TRANSCRANIAL COM,5363.1900000000005,3486.075,300.99,14761.0,20
CPT,93886,TRANSCRANIAL DOPPER STUDY OF THE INTRACTANIAL ARTERIES; COMPLETE STUDY,4663.64,3031.37,1228.52,1956.55,2
CPT,93886,TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; COMPLETE STUDY,4663.64,3031.37,560.33,560.33,2
CPT,93888,HB VAS DUPLEX TRANSCRANIAL LTD,2224.855,1446.155,132.41,14761.0,12
CPT,93888,TRANSCRANIAL DOPPER STUDY OF THE INTRACTANIAL ARTERIES; FOLLOW-UP OR LIMITED STUDY,1934.65,1257.52,810.08,1290.13,2
CPT,93888,TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; LIMITED STUDY,1934.65,1257.52,334.67,334.67,2
CPT,93890,"HB TCD, VASOREACTIVITY STUDY",4174.025,2713.115,13270.0,14761.0,2
CPT,93890,TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; VASOREACTIVITY STUDY,,,1648.79,2625.86,2
CPT,93892,"HB TCD, EMBOLI DETECT W/O INJ",4131.88,2685.7200000000003,132.41,14761.0,12
CPT,93892,TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; EMBOLI DETECTION WITHOUT INTRAVENOUS MICROBUBBLE INJECTION,3592.94,2335.41,1713.58,2729.05,2
CPT,93893,"HB TCD, EMBOLI DETECT W/INJ",4190.625,2723.9049999999997,132.41,14761.0,12
CPT,93893,TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; EMBOLI DETECTION WITH INTRAVENOUS MICROBUBBLE INJECTION,3644.02,2368.61,1666.84,2654.61,2
CPT,93895,HB CHD RISK IMT STUDY,2871.32,1866.36,,,0
CPT,93895,"Quantitative carotid intima media thickness and carotid atheroma evaluation, bilateral",2871.32,1866.36,1553.07,2473.42,2
CPT,93922,HB VAS DUPLEX ABI WO EX BILAT,1235.425,803.025,160.5,14761.0,20
CPT,93922,"LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, DOPPLER WAVEFORM RECORDING & ANA",1074.29,698.29,394.22,627.84,2
CPT,93922,"NON-INVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, SINGLE LEVEL, BILATERAL (E.G., ANKLE/BRACHIAL INDICES, DOPPLER WAVEFORM ANALYSIS, VOLUME PLETHYSMOGRAPHY, TRANSCUTANEOUS OXYGEN T",1074.29,698.29,174.08,174.08,2
CPT,93923,"COMPLETE BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, 3 OR MORE LEVELS; WITH BIDIRECT",3283.21,2134.09,743.93,1184.79,2
CPT,93923,HB VAS DUPLEX THORACIC OUTLET,3775.695,2454.205,194.82,14761.0,20
CPT,93923,"NON-INVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, MULTIPLE LEVELS OR WITH PROVOCATIVE FUNCTIONAL MANEUVERS, COMPLETE BILATERAL STUDY (E.G., SEGMENTAL BLOOD PRESSURE MEASUREMENTS, ",3283.21,2134.09,265.61,265.61,2
CPT,93924,"NON-INVASIVE PHYSIOLOGIC STUDIES OF LOWER EXTREMITY ARTERIES, AT REST AND FOLLOWING TREADMILL STRESS TESTING, COMPLETE BILATERAL STUDY",,,332.35,332.35,2
CPT,93924,"NONINVASIVE PHYSIOLOGIC STUDIES OF LOWER EXTREMITY ARTERIES AT REST AND FOLLOWING TREADMILL STRESS TESTING, COMPLETE",,,810.49,1290.79,2
CPT,93925,DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY,4663.64,3031.37,506.25,506.25,2
CPT,93925,DUPLEX SCAN OF LOWER EXTREMIY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY,4663.64,3031.37,1260.27,2007.11,2
CPT,93925,HB VAS DUPLEX LEG GRAFT BILAT,5363.1900000000005,3486.075,300.99,14761.0,20
CPT,93926,DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY,3592.94,2335.41,299.71,299.71,2
CPT,93926,DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS;FOLLOW-UP OR LIMITED STUDY,3592.94,2335.41,841.36,1339.95,2
CPT,93926,HB VAS DUPLEX LEG ART UNILAT,4131.88,2685.7200000000003,132.41,14761.0,10
CPT,93926,HB VAS DUPLEX POPLITEAL ASM UN,4131.88,2685.7200000000003,132.41,14761.0,10
CPT,93930,DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY,4663.64,3031.37,393.93,393.93,2
CPT,93930,DUPLEX SCAN OF UPPER EXTREMITY ARTETIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY,4663.64,3031.37,1333.47,2123.69,2
CPT,93930,HB VAS DUPLEX ARM ARTERY BILAT,5363.1900000000005,3486.075,300.99,14761.0,12
CPT,93931,DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; FOLLOW-UP OR LIMITED STUDY,3040.18,1976.12,886.8,1412.33,2
CPT,93931,DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY,3040.18,1976.12,250.63,250.63,2
CPT,93931,HB VAS DUPLEX ARM ARTERY UNI,3496.205,2272.535,132.41,14761.0,20
CPT,93970,DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE BILATERAL STUDY,4663.64,3031.37,387.27,1898.3,4
CPT,93970,HB VAS DUPLEX LEG VN SP/DP BIL,5363.1900000000005,3486.075,300.99,14761.0,20
CPT,93971,DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; FOLLOW-UP OR LIMITED STUDY,3592.94,2335.41,930.43,1481.81,2
CPT,93971,DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; UNILATERAL OR LIMITED STUDY,3592.94,2335.41,244.81,244.81,2
CPT,93971,HB VAS DUPLEX ARM VN SP/DP UNI,4131.88,2685.7200000000003,132.41,14761.0,20
CPT,93975,"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, AND/OR RETROPERITONEAL ORGAN; COMP STUDY",4663.64,3031.37,1341.0,2135.67,2
CPT,93975,"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETROPERITONEAL ORGANS; COMPLETE STUDY",4663.64,3031.37,526.22,526.22,2
CPT,93975,HB VAS DUPLEX RENAL/VISC ART,5363.1900000000005,3486.075,300.99,14761.0,20
CPT,93976,"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETROPERITONEAL ORGANS; LIMITED STUDY",4663.64,3031.37,301.38,301.38,2
CPT,93976,"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINPELVIC, AND/OR RETROPERITONEAL ORGAN; FOLLOW-UP/LIMITED STUD",4663.64,3031.37,1070.25,1704.47,2
CPT,93976,HB VAS DUPLEX RENAL TRANSPLANT,5363.1900000000005,3486.075,132.41,14761.0,20
CPT,93978,"DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; COMPLETE STUDY",4663.64,3031.37,355.65,355.65,2
CPT,93978,"DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE,OR BYPASS GRAFTS; COMPLETE STUDY",4663.64,3031.37,1299.55,2069.66,2
CPT,93978,HB VAS DUPLEX IVC/ILI VEIN COM,5363.1900000000005,3486.075,300.99,14761.0,12
CPT,93979,"DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY",3040.18,1976.12,234.82,234.82,2
CPT,93979,"DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE,OR BYPASS GRAFTS; FOLLOW-UP OR LIMITED STUDY",3040.18,1976.12,864.29,1376.46,2
CPT,93979,HB VAS DUPLEX IVC/ILI VEIN LTD,3496.205,2272.535,132.41,14761.0,20
CPT,93980,DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; COMPLETE STUDY,,,142.79,1587.15,4
CPT,93981,DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; FOLLOW-UP OR LIMITED STUDY,,,121.99,121.99,2
CPT,93981,FOLLOW-UP OR LIMITED STUDY,,,930.43,1481.81,2
CPT,93985,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study,4663.64,3031.37,524.56,2491.03,4
CPT,93985,HB DUPLEX SCAN ART IN & VEN OUT COMPL+J12 BIL,5363.1900000000005,3486.075,300.99,14761.0,12
CPT,93986,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study,3053.85,1985.0,309.7,1417.2,4
CPT,93986,HB DUPLEX SCAN ART IN & VEN OUT COMPL UNI,3511.9300000000003,2282.755,132.41,14761.0,10
CPT,93990,DUPLEX SCAN OF HEMODIALYSIS ACCESS,3592.94,2335.41,960.89,1530.31,2
CPT,93990,"DUPLEX SCAN OF HEMODIALYSIS ACCESS (INCLUDING ARTERIAL INFLOW, BODY OF ACCESS AND VENOUS OUTFLOW)",3592.94,2335.41,307.21,307.21,2
CPT,93990,HB VAS DUPLEX DIALYSIS ACCESS,4131.88,2685.7200000000003,132.41,14761.0,20
CPT,94002,"HB PC VENT, INITIAL",18153.8,11799.97,823.19,14761.0,10
CPT,94003,"HB PC VENT, SUBSEQUENT",16536.55,10748.76,823.19,14761.0,10
CPT,94010,HB SPIROMETRY,3283.21,2134.09,13270.0,14761.0,4
CPT,94010,"SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREMENT(S), AND/O",3283.21,2134.09,137.58,219.11,2
CPT,94011,MEASUREMENT OF SPIROMETRIC FORCED EXPIRATORY FLOWS IN AN INFANT OR CHILD THROUGH 2 YEARS OF AGE,3283.21,2134.09,596.65,950.23,2
CPT,94012,"MEASUREMENT OF SPIROMETRIC FORCED EXPIRATORY FLOWS, BEFORE AND AFTER BRONCHODILATOR, IN AN INFANT OR CHILD THROUGH 2 YEA",3969.24,2580.01,1238.69,1972.74,2
CPT,94013,"MEASUREMENT OF LUNG VOLUMES (IE, FUNCTIONAL RESIDUAL CAPACITY ?FRC¿, FORCED VITAL CAPACITY ?FVC¿, AND EXPIRATORY RESERVE",,,205.49,327.26,2
CPT,94014,PATIENT INITIATED SPIROMETRIC RECORDING PER 30 DAY PERIOD OF TIME;INCLUDES REINFORCED ED TRANSMISSION OF SPIROMETIRC,,,126.12,200.85,2
CPT,94015,PATIENT INITIATED SPIROMETIRIC RECORDING PR 30 DAY PERIOD OF TIME;RECORDING,505.5,328.57,122.59,195.23,2
CPT,94016,PATIENT INITIATED SPIROMETRIC RECORDING PER 30 DAY PERIOD OF TIME; PHYSICIAN REVIEW AND INTERPRETATION ONLY,,,192.73,306.94,2
CPT,94060,"BRONCHODILATION RESPONSIVENESS, SPIROMETRY AS IN 94010, PRE- AND POST-BRONCHODILATOR ADMINISTRATION",3969.24,2580.01,304.26,484.57,2
CPT,94060,HB PRE/POST SPIROMETRY,3969.24,2580.01,387.75,14761.0,20
CPT,94070,"BRONCHOSPASM WITH MULTIPLE SPIROMETRIC DETERMINATIONS AS IN 94010, WITH ADMINISTERED AGENTS (EG, ANTIGEN(S), COLD AIR, M",3969.24,2580.01,479.36,763.42,2
CPT,94070,HB METHACHOLINE CHALLENGE,3969.24,2580.01,387.75,445.91,8
CPT,94150,HB VITAL CAPACITY PER MEASUREMENT,3283.21,2134.09,194.82,14761.0,20
CPT,94150,"VITAL CAPACITY, TOTAL (SEPARATE PROCEDURE)",3283.21,2134.09,28.69,45.69,2
CPT,94200,HB PF MIPS/MEPS-PIMAX PEMAX,1037.19,674.17,73.96,14761.0,10
CPT,94200,"MAXIMUM BREATHING CAPACITY, MAXIMAL VOLUNTARY VENTILATION",1037.19,674.17,83.37,132.78,2
CPT,94375,HB SCREENING SPIROMETRY,3969.24,2580.01,387.75,14761.0,10
CPT,94375,RESPIRATORY FLOW VOLUME LOOP,3969.24,2580.01,158.75,252.82,2
CPT,94450,BREATHING RESPONSE TO HYPOXIA (HYPOXIA RESPONSE CURVE),,,130.52,207.87,2
CPT,94452,HB PF ALTITUDE 02 STUDY,1074.29,698.29,160.5,184.58,8
CPT,94452,"HIGH ALTITUDE SIMULATION TEST (HAST), WITH PHYSICIAN INTERPRETATION AND REPORT;",1074.29,698.29,321.49,512.01,2
CPT,94453,HB PF ALTITUDE 02 STUDY W/ O2,1074.29,698.29,160.5,14761.0,10
CPT,94453,"HIGH ALTITUDE SIMULATION TEST (HAST), WITH PHYSICIAN INTERPRETATION AND REPORT; WITH SUPPLEMENTAL OXYGEN TITRATION",1074.29,698.29,482.88,769.04,2
CPT,94617,Exercise tst brncspsm,1074.29,698.29,467.42,744.41,2
CPT,94618,HB 6 MIN WALK/ PULSE OXIMETRY,1074.29,698.29,160.5,14761.0,20
CPT,94618,Pulmonary stress testing,1074.29,698.29,84.66,134.84,2
CPT,94619,HB EXERCISE TEST BRONCHOSPASM W/O ECG,1074.29,698.29,73.96,85.06,8
CPT,94621,HB PULMONARY STRESS; COMPLEX,3969.24,2580.01,387.75,445.91,8
CPT,94621,PULMONARY STRESS TESTING;COMPLEX,3969.24,2580.01,432.14,688.23,2
CPT,94625,HB OP PULM REHAB W/O CONT OXIMETRY MONITOR,1037.19,674.17,73.96,85.06,8
CPT,94626,HB OP PULM REHAB W/ CONT OXIMETRY MONITOR,1244.64,809.02,73.96,14761.0,18
CPT,94640,HB PC IPPB TRT SUBSEQUENT,642.02,417.31,253.26,14761.0,10
CPT,94640,"HB PEDS PULM -INHAL. TREAT, MLTP",642.02,417.31,253.26,291.25,8
CPT,94640,PRESSURIZED OR NON-PRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION OR SPUTUM INDUCTION FOR DIAGNOSTIC PURP,642.02,417.31,132.29,210.68,2
CPT,94642,AEROSOL INHALATION OF PENTAMIDINE FOR PNEUMOCYSTIS CARINII PNEUMONIA TREATMENT FOR PROPHYLAXIS,1630.2,1059.63,359.41,572.4,2
CPT,94642,HB PC PENTAMIDINE TREATMENT,1630.2,1059.63,253.26,14761.0,10
CPT,94644,HB PC AEROSOL TREATMENT INIT HR,1074.29,698.29,160.5,14761.0,10
CPT,94644,INTRAPULMONARY SURFACTANT ADMINISTRATION BY A PHYSICIAN THROUGH ENDOTRACHEAL TUBE. ï,1074.29,698.29,352.77,561.82,2
CPT,94645,CONTINUOUS INHALATION TREATMENT WITH AEROSOL MEDICATION FOR ACUTE AIRWAY OBSTRUCTION; EACH ADDITIONAL HOUR ï,472.24,306.96,134.05,213.49,2
CPT,94645,HB PC AEROSOL TRMNT EA ADDL HOUR,472.24,306.96,13270.0,14761.0,2
CPT,94660,"CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION (CPAP), INITIATION AND MANAGEMENT",8036.56,5223.76,476.71,759.21,2
CPT,94660,"HB PC BIPAP, INITIAL",8036.56,5223.76,253.26,14761.0,10
CPT,94662,"CONTINUOUS NEGATIVE PRESSURE VENTILATION (CNP), INITIATION AND MANAGEMENT",,,335.13,533.73,2
CPT,94664,"DEMONSTRATION AND/OR EVAL OF PATIENT UTILIZATION OF AN AEROSOL GENERATOR, NEBULIZER, METERED DOSE INHLAER OR IPPB DEVICE",918.89,597.28,169.8,270.42,2
CPT,94664,HB SURFACTANT TREATMENT-NICU,918.89,597.28,13270.0,14761.0,2
CPT,94667,HB PC INITIAL CHEST PHYSIOTHERAP,1181.71,768.11,160.5,14761.0,10
CPT,94667,"MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, AND VIBRATION TO FACILITATE LUNG FUNCTION; INITIAL DEMONSTR",1181.71,768.11,188.73,300.57,2
CPT,94668,HB PC CHEST PHYSIO THER SUBS,1074.29,698.29,160.5,14761.0,10
CPT,94668,"MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, AND VIBRATION TO FACILITATE LUNG FUNCTION; SUBSEQUENT",1074.29,698.29,116.41,185.4,2
CPT,94669,"HB MECHN CHST WALL OSCIL,PR SN",1249.46,812.15,253.26,14761.0,10
CPT,94669,"MECHANICAL CHEST WALL OSCILLATION TO FACILITATE LUNG FUNCTION, PER SESSION",1249.46,812.15,263.25,419.26,2
CPT,94680,HB O2 PRESCRIPTION,3283.21,2134.09,194.82,14761.0,18
CPT,94680,"OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST AND EXERCISE, DIRECT, SIMPLE",3283.21,2134.09,179.03,285.12,2
CPT,94681,"OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; INCLUDING CO2 OUTPUT, PERCENTAGE OXYGEN EXTRACTED",,,395.57,629.99,2
CPT,94690,HB OXYGEN UPTAKE REST INDIRECT,689.18,447.97,73.96,14761.0,20
CPT,94690,"OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST, INDIRECT (SEPARATE PROCEDURE)",689.18,447.97,292.39,465.66,2
CPT,94726,HB THORACIC GAS VOLUME,3969.24,2580.01,387.75,14761.0,10
CPT,94726,"PLETHYSMOGRAPHY FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, AIRWAY RESISTANCE",3969.24,2580.01,270.34,430.54,2
CPT,94727,"GAS DILUTION OR WASHOUT FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, DISTRIBUTION OF VENTILATION AND CLOSING",3283.21,2134.09,195.79,311.81,2
CPT,94727,HB LUNG VOLUME-HELIUM,3283.21,2134.09,194.82,14761.0,10
CPT,94728,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,,,195.79,311.81,2
CPT,94729,"DIFFUSING CAPACITY (EG, CARBON MONOXIDE, MEMBRANE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",1426.51,927.23,296.33,471.93,2
CPT,94729,HB DIFFUSING CAPACITY,1426.51,927.23,13270.0,14761.0,4
CPT,94760,NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; SINGLE DETERMINATION,436.14,283.49,85.14,135.59,2
CPT,94761,HB PULSE OXIMETRY MULTIPLE,816.54,530.75,13270.0,14761.0,4
CPT,94761,"NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; MULTIPLE DETERMINATIONS (EG, DURING EXERCISE)",816.54,530.75,220.07,350.48,2
CPT,94762,NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING (SEPARATE PROCEDURE),,,325.02,517.63,2
CPT,94772,"CIRCADIAN RESPIRATORY PATTERN RECORDING(PEDIATRIC PNEUMOGRAM12 TO 24 HOUR CONTINUOUS RECORDING, INFANT",,,340.42,542.16,2
CPT,94774,"PED HOME APNEA MONITORING EVENT REC INCL RESP RATE, PATTERN AND HEART RATE/30-DAY PERIOD; INCL MONITOR ATTACHMENT, DOWNL",,,343.95,547.78,2
CPT,94775,"PED HOME APNEA MONITORING EVENT REC INCL RESP RATE, PATTERN AND HEART RATE/30-DAY PERIOD; INCL MONITOR ATTACHMENT, DOWNL",,,379.23,603.96,2
CPT,94776,"PED HOME APNEA MONITORING EVENT REC INCL RESP RATE, PATTERN AND HEART RATE/30-DAY PERIOD; MONITORING, DOWNLOAD OF INFO,",,,299.85,477.55,2
CPT,94777,"PED HOME APNEA MONITORING EVENT REC INCL RESP RATE, PATTERN AND HEART RATE/30-DAY PERIOD; PHYS REV, INTERPRETATION AND P",,,299.85,477.55,2
CPT,94780,"CAR SEAT/BED TESTING FOR AIRWAY INTEGRITY, NEONATE,AND RESPIRATORY RATE,WITH INTERPRETATION AND REPORT; 60 MINUTES",,,313.08,498.62,2
CPT,94781,"CAR SEAT/BED TESTING FOR AIRWAY INTEGRITY, NEONATE, WITH CONTINUAL NURSING OBSERVATION AND CONTINUOUS RECORDING OF",,,122.59,195.23,2
CPT,94799,HB PC MDI SUBSEQUENT TX,3283.21,2134.09,194.82,14761.0,20
CPT,94799,UNLISTED PULMONARY SERVICE OR PROCEDURE,3283.21,2134.09,,,0
CPT,95004,HB PERCUTANEOUS SKIN TESTS,1663.21,1081.09,1266.84,1456.87,8
CPT,95004,"PERCUTANEOUS TESTS(SCRATCH, PUNCTURE,PRICK)WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, SPECIFY NUMBER OF TESTS",1663.21,1081.09,27.34,43.54,2
CPT,95012,NITRIC OXIDE EXPIRED GAS DETERMINATION ï,,,147.28,234.56,2
CPT,95017,"ALLERGY TESTING, ANY COMBINATION OF PERCUTANEOUS AND INTRACUTANEOUS, INCLD TEST INTERPRETATION AND REPORT, SPECIFIY NO.O",,,65.73,104.69,2
CPT,95018,"ALLERGY TESTING, ANY COMBINATION OF PERCUTANEOUS, INTRACUTANEOUS, WITH DRUGS/BIOLOGICALS, SPECIFY NO. OF TESTS, IMMEDIAT",459.17,298.46,165.8,264.06,2
CPT,95018,"HB SKIN TEST ID IMMED, PER TST",459.17,298.46,48.87,56.2,8
CPT,95024,"INTRACUTANEOUS TEST, WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, SPECIFY NUMBER OF TESTS",1037.19,674.17,41.45,66.01,2
CPT,95027,"INTRACUTANEOUS (INTRADERMAL) TESTS (SPECIFY NUMBER), SEQUENTIAL & INCREMENTAL, W/ALLERGENIC EXTRACTS FOR AIRBORNE ALLERG",,,41.45,66.01,2
CPT,95028,"INTRACUTANEOUS TESTS, WITH ALLERGENIC EXTRACTS,DELAYED TYPE REACTION,INCLUDING READING SPECIFY NUMBER OF TESTS",,,63.97,101.88,2
CPT,95044,PATCH OR APPLICATION TEST(S)(SPECIFY NUMBER OF TEST),5225.32,3396.46,55.56,88.49,2
CPT,95052,PHOTO PATCH TEST(S)(SPECIFY NUMBER OF TESTS),305.7,198.71,69.67,110.96,2
CPT,95056,PHOTO TESTS,,,56.91,90.64,2
CPT,95060,OPHTHALMIC MUCOUS MEMBRANE TESTS,,,149.52,238.12,2
CPT,95065,DIRECT NASAL MUCOUS MEMBRANE TEST,,,63.09,100.47,2
CPT,95070,"INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOL",,,614.7,978.97,2
CPT,95076,HB INGEST CHALLENGE TEST INITIAL 120 MIN,12063.6,7841.34,660.7,759.8,8
CPT,95076,"INGESTION CHALLENGE TEST;INITIAL 120 MINS OF TESTING(SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS EG FOOD,DRUG OR",12063.6,7841.34,860.35,1370.19,2
CPT,95079,HB INGEST CHALLENGE ADDL 60 MN,1628.15,1058.3,,,0
CPT,95079,INGESTION CHALLENGE TEST; EACH ADDITIONAL 60 MINUTES OF TESTING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDU,1628.15,1058.3,589.13,938.24,2
CPT,95249,Cont gluc mntr pt prov eqp,1037.19,674.17,414.98,660.89,2
CPT,95249,HB CONT GLUC MONTR PAT PRVD EQUIP,1037.19,674.17,73.96,85.06,8
CPT,95250,"GLUCOSE MONITORING TO 72HRS,CONTINUOUS RECORDING AND STORAGEOF GLUCOSE VALUES FROM INTERSTITIAL TISSUE FLUID,SUBCUTANEOU",1669.54,1085.2,444.08,707.24,2
CPT,95250,HB GLUCOSE MONITORING CONT,1669.54,1085.2,160.47,184.54,8
CPT,95251,AMBULATORY CONTINUOUS GLUCOSE MONITORING OF INTERSTITIAL TISSUE FLUID VIA A SUBCUTANEOUS SENSOR FOR UP TO 72 HOURS; PHY,1168.62,759.6,78.49,125.01,2
CPT,95700,"Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels",4222.27,2744.48,2381.2,3792.3,2
CPT,95700,HB EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,4222.27,2744.48,194.82,14761.0,10
CPT,95705,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; unmonitored",14563.5,9466.27,4046.74,6444.85,2
CPT,95705,HB EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,14563.5,9466.27,387.75,14761.0,10
CPT,95706,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance",14563.5,9466.27,4046.74,6444.85,2
CPT,95707,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; with continuous, real-time monitoring and maintenance",14563.5,9466.27,4046.74,6444.85,2
CPT,95708,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored",19161.0,12454.65,4046.74,6444.85,2
CPT,95708,HB EEG WO VIDEO EA INCR 12-26HR UNMONITORED,19161.0,12454.65,660.7,759.8,8
CPT,95709,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance",19161.0,12454.65,4046.74,6444.85,2
CPT,95710,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance",19161.0,12454.65,1566.77,2495.24,2
CPT,95710,HB EEG WO VIDEO EA INCR 12-26HR CONT R-T MNTR,19161.0,12454.65,660.7,759.8,8
CPT,95711,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; unmonitored",23754.0,15440.1,4046.74,6444.85,2
CPT,95711,HB VEEG 2-12HR UNMONITORED,27317.1,17756.115,387.75,14761.0,10
CPT,95712,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance",13118.0,8526.7,4046.74,6444.85,2
CPT,95712,HB VEEG 2-12 HR INTERMITTENT MONITORING,17053.36,11084.68,13270.0,14761.0,2
CPT,95713,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with continuous, real-time monitoring and maintenance",32497.7,21123.51,4046.74,6444.85,2
CPT,95713,HB VEEG 2-12HR CONTINUOUS R-T MONITORING,37372.340000000004,24292.025,660.7,14761.0,10
CPT,95714,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored",32497.7,21123.51,2048.71,3262.78,2
CPT,95714,HB VEEG EA INCR 12-26HR UNMONITORED,37372.340000000004,24292.025,660.7,14761.0,10
CPT,95715,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance",17546.4,11405.16,9295.96,14804.76,2
CPT,95716,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance",32497.7,21123.51,9295.96,14804.76,2
CPT,95716,HB VEEG EA INCR 12-26HR CONT R-T MNTR,37372.340000000004,24292.025,1266.84,14761.0,10
CPT,95717,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2",,,546.79,870.82,2
CPT,95718,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2",,,720.12,1146.87,2
CPT,95719,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater th",,,845.77,1346.97,2
CPT,95720,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater th",,,1114.75,1775.36,2
CPT,95721,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,1125.34,1792.21,2
CPT,95722,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,1363.93,2172.19,2
CPT,95723,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,1393.44,2219.2,2
CPT,95724,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,1742.68,2775.4,2
CPT,95725,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,1591.46,2534.57,2
CPT,95726,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,2202.17,3507.17,2
CPT,95782,"POLYSOMNOGRAPHY;YOUNGER THAN 6 YRS,SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP,ATTENDED BY A TECHNOLOGIS",,,7267.53,11574.28,2
CPT,95782,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95783,"POLYSOMNOGRAPHY;YOUNGER THAN 6 YRS,SLEEP STAGING W/4 OR MORE ADDITIONAL PARAMETERS OF SLEEP,WITH INITIATION OF CONTINUOU",,,7729.66,12310.27,2
CPT,95783,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95800,"SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; HEART RATE, OXYGEN SATURATION, RESPIRATORY ANALYSIS (EG, BY AIRFLOW OR",2085.39,1355.5,1176.08,1873.02,2
CPT,95800,Sleep Studies - Unattended,2085.39,1355.5,,,0
CPT,95801,"SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; MINIMUM OF HEART RATE, OXYGEN SATURATION, AND RESPIRATORY ANALYSIS (EG,",,,362.06,576.62,2
CPT,95801,Sleep Studies - Unattended,8111.885,5272.725,,,0
CPT,95803,"ACTIGRAPHY TESTING, RECORDING, ANALYSIS, INTERPRETATION, AND REPORT (MIN OF 72 HRS TO 14 CONSECUTIVE DAYS)",,,674.26,1073.83,2
CPT,95805,"MULTIPLE SLEEP LATENCY TESTING (MSLT), RECORDING, ANALYSIS AND INTERPRETATION OF PHYSIOLOGICAL MEASUREMENTS OF SLEEP DUR",,,1445.06,2301.41,2
CPT,95805,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95806,HB SLEEP STUDY UNATT&RESP EFFT,2524.82,1641.13,194.82,224.05,8
CPT,95806,"SLEEP STUDY SIMULTANEOUS RECORDING OF VENTILATION RESPIRATOREFFORT,ECG OR HEART RATE/OXGEN SATURATION UNATTENDED BY TECH",2524.82,1641.13,1423.9,2267.7,2
CPT,95806,Sleep Studies - Unattended,2524.82,1641.13,,,0
CPT,95807,"SLEEP STUDY, 3 OR MORE PARAMETERS OF SLEEP OTHER THAN SLEEP STAGING, ATTENDED BY A TECHNOLOGIST",,,1706.11,2717.16,2
CPT,95807,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95808,HB POLYSOM ANY AGE 1-3> PARAM,1660.27,1079.18,1266.84,1456.87,8
CPT,95808,POLYSOMNOGRAPHY;SLEEP STAGING WITH 1-3 ADDITIONAL BY A TECHNOLOGIST,,,1719.34,2738.23,2
CPT,95808,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95809,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95810,"POLYSOMNOGRAPHY;SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A TECHNOLOGIST",,,1729.45,2754.33,2
CPT,95810,Sleep Studies - Attended,8111.885,5272.725,,,0
CPT,95811,POLYSOMNOGRAPHY; SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP W/INIT OF CONT POS AIRWAY ATTEND BY TECH,8552.49,5559.12,1992.27,3172.89,2
CPT,95811,Sleep Studies - Attended,8552.49,5559.12,,,0
CPT,95812,ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; 41-60 MINS,3969.24,2580.01,1043.32,1661.59,2
CPT,95812,HB EEG EXT- MON ( 41-60 MIN),4564.63,2967.01,387.75,14761.0,10
CPT,95813,ELECTROENCEPHOLOGRAM(EEG) EXTENDED MONITORING; GREATER THAN ONE HOUR,3969.24,2580.01,476.24,758.46,2
CPT,95813,HB EEG EXTENDED MON > 61-119 MINUTES,4564.63,2967.01,387.75,14761.0,10
CPT,95816,ELECTROENCEPHALOGRAM (EEG); INCL RECORDING AWAKE AND DROWSY,3969.24,2580.01,560.9,893.3,2
CPT,95816,HB EEG AWAKE/DROWSY,4564.63,2967.01,387.75,14761.0,10
CPT,95819,ELECTROENCEPHALOGRAM (EEG); INCL RECORDING AWAKE AND ASLEEP,3969.24,2580.01,455.54,725.5,2
CPT,95819,HB EEG (AWAKE & SLEEP),4564.63,2967.01,387.75,14761.0,10
CPT,95822,ELECTROENCEPHALOGRAM (EEG); RECORDING IN COMA OR SLEEP ONLY,3969.24,2580.01,1263.8,2012.73,2
CPT,95822,HB EEG IN COMA OR SLEEP ONLY,5160.02,3354.01,13270.0,14761.0,2
CPT,95824,ELECTROENCEPHALOGRAM (EEG); CEREBRAL DEATH EVALUATION ONLY,14373.5,9342.77,3631.36,5783.3,2
CPT,95824,HB ECI (BRAIN DEATH) STUDY,18686.33,12146.11,13270.0,14761.0,2
CPT,95829,ELECTROCORTICOGRAM AT SURGERY (SEPARATE PROCEDURE),34197.5,22228.38,11670.51,18586.48,2
CPT,95829,HB ECOG (ELECTROCORTICOGRAPHY),44456.79,28896.91,13270.0,14761.0,2
CPT,95830,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
CPT,95836,Ecog impltd brn npgt <30 d,,,774.8,1233.95,2
CPT,95851,"RANGE OF MOTION MEASUREMENTS AND REPORT (SEPARATE PROCEDURE); EACH EXTREMITY, EXCLUDING HAND",,,168.04,267.61,2
CPT,95852,"RANGE OF MOTION MEASUREMENTS AND REPORT (SEPARATE PROCEDURE); HAND, WITH OR WITHOUT COMPARISON WITH NORMAL SIDE",,,112.0,178.38,2
CPT,95857,TENSILON TEST FOR MYASTHENIA GRAVIS;,,,333.37,530.92,2
CPT,95860,ELECTROMYOGRAPHY; ONE EXTREMITY AND RELATED PARASPINAL AREAS,1074.29,698.29,127.88,203.66,2
CPT,95860,HB NEEDLE EMG 1 EXTREMITY,1235.425,803.025,160.5,14761.0,10
CPT,95861,ELECTROMYOGRAPHY; TWO EXTREMITIES AND RELATED PARASPINAL AREAS,1074.29,698.29,248.7,396.08,2
CPT,95861,HB NEEDLE EMG 2 EXTREMITIES,1235.425,803.025,160.5,14761.0,10
CPT,95863,ELECTROMYOGRAPHY; THREE EXTREMITIES AND RELATED PARASPINAL AREAS,3283.21,2134.09,314.44,500.77,2
CPT,95864,ELECTROMYOGRAPHY; FOUR EXTREMITIES AND RELATED PARASPINAL AREAS,3283.21,2134.09,594.89,947.42,2
CPT,95865,NEEDLE ELECTROMYOGRAPHY; LARYNX ï,1074.29,698.29,193.61,308.35,2
CPT,95866,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM ï,3283.21,2134.09,62.62,99.72,2
CPT,95867,HB NEEDLE EMG CRANIAL NERVE UNI,4564.63,2967.01,387.75,14761.0,10
CPT,95867,"NEEDLE ELECTROMYOGRAPHY; CRANIAL NERVE SUPPLIED MUSCLE(S), UNILATERAL",3969.24,2580.01,191.85,305.54,2
CPT,95868,"ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES; BILATERAL",3969.24,2580.01,232.42,370.15,2
CPT,95868,HB NEEDLE EMG CRANIAL NERVE BIL,5160.02,3354.01,13270.0,14761.0,2
CPT,95869,HB NEEDLE EMG THORACIC PARASPINAL,3283.21,2134.09,387.75,445.91,8
CPT,95869,NEEDLE ELECTROMYOGRAPHY; THORACIC PARASPINAL MUSCLES (EXCLUDING T1 OR T12),3283.21,2134.09,71.91,114.52,2
CPT,95870,HB NEEDLE EMG LMTD 1 EXT UNI/BIL,1037.19,674.17,160.5,184.58,8
CPT,95870,NEEDLE ELECTROMYOGRAPHY;OTHER THAN PARASPINAL,1037.19,674.17,61.32,97.66,2
CPT,95872,"ELECTROMYOGRAPHY, SINGLE FIBER, ANY TECHNIQUE",3283.21,2134.09,225.36,358.91,2
CPT,95873,ELECTRICAL STIMULATION FOR GUIDANCE IN CONJUNCTION WITH CHEMODENERVATION ï,593.74,385.93,59.97,95.51,2
CPT,95873,"HB GUIDE NERV DESTR, ELEC STIM",593.74,385.93,,,0
CPT,95874,HB NEEDLE EMG GUID W/ CHEMODENERVATION,593.74,385.93,,,0
CPT,95874,NEEDLE MYOGRAPHY FOR GUIDANCE IN CONJUNCTION WITH CHEMODENERVATION ï,593.74,385.93,59.97,95.51,2
CPT,95875,ISCHEMIC LIMB EXERCISE TEST W/SERIAL SPECIMEN(S) ACQUISITIONFOR MUSCLE(S) METABOLITE(S),,,134.52,214.24,2
CPT,95885,HB NEEDLE EMG EA EXT W/ NRV TEST LMTD,4687.280000000001,3046.73,13270.0,14761.0,4
CPT,95885,"NEEDLE ELECTROMYOGRAPHY, EACH EXTREMITY, WITH RELATED PARASPINAL AREAS, WHEN PERFORMED, DONE WITH NERVE CONDUCTION",4075.88,2649.32,251.35,400.3,2
CPT,95886,HB NEEDLE EMG EA EXT W/ NRV TEST COMP,4687.280000000001,3046.73,13270.0,14761.0,4
CPT,95886,"NEEDLE ELECTROMYOGRAPHY, EACH EXTREMITY, WITH RELATED PARASPINAL AREAS, WHEN PERFORMED, DONE WITH NERVE CONDUCTION",4075.88,2649.32,265.05,422.12,2
CPT,95887,HB NEEDLE EMG NON EXTREMITY,3508.7749999999996,2280.705,13270.0,14761.0,2
CPT,95887,"NEEDLE ELECTROMYOGRAPHY, NON-EXTREMITY (CRANIAL NERVE SUPPLIED OR AXIAL) MUSCLE(S) DONE WITH NERVE CONDUCTION,",3051.08,1983.2,269.46,429.14,2
CPT,95905,HB MOTOR/SENSRY NRV COND W/FWA,1087.62,706.95,13270.0,14761.0,2
CPT,95905,"MOTOR AND/OR SENSORY NERVE CONDUCTION, USING PRECONFIGURED ELECTRODE ARRAY(S), AMPLITUDE & LATENCY/VELOCITY STUDY, EA LI",836.64,543.82,471.83,751.44,2
CPT,95907,HB NERVE CND TST 1-2 STUDIES,3775.695,2454.205,194.82,14761.0,20
CPT,95907,NERVE CONDUCTION STUDIES; 1-2 STUDIES,3283.21,2134.09,336.01,535.14,2
CPT,95908,HB NERVE CND TST 3-4 STUDIES,4564.63,2967.01,387.75,14761.0,20
CPT,95908,NERVE CONDUCTION STUDIES; 3-4 STUDIES,3969.24,2580.01,406.57,647.5,2
CPT,95909,HB NERVE CND TST 5-6 STUDIES,4564.63,2967.01,387.75,14761.0,10
CPT,95909,NERVE CONDUCTION STUDIES; 5-6 STUDIES,3969.24,2580.01,487.7,776.72,2
CPT,95910,HB NERVE CND TEST 7-8 STUDIES,4564.63,2967.01,387.75,14761.0,20
CPT,95910,NERVE CONDUCTION STUDIES; 7-8 STUDIES,3969.24,2580.01,630.16,1003.6,2
CPT,95911,HB NERVE CND TEST 9-10 STUDIES,15966.935,10378.509999999998,660.7,14761.0,20
CPT,95911,NERVE CONDUCTION STUDIES; 9-10 STUDIES,13884.3,9024.8,730.7,1163.72,2
CPT,95912,HB NERVE CND TEST 11-12 STUDIES,17795.41,11567.02,660.7,14761.0,20
CPT,95912,NERVE CONDUCTION STUDIES; 11-12 STUDIES,15474.3,10058.3,825.07,1314.01,2
CPT,95913,HB NERVE CND TEST 13/> STUDIES,22406.705,14564.355,660.7,14761.0,20
CPT,95913,NERVE CONDUCTION STUDIES; 13 OR MORE STUDIES,19484.1,12664.66,922.08,1468.51,2
CPT,95919,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,95919,"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral",,,36.16,57.59,2
CPT,95921,TESTING OF AUTOMOMIC NERVOUS SYSTEM FUNCTION; CARDIOVAGAL INNERVATION INCLUDING TWO OR MORE OF THE FOLLOWING HEART RATE,,,110.71,176.32,2
CPT,95922,TESTING OF AUTOMOMIC NERVOUS SYSTEM FUNCTION; VOSOMOTER ADRENERGIC INTERVATION INCLUDING BEAT TO BEAT BLOOD PRESSURE,1074.29,698.29,112.89,179.78,2
CPT,95923,"TESTING OF AUTOMOMIC NERVOUS SYSTEM FUNCTION; VASOMOT0R ADENERGIC INTERVATION SUDOMOTOR,INCLUDING ONE OR MORE OF FOLLOW",1074.29,698.29,110.71,176.32,2
CPT,95924,TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; COMBINED PARASYMATHETIC & SYMPATHETIC ADRENERGIC TESTING WTH AT LEAST 5 MI,,,482.88,769.04,2
CPT,95925,HB SSEP - UPPER EXTREMITIES,4564.63,2967.01,387.75,14761.0,12
CPT,95925,"SOMATOSENSORY TESTING (EG, CEREBRAL EVOKED POTENTIALS), ONE OR MORE NERVES",3969.24,2580.01,460.36,733.18,2
CPT,95926,HB SSEP - LOWER EXTREMITIES,4564.63,2967.01,387.75,14761.0,12
CPT,95926,SHORT LATENCY SOMATOSENSORY EVOKED P0TENTIAL STUDY STIMULATION OF ANY/ALL PERIPHERAL NERVES OF SKIN IN LOWER LI,3969.24,2580.01,317.96,506.39,2
CPT,95927,SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY STIMULATION OF ANY/ALL IN THE TRUNK OR HEAD,,,317.96,506.39,2
CPT,95928,CENTRAL MOTOR EVOKED POTENTIAL STUDY (TRANSCRANIAL MOTOR STIMULATION); UPPER LIMBS,16460.4,10699.26,791.56,1260.63,2
CPT,95928,"HB C MOTOR EVOKED, UPPR LIMBS",16460.4,10699.26,1266.84,1456.87,8
CPT,95929,CENTRAL MOTOR EVOKED POTENTIAL STUDY (TRANSCRANIAL MOTOR STIMULATION); LOWER LIMBS,16460.4,10699.26,858.11,1366.63,2
CPT,95929,"HB C MOTOR EVOKED, LWR LIMBS",18929.475,12304.16,660.7,14761.0,10
CPT,95930,HB VEP - CHECKBOARD OR FLASH,3969.24,2580.01,387.75,445.91,8
CPT,95930,VISUAL EVOKED POTENTIAL TESTING CENTRAL NERVOUS SYSTEM CHECKERBOARD OR FLASH,3969.24,2580.01,136.7,217.71,2
CPT,95933,HB NCS - (BLINK) REFLEX,1037.19,674.17,73.96,85.06,8
CPT,95933,"ORBICULARIS OCULI (BLINK) REFLEX, BY ELECTRODIAGNOSTIC TESTING",1037.19,674.17,252.7,402.45,2
CPT,95937,HB NCS - REPET STIM,3775.695,2454.205,194.82,14761.0,10
CPT,95937,"NEUROMUSCULAR JUNCTION TESTING (REPETITIVE STIMULATION, PAIRED STIMULI), EACH NERVE, ANY ONE METHOD",3283.21,2134.09,104.54,166.49,2
CPT,95938,HB UPR/LWR SSEPS,13873.1,9017.515,660.7,14761.0,20
CPT,95938,"SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKIN SITES,",12063.6,7841.34,1667.31,2655.36,2
CPT,95939,HB C MOTOR EVOKED UPR&LWR LIMB,20178.370000000003,13115.939999999999,1266.84,14761.0,12
CPT,95939,"MOTOR EVOKED POTENTIAL STUDIES, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKIN SITES, RECORDING FROM THE CENTRAL",17546.4,11405.16,2301.82,3665.89,2
CPT,95940,"CONTINUOUS INTRAOPERATIVE NEUROPHYSIOLOGY MONITORING IN OP ROOM,(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDU",682.02,443.31,224.48,357.51,2
CPT,95940,HB IONM IN OPERATNG ROOM 15 MIN,886.61,576.3,13270.0,14761.0,2
CPT,95941,CONTINUOUS INTRAOPERATIVE NEUROPHYSIOLOGY MONITORING(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)OUTSIDE T,3117.77,2026.55,300.32,478.3,2
CPT,95941,HB IONM REMOTE/>1 PT OR PER HR,3585.435,2330.53,13270.0,14761.0,4
CPT,95954,PHARMACOLOGICAL ACTIVATION DURING PROLONGED MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS,4558.22,2962.84,156.57,249.36,2
CPT,95955,"ELECTROENCEPHALOGRAM (EEG) DURING NONINTRACRANIAL SURGERY (EG, CAROTID SURGERY)",5650.3,3672.7,,,0
CPT,95955,HB EEG DURING CEA SURGERY,7345.66,4774.68,13270.0,14761.0,2
CPT,95957,DIGITAL ANALYSIS OF ELETROENCEPHOGRAM (EEG) LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),5085.86,3305.81,1735.63,2764.16,2
CPT,95957,HB DIG/ANALYS/EPILEP/SPIKE/ANALYS,6611.56,4297.51,13270.0,14761.0,2
CPT,95958,HB WADA ( MEMORY DOMINANCE TEST),17546.4,11405.16,1266.84,1456.87,8
CPT,95958,"WADA ACTIVATION TEST FOR HEMISPHERIC FUNCTION, INCLUDING ELECTROENCEPHALOGRAPHIC (EEG) MONITORING",17546.4,11405.16,649.1,1033.75,2
CPT,95961,"FUNCTIONAL CORTICAL MAPPING BY STIMULATION OF ELECTRODES ON BRAIN SURFACE, OR OF DEPTH ELECTRODES, TO PROVOKE SEIZURES O",17546.4,11405.16,410.57,653.87,2
CPT,95961,HB FUNCT/MOTOR/LANGUAG MAP/1ST HR,22810.34,14826.72,13270.0,14761.0,2
CPT,95962,"FUNCTIONAL CORTICAL MAPPING BY STIMULATION OF ELECTRODES ON BRAIN SURFACE, OR OF DEPTH ELECTRODES, TO PROVOKE SEIZURES O",5827.31,3787.75,369.53,588.51,2
CPT,95962,HB FUNCT/MOTOR/LANG MAP ADD'L HR,7575.17,4923.86,13270.0,14761.0,2
CPT,95965,"MAGNETOENCEPHALOGRAPHY (MEG),RECORDING AND ANALYSIS;FOR SPONTANEOUS BRAIN MAGNETIC ACTIVITY",,,3643.23,5802.22,2
CPT,95966,"MAGNETOENCEPHALOGRAPHY (MEG),RECORDING AND ANALYSIS;FOR EVOKED MAGNETIC FIELDS,SINGLE MODALITY",,,1838.81,2928.5,2
CPT,95967,"MAGNETOENCEPHALOGRAPHY (MEG),RECORDING AND ANALYSIS; FOR EVOKED MAGNETIC FIELDS, EACH ADDITIONAL MODALITY",,,1872.8,2982.62,2
CPT,95970,ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM; SIMPLE OR COMPLEX NEUROSTIMULATOR PULSE,1074.29,698.29,160.1,254.97,2
CPT,95970,"HB ANALYZE NEUROSTIM, NO PROG",1235.425,803.025,160.5,14761.0,12
CPT,95971,"ELECCTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PLUSE GENERATOR SYSTEM;SIMPLE NEUROSTIMULATOR PULSE GENERATOR, ETC",1314.09,854.16,268.11,426.98,2
CPT,95971,HB VNS - SIMPLE PROGRAMMING,1314.09,854.16,114.3,131.44,8
CPT,95972,ELECTONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM;COMPLEX BRAIN OR SPINAL CORD NEUROSTIMULAT,3955.44,2571.04,500.93,797.79,2
CPT,95976,Alys smpl cn npgt prgrmg,1440.95,936.62,293.27,467.06,2
CPT,95976,HB CRANIAL NEUROSTIM ANALYSIS SIMPLE,1440.95,936.62,46.43,14761.0,18
CPT,95977,Alys cplx cn npgt prgrmg,3558.47,2313.01,389.81,620.81,2
CPT,95977,HB CRANIAL NEUROSTIM ANALYSIS COMPLEX,3558.47,2313.01,114.3,131.44,8
CPT,95980,ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM,,,248.29,395.43,2
CPT,95981,"ELECTRONIC ANLYSIS OF IMPLANTED NERUOSTIMULATOR PULSE GENERATOR SYSTEM, GASTRIC NEURSTIMULATOR PULSE GENRATR/TRANSMITTER",,,98.36,156.65,2
CPT,95982,"ELECTRNIC ANALYSIS OF IMPLNTD NEUROSTIMULATOR PUSE GENERATOR SYSTEM,GASTRIC NEURSTIMULATOR PULSE GENRATOR/TRANSMITTER;SU",,,194.02,309.0,2
CPT,95983,Alys brn npgt prgrmg 15 min,1660.27,1079.18,367.76,585.7,2
CPT,95983,HB NEUROSTIM ANALYSIS BRAIN 1ST 15 MIN,1909.305,1241.0500000000002,114.3,14761.0,10
CPT,95984,Alys brn npgt prgrmg addl 15,1435.11,932.82,320.61,510.6,2
CPT,95984,HB NEUROSTIM ANALYSIS BRAIN EA ADDL 15 MIN,1650.46,1072.8,13270.0,14761.0,2
CPT,95990,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,95990,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,95991,OUTPATIENT SURGERY CPT GROUP 1,2100.52,1365.34,6417.0,7038.0,2
CPT,95991,Outpatient Grouper - 0,2100.52,1365.34,9059.94,9827.82,24
CPT,95992,HB CANALITH REPOSITIONING PROC,563.29,366.14,,,0
CPT,96000,COMPREHENSIVE COMPUTER-BASED MOTION ANALYSIS BY VIDEO-TAPINGAND 3-D KINEMATICS,,,133.64,212.84,2
CPT,96001,COMPREHENSIVE COMPUTER BASED MOTION ANALYSIS VIDEO TAPPING & 3-D KINEMATICS;WITH DYNAMIC PLANTAR PRESSURE MEASUREMENTS,,,159.22,253.57,2
CPT,96002,"DYNAMIC SURFACE ELECTROMYOGRAPHY, DURING WALKING OR OTHER FUNCTIONAL ACTIVITIES, 1-12 MUSCLES",,,153.45,244.39,2
CPT,96003,"DYNAMIC FINE WIRE ELECTROMYOGRAPHY, DURING WALKING OR OTHER FUNCTIONAL ACTIVITIES, 1 MUSCLE",,,141.99,226.13,2
CPT,96040,HB GENETIC COUNSELING 16-30MINS 1 UNIT,1037.19,674.17,,,0
CPT,96105,ASSESSMENT OF APHASIS WITH INTERPRETATION AND REPORT,2259.41,1468.62,516.81,823.07,2
CPT,96110,DEVELOPMENT TESTING;LIMIT WITH INTERPRETATION AND REPORT PER HOUR,1256.47,816.71,440.96,702.28,2
CPT,96110,HB DEVELOPMENTAL SCREENING,1256.47,816.71,,,0
CPT,96112,HB DEVELOPEMENTAL TEST 1ST HR,3969.24,2580.01,194.82,224.05,16
CPT,96113,HB DEVELOPEMENTAL TEST EA ADDL 30 MIN,1793.78,1165.96,,,0
CPT,96116,HB NEUROBHV STATUS EXAM W INT/RPT,3969.24,2580.01,387.75,14761.0,18
CPT,96121,HB NEUROBEHAVIORAL EXAM EA ADDL HR,181.85,118.2,13270.0,14761.0,2
CPT,96121,Outpatient Surgical Group 0,181.85,118.2,2806.68,4166.87,50
CPT,96125,HB COGNITIVE TEST BY HC PRO,1514.37,984.34,,,0
CPT,96127,Brief emotional/behav assmt,951.11,618.22,52.03,82.87,2
CPT,96130,Outpatient Surgical Group 1,3969.24,2580.01,9088.3,13492.72,50
CPT,96131,Outpatient Surgical Group 0,1793.78,1165.96,2806.68,4166.87,50
CPT,96132,HB NEUROPSYCH TEST EVAL 1ST HR,3969.24,2580.01,660.7,14761.0,18
CPT,96132,Outpatient Surgical Group 1,3969.24,2580.01,9088.3,13492.72,50
CPT,96133,HB NEUROPSYCH TEST EVAL EA ADDL HR,1793.78,1165.96,13270.0,14761.0,2
CPT,96133,Outpatient Surgical Group 0,1793.78,1165.96,2806.68,4166.87,50
CPT,96136,HB PSYCH/NEUROPSYCH TEST 1ST 30 MIN,486.73,316.37,160.5,14761.0,18
CPT,96136,Outpatient Surgical Group 1,486.73,316.37,9088.3,13492.72,50
CPT,96137,HB PSYCH/NEUROPSYCH TEST EA ADDL 30 MIN,186.25,121.06,13270.0,14761.0,2
CPT,96137,Outpatient Surgical Group 0,186.25,121.06,2806.68,4166.87,50
CPT,96138,HB PSYCH/NEUROPSYCH TECH 1ST 30 MIN,739.73,480.82,496.88,571.41,16
CPT,96138,Outpatient Surgical Group 1,739.73,480.82,9088.3,13492.72,50
CPT,96139,HB PSYCH/NEUROPSYCH TECH EA ADDL 30 MIN,186.25,121.06,,,0
CPT,96139,Outpatient Surgical Group 1,186.25,121.06,9088.3,13492.72,50
CPT,96146,Outpatient Surgical Group 0,486.73,316.37,2806.68,4166.87,50
CPT,96158,"HB HEALTH BEHAVIOR INTERVENTION , 1ST 30 MIN",584.32,379.81,200.06,230.07,8
CPT,96159,"HB HEALTH BEHAVIOR INTERVENTION, EA ADDL 15 MIN",343.05,222.98,,,0
CPT,96167,"HB HEALTH BEHAVIOR INTERVENTION, FAMILY INITIAL 30MIN",584.32,379.81,37.09,42.66,8
CPT,96168,"HB HEALTH BEHAVIOR INTERVENTION, FAMILY EA ADDL 15MIN",343.05,222.98,,,0
CPT,96202,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,96203,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,96360,HB IV INFUS HYDRATION 31-60 MIN,2919.965,1897.975,262.35,14761.0,28
CPT,96360,HYDRATION THEARPY,2538.36,1649.93,,,0
CPT,96361,HB IV INFUSION HYDRATION ADDL HR,1140.325,741.2149999999999,57.45,14761.0,30
CPT,96361,HYDRATION THEARPY,991.58,644.53,,,0
CPT,96365,HB IV INFUSION THERAPY 1ST HR,3270.375,2125.74,262.35,14761.0,30
CPT,96365,INFUSION THERAPY,2842.96,1847.92,2148.0,2209.0,2
CPT,96366,HB IV INFUSION THERAPY EA ADDL HR,1140.325,741.2149999999999,57.45,14761.0,38
CPT,96366,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96367,HB IV INFUSION THERAPY EA ADDL HR,991.58,644.53,57.45,66.07,8
CPT,96367,HB IV THERAPY ADDL SEQ UP TO 1 HR,1140.325,741.2149999999999,88.62,14761.0,30
CPT,96367,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96368,HB IV THERAPY-CONCURRENT,1085.575,705.625,13270.0,14761.0,6
CPT,96368,INFUSION THERAPY,945.51,614.58,2148.0,2209.0,2
CPT,96369,INFUSION THERAPY,1167.71,759.01,2148.0,2209.0,2
CPT,96370,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96371,INFUSION THERAPY,,,2148.0,2209.0,2
CPT,96372,"HB THER/PROPH/DIAG INJ, SC/IM",473.59000000000003,307.835,88.62,14761.0,46
CPT,96372,INFUSION THERAPY,412.24,267.96,2148.0,2209.0,2
CPT,96373,INFUSION THERAPY,793.75,515.94,2148.0,2209.0,2
CPT,96374,HB IV PUSH INITIAL,1553.13,1009.53,262.35,14761.0,38
CPT,96374,HB IVP ADDL SEQ SAME DRUG,290.0,188.5,,,0
CPT,96374,INFUSION THERAPY,1553.13,1009.53,2148.0,2209.0,2
CPT,96375,HB IV PUSH ADDL SEQ NEW DRUG,1140.325,741.2149999999999,57.45,14761.0,38
CPT,96375,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96376,HB IVP ADDL SEQ SAME DRUG,991.58,644.53,13270.0,14761.0,6
CPT,96376,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96377,HB APPL ON-BODY INJECTOR SUBQ INJ,991.58,644.53,57.45,14761.0,10
CPT,96379,HB NON-CHEMO INF >8HRS VIA AMB PU,2434.68,1582.54,57.45,66.07,8
CPT,96401,"HB CHEMO ANTI-NEOPL, SC/IM",1386.795,901.415,88.62,14761.0,18
CPT,96401,INFUSION THERAPY,1205.91,783.84,2148.0,2209.0,2
CPT,96402,"HB CHEMO HORMNL ANTI-NEOPL, SC/IM",1273.465,827.75,88.62,14761.0,10
CPT,96402,INFUSION THERAPY,1107.36,719.78,2148.0,2209.0,2
CPT,96405,INFUSION THERAPY,1103.92,717.55,2148.0,2209.0,2
CPT,96406,INFUSION THERAPY,2483.38,1614.2,2148.0,2209.0,2
CPT,96409,HB CHEMO IVP/INF 0-15 MIN INITIAL,2865.705,1862.71,413.02,14761.0,10
CPT,96409,INFUSION THERAPY,2491.92,1619.75,2148.0,2209.0,2
CPT,96411,HB CHEMO IVP/INF 0-15 MIN ADD/SEQ,1140.325,741.2149999999999,88.62,14761.0,10
CPT,96411,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96413,HB CHEMO INFUSION FIRST HOUR,3907.7,2540.01,413.02,14761.0,18
CPT,96413,INFUSION THERAPY,3907.7,2540.01,2148.0,2209.0,2
CPT,96415,HB CHEMO INFUSION ADDL HOUR,1140.325,741.2149999999999,88.62,14761.0,10
CPT,96415,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96416,HB CHEMO INF>8HRS VIA AMB PUMP,2434.68,1582.54,413.02,14761.0,18
CPT,96416,INFUSION THERAPY,2434.68,1582.54,2148.0,2209.0,2
CPT,96417,HB CHEMO INF ADD/SEQ 1ST HOUR,1140.325,741.2149999999999,88.62,14761.0,10
CPT,96417,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
CPT,96420,HB CHEMOTHERAPY INTRA-ART PUSH,1915.67,1245.19,413.02,14761.0,10
CPT,96425,HB CHEMO INF>8HRS VIA INTERA PUMP,3907.7,2540.01,413.02,474.97,8
CPT,96446,INFUSION THERAPY,2434.68,1582.54,2148.0,2209.0,2
CPT,96450,"HB CHEMOTHERAPY, INTO CNS",2361.02,1534.665,413.02,14761.0,10
CPT,96450,INFUSION THERAPY,2053.07,1334.5,2148.0,2209.0,2
CPT,96521,HB AMBUL PUMP REFILL /MAINT-CHEMO,1782.96,1158.92,262.35,14761.0,20
CPT,96523,HB FLUSH IMPLANTABLE PORTS,1037.19,674.17,73.96,14761.0,20
CPT,96542,HB CHEMOTHERAPY INJECTION,2434.68,1582.54,413.02,474.97,8
CPT,96547,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,96548,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,96567,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,96570,HB PHOTODYNAMIC THERAPY ENDOSCOPIC INITIAL 30 MIN,1562.38,1015.55,13270.0,14761.0,2
CPT,96570,OUTPATIENT SURGERY CPT GROUP 1,1562.38,1015.55,6417.0,7038.0,2
CPT,96570,Outpatient Grouper - 0,1562.38,1015.55,9059.94,9827.82,24
CPT,96571,OUTPATIENT SURGERY CPT GROUP 1,330.5,214.83,6417.0,7038.0,2
CPT,96571,Outpatient Grouper - 0,330.5,214.83,9059.94,9827.82,24
CPT,96573,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,96574,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
CPT,96902,Laboratory Services,,,124.02,124.03,2
CPT,96920,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,96921,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,96922,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,96931,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,96932,Outpatient Surgical Group 4,7503.89,4877.53,17187.58,25517.11,50
CPT,96933,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,97010,HB OT APP MOD 1/> AREAS HOT/COLD PACKS,416.47,270.71,,,0
CPT,97010,HB PT APP MOD 1/> AREAS HOT/COLD PACKS,416.47,270.71,,,0
CPT,97012,HB PT APP MOD 1/> AREAS TRACT MECH,459.08,298.4,,,0
CPT,97014,HB APP MOD 1/> ELEC STIM UNATTEND,459.08,298.4,,,0
CPT,97018,HB OT APP MOD 1/> PARAFFIN BATH,482.06,313.34,,,0
CPT,97022,HB WHIRLPOOL/FLUIDTHERAPY,1131.36,735.38,,,0
CPT,97032,"HB ELEC STIM, ATTENDED EA 15M",564.03,366.62,,,0
CPT,97032,"HB OT ELEC STIM, ATTENDED EA 15M",564.03,366.62,,,0
CPT,97033,HB IONTOPHORESIS 15 MIN,564.03,366.62,,,0
CPT,97035,HB OTM ULTRASOUND EA 15M,544.37,353.84,,,0
CPT,97035,HB PT ULTRASOUND EA 15M,544.37,353.84,,,0
CPT,97037,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,97110,HB THER EXERCISE EA 15M,609.9749999999999,396.485,13270.0,14761.0,4
CPT,97112,HB NEUROMUSC REED EA 15M,632.435,411.08500000000004,13270.0,14761.0,4
CPT,97116,HB PT GAIT TRAINING EA 15M,649.295,422.03999999999996,13270.0,14761.0,2
CPT,97124,HB OT MASSAGE EA 15M,561.64,365.07,,,0
CPT,97124,HB PT MASSAGE THERAPY EA 15M,619.8,402.87,13270.0,14761.0,2
CPT,97129,"HB THER INTERVENTION W FOCUS COG FUNC, 1ST 15MIN",500.29499999999996,325.195,13270.0,14761.0,2
CPT,97130,"HB THER INTERVENTION W FOCUS COG FUNC,EA ADDL 15MIN",500.29499999999996,325.195,13270.0,14761.0,2
CPT,97140,HB MANUAL THERAPY EA 15M,579.755,376.84000000000003,13270.0,14761.0,2
CPT,97151,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97152,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97153,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97154,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97155,Outpatient Surgical Group 0,665.17,432.36,2806.68,4166.87,50
CPT,97156,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97157,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97158,Outpatient Surgical Group 0,183.68,119.39,2806.68,4166.87,50
CPT,97161,HB PT EVAL LOW COMPLEXITY,1298.4299999999998,843.98,13270.0,14761.0,4
CPT,97162,HB PT EVAL MOD COMPLEXITY,1949.57,1267.22,13270.0,14761.0,4
CPT,97163,HB PT EVAL HIGH COMPLEXITY,2598.83,1689.2399999999998,13270.0,14761.0,4
CPT,97164,HB PT REEVALUATION (2) INT,1624.92,1056.1950000000002,13270.0,14761.0,4
CPT,97165,HB OT EVAL LOW COMPLEXITY,1298.4299999999998,843.98,13270.0,14761.0,4
CPT,97166,HB OT EVAL MOD COMPLEXITY,1949.57,1267.22,13270.0,14761.0,4
CPT,97167,HB OT EVAL HIGH COMPLEXITY,2598.83,1689.2399999999998,13270.0,14761.0,4
CPT,97168,HB OT REEVALUATION (2) INT,1624.92,1056.1950000000002,13270.0,14761.0,4
CPT,97530,"HB THER ACTVTIES, DIR EA 15M",633.9000000000001,412.03499999999997,13270.0,14761.0,4
CPT,97533,"HB SENSORY INTEGRATION, 15 MIN",2938.25,1909.86,,,0
CPT,97535,HB OT ADL THERAPY EA 15M,508.225,330.34000000000003,13270.0,14761.0,2
CPT,97535,HB PT ADL THERAPY EA 15M,442.24,287.45,,,0
CPT,97537,HB COMM TRN/REINT 15M,567.35,368.78,,,0
CPT,97542,HB WHEELCHAIR MGMT TRAINING EA 15 MIN,565.6949999999999,367.70500000000004,13270.0,14761.0,2
CPT,97550,Outpatient Surgical Group 0,603.28,392.13,2806.68,4166.87,50
CPT,97551,Outpatient Surgical Group 0,299.55,194.71,2806.68,4166.87,50
CPT,97552,Outpatient Surgical Group 0,264.93,172.2,2806.68,4166.87,50
CPT,97597,HB PT WND CARE SELECT DEBRDMNT,1797.2150000000001,1168.19,247.42,14761.0,10
CPT,97597,Outpatient Grouper - 0,1562.8,1015.82,9059.94,9827.82,24
CPT,97597,Outpatient Surgical Group 0,1562.8,1015.82,2806.68,4166.87,50
CPT,97598,Outpatient Grouper - 0,1143.79,743.46,9059.94,9827.82,24
CPT,97598,Outpatient Surgical Group 0,1143.79,743.46,2806.68,4166.87,50
CPT,97605,HB NEG PRES WND THER <50CM,1562.8,1015.82,247.42,284.53,8
CPT,97605,HB NEG PRESS WND TX DME <=50 SQ CM,2031.63,1320.56,13270.0,14761.0,2
CPT,97606,HB NEG PRES WND THER >50CM,2063.43,1341.23,497.49,572.11,8
CPT,97607,HB NEG PRESS WND TX <=50 SQ CM,2372.935,1542.4099999999999,497.49,14761.0,10
CPT,97610,HB LOW FREQUENCY NON-THERMAL US,1562.8,1015.82,13270.0,14761.0,2
CPT,97750,HB OT JOB SITE EVAL EA 15M,564.03,366.62,,,0
CPT,97750,HB PT PHYS PERFRM TEST EA 15M,564.03,366.62,,,0
CPT,97760,HB ORTHOTIC SPLINT/TRN 15M,629.51,409.185,13270.0,14761.0,2
CPT,97760,HB ORTHTC ASSESS/TRN EA 15M,629.51,409.185,13270.0,14761.0,2
CPT,97761,HB OT PROSTHETIC TRAIN EA 15M,757.5,492.38,13270.0,14761.0,2
CPT,97761,HB PT PROSTHETIC TRAIN EA 15M,670.61,435.9,13270.0,14761.0,2
CPT,97763,HB ORTH/PROS CHECK EA 15M,837.88,544.62,13270.0,14761.0,2
CPT,97799,HB PATIENT/FAM CONF INTERM,1114.98,724.74,13270.0,14761.0,4
CPT,97799,HB SP PATIENT/FAM CONF INTERM,1114.98,724.74,13270.0,14761.0,2
CPT,97802,HB NUTRITION THERAPY (IND) EA 15,1253.27,814.63,13270.0,14761.0,2
CPT,97803,HB NUTRITION REASSES (IND) EA 15,426.87,277.47,13270.0,14761.0,2
CPT,97804,HB NUTRITION THER (GRP V1) EA 30M,747.69,486.0,,,0
CPT,98978,Outpatient Surgical Group 0,1440.95,936.62,2806.68,4166.87,50
CPT,99001,HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE PATIENT IN OTHER THAN A PHYSICIAN'S OFFICE TO A LABORATORY,,,89.96,143.26,2
CPT,99002,"HANDLING, CONVEYANCE, AND/OR ANY OTHER SERVICE IN CONNECTION WITH THE IMPLEMENTATION OF AN ORDER INVOLVING DEVIC",,,308.67,491.59,2
CPT,99151,HB MODERATE SEDATION <5YRS 15 MIN,1163.18,756.0699999999999,13270.0,14761.0,2
CPT,99152,HB MODERATE SEDATION >5YRS 15 MIN,1163.18,756.0699999999999,13270.0,14761.0,2
CPT,99153,HB MODERATE SEDATION EA ADDL 15 MIN,480.39,312.25,13270.0,14761.0,2
CPT,99155,HB MOD SED OTH PHYS/QHP <5 YRS,1011.67,657.59,,,0
CPT,99156,HB MOD SED OTH PHYS/QHP 5/>YRS,1163.18,756.0699999999999,13270.0,14761.0,2
CPT,99157,HB MOD SED OTHER PHYS/QHP EA,455.775,296.25,13270.0,14761.0,2
CPT,99170,OUTPATIENT SURGERY CPT GROUP 1,,,6417.0,7038.0,2
CPT,99174,"OCULAR PHOTSCREENING WITH INTERPRETATION AND REPORT, BILATERAL",,,661.44,1053.42,2
CPT,99184,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,99195,HB THERAPEUTIC PHLEBOTOMY,1074.29,698.29,160.5,14761.0,10
CPT,99195,HB THERAPEUTIC PHLEBOTOMY CC,1074.29,698.29,160.5,184.58,8
CPT,99195,OUTPATIENT SURGERY CPT GROUP 1,1074.29,698.29,6417.0,7038.0,2
CPT,99201,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99202,"HB NEW PATIENT, LEVEL 2",461.97,300.28,13270.0,14761.0,4
CPT,99202,Pediatric and Neonatal Services: Clinic Fee,461.97,300.28,127.0,127.0,1
CPT,99203,"HB NEW PATIENT, LEVEL 3",812.54,528.15,160.47,14761.0,10
CPT,99203,Pediatric and Neonatal Services: Clinic Fee,587.89,382.13,127.0,127.0,1
CPT,99204,"HB NEW PATIENT, LEVEL 4",998.05,648.73,160.47,14761.0,12
CPT,99204,Pediatric and Neonatal Services: Clinic Fee,958.91,623.29,127.0,127.0,1
CPT,99205,"HB NEW PATIENT, LEVEL 5",1741.18,1131.7649999999999,160.47,14761.0,10
CPT,99205,Pediatric and Neonatal Services: Clinic Fee,2445.17,1589.36,127.0,127.0,1
CPT,99206,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99207,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99208,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99209,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99210,Pediatric and Neonatal Services: Clinic Fee,,,127.0,127.0,1
CPT,99211,"HB EST PATIENT, LEVEL 1",722.755,469.78999999999996,160.47,14761.0,12
CPT,99211,Pediatric and Neonatal Services: Clinic Fee,408.32,265.41,127.0,127.0,1
CPT,99212,"HB EST. PATIENT, LEVEL 2",749.58,487.22499999999997,160.47,14761.0,20
CPT,99212,"HB NEW PATIENT, LEVEL 2",461.97,300.28,,,0
CPT,99212,HB TELEHEALTH ORIGINATING SITE FACILITY FEE,485.73,315.72,,,0
CPT,99212,Pediatric and Neonatal Services: Clinic Fee,461.97,300.28,127.0,127.0,1
CPT,99213,"HB EST. PATIENT, LEVEL 3",812.54,528.15,160.47,14761.0,12
CPT,99213,Pediatric and Neonatal Services: Clinic Fee,587.89,382.13,127.0,127.0,1
CPT,99214,"HB EST. PATIENT, LEVEL 4",998.05,648.73,160.47,14761.0,12
CPT,99214,Pediatric and Neonatal Services: Clinic Fee,958.91,623.29,127.0,127.0,1
CPT,99215,"HB EST. PATIENT, LEVEL 5",4082.1050000000005,2653.3650000000002,160.47,14761.0,12
CPT,99215,Pediatric and Neonatal Services: Clinic Fee,7127.02,4632.56,127.0,127.0,1
CPT,99281,EMERGENCY CARE LEVEL 1,3692.05,2399.83,705.0,763.0,2
CPT,99281,Emergency Department Services Level I,3692.05,2399.83,1311.58,1680.39,2
CPT,99281,Emergency Level 1,3692.05,2399.83,899.94,976.61,12
CPT,99281,Emergency Level 1: Limited,3692.05,2399.83,1148.08,2290.16,20
CPT,99281,HB ED FACILITY LEVEL 1,6215.280000000001,4039.93,109.64,14761.0,18
CPT,99281,OUTPATIENT/EMERGENCY ROOM,3692.05,2399.83,,,0
CPT,99282,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,26
CPT,99282,Emergency Department Services Level II,5680.04,3692.03,2465.68,2811.7,2
CPT,99282,Emergency Level 1: Limited,5680.04,3692.03,1148.08,2290.16,20
CPT,99282,Emergency Level 2,5680.04,3692.03,2055.94,2230.11,12
CPT,99282,HB ED FACILITY LEVEL 2,7209.275,4686.03,197.19,14761.0,26
CPT,99282,OUTPATIENT/EMERGENCY ROOM,5680.04,3692.03,,,0
CPT,99283,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,20
CPT,99283,Emergency Department Services Level III,8738.51,5680.03,5267.02,5938.35,2
CPT,99283,Emergency Level 2: Intermediate,8738.51,5680.03,2710.42,5406.67,20
CPT,99283,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,12
CPT,99283,HB ED FACILITY LEVEL 3,8738.51,5680.03,344.78,14761.0,10
CPT,99283,HB ED FACILITY LEVEL 3 W/PROC,8738.51,5680.03,344.78,396.5,16
CPT,99283,OUTPATIENT/EMERGENCY ROOM,8738.51,5680.03,,,0
CPT,99284,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,20
CPT,99284,Emergency Department Services Level IV,12553.6,8159.84,9356.12,11765.85,2
CPT,99284,Emergency Level 3: Comprehensive,12553.6,8159.84,5444.5,10860.55,20
CPT,99284,Emergency Level 4,12553.6,8159.84,8353.38,9063.15,12
CPT,99284,HB ED FACILITY LEVEL 4,12553.615,8159.85,530.23,14761.0,18
CPT,99284,HB ED FACILITY LEVEL 4 W/PROC,8738.51,5680.03,530.23,609.76,16
CPT,99284,OUTPATIENT/EMERGENCY ROOM,12553.6,8159.84,,,0
CPT,99285,EMERGENCY CARE LEVEL 5,13870.7,9015.95,16899.0,18206.0,20
CPT,99285,Emergency Department Services Level V,13870.7,9015.95,14679.08,16023.81,2
CPT,99285,Emergency Level 3: Comprehensive,13870.7,9015.95,5444.5,10860.55,20
CPT,99285,Emergency Level 5,13870.7,9015.95,9061.0,9829.95,12
CPT,99285,HB ED FACILITY LEVEL 5,8738.51,5680.03,763.42,877.94,16
CPT,99285,HB ED FACILITY LEVEL 5 W/PROC,13870.685000000001,9015.945,763.42,14761.0,18
CPT,99285,OUTPATIENT/EMERGENCY ROOM,13870.7,9015.95,,,0
CPT,99291,EMERGENCY CARE LEVEL 5,16839.3,10945.55,16899.0,18206.0,20
CPT,99291,Emergency Critical Care,16839.3,10945.55,13495.88,14640.56,12
CPT,99291,Emergency Department Services Level VI,16839.3,10945.55,16919.95,18488.46,2
CPT,99291,Emergency Level 4: Critical Care,16839.3,10945.55,8746.72,17447.72,20
CPT,99291,HB CRITICAL CARE 30-74 MIN,16839.295,10945.545,1049.21,14761.0,10
CPT,99291,OUTPATIENT/EMERGENCY ROOM,16839.3,10945.55,,,0
CPT,99292,Emergency Department Services Level VI,6735.72,4378.22,16919.95,18488.46,2
CPT,99292,HB CRITICAL CARE EACH ADD 30 MIN,6735.72,4378.22,13270.0,14761.0,2
CPT,99401,HB PREV COUNSEL INDIV 15 MIN,449.15,291.95,,,0
CPT,99402,HB PREV COUNSEL INDIV 30 MIN,489.64,318.27,,,0
CPT,99403,HB PREV COUNSEL INDIV 45 MIN,580.76,377.49,,,0
CPT,99406,HB TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,183.68,119.39,37.09,42.66,8
CPT,99418,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,99483,HB ASSMT & CARE PLN PT WCOG IMPRMT 50 MIN,584.32,379.81,115.18,132.46,8
CPT,A6460,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,A6461,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C1052,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C1062,Outpatient Surgical Group 0,40594.85,26386.65,2806.68,4166.87,50
CPT,C5271,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C5273,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C5275,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C5277,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7500,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7501,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7502,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7503,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7504,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7505,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7506,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7507,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7508,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7509,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7510,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7511,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7512,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7513,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7514,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7515,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7516,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7517,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7518,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7519,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7520,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7521,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7522,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7523,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7524,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7525,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7526,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7527,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7528,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7529,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7530,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7531,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7532,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7533,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7534,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7535,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7537,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7538,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7539,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7540,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C7541,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7542,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7543,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7544,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7545,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7546,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7547,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7548,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7549,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7550,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7551,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7552,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7553,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7554,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7555,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7900,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7901,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C7902,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C8929,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C8930,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C9600,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9601,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9602,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9603,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9604,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9605,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9606,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9607,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9608,Outpatient Surgical Group 5,7503.89,4877.53,19539.84,29009.34,50
CPT,C9739,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,C9740,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,C9751,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C9757,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,C9771,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C9772,Outpatient Surgical Group 4,102328.0,66513.2,17187.58,25517.11,50
CPT,C9773,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,C9774,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,C9775,Outpatient Surgical Group 4,114605.0,74493.25,17187.58,25517.11,50
CPT,C9787,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,C9789,Outpatient Surgical Group 1,8578.46,5576.0,9088.3,13492.72,50
CPT,C9790,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,G0104,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,G0105,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0121,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0168,Outpatient Surgical Group 1,7503.89,4877.53,9088.3,13492.72,50
CPT,G0260,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0276,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,G0277,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,G0279,Outpatient Surgical Group 2,7503.89,4877.53,12162.28,18056.43,50
CPT,G0317,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0318,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0320,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0321,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0322,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0323,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G0330,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G3002,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,G3003,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q2042,Outpatient Surgical Group 0,1542630.0,1002709.5,2806.68,4166.87,50
CPT,Q4183,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4184,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4185,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4186,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4187,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4188,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4189,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4190,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4191,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4192,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4193,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4194,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4195,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4196,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4197,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4198,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4200,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4201,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4202,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4203,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
CPT,Q4204,Outpatient Surgical Group 0,7503.89,4877.53,2806.68,4166.87,50
HCPCS,0001A,HB TERM ADM SARSCOV2 30MCG/0.3ML 1ST,396.14,257.49,,,0
HCPCS,0034U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0035U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0042T,HB CT PERFUSION BRAIN,6006.14,3903.99,,,0
HCPCS,0049U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0051A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR 1,396.14,257.49,,,0
HCPCS,0054A,HB TERM ADM 12-18 SARSCV2 30MCG TRS-SUCR B,396.14,257.49,,,0
HCPCS,0077U,HB MISC LAB SPECIAL TEST,449.47999999999996,292.15999999999997,,,0
HCPCS,0119U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0124A,HB TERM ADM SARSCOV2 30MCG/0.3 ML BIVALENT BST,396.14,257.49,,,0
HCPCS,0152U,HB MISC LAB SPECIAL TEST,1800.0,1170.0,,,0
HCPCS,0202U,HB VIRAL RESPIRATORY PANEL WITH COVID19 - 22 TARGETS,535.86,348.31,,,0
HCPCS,0232T,HB INJ PLATELET PLASMA & IMG,739.73,480.82,,,0
HCPCS,0238T,"HB ATHERECTOMY ILIAC,EA VESSEL",114605.0,74493.25,,,0
HCPCS,0241U,HB COVID SEASONAL INFLUENZA PCR PANEL RESP (COVID-19),868.53,564.54,,,0
HCPCS,0277U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0346U,HB MISC LAB SPECIAL TEST,30.43,19.78,,,0
HCPCS,0394T,HB HDR ELCTRNC SKN SURF BRCHYTX,3386.14,2200.99,,,0
HCPCS,0395T,HB HDR ELCTR NTRST/NTRCV BRCHTX,20280.0,13182.0,,,0
HCPCS,0398T,HB MRGFUS STEREOTACTIC ABLAT LES INTRCRNL,6099.75,3964.84,,,0
HCPCS,0408T,HB CATH UNLISTED PROCEDURES,37207.0,24184.55,,,0
HCPCS,0441T,"HB ABLTN, PERQ CRYO PERP NRV LOWER EXT",13722.6,8919.69,,,0
HCPCS,0448T,HB RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE,7948.54,5166.55,,,0
HCPCS,0502T,HB TERM COR FFR DATA PREP & TRANS,1440.95,936.62,,,0
HCPCS,0503T,HB TERM COR FFR CTA DATA ALYS & GNRJ,1440.95,936.62,,,0
HCPCS,0537T,HB LYMPHS CAR-T CELL HARVEST,8187.66,5321.98,,,0
HCPCS,0538T,HB LYMPHS PREP/TRNSPRT,4420.69,2873.45,,,0
HCPCS,0648T,HB QUANT MR ANALYSIS TISSUE W/O MRI EXAM,3428.63,2228.61,,,0
HCPCS,0649T,HB QUANT MR ANALYSIS TISSUE W/ MRI EXAM,4712.23,3062.95,,,0
HCPCS,0715T,HB PERC TRANSLUMINAL CORONARY LITHOTRIPSY,37207.0,24184.55,,,0
HCPCS,0720T,HB PERQ ELEC NRV STIM CRANIAL WO IMPLT,3969.24,2580.01,,,0
HCPCS,A2006,HB MISCELLANEOUS IMPLANT,170.72,110.97,,,0
HCPCS,A4100,HB MISCELLANEOUS IMPLANT,46574.5,30273.42,,,0
HCPCS,A4248,"Chlorhexidine containing antiseptic, 1 mL (Code Price is based on median pricing methodology)",,,0.05,0.05,2
HCPCS,A4248,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.03,0.04,2
HCPCS,A4270,HB ENDOSCOPE SHEATH DISPOSABLE,601.53,390.99,13270.0,14761.0,2
HCPCS,A4300,HB MISCELLANEOUS IMPLANT,2385.1,1550.32,,,0
HCPCS,A4351,"HB CATHETER, URINARY STRAIGHT",495.96,322.37,13270.0,14761.0,2
HCPCS,A4562,HB PESSARY (SILICONE),502.46,326.6,,,0
HCPCS,A4627,"INHALAT. SPACING DEV,SM. MASK MISC SPCR",731.04,475.18,13270.0,14761.0,2
HCPCS,A4648,"HB TISSUE MARKER, CLIP/WIRE",1915.84,1245.3,13270.0,14761.0,2
HCPCS,A4649,"HB ADHESIVE, SKIN",442.0,287.3,,,0
HCPCS,A4649,"HB RELOAD, ENDOSCOPIC 1",899.57,584.72,13270.0,14761.0,2
HCPCS,A4802,"PROTAMINE SULFATE, FOR HEMODIALYSIS, PER 50MG",,,21.62,23.08,2
HCPCS,A4802,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.34,16.19,2
HCPCS,A6550,HB MISCELLANEOUS SUPPLY,3438.85,2235.25,13270.0,14761.0,4
HCPCS,A9155,"Artificial saliva, 30 mL (Code Price is based on median pricing methodology)",,,18.16,19.39,2
HCPCS,A9155,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.05,13.6,2
HCPCS,A9180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.76,4.25,2
HCPCS,A9500,KIT FOR TC 99M-SESTAMIBI NO.1 IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9500,SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT TECHETIUM TC 99M SESTAMIBI PER DOSE,,,284.54,303.79,2
HCPCS,A9500,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,188.71,213.1,2
HCPCS,A9502,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",,,279.87,298.81,2
HCPCS,A9502,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,185.61,209.61,2
HCPCS,A9503,MEDRONATE (TC-99M MDP) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
HCPCS,A9503,SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGIN AGENT TECHNETIUM TC 99M MEDRONATE UP TO 30 MCI,,,360.65,385.05,2
HCPCS,A9503,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,239.19,270.11,2
HCPCS,A9504,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M APCITIDE",,,1110.6,1185.75,2
HCPCS,A9504,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,736.56,831.78,2
HCPCS,A9505,SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT THALLOUS CHLORIDE TL 201 PER MCI,,,72.76,77.68,2
HCPCS,A9505,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,48.25,54.49,2
HCPCS,A9507,KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR,1.01,0.65,13270.0,14761.0,2
HCPCS,A9507,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSITIC IMAGING AGENT INDIUM IN 111 CAPROMAB PENDETIDE, PER DOSE",,,5125.42,5472.24,2
HCPCS,A9507,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3399.22,3838.66,2
HCPCS,A9508,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IOBENGUANE SULFATE",,,1158.87,1237.29,2
HCPCS,A9508,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,768.58,867.93,2
HCPCS,A9509,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER MILLICURIE",,,3730.8,3983.25,2
HCPCS,A9509,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2474.3,2794.17,2
HCPCS,A9510,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M",,,133.27,142.29,2
HCPCS,A9510,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.39,99.81,2
HCPCS,A9512,SODIUM PERTECHNETATE (TC-99M O4) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
HCPCS,A9512,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",,,4.27,4.56,2
HCPCS,A9512,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.83,3.2,2
HCPCS,A9513,All drugs or drug agents without specific rate set forth above or herein,,,814.87,814.87,2
HCPCS,A9513,LU-177 DOTATATE (LUTATHERA) ISOTOPE (NUC MED),1.01,0.65,368.89,14761.0,26
HCPCS,A9513,"Lutetium lu 177, dotatate, therapeutic, 1 millicurie (Code reused by CMS 1/1/2019)",,,633.04,675.88,2
HCPCS,A9513,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,419.84,474.11,2
HCPCS,A9515,"Choline c-11, diagnostic, per study dose up to 20 millicuries",,,13327.2,14229.0,2
HCPCS,A9515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8838.72,9981.36,2
HCPCS,A9516,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MILLICURIES",,,152.05,162.34,2
HCPCS,A9516,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) PO CAPS,1.01,0.65,13270.0,14761.0,2
HCPCS,A9516,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,100.84,113.88,2
HCPCS,A9517,All drugs or drug agents without specific rate set forth above or herein,,,63.62,63.62,2
HCPCS,A9517,"IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE",,,385.35,411.43,2
HCPCS,A9517,SODIUM IODIDE I-131 CAPSULE,,,28.8,14761.0,18
HCPCS,A9517,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,255.57,288.61,2
HCPCS,A9520,"TECHNETIUM TC-99M, TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",,,603.5,644.34,2
HCPCS,A9520,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,400.25,451.99,2
HCPCS,A9521,"TECHNETIUM TC-99M EXAMETAZIME, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",,,2082.38,2223.28,2
HCPCS,A9521,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1381.05,1559.59,2
HCPCS,A9524,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IODINATED I-131 SERUM ALBUM, 5 MICROCURIES",,,120.83,129.01,2
HCPCS,A9524,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,80.14,90.5,2
HCPCS,A9526,"SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, AMMONIA N-13, PER DOSE",,,1599.26,1707.48,2
HCPCS,A9526,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1060.65,1197.76,2
HCPCS,A9528,"IODINE I-131 SODIUM IODIDE CAPSULE(S), DIAGNOSTIC, PER MILLICURIE",,,64.24,68.59,2
HCPCS,A9528,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,42.61,48.11,2
HCPCS,A9532,"IODINE I-125 SERUM ALBUMIN, DIAGNOSTIC, PER 5 MICROCURIES",,,41.76,44.58,2
HCPCS,A9532,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.69,31.27,2
HCPCS,A9536,"TECHNETIUM TC-99M DEPREOTIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 35 MILLICURIES ï",,,1875.68,2002.6,2
HCPCS,A9536,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1243.97,1404.78,2
HCPCS,A9537,KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9537,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES ï",,,146.94,156.89,2
HCPCS,A9537,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,97.46,110.05,2
HCPCS,A9538,KIT PREP OF TC-99M-SOD PYROPH 12 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9538,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES ï",,,60.96,65.08,2
HCPCS,A9538,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.43,45.66,2
HCPCS,A9539,KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9539,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES ï",,,40.11,42.82,2
HCPCS,A9539,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.6,30.04,2
HCPCS,A9540,KIT FOR PREP OF TC-99M-ALBUMIN 2.5 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9540,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES ï",,,53.14,56.73,2
HCPCS,A9540,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.24,39.8,2
HCPCS,A9541,KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9541,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES ï",,,131.3,140.18,2
HCPCS,A9541,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,87.08,98.33,2
HCPCS,A9542,"INDIUM IN-111 IBRITUMOMAB TIUXETAN, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES ï",,,6835.45,7297.98,2
HCPCS,A9542,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4533.33,5119.38,2
HCPCS,A9543,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,98243.5,110944.09,2
HCPCS,A9543,"YTTRIUM Y-90 IBRITUMOMAB TIUXETAN, THERAPEUTIC, PER TREATMENT DOSE, UP TO 40 MILLICURIES ï",,,148133.53,158157.15,2
HCPCS,A9547,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE ï",,,719.69,768.39,2
HCPCS,A9547,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,477.31,539.01,2
HCPCS,A9548,"INDIUM IN-111 PENTETATE, DIAGNOSTIC, PER 0.5 MILLICURIE ï",,,671.81,717.27,2
HCPCS,A9548,PENTETATE INDIUM DISOD. IN-111 1.5 MCI/1.5 ML IT SOLN,1.01,0.65,890.67,14761.0,10
HCPCS,A9548,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,445.55,503.15,2
HCPCS,A9551,"TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES ï",,,312.52,333.67,2
HCPCS,A9551,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,207.27,234.06,2
HCPCS,A9552,FLUORODEOXYGLUCOSE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
HCPCS,A9552,"FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES ï",,,1110.6,1185.75,2
HCPCS,A9552,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,736.56,831.78,2
HCPCS,A9554,"IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MICROCURIES ï",,,93.29,99.6,2
HCPCS,A9554,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,61.87,69.87,2
HCPCS,A9555,RUBIDIUM CHLORIDE RB-82,1.01,0.65,13270.0,14761.0,4
HCPCS,A9555,"RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURIES ï",,,1234.0,1317.5,2
HCPCS,A9555,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,818.4,924.2,2
HCPCS,A9556,GALLIUM (GA-67) CITRATE ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
HCPCS,A9556,"GALLIUM GA-67 CITRATE, DIAGNOSTIC, PER MILLICURIE ï",,,59.97,64.03,2
HCPCS,A9556,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,39.77,44.92,2
HCPCS,A9557,BICISATE DIHYDROCHLORIDE (TC-99M) (NEUROLITE) ISOTOPE (NUC ME),1.01,0.65,851.46,14761.0,13
HCPCS,A9557,"TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES ï",,,944.58,1008.49,2
HCPCS,A9557,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,626.45,707.44,2
HCPCS,A9558,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,46.78,52.83,2
HCPCS,A9558,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES ï",,,70.54,75.31,2
HCPCS,A9560,LABELED RED BLOOD CELLS (TC-99M RBC) (ULTRATAG) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
HCPCS,A9560,"TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILICURIES ï",,,281.35,300.39,2
HCPCS,A9560,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,186.6,210.72,2
HCPCS,A9561,"TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES ï",,,81.02,86.51,2
HCPCS,A9561,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.74,60.68,2
HCPCS,A9562,KIT TC-99M-MERTIATIDE (BETIAT) 1 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
HCPCS,A9562,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES ï",,,1099.52,1173.92,2
HCPCS,A9562,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,729.21,823.48,2
HCPCS,A9563,All drugs or drug agents without specific rate set forth above or herein,,,492.69,492.69,2
HCPCS,A9563,"SODIUM PHOSPHATE P-32, THERAPEUTIC, PER MILLICURIE ï",,,189.64,202.47,2
HCPCS,A9563,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,125.77,142.03,2
HCPCS,A9564,"CHROMIC PHOSPHATE P-32 SUSPENSION, THERAPEUTIC, PER MILLICURIE ï",,,1919.96,2049.87,2
HCPCS,A9564,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1273.33,1437.94,2
HCPCS,A9567,DIETHYLENE TRIAMINE PENTAACETIC ACID (TC-99M DTPA) ISOTOPE (NUC MED) N,1.01,0.65,13270.0,14761.0,4
HCPCS,A9567,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES ï",,,,,0
HCPCS,A9567,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,,,0
HCPCS,A9569,"TECHNETIUM TC-99M EXAMETAZIME LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",,,2762.85,2949.8,2
HCPCS,A9569,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1832.35,2069.23,2
HCPCS,A9570,"IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",1.01,0.65,1284.27,14761.0,13
HCPCS,A9570,"INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",,,9532.28,10177.29,2
HCPCS,A9570,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6321.89,7139.17,2
HCPCS,A9571,"INDIUM IN-111 LABELED AUTOLOGOUS PLATELETS, DIAGNOSTIC, PER STUDY DOSE",,,9532.28,10177.29,2
HCPCS,A9571,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6321.89,7139.17,2
HCPCS,A9572,INDIUM 111-PENTETREOTIDE 3-10 MCI/ML-MCG IV KIT,1.01,0.65,2384.05,2741.66,8
HCPCS,A9572,"INDIUM IN-111 PENTETREOTIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 6 MILLICURIES",,,24009.1,25633.7,2
HCPCS,A9572,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15923.05,17981.53,2
HCPCS,A9575,"INJECTION, GADOTERATE MEGLUMINE, 0.1 ML",,,1.26,1.34,2
HCPCS,A9575,"Injection, gadoterate meglumine, 0.1 mL",,,0.28,0.28,2
HCPCS,A9575,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.83,0.94,2
HCPCS,A9576,"INJECTION, GADOTERIDOL, (PROHANCE MULTIPACK), PER ML",,,15.35,16.39,2
HCPCS,A9576,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.18,11.5,2
HCPCS,A9577,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",,,14.59,15.57,2
HCPCS,A9577,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.67,10.92,2
HCPCS,A9578,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE MULTIPACK), PER ML",,,15.35,16.39,2
HCPCS,A9578,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.18,11.5,2
HCPCS,A9579,GADODIAMIDE 5 MMOL/10 ML (287 MG/ML) IV SOLN,20482.8,13313.82,,,0
HCPCS,A9579,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (DOSAGE EQUALS 1 ML/UNIT)",,,9.55,10.2,2
HCPCS,A9579,"Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per mL",,,3.34,3.34,2
HCPCS,A9579,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.33,7.15,2
HCPCS,A9580,SODIUM FLOURIDE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
HCPCS,A9581,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,6
HCPCS,A9581,"INJECTION, GADOXETATE DISODIUM, 1 ML",,,34.65,37.0,2
HCPCS,A9581,"Injection, gadoxetate disodium, 1 mL (For billing prior to 1/1/10 use J3490 or C9246)",,,32.43,32.43,2
HCPCS,A9581,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.98,25.95,2
HCPCS,A9582,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN,1.01,0.65,2583.53,14761.0,13
HCPCS,A9582,"IODINE, I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",,,9021.5,9631.95,2
HCPCS,A9582,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5983.14,6756.62,2
HCPCS,A9583,"INJECTION, GADOFOSVESET TRISODIUM, 1 ML",,,32.4,34.6,2
HCPCS,A9583,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.49,24.27,2
HCPCS,A9584,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",,,6015.9,6422.97,2
HCPCS,A9584,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,1.01,0.65,1728.35,1987.6,8
HCPCS,A9584,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3989.8,4505.59,2
HCPCS,A9585,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
HCPCS,A9585,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,2
HCPCS,A9585,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,8
HCPCS,A9585,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
HCPCS,A9585,"INJECTION, GADOBUTROL, 0.1 ML",,,2.22,2.37,2
HCPCS,A9585,"Injection, gadobutrol, 0.1 mL (For billing prior to 1/1/12 use J3490 or C9399)",,,0.75,0.75,2
HCPCS,A9585,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.47,1.66,2
HCPCS,A9586,FLORBETAPIR F-18 10 MCI (370 MBQ) IV SOLN,1.01,0.65,2732.71,3142.62,8
HCPCS,A9586,"FLORBETAPIR F18, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICCURIES",,,4264.7,4553.28,2
HCPCS,A9586,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2828.39,3194.04,2
HCPCS,A9587,GALLIUM DOTATATE (GA-68)(NETSPOT) ISOTOPE (NUC MED),1.01,0.65,63.62,73.16,16
HCPCS,A9587,"Gallium ga-68, dotatate, diagnostic, 0.1 millicurie",,,167.82,179.18,2
HCPCS,A9587,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,111.3,125.69,2
HCPCS,A9588,F-18 FLUCICLOVINE,1.01,0.65,334.23,384.37,8
HCPCS,A9588,"Fluciclovine f-18, diagnostic, 1 millicurie",,,979.55,1045.83,2
HCPCS,A9588,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,649.65,733.63,2
HCPCS,A9589,"Instillation, hexaminolevulinate hydrochloride, 100 mg",,,2865.35,3059.24,2
HCPCS,A9589,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1900.32,2145.99,2
HCPCS,A9590,"Iodine i-131, iobenguane, 1 millicurie",,,804.96,859.43,2
HCPCS,A9590,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,533.86,602.87,2
HCPCS,A9591,"FLUOROESTRADIOL F-18 148 MBQ/ML TO 3,700 MBQ/ML IV SOLN",1.01,0.65,620.94,714.08,8
HCPCS,A9591,"Fluoroestradiol f 18, diagnostic, 1 millicurie",,,97.29,103.87,2
HCPCS,A9591,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,64.52,72.86,2
HCPCS,A9592,"Copper Cu-64, dotatate, diagnostic, 1 millicurie",,,2332.26,2490.08,2
HCPCS,A9592,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1546.78,1746.74,2
HCPCS,A9595,Drug - Radiopharmaceutical,,,1362.34,1454.52,2
HCPCS,A9595,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML IV SOLN",1.01,0.65,413.95,476.04,8
HCPCS,A9595,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,903.51,1020.32,2
HCPCS,A9596,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",,,2505.51,2675.05,2
HCPCS,A9596,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1661.68,1876.5,2
HCPCS,A9600,All drugs or drug agents without specific rate set forth above or herein,,,4788.06,4788.06,2
HCPCS,A9600,"STRONTIUM SR-89 CHLORIDE, THERAPEUTIC, PER MILLICURIE",,,2252.57,2404.99,2
HCPCS,A9600,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1493.92,1687.05,2
HCPCS,A9602,"Fluorodopa f-18, diagnostic, per millicurie",,,1329.71,1419.69,2
HCPCS,A9602,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,881.88,995.88,2
HCPCS,A9604,"SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TREATMENT DOSE, UP TO 150 MILLICURIES",,,14996.33,16011.08,2
HCPCS,A9604,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9945.7,11231.45,2
HCPCS,A9606,"RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN",,,205.77,236.63,8
HCPCS,A9606,"Radium Ra-223 dichloride, therapeutic, per microcurie (For billing prior to 1/1/15 use C9399 or A9699)",,,303.39,323.92,2
HCPCS,A9606,Radium ra223 dichloride ther,,,722.77,1151.08,2
HCPCS,A9606,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,201.21,227.22,2
HCPCS,A9607,"LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",1465.56,952.61,300.39,345.45,24
HCPCS,A9607,"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie",,,566.41,604.73,2
HCPCS,A9607,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,375.65,424.21,2
HCPCS,A9698,ETHIODIZED OIL 480 MG IODINE/ML IJ OIL,16401.9,10661.235,13270.0,14761.0,4
HCPCS,A9698,IOHEXOL 12 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,A9698,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,A9698,"NON-RADIOACTIVE CONTRAST IMAGING MATERIAL, NOT OTHERWISE CLASSIFIED, PER STUDY ï",,,,,0
HCPCS,A9700,"SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY",,,277.65,296.44,2
HCPCS,A9700,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,184.14,207.95,2
HCPCS,A9800,"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie",,,2132.35,2276.64,2
HCPCS,A9800,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1414.2,1597.02,2
HCPCS,B4158,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITHINTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VI",,,9.08,9.7,2
HCPCS,B4158,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.02,6.8,2
HCPCS,B4159,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE SOY BASED WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBO",,,10.39,11.09,2
HCPCS,B4159,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.89,7.78,2
HCPCS,B4160,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE CALORICALLY DENSE, WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FAT",,,6.17,6.59,2
HCPCS,B4160,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.09,4.62,2
HCPCS,B4161,"ENTERAL FORMULA, FOR PEDIATRICS, HYDROLYZED/AMINO ACIDS AND PEPTIDE CHAIN PROTEINS, INCLUDES FATS, CARBOHYDRATES, VITAMI",,,20.41,21.79,2
HCPCS,B4161,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.54,15.29,2
HCPCS,B4162,"ENTERAL FORMULA, FOR PEDIATRICS, SPECIAL METABOLIC NEEDS FORINHERITED DISEASE OF METABOLISM, INCLUDES PROTEINS, FATS, CA",,,18.93,20.21,2
HCPCS,B4162,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.55,14.18,2
HCPCS,B4185,FAT EMULSION 20 % IV EMUL,684.0,444.6,13270.0,14761.0,4
HCPCS,B4187,FAT EMULSION 20% (SMOFLIPID) ADULT,432.0,280.8,13270.0,14761.0,10
HCPCS,B4187,FAT EMULSION WITH FISH OIL (OMEGAVEN) (NEO-PEDS) 10% IV SYRINGE,894.4,581.36,13270.0,14761.0,2
HCPCS,B4187,FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL,894.4,581.36,13270.0,14761.0,2
HCPCS,B5000,"PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES, WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS",,,185.1,197.63,2
HCPCS,B5000,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,122.76,138.63,2
HCPCS,B5100,"PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS",,,246.8,263.5,2
HCPCS,B5100,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,163.68,184.84,2
HCPCS,B5200,"PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS",,,187.57,200.26,2
HCPCS,B5200,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,124.4,140.48,2
HCPCS,C1062,HB MISCELLANEOUS IMPLANT,40594.85,26386.65,13270.0,14761.0,2
HCPCS,C1062,Outpatient Surgery Group 3 Global Rate,40594.85,26386.65,22055.0,22787.0,2
HCPCS,C1713,HB ANCHOR /SCREW 7,19592.1,12734.86,,,0
HCPCS,C1713,HB BONE CEMENT 1,976.04,634.43,,,0
HCPCS,C1713,HB GASTRO ANCHOR SET,19592.1,12734.86,13270.0,14761.0,4
HCPCS,C1713,"HB KIT, CAGE INTERLOCK 1",25550.3,16607.69,,,0
HCPCS,C1713,HB MISCELLANEOUS IMPLANT,19592.1,12734.86,13270.0,14761.0,2
HCPCS,C1714,HB CATH ARTHERECTOMY,24242.95,15757.92,13270.0,14761.0,2
HCPCS,C1715,HB BRACHYTHERAPY NEEDLE,747.0,485.55,13270.0,14761.0,2
HCPCS,C1717,"HB RT BRACYTX SOURCE, HDR IR-192",2185.64,1420.67,426.34,14761.0,10
HCPCS,C1721,HB ICD DUAL CHAMBER,157641.0,102466.65,13270.0,14761.0,2
HCPCS,C1722,HB ICD SINGLE CHAMBER,190314.0,123704.1,13270.0,14761.0,4
HCPCS,C1722,HB MISCELLANEOUS IMPLANT,190314.0,123704.1,,,0
HCPCS,C1724,"HB CATHETER, JETSTREAM G2 PV",21139.2,13740.48,13270.0,14761.0,4
HCPCS,C1725,HB CATH DILITATION PTA,5256.27,3416.57,13270.0,14761.0,2
HCPCS,C1725,HB CATH PERIPHERAL DILITATION,5256.27,3416.57,13270.0,14761.0,4
HCPCS,C1725,"HB CATHETER, SHOCKWAVE PERIPHERAL",19556.8,12711.92,13270.0,14761.0,2
HCPCS,C1725,HB MISCELLANEOUS SUPPLY,5256.27,3416.57,13270.0,14761.0,2
HCPCS,C1725,HB NO COST ITEM SUPPLY-CL,1.0,0.65,,,0
HCPCS,C1726,"HB CATHETER, BILIARY DILAT",4996.29,3247.59,13270.0,14761.0,4
HCPCS,C1726,"HB CATHETER, TRANSLUMINAL DRUG-COATED",12530.05,8144.53,13270.0,14761.0,2
HCPCS,C1726,HB GUIDE WIRE PTCA,1822.65,1184.72,13270.0,14761.0,2
HCPCS,C1726,HB MISCELLANEOUS SUPPLY,4996.29,3247.59,13270.0,14761.0,2
HCPCS,C1727,HB MISCELLANEOUS SUPPLY,4633.97,3012.08,13270.0,14761.0,2
HCPCS,C1728,"HB CATHETER, BALLOON RADIOELEMENT",1655.46,1076.05,,,0
HCPCS,C1728,HB MISCELLANEOUS SUPPLY,1655.46,1076.05,13270.0,14761.0,4
HCPCS,C1729,"HB CATHETER, DRAINAGE BILIARY",1784.22,1159.74,13270.0,14761.0,2
HCPCS,C1729,HB MISCELLANEOUS IMPLANT,1784.22,1159.74,13270.0,14761.0,4
HCPCS,C1729,HB MISCELLANEOUS SUPPLY,1784.22,1159.74,13270.0,14761.0,4
HCPCS,C1729,HB PLEURX DRAINAGE,1000.31,650.2,,,0
HCPCS,C1730,HB CATH EP <19 ELECTRODES,5688.95,3697.82,13270.0,14761.0,6
HCPCS,C1730,HB CATH EP ABLATION NON 3D,19444.75,12639.09,13270.0,14761.0,2
HCPCS,C1730,HB MISCELLANEOUS SUPPLY,5688.95,3697.82,,,0
HCPCS,C1731,HB CATH EP <19 ELECTRODES,5688.95,3697.82,13270.0,14761.0,2
HCPCS,C1732,HB CATH EP ABLATION 3D,15210.45,9886.79,13270.0,14761.0,2
HCPCS,C1733,HB CATH EP ABLATION NON 3D,19444.75,12639.09,13270.0,14761.0,2
HCPCS,C1733,HB MISCELLANEOUS SUPPLY,19444.75,12639.09,13270.0,14761.0,4
HCPCS,C1747,HB MISCELLANEOUS SUPPLY,9990.0,6493.5,,,0
HCPCS,C1748,HB DUODENOSCOPE STERILE SINGLE USE,24492.5,15920.13,13270.0,14761.0,2
HCPCS,C1749,HB MISCELLANEOUS SUPPLY,853.92,555.05,,,0
HCPCS,C1749,"HB VALVE, BRONCH SUCTION",853.92,555.05,13270.0,14761.0,2
HCPCS,C1750,"HB CATHETER, HEMO, LONG TERM",3903.67,2537.39,13270.0,14761.0,2
HCPCS,C1750,HB MISCELLANEOUS SUPPLY,3903.67,2537.39,13270.0,14761.0,2
HCPCS,C1751,"HB CATHETER, PICC DBL LUMEN",1788.14,1162.29,13270.0,14761.0,4
HCPCS,C1751,"HB CATHETER, QUATTRO",1788.14,1162.29,13270.0,14761.0,2
HCPCS,C1752,HB MISCELLANEOUS IMPLANT,1093.88,711.02,13270.0,14761.0,4
HCPCS,C1752,HB MISCELLANEOUS SUPPLY,1093.88,711.02,13270.0,14761.0,2
HCPCS,C1753,HB MISCELLANEOUS SUPPLY,7503.14,4877.04,13270.0,14761.0,4
HCPCS,C1754,"HB CATHETER, EPIDURAL ARROW 19 GA",8527.28,5542.73,13270.0,14761.0,2
HCPCS,C1755,"HB CATHETER, INTRASPINAL 1",5147.87,3346.12,13270.0,14761.0,2
HCPCS,C1757,"HB CATHETER, JETSTREAM G2 PV",21139.2,13740.48,13270.0,14761.0,2
HCPCS,C1757,HB MISCELLANEOUS SUPPLY,21740.9,14131.59,13270.0,14761.0,6
HCPCS,C1758,"HB CATHETER, URETERAL 1",1240.9,806.59,13270.0,14761.0,2
HCPCS,C1759,HB CATH ULTRASOUND ACUNAV,14551.7,9458.61,13270.0,14761.0,2
HCPCS,C1760,"HB CLOSURE DEVICE, VASC PLUG",3134.6,2037.49,13270.0,14761.0,2
HCPCS,C1760,HB NO COST SUPPLY,1.0,0.65,13270.0,14761.0,2
HCPCS,C1761,HB MISCELLANEOUS SUPPLY,30830.1,20039.56,13270.0,14761.0,4
HCPCS,C1762,HB MISCELLANEOUS IMPLANT,34112.6,22173.19,13270.0,14761.0,4
HCPCS,C1763,HB GRAFT SYNTHETIC TISSUE 3,16925.8,11001.77,13270.0,14761.0,2
HCPCS,C1764,HB CARDIAC MONITOR (LOOP RECORDER),60914.15,39594.2,13270.0,14761.0,2
HCPCS,C1765,HB ADHESION BARRIER 1,4590.26,2983.67,13270.0,14761.0,2
HCPCS,C1766,HB GUIDE WIRE PTCA,1822.65,1184.72,13270.0,14761.0,2
HCPCS,C1766,HB INTRO/SHEATH EP FIXED NON-PEEL,8148.66,5296.63,13270.0,14761.0,4
HCPCS,C1766,HB INTRO/SHEATH EP FLEXCATH,8148.66,5296.63,,,0
HCPCS,C1766,HB INTRO/SHEATH FIXED NON PEEL,2004.64,1303.02,13270.0,14761.0,2
HCPCS,C1767,"HB GENERATOR,NEUROSTIMULATOR12",231525.0,150491.25,13270.0,14761.0,2
HCPCS,C1767,HB MISCELLANEOUS IMPLANT,231525.0,150491.25,,,0
HCPCS,C1767,HB NO COST IMPLANT,1.0,0.65,,,0
HCPCS,C1768,HB MISCELLANEOUS IMPLANT,26196.95,17028.02,13270.0,14761.0,6
HCPCS,C1769,HB GUIDE WIRE CATH LAB,1822.65,1184.72,13270.0,14761.0,2
HCPCS,C1769,HB GUIDE WIRE PTCA,1822.65,1184.72,13270.0,14761.0,6
HCPCS,C1769,"HB GUIDEWIRE, 0.18/GOLD",1822.65,1184.72,13270.0,14761.0,2
HCPCS,C1769,HB MISCELLANEOUS SUPPLY,1822.65,1184.72,,,0
HCPCS,C1769,HB NO COST ITEM SUPPLY-CL,1.0,0.65,,,0
HCPCS,C1771,HB REP DEV URINARY W/SLING 3,10157.05,6602.08,13270.0,14761.0,2
HCPCS,C1772,HB PUMP INFUSION 1,101414.0,65919.1,13270.0,14761.0,2
HCPCS,C1773,HB MISCELLANEOUS SUPPLY,4841.83,3147.19,13270.0,14761.0,6
HCPCS,C1776,HB BONE AND IMPLANT MODEL,8369.76,5440.34,,,0
HCPCS,C1776,HB MISCELLANEOUS IMPLANT,27782.15,18058.4,13270.0,14761.0,6
HCPCS,C1777,HB LEAD ICD ENDOCARD COIL,40908.0,26590.2,,,0
HCPCS,C1777,HB LEAD ICD ENDOCARD DUAL COIL,41929.4,27254.11,13270.0,14761.0,2
HCPCS,C1778,"HB LEAD, NEUROSTIMULATOR",30232.4,19651.06,,,0
HCPCS,C1778,HB MISCELLANEOUS IMPLANT,30232.4,19651.06,13270.0,14761.0,4
HCPCS,C1778,HB NO COST IMPLANT,1.0,0.65,,,0
HCPCS,C1779,HB LEAD PCMKR TRANSVN SNGL PASS,11333.6,7366.84,13270.0,14761.0,2
HCPCS,C1781,HB MISCELLANEOUS IMPLANT,16204.05,10532.63,13270.0,14761.0,4
HCPCS,C1785,"HB PACEMAKER, DUAL CHAMBER",39180.65,25467.42,13270.0,14761.0,2
HCPCS,C1786,HB MISCELLANEOUS PACEMAKER,116392.5,75655.13,13270.0,14761.0,2
HCPCS,C1786,"HB PACEMAKER, LEADLESS MICRA",116392.5,75655.13,13270.0,14761.0,4
HCPCS,C1786,"HB PACEMAKER, SINGLE CHAMBER",116392.5,75655.13,13270.0,14761.0,4
HCPCS,C1787,HB MISCELLANEOUS SUPPLY,9009.58,5856.22,,,0
HCPCS,C1788,HB MISCELLANEOUS IMPLANT,3243.19,2108.07,,,0
HCPCS,C1788,"HB PORT, INDWELLING (IMPLANTABLE)",3243.19,2108.07,13270.0,14761.0,2
HCPCS,C1789,HB PROSTHESIS BREAST IMP 8,7680.0,4992.0,13270.0,14761.0,2
HCPCS,C1813,HB MISCELLANEOUS IMPLANT,82864.2,53861.73,,,0
HCPCS,C1813,"HB PROSTHESIS, PENILE INFLATABLE 2",82864.2,53861.73,13270.0,14761.0,2
HCPCS,C1815,"HB PROSTHESIS, URINARY SPHINCTER",40928.3,26603.4,13270.0,14761.0,2
HCPCS,C1816,"HB KIT, NEUROSTIMULATOR DUAL LEAD",95150.3,61847.7,,,0
HCPCS,C1817,HB MISCELLANEOUS IMPLANT,151039.9,98175.93,,,0
HCPCS,C1817,HB MISCELLANEOUS SUPPLY,151039.9,98175.93,,,0
HCPCS,C1817,HB SEPTAL DEFECT CLOSE IMPLANT,151039.9,98175.93,13270.0,14761.0,4
HCPCS,C1819,"HB WIRE, SUR TISSUE LOC DEVICE",405.47,263.56,13270.0,14761.0,2
HCPCS,C1820,HB MISCELLANEOUS IMPLANT,221814.0,144179.1,13270.0,14761.0,2
HCPCS,C1821,HB BMP SMALL 3,54859.1,35658.42,13270.0,14761.0,2
HCPCS,C1821,HB MISCELLANEOUS IMPLANT,54859.1,35658.42,13270.0,14761.0,2
HCPCS,C1822,HB MISCELLANEOUS IMPLANT,241463.0,156950.95,13270.0,14761.0,2
HCPCS,C1824,HB OPTIMIZER SMART IPG,267260.0,173719.0,,,0
HCPCS,C1874,HB MISCELLANEOUS IMPLANT,29959.6,19473.74,13270.0,14761.0,4
HCPCS,C1874,HB MISCELLANEOUS SUPPLY,29959.6,19473.74,13270.0,14761.0,4
HCPCS,C1875,HB MISCELLANEOUS IMPLANT,152028.4,98818.46,13270.0,14761.0,4
HCPCS,C1876,HB CAROTID STENT SYSTEM,1.0,0.65,13270.0,14761.0,2
HCPCS,C1876,HB MISCELLANEOUS IMPLANT,9539.65,6200.775,13270.0,14761.0,2
HCPCS,C1876,"HB STENT, OASIS NON-COAT/COV W/DEL",9539.65,6200.775,13270.0,14761.0,4
HCPCS,C1877,"HB STENT, BIL/PAN NON-METAL",10838.8,7045.22,13270.0,14761.0,2
HCPCS,C1880,HB VENA CAVA FILTER 1,9211.66,5987.58,13270.0,14761.0,2
HCPCS,C1880,"HB VENA CAVA FILTER, IVC",9211.66,5987.58,13270.0,14761.0,2
HCPCS,C1881,HB VASCULAR ACCESS GUIDANCE,2215.88,1440.32,,,0
HCPCS,C1882,HB ICD OTHER THAN SINGLE/DUAL,216134.0,140487.1,13270.0,14761.0,4
HCPCS,C1883,HB ADAPTER/LEAD IMPLANTABLE 6,8052.88,5234.37,13270.0,14761.0,2
HCPCS,C1884,HB EMBOLIC PROTECTION SYSTEM,14884.5,9674.93,13270.0,14761.0,4
HCPCS,C1884,HB WATCHMAN LAA DEVICE,14884.5,9674.93,13270.0,14761.0,2
HCPCS,C1886,HB PROBE ABLATION,22009.45,14306.14,13270.0,14761.0,2
HCPCS,C1887,"HB CATHETER, ENDOVASCULAR",17780.1,11557.06,13270.0,14761.0,2
HCPCS,C1887,"HB CATHETER, GUIDING 1",5630.15,3659.59,13270.0,14761.0,2
HCPCS,C1887,HB GUIDE WIRE PTCA,1822.65,1184.72,13270.0,14761.0,2
HCPCS,C1887,HB MISCELLANEOUS SUPPLY,5630.15,3659.59,13270.0,14761.0,6
HCPCS,C1887,HB NO COST ITEM SUPPLY-CL,1.0,0.65,,,0
HCPCS,C1888,"HB CATHETER, ABLATION, NON-CARDIAC",10368.1,6739.27,13270.0,14761.0,2
HCPCS,C1889,HB AUDITORY IMPLANT 2,3231.18,2100.27,,,0
HCPCS,C1889,HB BASKET RETRIEVABLE INSERTABLE,5598.91,3639.29,13270.0,14761.0,2
HCPCS,C1889,HB BONE CEMENT 1,976.04,634.43,,,0
HCPCS,C1889,"HB CLIP, HEMOSTASIS",1647.07,1070.6,,,0
HCPCS,C1889,"HB COVER, BUR HOLE 1",1194.46,776.4,,,0
HCPCS,C1889,"HB COVER, BUR HOLE 2",3550.38,2307.75,,,0
HCPCS,C1889,HB EMBOLIC LIQUID SYSTEM GLUE,28770.0,18700.5,,,0
HCPCS,C1889,HB ENDOSCOPY BRAVO CAPSULE,2722.74,1769.78,,,0
HCPCS,C1889,HB IMPLANTABLE CERV/LUMB/THOR DISC,5598.91,3639.29,13270.0,14761.0,2
HCPCS,C1889,HB MISCELLANEOUS IMPLANT,5598.91,3639.29,13270.0,14761.0,2
HCPCS,C1889,HB MISCELLANEOUS SUPPLY,5598.91,3639.29,13270.0,14761.0,2
HCPCS,C1889,HB SEALANT HEMOSTATIC 1,2301.31,1495.85,,,0
HCPCS,C1889,HB TESTICULAR PROSTHESIS 3,18933.4,12306.71,,,0
HCPCS,C1889,HB VASCULAR PLUG AMPLATZ,8179.08,5316.4,,,0
HCPCS,C1890,HB MISCELLANEOUS IMPLANT,19799.1,12869.41,,,0
HCPCS,C1892,"HB INTRO/SHEATH, GUIDING 1",1136.83,738.94,13270.0,14761.0,2
HCPCS,C1893,HB INTRO/SHEATH FIXED NON PEEL,2004.64,1303.02,13270.0,14761.0,2
HCPCS,C1893,HB MISCELLANEOUS SUPPLY,2004.64,1303.02,13270.0,14761.0,4
HCPCS,C1894,HB INTRO/SHEATH EP FIXED NON-PEEL,8148.66,5296.63,,,0
HCPCS,C1894,"HB INTRODUCER/SHEATH,NONGDNG 1",2814.08,1829.15,,,0
HCPCS,C1894,HB MICROPUNCTURE SET,2814.08,1829.15,13270.0,14761.0,4
HCPCS,C1894,HB NO COST SUPPLY,1.0,0.65,,,0
HCPCS,C1895,HB LEAD ICD ENDOCARD COIL,40908.0,26590.2,,,0
HCPCS,C1895,HB MISCELLANEOUS IMPLANT,40908.0,26590.2,13270.0,14761.0,4
HCPCS,C1896,"HB ICD ELECTRODE, SUBCUTANEOUS",23174.4,15063.36,13270.0,14761.0,2
HCPCS,C1897,HB KIT SPRINT EXTENSA PNS SYSTEM,25438.6,16535.09,,,0
HCPCS,C1897,HB MISCELLANEOUS IMPLANT,10977.65,7135.47,13270.0,14761.0,2
HCPCS,C1897,HB NO COST IMPLANT,1.0,0.65,,,0
HCPCS,C1898,"HB LEAD, PACEMAKER 1",6638.01,4314.71,13270.0,14761.0,2
HCPCS,C1900,HB LEAD BI-V LEFT VENTRCULAR,20626.4,13407.16,13270.0,14761.0,2
HCPCS,C2596,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,C2613,HB BIOSENTRY LUNG PLUG,2491.3,1619.35,13270.0,14761.0,2
HCPCS,C2616,MICROSPHERES (Y-90 GLASS) (THERA-SPHERES) ISOTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
HCPCS,C2616,MICROSPHERES (Y-90 RESIN) (SIR-SPHERES) ISOPTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
HCPCS,C2617,HB MISCELLANEOUS IMPLANT,1659.44,1078.64,13270.0,14761.0,4
HCPCS,C2618,"HB PROBE, CRYOABLATION 3",17233.3,11201.65,13270.0,14761.0,2
HCPCS,C2621,HB ICD OTHER THAN SINGLE/DUAL,216134.0,140487.1,,,0
HCPCS,C2621,"HB PACEMAKER, OTHER THAN SINGLE/DUAL CHAMBER",87229.1,56698.92,13270.0,14761.0,4
HCPCS,C2622,HB MISCELLANEOUS IMPLANT,69703.05,45306.98,,,0
HCPCS,C2623,"HB BALLOON, CATHETER PTCA COATED (G200100)",12530.05,8144.53,,,0
HCPCS,C2623,"HB CATHETER, TRANSLUMINAL DRUG-COATED",12530.05,8144.53,13270.0,14761.0,2
HCPCS,C2623,HB MISCELLANEOUS SUPPLY,12530.05,8144.53,13270.0,14761.0,6
HCPCS,C2624,HB SENSOR/CARDIO MEMS PULM ART,259504.0,168677.6,13270.0,14761.0,2
HCPCS,C2625,HB CAROTID STENT SYSTEM,1.0,0.65,13270.0,14761.0,2
HCPCS,C2625,HB MISCELLANEOUS IMPLANT,32326.7,21012.35,13270.0,14761.0,6
HCPCS,C2626,HB NO COST SUPPLY,1.0,0.65,13270.0,14761.0,4
HCPCS,C2626,HB PAIN PUMP PCA SYSTEM,3205.61,2083.65,,,0
HCPCS,C2627,"HB CATHETER, SUPRAPUBIC 1",766.96,498.52,13270.0,14761.0,2
HCPCS,C2628,HB MISCELLANEOUS SUPPLY,4769.01,3099.85,13270.0,14761.0,2
HCPCS,C2628,HB PC BROCH OCC CATH,4769.01,3099.85,13270.0,14761.0,2
HCPCS,C2629,"HB INTRODUCER/SHEATH, LASER",18730.1,12174.56,13270.0,14761.0,2
HCPCS,C2630,HB EP CATHETER-EZ STEER NAV BI-D,22500.8,14625.52,13270.0,14761.0,2
HCPCS,C5271,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5272,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5273,Outpatient Grouper - 2,8092.5599999999995,5260.165,13036.88,14143.2,24
HCPCS,C5274,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5275,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5276,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5277,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C5278,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C7500,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7502,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7503,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7504,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7505,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7506,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7507,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7508,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7509,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7510,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7511,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7512,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7513,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7514,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7515,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7516,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7517,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7518,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7519,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7520,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7521,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7522,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7523,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7524,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7525,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7526,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7527,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7528,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7529,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7530,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7531,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7532,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7533,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7534,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7535,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7537,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7538,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7539,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7540,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7541,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7542,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7543,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7544,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7545,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7546,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7547,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7548,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7549,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7550,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7551,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7552,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7553,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7554,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7555,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7557,Outpatient Grouper - Unlisted,36421.6,23674.04,13030.5,14136.81,24
HCPCS,C7558,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C7560,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C8900,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, ABDOMEN",,,899.42,899.42,2
HCPCS,C8900,MRI,,,4065.4,4105.26,2
HCPCS,C8900,"Magnetic resonance angiography with contrast, abdomen",,,4177.44,6653.0,2
HCPCS,C8901,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, ABDOMEN",,,570.08,570.08,2
HCPCS,C8901,MRI,,,3643.64,3679.37,2
HCPCS,C8901,Magnetic resonance angiography without contrast abdomen,,,3744.07,5962.8,2
HCPCS,C8902,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, ABDOMEN",,,899.42,899.42,2
HCPCS,C8902,MRI,,,3643.64,3679.37,2
HCPCS,C8902,"Magnetic resonance angiography without contrast followed by with contrast, abdomen",,,3744.07,5962.8,2
HCPCS,C8903,"MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; UNILATERAL",,,440.25,440.25,2
HCPCS,C8903,MRI,,,5866.73,5924.25,2
HCPCS,C8903,"Magnetic resonance imaging with contrast, breast; unilateral",,,6028.43,9600.88,2
HCPCS,C8905,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL",,,899.42,899.42,2
HCPCS,C8905,MRI,,,5866.73,5924.25,2
HCPCS,C8905,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral",,,6028.43,9600.88,2
HCPCS,C8906,"MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; BILATERAL",,,899.42,899.42,2
HCPCS,C8906,MRI,,,5866.73,5924.25,2
HCPCS,C8906,"Magnetic resonance imaging with contrast, breast; bilateral",,,6028.43,9600.88,2
HCPCS,C8908,"HB MRI BREAST CA, W & W/O BILAT",7500.04,4875.03,444.69,511.4,8
HCPCS,C8908,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL",,,899.42,899.42,2
HCPCS,C8908,MRI,,,4065.4,4105.26,2
HCPCS,C8908,MRI/MRA,,,3089.09,3116.45,2
HCPCS,C8908,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral",,,4177.44,6653.0,2
HCPCS,C8909,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)",,,899.42,899.42,2
HCPCS,C8909,MRI,,,4065.4,4105.26,2
HCPCS,C8909,"Magnetic resonance angiography with contrast, chest (excluding myocardium)",,,4177.44,6653.0,2
HCPCS,C8910,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, CHEST (EXCLUDING MYOCARDIUM)",,,570.08,570.08,2
HCPCS,C8910,MRI,,,3592.66,3627.89,2
HCPCS,C8910,"Magnetic resonance angiography without contrast, chest (excluding myocardium)",,,3691.68,5879.37,2
HCPCS,C8911,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)",,,899.42,899.42,2
HCPCS,C8911,MRI,,,3645.93,3681.68,2
HCPCS,C8911,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)",,,3746.42,5966.55,2
HCPCS,C8912,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, LOWER EXTREMITY",,,899.42,899.42,2
HCPCS,C8912,MRI,,,3630.48,3666.08,2
HCPCS,C8912,"Magnetic resonance angiography with contrast, lower extremity",,,3730.54,5941.27,2
HCPCS,C8913,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, LOWER EXTREMITY",,,570.08,570.08,2
HCPCS,C8913,MRI,,,3355.49,3388.39,2
HCPCS,C8913,"Magnetic resonance angiography without contrast, lower extremity",,,3447.97,5491.25,2
HCPCS,C8914,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMITY",,,899.42,899.42,2
HCPCS,C8914,MRI,,,3630.48,3666.08,2
HCPCS,C8914,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity",,,3730.54,5941.27,2
HCPCS,C8918,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, PELVIS",,,899.42,899.42,2
HCPCS,C8918,MRI,,,3643.64,3679.37,2
HCPCS,C8918,"Magnetic resonance angiography with contrast, pelvis",,,3744.07,5962.8,2
HCPCS,C8919,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, PELVIS",,,570.08,570.08,2
HCPCS,C8919,MRI,,,3952.62,3991.37,2
HCPCS,C8919,"Magnetic resonance angiography without contrast, pelvis",,,4061.56,6468.44,2
HCPCS,C8920,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, PELVIS",,,899.42,899.42,2
HCPCS,C8920,MRI,,,3643.64,3679.37,2
HCPCS,C8920,"Magnetic resonance angiography without contrast followed by with contrast, pelvis",,,3744.07,5962.8,2
HCPCS,C8923,"Transthoracic echocardiography with contrast, or without contrast follwed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectr",,,1704.29,2714.26,2
HCPCS,C8925,"Transesophageal echocardiography (TEE) with contrast, or without contrast followed by with contrast, real time with image documentation (2D) (with or without M-mode recording); including probe placeme",,,1717.87,2735.89,2
HCPCS,C8926,"Transesophageal echocardiography (TEE) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquistion, interpretation and r",,,1728.57,2752.93,2
HCPCS,C8928,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiov",,,1717.87,2735.89,2
HCPCS,C8929,"TRANSTHORACIC ECHO W/CONTR, OR W/O CONTR FOLLOWED BY W/CONTR, REAL-TIME W/IMAGE DOC (2D), INCLS M-MODE RECDING , WHEN P",,,2586.69,4119.56,2
HCPCS,C8930,"TRANSTHOR ECHO, W/CONTR, OR W/O CONTR FLLWD BY W/CONTR, W/INTERPRET & RPRT; W/PHYS SUPERV",,,1704.29,2714.26,2
HCPCS,C8931,"MR ANGIOGRAPHY W CONTRAST, SPINAL CANAL N' CONTENTS",,,899.42,899.42,2
HCPCS,C8932,"MR ANGIOGRAPHY W/O CONTRAST, SPINAL CANAL N' CONTENTS",,,570.08,570.08,2
HCPCS,C8933,MR ANGIOGRAPHY W/O CONTRAST FOLLWD BY W CONTRST SPINL CANAL N' CONTS,,,899.42,899.42,2
HCPCS,C8934,"MR ANGIOGRAPHY WITH CONTRAST, UPPER EXTREMITY",,,899.42,899.42,2
HCPCS,C8935,"MR ANGIOGRAPHY W/O CONTRAST, UPPER EXTREMITY",,,570.08,570.08,2
HCPCS,C8936,MR ANGIOGRAPHY W/O CONTRAST FOLLOWED BY W CONTRAST UPPER EXTREMITY,,,899.42,899.42,2
HCPCS,C8937,"HB MRI BREAST W CAD, W & W/O BILAT",7500.04,4875.03,,,0
HCPCS,C8937,MRI/MRA,,,3089.09,3116.45,2
HCPCS,C8957,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,C9034,"Injection, dexamethasone 9%, intraocular, 1 mcg (Code deleted effective 12/31/2018)",,,2.79,2.98,2
HCPCS,C9034,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.85,2.09,2
HCPCS,C9046,"Cocaine hydrochloride nasal solution for topical administration, 1 mg",,,3.68,3.93,2
HCPCS,C9046,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.44,2.75,2
HCPCS,C9047,CAPLACIZUMAB-YHDP 11 MG IJ KIT,1465.56,952.61,13270.0,14761.0,2
HCPCS,C9047,"Injection, caplacizumab-yhdp, 1 mg",,,1768.86,1888.56,2
HCPCS,C9047,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1173.13,1324.79,2
HCPCS,C9055,"Injection, brexanolone, 1mg",,,198.58,212.01,2
HCPCS,C9055,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,131.7,148.72,2
HCPCS,C9065,"Injection, romidepsin, non-lypohilized (e.g. liquid), 1mg",,,852.57,910.26,2
HCPCS,C9065,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,565.43,638.53,2
HCPCS,C9067,All drugs or drug agents without specific rate set forth above or herein,,,11.14,11.14,2
HCPCS,C9067,"Gallium ga-68, dotatoc, diagnostic, 0.01 mci",,,1.46,1.55,2
HCPCS,C9067,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.97,1.09,2
HCPCS,C9074,"Injection, lumasiran, 0.5 mg",,,775.67,828.15,2
HCPCS,C9074,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,514.43,580.93,2
HCPCS,C9084,OPPS codes,,,626.38,668.76,2
HCPCS,C9084,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,415.42,469.12,2
HCPCS,C9085,OPPS codes,,,182.85,195.23,2
HCPCS,C9085,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,121.27,136.95,2
HCPCS,C9086,OPPS codes,,,40.87,43.64,2
HCPCS,C9086,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.11,30.61,2
HCPCS,C9087,Quality Measures,,,19.45,20.76,2
HCPCS,C9087,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.9,14.57,2
HCPCS,C9088,Quality Measures,,,1.78,1.9,2
HCPCS,C9088,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.18,1.33,2
HCPCS,C9089,OPPS codes,,,2.1,2.24,2
HCPCS,C9089,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.39,1.57,2
HCPCS,C9094,"Inj, sutimlimab-jome, 10 mg (Code deleted effective 9/30/2022)",,,43.63,46.59,2
HCPCS,C9094,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.94,32.68,2
HCPCS,C9095,"Inj, tebentafusp-tebn, 1 mcg (Code deleted effective 9/30/2022)",,,500.04,533.88,2
HCPCS,C9095,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,331.63,374.5,2
HCPCS,C9096,"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram (Code deleted effective 9/30/2022)",,,2.02,2.16,2
HCPCS,C9096,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.34,1.52,2
HCPCS,C9097,"Inj, faricimab-svoa, 0.1 mg (Code deleted effective 9/30/2022)",,,97.29,103.87,2
HCPCS,C9097,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,64.52,72.86,2
HCPCS,C9098,"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose (C",,,1239429.6,1323297.0,2
HCPCS,C9098,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,822000.96,928266.48,2
HCPCS,C9101,"Injection, oliceridine, 0.1 mg",,,3.46,3.69,2
HCPCS,C9101,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,C9113,"Injection, pantoprazole sodium, per vial (Code Price is per 40 mg)",,,79.64,85.03,2
HCPCS,C9113,PANTOPRAZOLE 40 MG IV SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,C9113,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,52.82,59.65,2
HCPCS,C9132,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY (FOR OPPS BILLING PRIOR TO 10/1/13 USE C9399)",,,4.81,5.14,2
HCPCS,C9132,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.19,3.6,2
HCPCS,C9143,"Cocaine hydrochloride nasal solution (numbrino), 1 mg",,,3.68,3.93,2
HCPCS,C9143,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.44,2.75,2
HCPCS,C9144,"Injection, bupivacaine (posimir), 1 mg",,,1.28,1.37,2
HCPCS,C9144,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.85,0.96,2
HCPCS,C9146,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
HCPCS,C9147,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,365180.4,237367.26,,,0
HCPCS,C9148,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,13270.0,14761.0,2
HCPCS,C9148,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,13270.0,14761.0,2
HCPCS,C9248,"INJECTION, CLEVIDIPIEN BUTYRATE, 1 MG",,,16.12,17.21,2
HCPCS,C9248,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.69,12.07,2
HCPCS,C9250,"Human plasma fibrin sealant, vapor-heated, solvent-detergent (Artiss), 2 mL (For billing prior to 7/1/09 see C9399) - see also J3590",4137.82,2689.58,414.53,442.57,2
HCPCS,C9250,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",4137.82,2689.58,274.92,310.46,2
HCPCS,C9254,"INJECTION, LACOSAMIDE, 1 MG",,,0.47,0.5,2
HCPCS,C9254,LACOSAMIDE 200 MG/20 ML IV SOLN,356.32,231.60500000000002,13270.0,14761.0,10
HCPCS,C9254,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.31,0.35,2
HCPCS,C9257,BEVACIZUMAB (AVASTIN) INTRAVITREAL INJECTION,12751.04,8288.18,2.26,2.6,8
HCPCS,C9257,"INJECTION, BEVACIZUMAB, 0.25 MG",,,123.4,131.75,2
HCPCS,C9257,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.84,92.42,2
HCPCS,C9270,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,C9285,"LIDOCAINE 70 MG/TETRACAINE 70 MG, PER PATCH",,,34.11,36.42,2
HCPCS,C9285,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.62,25.54,2
HCPCS,C9290,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",,,3.36,3.58,2
HCPCS,C9290,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.23,2.51,2
HCPCS,C9293,"INJECTION, GLUCARPIDASE, 10 UNITS",,,599.72,640.31,2
HCPCS,C9293,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,397.74,449.16,2
HCPCS,C9352,"Microporous collagen implantable tube (Neuragen Nerve Guide), per centimeter length (Code Price is based on median pricing methodology)",15852.8,10304.32,1218.62,1301.08,2
HCPCS,C9352,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",15852.8,10304.32,808.2,912.68,2
HCPCS,C9353,"Microporous collagen implantable slit tube (Neurawrap Nerve Protector), per centimeter length (Code Price is based on median pricing methodology)",,,2084.89,2225.97,2
HCPCS,C9353,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1382.72,1561.47,2
HCPCS,C9354,"Acellular pericardial tissue matrix of non-human origin (Veritas), per square centimeter (Code Price based on median pricing methodology)",,,50.64,54.07,2
HCPCS,C9354,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.59,37.93,2
HCPCS,C9355,"Collagen nerve cuff (NeuroMatrix), per 0.5 centimeter length",,,476.23,508.45,2
HCPCS,C9355,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,315.84,356.67,2
HCPCS,C9356,"Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (TenoGlide Tendon Protector Sheet), per square centimeter (Code Price is based on median pricing methodology)",,,214.86,229.4,2
HCPCS,C9356,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,142.5,160.92,2
HCPCS,C9358,"Dermal substitute, native, non-denatured collagen, fetal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters (Code Price based on median pricing methodology)",,,40.03,42.74,2
HCPCS,C9358,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.55,29.98,2
HCPCS,C9359,HB MISCELLANEOUS IMPLANT,10781.65,7008.07,13270.0,14761.0,4
HCPCS,C9360,"Dermal substitute, native, non-denatured collagen, neonatal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters (Code Price is based on median pricing methodology)",,,42.89,45.8,2
HCPCS,C9360,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.45,32.13,2
HCPCS,C9361,"Collagen matrix nerve wrap (NeuroMend Collagen Nerve Wrap), per 0.5 centimeter length (Code Price based on median pricing methodology)",,,463.22,494.56,2
HCPCS,C9361,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,307.21,346.93,2
HCPCS,C9362,HB MISCELLANEOUS IMPLANT,14709.95,9561.47,13270.0,14761.0,2
HCPCS,C9363,"Skin substitute, Integra Meshed Bilayer Wound Matrix, per square centimeter (Code Price based on median pricing methodology)",,,144.85,154.65,2
HCPCS,C9363,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,96.06,108.48,2
HCPCS,C9364,"Porcine implant, Permacol, per square centimeter (Code Price is based on median pricing methodology)",,,48.05,51.3,2
HCPCS,C9364,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.87,35.99,2
HCPCS,C9399,ANGIOTENSIN II 2.5 MG/ML IV SOLN,15884.55,10324.96,13270.0,14761.0,2
HCPCS,C9399,ARTESUNATE 110 MG IV SOLR,48406.5,31464.23,13270.0,14761.0,2
HCPCS,C9399,BARICITINIB 1 MG PO TABS,41923.68,27250.394999999997,13270.0,14761.0,4
HCPCS,C9399,BARICITINIB 2 MG PO TABS,43614.24,28349.26,13270.0,14761.0,2
HCPCS,C9399,CAR-T Cell Therapy,1798400.0,1168960.0,,,0
HCPCS,C9399,Cellular Immunotherapy Hospital Services,1798400.0,1168960.0,150960.0,185700.0,3
HCPCS,C9399,DUPILUMAB 200 MG/1.14 ML SC SYRG,16742.74,10882.78,,,0
HCPCS,C9399,EPHEDRINE SULFATE 50 MG/ML IV SOLN,1798400.0,1168960.0,,,0
HCPCS,C9399,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
HCPCS,C9399,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,299642.4,194767.56,13270.0,14761.0,2
HCPCS,C9399,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,13270.0,14761.0,2
HCPCS,C9399,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,13270.0,14761.0,2
HCPCS,C9399,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,,,0
HCPCS,C9399,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,365180.4,237367.26,,,0
HCPCS,C9399,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,,,0
HCPCS,C9460,All drugs or drug agents without specific rate set forth above or herein,,,51.78,51.78,2
HCPCS,C9460,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,23.44,14761.0,22
HCPCS,C9460,"Injection, cangrelor, 1 mg (For billing prior to 1/1/16 use C9399 or J3490)",,,39.88,42.58,2
HCPCS,C9460,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.45,29.87,2
HCPCS,C9462,"Injection, delafloxacin, 1 mg (For Hospital OPPS billing prior to 4/1/18 use C9399) - see also J3490",,,1.18,1.26,2
HCPCS,C9462,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.79,0.89,2
HCPCS,C9482,All drugs or drug agents without specific rate set forth above or herein,,,62.79,62.79,2
HCPCS,C9482,"Injection, sotalol hydrochloride, 1 mg (For Hospital OPPS billing prior to 10/1/16 use C9399) - see also J3490",,,44.2,47.19,2
HCPCS,C9482,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,29.32,33.1,2
HCPCS,C9488,"Injection, conivaptan hydrochloride, 1 mg (For Hospital OPPS billing prior to 4/1/17 use C9399) -see also J3490",,,118.78,126.82,2
HCPCS,C9488,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,78.78,88.96,2
HCPCS,C9600,"HB STENT, PLACE LC RX-ELUT",37207.0,24184.55,14121.14,16239.31,8
HCPCS,C9600,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9600,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9601,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9601,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9602,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9602,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9603,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9603,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9604,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9604,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9605,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9605,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9606,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,C9606,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9607,HB REVSC CTO INI VSL W DES,37207.0,24184.55,14121.14,16239.31,8
HCPCS,C9607,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9607,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9608,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9608,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,C9725,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,C9726,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9727,Outpatient Grouper - 2,6745.34,4384.47,13036.88,14143.2,24
HCPCS,C9734,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9738,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9739,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9739,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9740,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,C9740,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,C9745,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9747,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,C9749,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,C9751,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
HCPCS,C9751,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9752,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9754,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,C9755,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,C9756,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9757,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,C9757,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
HCPCS,C9758,Outpatient Grouper - 9,75992.3,49395.0,38279.75,41528.61,24
HCPCS,C9758,Outpatient Surgery Group 9 Global Rate,75992.3,49395.0,36365.0,36365.0,1
HCPCS,C9759,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,C9759,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9760,Outpatient Grouper - 10,8092.5599999999995,5260.165,43941.81,47671.53,24
HCPCS,C9760,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
HCPCS,C9761,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9761,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,C9762,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging",,,1228.26,1228.26,2
HCPCS,C9763,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging",,,1228.26,1228.26,2
HCPCS,C9764,HB REVASC LOW EXT EXCPT TIB/PER INTRVSC LITHO,47896.9,31132.99,13270.0,16239.31,10
HCPCS,C9764,Outpatient Grouper - 6,47896.9,31132.99,28632.25,34209.93,24
HCPCS,C9764,Outpatient Surgery Group 4 Global Rate,47896.9,31132.99,26623.0,28144.0,2
HCPCS,C9765,HB REVASC LOW EXT EXCPT TIB/PER INTRVSC LITHO-STENT,102328.0,66513.2,13270.0,25713.42,10
HCPCS,C9765,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
HCPCS,C9765,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
HCPCS,C9766,HB REVASC LOW EXT EXCPT TIB/PER INTRVSC LITHO-ATHRCTMY,102328.0,66513.2,13270.0,25713.42,10
HCPCS,C9766,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
HCPCS,C9766,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
HCPCS,C9767,HB REVASC LOW EXT EXCPT TIB/PER INTRVSC LITHO-STENT-ATHRCTMY,114605.0,74493.25,22359.49,25713.42,8
HCPCS,C9767,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
HCPCS,C9767,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
HCPCS,C9768,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9769,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9769,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,C9770,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,C9771,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,C9772,HB REVASC TIB/PER ART INTRVSC LITHO,102328.0,66513.2,13270.0,14761.0,2
HCPCS,C9772,Outpatient Grouper - 7,102328.0,66513.2,32948.13,35744.6,24
HCPCS,C9772,Outpatient Surgery Group 4 Global Rate,102328.0,66513.2,26623.0,28144.0,2
HCPCS,C9773,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
HCPCS,C9773,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
HCPCS,C9774,HB REVASC TIB/PER ART INTRVSC LITHO-ATHRCTMY,114605.0,74493.25,22359.49,25713.42,8
HCPCS,C9774,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
HCPCS,C9774,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
HCPCS,C9775,Outpatient Grouper - 7,114605.0,74493.25,32948.13,35744.6,24
HCPCS,C9775,Outpatient Surgery Group 5 Global Rate,114605.0,74493.25,32992.0,34883.0,2
HCPCS,C9777,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9778,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9779,Outpatient Grouper - 3,8092.5599999999995,5260.165,14341.63,15558.59,24
HCPCS,C9780,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9781,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,C9782,Outpatient Grouper - 9,8092.5599999999995,5260.165,38279.75,41528.61,24
HCPCS,C9783,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9784,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,C9785,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,C9789,Outpatient Grouper - 3,8578.46,5576.0,14341.63,15558.59,24
HCPCS,C9792,Outpatient Grouper - 7,8092.5599999999995,5260.165,32948.13,35744.6,24
HCPCS,C9803,HB TERM COVID-19 SWABBING,1132.545,736.15,13270.0,14761.0,2
HCPCS,C9803,"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source",,,135.11,215.18,2
HCPCS,C9803,Laboratory Services,,,147.54,147.56,2
HCPCS,C9898,"HB ISOTOPE, IP AND OP SERVICES",1.0,0.65,,,0
HCPCS,D2989,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3471,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3472,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3473,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3501,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3502,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3503,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D3921,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D4286,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D5995,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D5996,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6089,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6105,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6106,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6107,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6191,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6192,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6197,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D6198,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7284,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7298,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7299,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7300,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7509,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7939,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7956,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7957,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7961,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7962,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7993,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D7994,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,D9949,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,E0782,HB NON-PROGRAMMABLE INFUSION PUMP,167914.0,109144.1,13270.0,14761.0,2
HCPCS,G0008,HB ADMIN INFLUENZA VACCINE,396.14,257.49,88.62,101.91,8
HCPCS,G0009,HB ADMIN PNEUMOCOCCAL VACCINE,455.565,296.115,88.62,14761.0,10
HCPCS,G0010,HB ADMIN HEPATITIS B VACCINE,396.14,257.49,88.62,101.91,8
HCPCS,G0027,Laboratory Services,,,48.93,48.93,2
HCPCS,G0027,SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER,,,15.81,58.34,4
HCPCS,G0103,"HB LAB PSA, SCREEN",503.09,327.01,13270.0,14761.0,2
HCPCS,G0103,Laboratory Services,503.09,327.01,138.42,138.44,2
HCPCS,G0103,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),503.09,327.01,160.63,255.82,2
HCPCS,G0103,"PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA), TOTAL",503.09,327.01,47.43,47.43,2
HCPCS,G0104,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,G0105,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,G0105,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,G0106,"COLORECTAL CANCER SCREENING; ALTERNATIVE TO GO104, SCREENINGSIGMOIDOSCOPY, BARIUM",,,363.82,579.43,2
HCPCS,G0108,"HB DIABETES TEACH, IND PER 30 MIN",1064.89,692.18,13270.0,14761.0,2
HCPCS,G0109,"HB DIABETES TEACH, GRP PER 30 MIN",969.73,630.32,,,0
HCPCS,G0120,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,G0121,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,G0121,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,G0121,"Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121",,,,,0
HCPCS,G0122,COLORECTAL CANCER SCREENING;BARIUM ENEMA,,,34.4,54.78,2
HCPCS,G0123,Laboratory Services,,,152.39,152.4,2
HCPCS,G0123,"SCREENING CYTOPATHOLOGY CERVICAL OR VAGINAL (ANY REPORTING SYSTEM) COLLECTED IN PRESERVATIVE FLUID,AUTOMATED THIN LAYER",,,123.47,196.64,2
HCPCS,G0123,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BYCYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",,,49.92,49.92,2
HCPCS,G0124,Laboratory Services,,,161.69,161.71,2
HCPCS,G0124,SCREENING CYTOPATHOLOGY CERVICAL OR VAGINAL(ANY REPORTING SYSTEM)COLLECTED IN PRESERVATIVE FLUID AUTOMATED;REQUIRE MD,,,123.47,196.64,2
HCPCS,G0127,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0130,"SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEX A) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON",,,713.18,1135.82,2
HCPCS,G0141,Laboratory Services,,,161.69,161.71,2
HCPCS,G0141,"SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMBY AUTOMATED SYSTEM, W/ MANUAL RESCREEN REQUIRING PHYS INTER",,,56.91,90.64,2
HCPCS,G0143,Laboratory Services,,,152.39,152.4,2
HCPCS,G0143,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENINGAND RESCREENING BY CYTOTECHNOLOGIST UNDER P",,,66.56,66.56,2
HCPCS,G0143,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL, COLLECTED IN PRESERVATIVE FLUID, AUTO THIN LAYER PREP, WITH MAN SCREE, ET",,,123.47,196.64,2
HCPCS,G0144,Laboratory Services,,,160.69,160.7,2
HCPCS,G0144,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENINGAND COMPUTER-ASSISTED RESCREENING BY CYTOTE",,,108.17,108.17,2
HCPCS,G0144,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL(ANY REPORT SYS)AUTO SCREEN UNDER PHYS SUP, AUTO THIN LAYER PREP, COLL PRSV",,,123.47,196.64,2
HCPCS,G0145,Laboratory Services,,,199.3,199.32,2
HCPCS,G0145,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENINGAND COMPUTER-ASSISTED RESCREENING USING CEL",,,64.9,64.9,2
HCPCS,G0145,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL(ANY REPORT SYS)AUTO SCREEN & MAN RESCRN UNDR PHYS SUP, THIN LAYER PREP, ETC",,,123.47,196.64,2
HCPCS,G0147,Laboratory Services,,,85.66,85.67,2
HCPCS,G0147,"SCREEENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PER FORMED BY AUTOMATED SYSTEM UNDER PHYSICIAN SUPERVISION",,,56.91,90.64,2
HCPCS,G0147,"SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
HCPCS,G0148,Laboratory Services,,,114.34,114.35,2
HCPCS,G0148,"SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PER FORMED BY AUTOMATED SYSTEM WITH MANUAL RESCREENING",,,56.91,90.64,2
HCPCS,G0148,"SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM WITH MANUAL RESCREENING",,,78.21,78.21,2
HCPCS,G0166,HB EECP PER TREATMENT,1074.29,698.29,160.5,184.58,8
HCPCS,G0168,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0186,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,G0186,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,G0219,PET IMAGING WHOLE BODY; MELANOMA FOR NON-COVERED INDICATIONS,,,5879.5,9363.7,2
HCPCS,G0219,PET Scan,,,4155.27,4200.53,2
HCPCS,G0235,"PET IMAGING, ANY SITE, NOT OTHERWISE SPECIFIED",,,8493.41,13526.61,2
HCPCS,G0235,PET Scan,,,4155.27,4200.53,2
HCPCS,G0238,HB PR SELF CARE/HOME MGT,486.73,316.37,30.49,14761.0,10
HCPCS,G0239,HB PR THER GROUP 2 OR,1490.4,968.76,48.87,14761.0,10
HCPCS,G0252,"PET IMAGING, FULL AND PARTIAL-RING PET SCANNERS ONLY, FOR INDIAGNOSIS OF BREAST CANCER AND/OR SURGICAL PLANNING FOR BREA",,,5879.5,9363.7,2
HCPCS,G0252,PET Scan,,,4155.27,4200.53,2
HCPCS,G0256,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,G0257,HB UNSCHEDULED/EMERGENY OUTPATIENT DIALYSIS,10688.3,6947.39,871.28,1001.98,8
HCPCS,G0259,HB ARTHROGRAM INJ SI JOINT UNI,2474.51,1608.43,13270.0,14761.0,2
HCPCS,G0259,Outpatient Grouper - 0,2474.51,1608.43,9059.94,9827.82,24
HCPCS,G0260,Outpatient Grouper - 1,8092.5599999999995,5260.165,10495.38,11385.92,24
HCPCS,G0268,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0269,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0276,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,G0276,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,G0278,"ILIAC ARTERY ANGIOGRAPHY PERFORMED AT THE SAME TIME OF CARDIAC CATH, INC CATH PLACEMENT, INJECT OF DYE, RAD SUP/INTER A",,,82.14,130.81,2
HCPCS,G0279,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to g0204 or g0206)",,,59.91,59.91,2
HCPCS,G0279,"Tomosynthesis, mammo screen",,,270.75,431.2,2
HCPCS,G0288,HB RECON CTA SURGICAL PLANNING,6374.36,4143.33,,,0
HCPCS,G0288,"RECONSTRUCTION, COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF AORTA FOR SURGICAL PLANNING",6374.36,4143.33,2578.57,4106.64,2
HCPCS,G0289,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0289,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,G0296,Visit to determ ldct elig,,,397.75,633.45,2
HCPCS,G0297,CAT Scan,,,2808.07,2839.65,2
HCPCS,G0297,CT SCAN,,,2677.8,2704.06,2
HCPCS,G0297,Low-dose computer tomography,,,2751.61,4382.21,2
HCPCS,G0306,"COMPLETE CBC, AUTOMATED (HGB, HCT, RBC, WBC, WITHOUT PLATELECOUNT) AND AUTOMATED WBC DIFFERENTIAL COUNT",,,68.14,108.53,2
HCPCS,G0306,"COMPLETE CBC, AUTOMATED (HGB, HCT, RBC, WBC, WITHOUT PLATELET COUNT) AND AUTOMATED WBC DIFFERENTIAL COUNT",,,19.13,19.13,2
HCPCS,G0306,Laboratory Services,,,58.49,58.49,2
HCPCS,G0307,"COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC; WITHOUT PLATELET COUNT)",,,15.81,90.36,4
HCPCS,G0307,Laboratory Services,,,48.68,48.68,2
HCPCS,G0328,"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS",,,44.1,44.1,2
HCPCS,G0328,"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 ï",,,26.46,42.14,2
HCPCS,G0328,Laboratory Services,,,119.62,119.63,2
HCPCS,G0330,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,G0339,Outpatient Grouper - 5,8092.5599999999995,5260.165,25486.19,27649.53,24
HCPCS,G0339,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
HCPCS,G0340,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
HCPCS,G0340,Outpatient Surgery Group 9 Global Rate,,,36365.0,36365.0,1
HCPCS,G0378,"HB OBSERVATION, PER HOUR",540.0,351.0,13270.0,14761.0,4
HCPCS,G0380,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
HCPCS,G0380,Emergency Level 1,8738.51,5680.03,899.94,976.61,12
HCPCS,G0381,EMERGENCY CARE LEVEL 2,,,1720.0,1858.0,26
HCPCS,G0381,Emergency Level 2,8738.51,5680.03,2055.94,2230.11,12
HCPCS,G0382,EMERGENCY CARE LEVEL 3,,,4518.0,4862.0,20
HCPCS,G0382,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,12
HCPCS,G0383,EMERGENCY CARE LEVEL 4,,,9060.0,9859.0,20
HCPCS,G0383,Emergency Level 4,8738.51,5680.03,8353.38,9063.15,12
HCPCS,G0384,EMERGENCY CARE LEVEL 5,,,16899.0,18206.0,20
HCPCS,G0384,Emergency Level 5,8738.51,5680.03,9061.0,9829.95,12
HCPCS,G0390,"HB TRAUMA, LOW LEVEL RESPONSE",39402.785,25611.809999999998,1647.6,14761.0,20
HCPCS,G0390,"HB TRAUMA, MID LEVEL RESPONSE",39402.8,25611.82,1647.6,1894.73,8
HCPCS,G0398,Sleep Studies - Unattended,8111.885,5272.725,,,0
HCPCS,G0399,Sleep Studies - Unattended,8111.885,5272.725,,,0
HCPCS,G0400,Sleep Studies - Unattended,8111.885,5272.725,,,0
HCPCS,G0403,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAM W/INTERP",,,250.47,398.89,2
HCPCS,G0404,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING",,,167.57,266.87,2
HCPCS,G0405,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL P",,,96.13,153.1,2
HCPCS,G0412,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,G0412,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,G0413,Outpatient Grouper - 4,8092.5599999999995,5260.165,19724.25,21397.98,24
HCPCS,G0413,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,G0414,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,G0414,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
HCPCS,G0415,Outpatient Grouper - 6,8092.5599999999995,5260.165,28632.25,34209.93,24
HCPCS,G0415,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
HCPCS,G0416,Laboratory Services,,,3475.05,3475.4,2
HCPCS,G0416,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION FOR PROSTATE NEEDLE SATURATION BIOPSY SAMPLING, 1-20 SPECIMENS",,,461.32,461.32,2
HCPCS,G0416,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS FOR PROSTATE NEEDLE",,,2116.62,3370.93,2
HCPCS,G0422,"INTENSIVE CARDIAC REHABILITATION; WITH OR WITHOUT CONTINUOUS ECG MONITORING WITH EXERCISE, PER SESSION",,,437.02,696.0,2
HCPCS,G0423,"INTENSIVE CARDIAC REHABILITATION; WITH OR WITHOUT CONTINUOUS ECG MONITORING WITHOUT EXERCISE, PER SESSION",,,437.02,696.0,2
HCPCS,G0424,"PULMONARY REHABILITATION, INCLUDING EXERCISE (INCLUDES MONITORING), 1 HOUR, PER SESSION, UP TO TWO SESSIONS PER DAY",,,185.67,295.71,2
HCPCS,G0428,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,G0432,INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY (EIA) TECH,,,48.26,48.26,2
HCPCS,G0432,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY (EIA) TECHNIQUE, QUALITATIVE OR SEMI-QUANTITIATIVE, MULTIPLE-ST",,,97.45,155.2,2
HCPCS,G0432,Laboratory Services,,,103.2,103.21,2
HCPCS,G0433,"INECTIOUS AGENT ANTIGEN DETECTION BY ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) TECHNIQUE, ANTIBODY, HIV-1 OR HIV-2, SCRE",,,97.45,155.2,2
HCPCS,G0433,INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME-LINKED IMMUNOSORBENT,,,44.93,44.93,2
HCPCS,G0433,Laboratory Services,,,103.2,103.21,2
HCPCS,G0435,INFECTIOUS AGENT ANTIGEN DETECTION BY RAPID ANTIBODY TEST OF ORAL,,,29.12,29.12,2
HCPCS,G0435,"INFECTIOUS AGENT ANTIGEN DETECTION BY RAPID ANTIBODY TEST OF ORAL MUCOSA TRANSUDATE, HIV-1 OR HIV-2, SCREENING",,,66.14,105.34,2
HCPCS,G0435,Laboratory Services,,,69.87,69.88,2
HCPCS,G0448,Outpatient Grouper - Unlisted,8092.5599999999995,5260.165,13030.5,14136.81,24
HCPCS,G0448,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,G0452,HB MISC LAB SPECIAL TEST,713.495,463.77,13270.0,14761.0,4
HCPCS,G0452,HB PROF ACGH INT REPORT,,,13270.0,14761.0,2
HCPCS,G0452,Laboratory Services,,,98.55,98.56,2
HCPCS,G0452,MOLECULAR PATHOLOGY PROCEDURE; PHYSICIAN INTERPRETATION AND REPORT,,,104.07,165.74,2
HCPCS,G0452,Molecular pathology procedure; physician interpretation and report,,,7.17,7.17,2
HCPCS,G0453,"CONTINUOUS INTRAOPERATIVE NEUROPHYSIOLOGY MONITORING, FROM OUTSIDE THE OPERATING ROOM PER PATIENT, EACH 15 MINUTES",,,147.75,235.31,2
HCPCS,G0453,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0455,Outpatient Surgery Group 3 Global Rate,,,22055.0,22787.0,2
HCPCS,G0463,HB ED FACILITY LEVEL 3 W/PROC,8738.51,5680.03,344.78,396.5,8
HCPCS,G0463,HB ED FACILITY LEVEL 4 W/PROC,8738.51,5680.03,530.23,609.76,8
HCPCS,G0463,"HB EST PATIENT, LEVEL 1",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB EST. PATIENT, LEVEL 2",1037.19,674.17,160.47,184.54,16
HCPCS,G0463,"HB EST. PATIENT, LEVEL 3",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB EST. PATIENT, LEVEL 4",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB EST. PATIENT, LEVEL 5",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB NEW PATIENT, LEVEL 3",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB NEW PATIENT, LEVEL 4",1037.19,674.17,160.47,184.54,8
HCPCS,G0463,"HB NEW PATIENT, LEVEL 5",1037.19,674.17,160.47,184.54,8
HCPCS,G0471,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a SNF or by a laboratory on behalf of a HHA,,,25.8,25.8,2
HCPCS,G0472,Hepatitis C antibody screening for individual at high risk and other covered indication(s),,,122.18,194.58,2
HCPCS,G0472,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s)",,,113.99,113.99,2
HCPCS,G0472,Laboratory Services,,,121.88,121.9,2
HCPCS,G0475,"HIV ANTIGEN/ANTIBODY, COMBINATION ASSAY, SCREENING",,,136.29,217.05,2
HCPCS,G0475,"Hiv antigen/antibody, combination assay, screening",,,59.07,59.07,2
HCPCS,G0475,Laboratory Services,,,232.63,232.66,2
HCPCS,G0476,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES (E.G., 16, 18,",,,198.43,316.02,2
HCPCS,G0476,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be per",,,86.54,86.54,2
HCPCS,G0476,Laboratory Services,,,210.81,210.83,2
HCPCS,G0480,Drug test def 1-7 classes,1399.8,909.87,727.59,1158.76,2
HCPCS,G0480,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not lim",1399.8,909.87,281.23,281.23,2
HCPCS,G0480,"HB DIHYDROTESTOSTERON,LCMSMS",30.43,19.78,,,0
HCPCS,G0480,HB DRUG SCREEN PANEL 1,1399.8,909.87,13270.0,14761.0,2
HCPCS,G0480,"HB DRUG TEST, GEN TOXICOLOGY, URINE",30.43,19.78,,,0
HCPCS,G0480,HB LAB ETHANOL QUAN ER,668.37,434.44,,,0
HCPCS,G0480,HB LAB OPIATES UR,1399.8,909.87,13270.0,14761.0,2
HCPCS,G0480,"HB PHOSPHOETHANOL, BLD",30.43,19.78,,,0
HCPCS,G0480,HB SULFONYLUREA HYPOGLYCEMICS,1399.8,909.87,13270.0,14761.0,2
HCPCS,G0480,HB URN CANNABINOID,30.43,19.78,,,0
HCPCS,G0480,Laboratory Services,1399.8,909.87,427.34,427.39,2
HCPCS,G0481,Drug test def 8-14 classes,,,1119.63,1783.13,2
HCPCS,G0481,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not lim",,,384.4,384.4,2
HCPCS,G0481,Laboratory Services,,,657.46,657.53,2
HCPCS,G0482,Drug test def 15-21 classes,,,1511.21,2406.75,2
HCPCS,G0482,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not lim",,,487.57,487.57,2
HCPCS,G0482,Laboratory Services,,,887.58,887.67,2
HCPCS,G0483,Drug test def 22+ classes,,,1959.23,3120.27,2
HCPCS,G0483,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not lim",,,606.56,606.56,2
HCPCS,G0483,Laboratory Services,,,1150.59,1150.71,2
HCPCS,G0498,HB CHEMO INF>8HRS VIA AMB PUMP,2361.02,1534.665,413.02,14761.0,10
HCPCS,G0498,HB CHEMO INFUSION FIRST HOUR,991.58,644.53,413.02,474.97,8
HCPCS,G0498,HB IV PUSH ADDL SEQ NEW DRUG,991.58,644.53,57.45,66.07,8
HCPCS,G0499,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag) followed by a neutralizing confirmatory test for initially reactive results, and antibodies to ",,,375.29,597.68,2
HCPCS,G0499,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,69.06,69.06,2
HCPCS,G0516,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0517,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0518,Outpatient Grouper - 0,8092.5599999999995,5260.165,9059.94,9827.82,24
HCPCS,G0659,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,152.26,879.25,4
HCPCS,G0659,"HB DRUG TEST, GEN TOXICOLOGY, URINE",30.43,19.78,,,0
HCPCS,G2023,"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source",,,147.75,235.31,2
HCPCS,G2024,"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of ",,,160.51,255.63,2
HCPCS,G2066,HB REM INTERROG SCRMS <30 D PHYS/QHP,1440.95,936.62,46.43,53.4,8
HCPCS,G2170,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,G2171,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,G2215,Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure,,,52.03,55.55,2
HCPCS,G2215,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.5,38.96,2
HCPCS,G2216,Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure,,,52.03,55.55,2
HCPCS,G2216,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.5,38.96,2
HCPCS,G6001,Echo guidance radiotherapy,,,190.5,303.38,2
HCPCS,G6001,RADIATION THERAPY SERVICES,,,178.63,287.12,2
HCPCS,G6001,Ultrasonic guidance for placement of radiation therapy fields,,,369.93,369.93,2
HCPCS,G6002,RADIATION THERAPY SERVICES,,,659.54,1060.13,2
HCPCS,G6002,Stereoscopic x-ray guidance,,,703.36,1120.18,2
HCPCS,G6002,Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy,,,134.46,134.46,2
HCPCS,G6003,GLOBAL RADIATION THERAPY,,,1429.19,2154.1,2
HCPCS,G6003,Radiation treatment delivery,,,1429.19,2276.13,2
HCPCS,G6004,GLOBAL RADIATION THERAPY,,,1106.4,1667.59,2
HCPCS,G6004,Radiation treatment delivery,,,1106.4,1762.06,2
HCPCS,G6005,GLOBAL RADIATION THERAPY,,,1236.05,1863.0,2
HCPCS,G6005,Radiation treatment delivery,,,1236.05,1968.53,2
HCPCS,G6006,GLOBAL RADIATION THERAPY,,,1229.87,1853.69,2
HCPCS,G6006,Radiation treatment delivery,,,1229.87,1958.7,2
HCPCS,G6007,GLOBAL RADIATION THERAPY,,,2274.48,3428.15,2
HCPCS,G6007,Radiation treatment delivery,,,2274.48,3622.35,2
HCPCS,G6008,GLOBAL RADIATION THERAPY,,,1530.61,2306.97,2
HCPCS,G6008,Radiation treatment delivery,,,1530.61,2437.65,2
HCPCS,G6009,GLOBAL RADIATION THERAPY,,,1695.06,2554.83,2
HCPCS,G6009,Radiation treatment delivery,,,1695.06,2699.55,2
HCPCS,G6010,GLOBAL RADIATION THERAPY,,,1695.06,2554.83,2
HCPCS,G6010,Radiation treatment delivery,,,1695.06,2699.55,2
HCPCS,G6011,GLOBAL RADIATION THERAPY,,,2432.35,3666.09,2
HCPCS,G6011,Radiation treatment delivery,,,2432.35,3873.76,2
HCPCS,G6012,GLOBAL RADIATION THERAPY,,,2014.79,3036.73,2
HCPCS,G6012,Radiation treatment delivery,,,2014.79,3208.75,2
HCPCS,G6013,GLOBAL RADIATION THERAPY,,,2267.9,3418.22,2
HCPCS,G6013,Radiation treatment delivery,,,2267.9,3611.86,2
HCPCS,G6014,GLOBAL RADIATION THERAPY,,,2267.9,3418.22,2
HCPCS,G6014,Radiation treatment delivery,,,2267.9,3611.86,2
HCPCS,G6015,GLOBAL RADIATION THERAPY,,,3535.64,5328.98,2
HCPCS,G6015,Radiation tx delivery imrt,,,3535.64,5630.86,2
HCPCS,G6016,Delivery comp imrt,,,3530.82,5623.18,2
HCPCS,G6016,GLOBAL RADIATION THERAPY,,,3530.82,5321.72,2
HCPCS,G8627,Outpatient Surgery Group 4 Global Rate,,,26623.0,28144.0,2
HCPCS,G8628,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
HCPCS,G9018,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.33,10.54,2
HCPCS,G9143,Laboratory Services,,,908.08,908.18,2
HCPCS,G9143,"WARFARIN RESPONSIVENESS TESTING BY GENETIC TECHNIQUE USING ANY METHOD, ANY NUMBER OF SPECIMEN(S)",,,296.2,1087.87,4
HCPCS,H0003,Laboratory Services,,,0.06,0.06,2
HCPCS,H0049,Laboratory Services,,,0.06,0.06,2
HCPCS,J0121,All drugs or drug agents without specific rate set forth above or herein,,,10.46,10.46,2
HCPCS,J0121,"Injection, omadacycline, 1 mg",,,9.75,10.41,2
HCPCS,J0121,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.47,7.3,2
HCPCS,J0122,"Injection, eravacycline, 1 mg",,,2.62,2.79,2
HCPCS,J0122,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.74,1.96,2
HCPCS,J0129,ABATACEPT (WITH MALTOSE) 250 MG IV SOLR,11987.465,7791.8550000000005,54.09,14761.0,11
HCPCS,J0129,All drugs or drug agents without specific rate set forth above or herein,,,119.48,119.48,2
HCPCS,J0129,"INJECTION, ABATACEPT, 10 MG ï",,,50.1,53.49,2
HCPCS,J0129,"Injection, abatacept, 10 mg (Code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug self administered)",,,94.92,94.92,2
HCPCS,J0129,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.23,37.52,2
HCPCS,J0130,"INJECTION, ABCIXIMAB 10 MG",,,1332.84,1423.03,2
HCPCS,J0130,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,883.95,998.23,2
HCPCS,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",1465.56,952.61,13270.0,14761.0,2
HCPCS,J0131,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,1465.56,952.61,13270.0,14761.0,12
HCPCS,J0131,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0131,"INJECTION, ACETAMINOPHEN, 10 MG",,,0.35,0.37,2
HCPCS,J0131,"Injection, acetaminophen, not otherwise specified, 10 mg",,,0.09,0.09,2
HCPCS,J0131,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J0132,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN INTRAPROCEDURE,3270.72,2125.97,,,0
HCPCS,J0132,ACETYLCYSTEINE 20% INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
HCPCS,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN,1944.7199999999998,1264.07,13270.0,14761.0,4
HCPCS,J0132,"INJECTION, ACETYLCYSTEINE, 100 MG ï",,,29.89,31.91,2
HCPCS,J0132,"Injection, acetylcysteine, 100 mg",,,1.54,1.54,2
HCPCS,J0132,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.82,22.38,2
HCPCS,J0133,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J0133,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0133,"INJECTION, ACYCLOVIR, 5 MG ï",,,0.35,0.37,2
HCPCS,J0133,"Injection, acyclovir, 5 mg",,,0.11,0.11,2
HCPCS,J0133,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J0134,"Injection, acetaminophen (fresenius kabi) not therapeutically equivalent to j0131, 10 mg",,,0.35,0.37,2
HCPCS,J0134,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J0135,ADALIMUMAB 40 MG/0.4 ML SC PNKT,20482.8,13313.82,,,0
HCPCS,J0135,ADALIMUMAB 40 MG/0.8 ML SC PNKT,58048.29,37731.39,,,0
HCPCS,J0135,ADALIMUMAB 40 MG/0.8 ML SC SYKT,58048.29,37731.39,13270.0,14761.0,2
HCPCS,J0135,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
HCPCS,J0135,"INJECTION, ADALIMUMAB, 20 MG",,,630.23,672.87,2
HCPCS,J0135,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,417.97,472.01,2
HCPCS,J0136,"Injection, acetaminophen (b braun) not therapeutically equivalent to j0131, 10 mg",,,0.35,0.37,2
HCPCS,J0136,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J0153,ADENOSINE (ADENOCARD) 100 MCG/ML INJECTION FOR INTRAPROCEDURE,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0153,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J0153,ADENOSINE 3 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J0153,ADENOSINE IN 0.9% NACL 90 MG/90 ML INFUSION (CATH LAB USE),691.2,449.28,13270.0,14761.0,2
HCPCS,J0153,Adenosine inj 1mg,,,5.36,5.72,2
HCPCS,J0153,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0153,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",,,1.33,1.33,2
HCPCS,J0153,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J0170,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,20482.8,13313.82,,,0
HCPCS,J0171,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0171,EPINEPHRINE 0.1 MG/ML IJ SYRG,1465.56,952.61,13270.0,14761.0,8
HCPCS,J0171,EPINEPHRINE 0.1 MG/ML SYRINGE,290.0,188.5,13270.0,14761.0,2
HCPCS,J0171,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,1996.86,1297.955,13270.0,14761.0,8
HCPCS,J0171,EPINEPHRINE 1 MG/ML IJ SOLN,1844.64,1199.02,13270.0,14761.0,2
HCPCS,J0171,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J0171,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",,,1.21,1.29,2
HCPCS,J0171,"Injection, adrenalin, epinephrine, 0.1 mg",,,1.66,1.66,2
HCPCS,J0171,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J0172,Drug - Skin Substitute Tissue Matrix Collagen,,,29.89,31.91,2
HCPCS,J0172,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.82,22.38,2
HCPCS,J0178,AFLIBERCEPT 2 MG/0.05 ML IAV SYRG,1465.56,952.61,1023.52,14761.0,3
HCPCS,J0178,All drugs or drug agents without specific rate set forth above or herein,,,2260.95,2260.95,2
HCPCS,J0178,"INJECTION, AFLIBERCEPT, 1 MG",,,2465.46,2632.29,2
HCPCS,J0178,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1635.11,1846.5,2
HCPCS,J0179,All drugs or drug agents without specific rate set forth above or herein,,,914.76,914.76,2
HCPCS,J0179,"Injection, brolucizumab-dbll, 1 mg",,,821.82,877.43,2
HCPCS,J0179,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,545.04,615.5,2
HCPCS,J0180,All drugs or drug agents without specific rate set forth above or herein,,,614.82,614.82,2
HCPCS,J0180,"INJECTION, AGALSIDASE BETA, 1 MG",,,480.13,480.13,2
HCPCS,J0180,"INJECTION, AGALSIDASE BETA, 1MG",,,317.19,338.65,2
HCPCS,J0180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,210.36,237.56,2
HCPCS,J0185,All drugs or drug agents without specific rate set forth above or herein,,,4.85,4.85,2
HCPCS,J0185,"Injection, aprepitant, 1 mg",,,6.56,7.01,2
HCPCS,J0185,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.35,4.92,2
HCPCS,J0190,"INJECTION, BIPERIDEN, 2 MG",,,8.29,8.85,2
HCPCS,J0190,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.5,6.21,2
HCPCS,J0200,"INJECTION, ALATROFLOXACIN MESYLATE, 100MG",,,91.04,97.21,2
HCPCS,J0200,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,60.38,68.19,2
HCPCS,J0202,ALEMTUZUMAB 30 MG/ML IV SOLN,1465.56,952.61,2910.87,14761.0,22
HCPCS,J0202,All drugs or drug agents without specific rate set forth above or herein,,,6430.11,6430.11,2
HCPCS,J0202,"Injection, Alemtuzumab",,,4386.89,4683.74,2
HCPCS,J0202,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2909.43,3285.55,2
HCPCS,J0205,"INJECTION, ALGLUCERASE, PER 10 UNITS",,,87.76,93.7,2
HCPCS,J0205,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,58.2,65.73,2
HCPCS,J0207,AMIFOSTINE 500 MG,,,916.84,978.88,2
HCPCS,J0207,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,608.05,686.66,2
HCPCS,J0210,"INJECTION, METHYLDOPATE HCL, UP TO 250 MG",,,27.81,29.7,2
HCPCS,J0210,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.45,20.83,2
HCPCS,J0215,"INJECTION, ALEFACEPT, 0.5 MG",,,103.83,110.85,2
HCPCS,J0215,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,68.86,77.76,2
HCPCS,J0219,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",,,182.78,195.15,2
HCPCS,J0219,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,121.22,136.89,2
HCPCS,J0220,"INJECTION, AGLUCOSIDASE ALFA, 10 MG",,,333.25,355.8,2
HCPCS,J0220,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,221.02,249.59,2
HCPCS,J0221,All drugs or drug agents without specific rate set forth above or herein,,,555.53,555.53,2
HCPCS,J0221,"INJECTION, ALGLUCOSIDASE ALFA, (LUMIZYME), 10 MG",,,373.16,398.41,2
HCPCS,J0221,"Injection, alglucosidase alfa, (Lumizyme), 10 mg (For billing prior to 1/1/12 use J3590 or C9277)",,,433.83,433.83,2
HCPCS,J0221,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,247.48,279.48,2
HCPCS,J0222,All drugs or drug agents without specific rate set forth above or herein,,,271.98,271.98,2
HCPCS,J0222,"Injection, Patisiran, 0.1 mg",,,219.86,270.35,4
HCPCS,J0222,PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN,88065.0,57242.25,123.12,141.59,8
HCPCS,J0222,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,167.94,189.65,2
HCPCS,J0223,All drugs or drug agents without specific rate set forth above or herein,,,308.44,308.44,2
HCPCS,J0223,"Injection, givosiran, 0.5 mg",,,275.01,293.62,2
HCPCS,J0223,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,182.39,205.97,2
HCPCS,J0224,Drug,,,775.69,828.18,2
HCPCS,J0224,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,514.45,580.95,2
HCPCS,J0225,All drugs or drug agents without specific rate set forth above or herein,,,13549.56,13549.56,2
HCPCS,J0225,"Injection, vutrisiran, 1 mg",,,10879.56,13190.2,4
HCPCS,J0225,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,6133.8,14761.0,11
HCPCS,J0225,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8193.44,9252.67,2
HCPCS,J0248,All drugs or drug agents without specific rate set forth above or herein,,,17.48,17.48,2
HCPCS,J0248,"INJECTION, REMDESIVIR, 1 MG",,,13.82,14.76,2
HCPCS,J0248,"Injection, remdesivir, 1 mg",,,13.33,13.33,2
HCPCS,J0248,REMDESIVIR (VEKLURY) IN 0.9% NACL 100 MG/250 ML IV PGBK PREMIX,9144.0,5943.6,7.91,14761.0,3
HCPCS,J0248,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,7.91,14761.0,22
HCPCS,J0248,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.17,10.35,2
HCPCS,J0256,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG IV SOLR,5350.0,3477.5,6.15,7.07,16
HCPCS,J0256,All drugs or drug agents without specific rate set forth above or herein,,,13.57,13.57,2
HCPCS,J0256,"INJECTION, ALPHA 1 - PROTEINASE INHIBITOR - HUMAN PER 10 MG",,,6.22,6.64,2
HCPCS,J0256,"INJECTION, ALPHA 1-PROTEINASE INHIBITOR, HUMAN, 10 MG, NOT OTHERWISE SPECIFIED",,,10.74,10.74,2
HCPCS,J0256,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.12,4.66,2
HCPCS,J0257,All drugs or drug agents without specific rate set forth above or herein,,,15.34,15.34,2
HCPCS,J0257,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), (GLASSIA), 10 MG",,,12.27,13.1,2
HCPCS,J0257,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.13,9.19,2
HCPCS,J0270,ALPROSTADIL 500 MCG/ML IJ SOLN,1698.6999999999998,1104.155,13270.0,14761.0,6
HCPCS,J0270,INJECTION ALPROSTADIL PER 1.25 MCG,,,33.69,35.97,2
HCPCS,J0270,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.34,25.23,2
HCPCS,J0275,"ALPROSTADIL URETHRAL SUPPOSITORY, ADMINISTERED UNDER DIRECT PHYSICIAN SUPERVISION, EXCLUDES SELF ADMINISTRATION",,,48.89,52.2,2
HCPCS,J0275,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.43,36.62,2
HCPCS,J0278,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J0278,"INJECTION, AMIKACIN SULFATE, 100 MG",,,1.81,1.81,2
HCPCS,J0278,"INJECTION, AMIKACIN SULFATE, 100 MG ï",,,15.89,16.97,2
HCPCS,J0278,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.54,11.9,2
HCPCS,J0280,AMINOPHYLLINE 250 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J0280,AMINOPHYLLINE 500 MG/20 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J0280,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0280,"INJECTION, AMINOPHYLLINE, UP TO 250 MG",,,5.36,5.72,2
HCPCS,J0280,"Injection, aminophyllin, up to 250mg",,,11.28,11.28,2
HCPCS,J0280,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J0282,AMIODARONE 50 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,16
HCPCS,J0282,AMIODARONE IV INFUSION (1 MG/ML),290.0,188.5,,,0
HCPCS,J0282,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0282,"INJECTION, AMIODARONE HYDROCHLORIDE, 30MG",,,73.25,78.21,2
HCPCS,J0282,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,48.58,54.86,2
HCPCS,J0283,"Injection, amiodarone hydrochloride (nexterone), 30 mg",,,10.19,10.88,2
HCPCS,J0283,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.76,7.63,2
HCPCS,J0285,AMPHOTERICIN B 50 MG IJ SOLR,562.72,365.77,13270.0,14761.0,2
HCPCS,J0285,"AMPHOTERICIN B, 50MG",,,42.67,45.56,2
HCPCS,J0285,"Injection, amphotericin B, 50mg",,,20.98,20.98,2
HCPCS,J0285,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.3,31.96,2
HCPCS,J0287,All drugs or drug agents without specific rate set forth above or herein,,,30.61,30.61,2
HCPCS,J0287,"INJECTION, AMPHOTERICIN B LIPID COMPLEX, 10 MG",,,51.14,54.6,2
HCPCS,J0287,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.91,38.3,2
HCPCS,J0288,"INJECTION, AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, 10 MG",,,41.64,44.45,2
HCPCS,J0288,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.61,31.18,2
HCPCS,J0289,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,1540.48,1001.31,29.04,14761.0,11
HCPCS,J0289,All drugs or drug agents without specific rate set forth above or herein,,,64.16,64.16,2
HCPCS,J0289,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",,,58.63,89.46,4
HCPCS,J0289,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.57,62.75,2
HCPCS,J0290,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,10
HCPCS,J0290,AMPICILLIN SODIUM 2 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,16
HCPCS,J0290,AMPICILLIN SODIUM 500 MG IJ SOLR,1465.56,952.61,13270.0,14761.0,12
HCPCS,J0290,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J0290,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0290,"INJECTION, AMPICILLIN, UP TO 500 MG",,,9.33,9.96,2
HCPCS,J0290,"Injection, ampicillin sodium, 500 mg",,,2.22,2.22,2
HCPCS,J0290,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.19,6.99,2
HCPCS,J0291,All drugs or drug agents without specific rate set forth above or herein,,,9.88,9.88,2
HCPCS,J0291,"Injection, plazomicin, 5 mg",,,8.39,8.96,2
HCPCS,J0291,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.57,6.28,2
HCPCS,J0295,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,290.0,188.5,,,0
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,12
HCPCS,J0295,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0295,INJECTION AMPICILLIM SODIUM/SULBACTAM SODIUM PER 1.5 G,,,18.14,19.37,2
HCPCS,J0295,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",,,3.9,3.9,2
HCPCS,J0295,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.03,13.59,2
HCPCS,J0300,AMOBARBITAL 500 MG IJ SOLR,10927.68,7102.99,,,0
HCPCS,J0300,"INJECTION, AMOBARBITAL, UP TO 125 MG",,,6.74,7.19,2
HCPCS,J0300,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.47,5.05,2
HCPCS,J0330,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0330,"INJECTION, SUCCINYCHOLINE CHLORIDE, UP TO 20 MG",,,8.12,8.67,2
HCPCS,J0330,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,12
HCPCS,J0330,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.39,6.08,2
HCPCS,J0348,"INJECTION, ANIDULAFUNGIN, 1 MG",,,5.01,5.35,2
HCPCS,J0348,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J0350,INJECTION ANISTREPLASE PER 30 UNITS,,,6298.48,6724.68,2
HCPCS,J0350,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4177.21,4717.23,2
HCPCS,J0360,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0360,HYDRALAZINE 20 MG/ML IJ SOLN,1016.02,660.41,13270.0,14761.0,8
HCPCS,J0360,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",,,19.0,20.29,2
HCPCS,J0360,"Injection, hydralazine HCl, up to 20mg",,,12.29,12.29,2
HCPCS,J0360,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.6,14.23,2
HCPCS,J0364,"INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG ï",,,8.12,8.67,2
HCPCS,J0364,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.39,6.08,2
HCPCS,J0365,"INJECTION, APROTONIN, 10,000 KIU ï",,,5.7,6.09,2
HCPCS,J0365,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.78,4.27,2
HCPCS,J0380,"INJECTION, METARAMINOL, UP TO 10 MG",,,26.26,28.04,2
HCPCS,J0380,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.42,19.67,2
HCPCS,J0390,"INJECTION, CHLOROQUINE HCL, UP TO 50 MG",,,46.13,49.25,2
HCPCS,J0390,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.59,34.55,2
HCPCS,J0391,All drugs or drug agents without specific rate set forth above or herein,,,142.56,142.56,2
HCPCS,J0395,INJECTION ARBUTAMINE HCI 1MG,,,473.88,505.95,2
HCPCS,J0395,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,314.28,354.91,2
HCPCS,J0400,"INJECTION, ARIPIPRAZOLE, INTRAMUSCULAR, 0.25 MG",,,0.86,0.92,2
HCPCS,J0400,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J0401,All drugs or drug agents without specific rate set forth above or herein,,,19.46,19.46,2
HCPCS,J0401,"INJECTION, ARIPIPRAZOLE, EXTENDED RELEASE, 1 MG",,,9.67,10.33,2
HCPCS,J0401,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.42,7.25,2
HCPCS,J0456,AZITHROMYCIN 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,12
HCPCS,J0456,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0456,"INJECTION, AZITHROMYCIN, 500 MG",,,5.71,5.71,2
HCPCS,J0456,"INJECTION, AZITHROMYCIN, 500MG",,,58.57,62.53,2
HCPCS,J0456,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,38.84,43.86,2
HCPCS,J0461,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,J0461,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,8
HCPCS,J0461,"INJECTION, ATROPINE SULFATE, 0.01 MG",,,0.17,0.74,4
HCPCS,J0461,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J0470,"INJECTION, DIMECAPROL, UP TO 100 MG",,,65.13,69.54,2
HCPCS,J0470,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,43.2,48.78,2
HCPCS,J0475,All drugs or drug agents without specific rate set forth above or herein,,,480.21,480.21,2
HCPCS,J0475,BACLOFEN 500 MCG/ML IT SOLN,20482.8,13313.82,217.39,249.99,8
HCPCS,J0475,INJECTION BACLOFEN 10 MG,,,546.44,583.42,2
HCPCS,J0475,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,362.4,409.25,2
HCPCS,J0476,BACLOFEN 2000 MCG/ML IT SOLN,6205.14,4033.34,13270.0,14761.0,4
HCPCS,J0476,BACLOFEN 50 MCG/ML IT SOLN,447.23,290.7,,,0
HCPCS,J0476,BACLOFEN 500 MCG/ML IT SOLN,11721.4,7618.91,,,0
HCPCS,J0476,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",,,192.63,205.66,2
HCPCS,J0476,"Injection, baclofen, 50 mcg, for intrathecal trial",,,82.33,82.33,2
HCPCS,J0476,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,127.75,144.27,2
HCPCS,J0480,All drugs or drug agents without specific rate set forth above or herein,,,12621.96,12621.96,2
HCPCS,J0480,BASILIXIMAB 20 MG IV SOLR,38230.02,24849.51,5713.88,14761.0,11
HCPCS,J0480,"INJECTION, BASILIXIMAB, 20 MG",,,9843.55,9843.55,2
HCPCS,J0480,"INJECTION, BASILIXIMAB, 20 MG ï",,,3746.99,4000.54,2
HCPCS,J0480,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2485.04,2806.3,2
HCPCS,J0485,All drugs or drug agents without specific rate set forth above or herein,,,10.49,10.49,2
HCPCS,J0485,BELATACEPT 250 MG IV SOLR,14744.0,9583.6,4.75,14761.0,11
HCPCS,J0485,"INJECTION, BELATACEPT, 1 MG",,,9.85,10.51,2
HCPCS,J0485,"Injection, belatacept, 1 mg (For billing prior to 1/1/13 use C9286 or J3590)",,,8.51,8.51,2
HCPCS,J0485,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.53,7.38,2
HCPCS,J0490,All drugs or drug agents without specific rate set forth above or herein,,,148.94,148.94,2
HCPCS,J0490,BELIMUMAB 120 MG IV SOLR,10156.0,6601.4,67.43,77.54,8
HCPCS,J0490,BELIMUMAB 400 MG IV SOLR,19041.3,12376.84,67.43,77.54,8
HCPCS,J0490,"INJECTION, BELIMUMAB, 10 MG",,,98.47,114.33,4
HCPCS,J0490,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,65.31,73.75,2
HCPCS,J0491,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",,,41.46,44.27,2
HCPCS,J0491,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.5,31.05,2
HCPCS,J0500,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0500,DICYCLOMINE 10 MG/ML IM SOLN,771.53,501.495,13270.0,14761.0,6
HCPCS,J0500,"INJECTION, DICYCLOMINE, UP TO 20 MG",,,37.32,39.84,2
HCPCS,J0500,"Injection, dicyclomine HCl, up to 20mg",,,54.9,54.9,2
HCPCS,J0500,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.75,27.95,2
HCPCS,J0515,BENZTROPINE 1 MG/ML IJ SOLN,372.67,242.24,13270.0,14761.0,4
HCPCS,J0515,"INJECTION, BENZTROPINE",,,15.03,16.05,2
HCPCS,J0515,"Injection, benztropine mesylate, per 1mg",,,36.14,36.14,2
HCPCS,J0515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.97,11.26,2
HCPCS,J0517,All drugs or drug agents without specific rate set forth above or herein,,,460.17,460.17,2
HCPCS,J0517,"Injection, benralizumab, 1 mg",,,422.23,450.8,2
HCPCS,J0517,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,280.02,316.22,2
HCPCS,J0520,"INJECTION, BETHANECHOL CHLORIDE, MYOTONACHOL OR URECHOLINE, UP TO 5 MG",,,12.61,13.46,2
HCPCS,J0520,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.36,9.45,2
HCPCS,J0558,All drugs or drug agents without specific rate set forth above or herein,,,53.7,53.7,2
HCPCS,J0558,"INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, 100,000 UNITS",,,8.47,9.04,2
HCPCS,J0558,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.61,6.34,2
HCPCS,J0561,All drugs or drug agents without specific rate set forth above or herein,,,67.03,67.03,2
HCPCS,J0561,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",,,10.71,11.44,2
HCPCS,J0561,"Injection, penicillin G benzathine, 100,000 units",,,47.79,47.79,2
HCPCS,J0561,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,5250.865,3413.06,30.34,14761.0,19
HCPCS,J0561,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,10760.285,6994.1900000000005,30.34,14761.0,22
HCPCS,J0561,PENICILLIN G BENZATHINE 600000 UNITS/ML IM SYRG,3176.0,2064.4,30.34,14761.0,3
HCPCS,J0561,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.1,8.02,2
HCPCS,J0565,All drugs or drug agents without specific rate set forth above or herein,,,109.65,109.65,2
HCPCS,J0565,BEZLOTOXUMAB 25 MG/ML IV SOLN,20482.8,13313.82,49.64,57.08,8
HCPCS,J0565,"Injection, bezlotoxumab, 10 mg (For billing prior to 1/1/18 use J3590 or C9490 for OPPS billing)",,,101.24,108.09,2
HCPCS,J0565,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,67.14,75.82,2
HCPCS,J0567,"Injection, cerliponase alfa, 1 mg",,,239.96,256.2,2
HCPCS,J0567,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,159.15,179.72,2
HCPCS,J0570,"Buprenorphine implant, 74.2 mg",,,3298.51,3521.7,2
HCPCS,J0570,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2187.6,2470.41,2
HCPCS,J0571,BUPRENORPHINE HCL 2 MG SL SUBL,306.52,199.24,13270.0,14761.0,8
HCPCS,J0571,BUPRENORPHINE HCL 8 MG SL SUBL,491.56,319.515,13270.0,14761.0,4
HCPCS,J0571,"Buprenorphine, oral, 1 mg",,,5.01,5.35,2
HCPCS,J0571,Other Outpatient Services,290.0,188.5,,,0
HCPCS,J0571,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J0572,BUPRENORPHINE-NALOXONE 0.7-0.18 MG SL SUBL,2372.16,1541.9,13270.0,14761.0,2
HCPCS,J0572,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,13270.0,14761.0,6
HCPCS,J0572,BUPRENORPHINE-NALOXONE 8-2 MG SL FILM,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J0572,"Buprenorphine/naloxone, oral, less than or equal to 3 mg (Code Price is per 1 tab/film)",,,9.33,9.96,2
HCPCS,J0572,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J0572,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.19,6.99,2
HCPCS,J0573,"Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg (Code Price is per 1 tab/film)",,,18.83,20.11,2
HCPCS,J0573,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.49,14.1,2
HCPCS,J0574,BUPRENORPHINE HCL 8 MG SL SUBL,491.56,319.515,13270.0,14761.0,4
HCPCS,J0574,"Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg (Code Price is per 1 tab/film)",,,18.83,20.11,2
HCPCS,J0574,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.49,14.1,2
HCPCS,J0575,"Buprenorphine/naloxone, oral, greater than 10 mg (Code Price is per 1 tab/film)",,,37.49,40.03,2
HCPCS,J0575,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.86,28.08,2
HCPCS,J0583,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0583,BIVALIRUDIN 250 MG IV SOLR,722.99,469.94,13270.0,14761.0,4
HCPCS,J0583,"INJECTION, BIVALIRUDIN, 1 MG",,,0.47,4.43,4
HCPCS,J0583,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.75,3.11,2
HCPCS,J0584,All drugs or drug agents without specific rate set forth above or herein,,,1291.63,1291.63,2
HCPCS,J0584,"Injection, burosumab-twza 1 mg",,,906.3,967.62,2
HCPCS,J0584,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,601.07,678.77,2
HCPCS,J0585,All drugs or drug agents without specific rate set forth above or herein,,,17.62,17.62,2
HCPCS,J0585,"BOTULINUM TOXIN TYPE A, PER UNIT",,,11.75,12.54,2
HCPCS,J0585,"HB ABN INJ, ONABOTULINUMTOXINA, 1 UNIT",,,7.98,9.17,8
HCPCS,J0585,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",,,13.91,13.91,2
HCPCS,J0585,ONABOTULINUMTOXINA 100 UNITS IJ SOLR,8398.0,5458.7,7.98,14761.0,11
HCPCS,J0585,ONABOTULINUMTOXINA 200 UNITS IJ SOLR,10336.0,6718.4,7.98,9.17,8
HCPCS,J0585,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.79,8.8,2
HCPCS,J0586,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,20482.8,13313.82,10.75,12.36,8
HCPCS,J0586,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,8590.0,5583.5,10.75,12.36,8
HCPCS,J0586,All drugs or drug agents without specific rate set forth above or herein,,,23.74,23.74,2
HCPCS,J0586,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",,,19.0,20.29,2
HCPCS,J0586,"Injection, abobotulinumtoxinA, 5 units (For billing prior to 1/1/10 use J3590 or C9399)",,,19.37,19.37,2
HCPCS,J0586,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.6,14.23,2
HCPCS,J0587,All drugs or drug agents without specific rate set forth above or herein,,,35.73,35.73,2
HCPCS,J0587,"BOTULINUM TOXIN TYPE B, PER 100 UNITS",,,22.98,24.53,2
HCPCS,J0587,"Injection, rimabotulinumtoxinB, 100 units",,,28.65,28.65,2
HCPCS,J0587,RIMABOTULINUMTOXINB 5000 UNITS/ML IM SOLN,6350.8,4128.02,16.17,18.6,8
HCPCS,J0587,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.24,17.21,2
HCPCS,J0588,All drugs or drug agents without specific rate set forth above or herein,,,14.68,14.68,2
HCPCS,J0588,INCOBOTULINUMTOXINA 100 UNITS IM SOLR,5110.0,3321.5,6.65,7.64,8
HCPCS,J0588,INCOBOTULINUMTOXINA 200 UNITS IM SOLR,10220.0,6643.0,6.65,7.64,8
HCPCS,J0588,INCOBOTULINUMTOXINA 50 UNITS IM SOLR,2680.0,1742.0,6.65,7.64,8
HCPCS,J0588,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",,,11.4,12.17,2
HCPCS,J0588,"INJECTION, INCOBOTULINUMTOXINA, 1 UNIT",,,11.4,11.4,2
HCPCS,J0588,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.56,8.54,2
HCPCS,J0591,"Injection, deoxycholic acid, 1 mg",,,39.98,42.69,2
HCPCS,J0591,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.52,29.94,2
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J0592,"INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG",,,2.42,2.58,2
HCPCS,J0592,"Injection, buprenorphine hydrochloride, 0.1 mg",,,9.07,9.07,2
HCPCS,J0592,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J0593,"Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)",,,201.98,215.65,2
HCPCS,J0593,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,133.96,151.27,2
HCPCS,J0594,All drugs or drug agents without specific rate set forth above or herein,,,3.49,3.49,2
HCPCS,J0594,"INJECTION, BUSULFAN, 1 MG ï",,,23.32,24.9,2
HCPCS,J0594,"Injection, busulfan, 1 mg",,,3.1,3.1,2
HCPCS,J0594,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.47,17.47,2
HCPCS,J0595,BUTORPHANOL 10 MG/ML NA SPRY,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0595,"INJECTION, BUTORPHANOL TARTRATE, 1 MG",,,15.03,16.05,2
HCPCS,J0595,"Injection, butorphanol tartrate, 1mg",,,6.15,6.15,2
HCPCS,J0595,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.97,11.26,2
HCPCS,J0596,All drugs or drug agents without specific rate set forth above or herein,,,95.51,95.51,2
HCPCS,J0596,"Injection, c-1 esterase inhibitor (recombinant), Ruconest, 10 units (For billing prior to 1/1/16 use C9445 or J3590)",,,69.28,73.96,2
HCPCS,J0596,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,45.94,51.88,2
HCPCS,J0597,All drugs or drug agents without specific rate set forth above or herein,,,188.04,188.04,2
HCPCS,J0597,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT,16695.27,10851.925000000001,85.12,14761.0,14
HCPCS,J0597,"INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS",,,91.91,98.13,2
HCPCS,J0597,"Injection, C-1 esterase inhibitor (human), Berinert, 10 units (For billing prior to 1/1/11 use J3590 or C9269)",,,141.52,141.52,2
HCPCS,J0597,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,60.95,68.83,2
HCPCS,J0598,All drugs or drug agents without specific rate set forth above or herein,,,176.62,176.62,2
HCPCS,J0598,"INJECTION, C1 ESTERASE INHIBITOR (HUMAN), 10 UNITS",,,91.91,98.13,2
HCPCS,J0598,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,60.95,68.83,2
HCPCS,J0599,"Injection, c-1 esterase inhibitor (human), (haegarda), 10 units",,,25.05,26.75,2
HCPCS,J0599,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.61,18.76,2
HCPCS,J0600,All drugs or drug agents without specific rate set forth above or herein,,,16741.15,16741.15,2
HCPCS,J0600,"INJECTION, EDETATE CALCIUM DISODIUM, UP TO 200 MG",,,93.81,100.16,2
HCPCS,J0600,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,62.21,70.26,2
HCPCS,J0604,CINACALCET 30 MG PO TABS,4053.4,2634.71,13270.0,14761.0,4
HCPCS,J0604,"Cinacalcet, oral, 1 mg, (for ESRD on dialysis) (For billing prior to 1/1/18 use J8499)",,,2.42,2.58,2
HCPCS,J0604,Other Outpatient Services,1999.98,1299.985,,,0
HCPCS,J0604,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J0606,"Injection, etelcalcetide, 0.1 mg (For billing prior to 1/1/18 use J3490 or C9399 for OPPS billing)",,,8.64,9.22,2
HCPCS,J0606,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.73,6.47,2
HCPCS,J0610,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
HCPCS,J0610,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,1019.18,662.465,13270.0,14761.0,10
HCPCS,J0610,"INJECTION, CALCIUM GLUCONATE, UP TO 10 ML",,,4.15,4.43,2
HCPCS,J0610,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.75,3.11,2
HCPCS,J0611,"Injection, calcium gluconate (wg critical care), per 10 ml",,,10.54,11.25,2
HCPCS,J0611,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.99,7.89,2
HCPCS,J0612,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0612,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J0612,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,10386.4,6751.16,13270.0,14761.0,4
HCPCS,J0612,"Injection, calcium gluconate (fresenius kabi), per 10 mg",,,0.11,0.11,2
HCPCS,J0620,"INJECTION, CALCIUM GLYCEROPHOSPHATE AND CALCIUM LACTATE, UP TO 10ML",,,14.17,15.12,2
HCPCS,J0620,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.4,10.61,2
HCPCS,J0630,All drugs or drug agents without specific rate set forth above or herein,,,3226.64,3226.64,2
HCPCS,J0630,CALCITONIN (SALMON) 200 UNITS/ML IJ SOLN,5506.65,3579.32,1460.68,14761.0,9
HCPCS,J0630,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",,,115.06,2351.89,4
HCPCS,J0630,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,76.31,86.17,2
HCPCS,J0636,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0636,CALCITRIOL 1 MCG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0636,"INJECTION, CALCITRIOL, 0.1 MCG",,,2.76,2.95,2
HCPCS,J0636,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.83,2.07,2
HCPCS,J0637,"INJECTION, CASPOFUNGIN ACETATE, 5 MG",,,11.93,85.4,4
HCPCS,J0637,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.05,59.91,2
HCPCS,J0638,All drugs or drug agents without specific rate set forth above or herein,,,351.56,351.56,2
HCPCS,J0638,"INJECTION, CANAKINUMAB, 1 MG",,,234.44,250.3,2
HCPCS,J0638,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,155.48,175.58,2
HCPCS,J0640,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0640,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",,,9.83,57.18,4
HCPCS,J0640,LEUCOVORIN CALCIUM 350 MG IJ SOLR,913.5,593.775,13270.0,14761.0,6
HCPCS,J0640,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.52,40.11,2
HCPCS,J0641,"INJECTION, LEVOLEUCOVORIN CALCIUM, 0.5 MG",,,3.46,3.69,2
HCPCS,J0641,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J0642,"Injection, levoleucovorin (khapzory), 0.5 mg",,,5.38,5.74,2
HCPCS,J0642,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.57,4.03,2
HCPCS,J0670,"INJECTION, MEPIVACAINE",,,37.14,39.66,2
HCPCS,J0670,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",,,7.22,7.22,2
HCPCS,J0670,MEPIVACAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
HCPCS,J0670,MEPIVACAINE (PF) 20 MG/ML (2 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0670,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.63,27.82,2
HCPCS,J0689,"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg",,,6.56,7.01,2
HCPCS,J0689,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.35,4.92,2
HCPCS,J0690,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0690,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,10
HCPCS,J0690,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
HCPCS,J0690,CEFAZOLIN 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,4
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OS) 1 GRAM/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0690,"INJECTION, CEFAZOLIN SODIUM, 500 MG",,,1.68,1.68,2
HCPCS,J0690,"INJECTION, CEFAZOLIN SODIUM, UP TO 500 MG",,,7.26,7.75,2
HCPCS,J0690,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.81,5.43,2
HCPCS,J0691,"Injection, lefamulin, 1 mg",,,1.83,1.95,2
HCPCS,J0691,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.21,1.37,2
HCPCS,J0692,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0692,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,10
HCPCS,J0692,CEFEPIME 2 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,J0692,CEFEPIME IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
HCPCS,J0692,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",,,19.87,21.21,2
HCPCS,J0692,"Injection, cefepime HCl, 500 mg",,,2.78,2.78,2
HCPCS,J0692,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.18,14.88,2
HCPCS,J0693,"Injection, cefiderocol, 5 mg",,,2.42,2.58,2
HCPCS,J0693,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J0694,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0694,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,6
HCPCS,J0694,CEFOXITIN 2 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,8
HCPCS,J0694,CEFOXITIN 95 MG/ML IV PUSH,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J0694,"INJECTION, CEFOXITIN SODIUM, 1 GM",,,43.02,45.93,2
HCPCS,J0694,"Injection, cefoxitin sodium, 1 g",,,11.17,11.17,2
HCPCS,J0694,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.53,32.22,2
HCPCS,J0695,All drugs or drug agents without specific rate set forth above or herein,,,22.64,22.64,2
HCPCS,J0695,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR,2364.96,1537.22,10.25,14761.0,3
HCPCS,J0695,"INJECTION, CEFTOLOZANE 50 MG AND TAZOBACTAM 25 MG (CODE RE-USED BY CMS EFFECTIVE 1/1/16) (FOR BILLING PRIOR TO 1/1/16 USE C9452 OR J3490)",,,16.2,16.2,2
HCPCS,J0695,"Injection, ceftolozane 50 mg and tazobactam 25 mg (Code re-used by CMS effective 1/1/16) (For billing prior to 1/1/16 use C9452 or J3490)",,,11.06,11.8,2
HCPCS,J0695,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.33,8.28,2
HCPCS,J0696,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0696,CEFTRIAXONE 1 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,14
HCPCS,J0696,CEFTRIAXONE 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J0696,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,14
HCPCS,J0696,CEFTRIAXONE 250 MG IJ SOLR,290.0,188.5,,,0
HCPCS,J0696,CEFTRIAXONE IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J0696,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",,,1.07,39.1,4
HCPCS,J0696,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.29,27.43,2
HCPCS,J0697,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,6
HCPCS,J0697,CEFUROXIME SODIUM 750 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J0697,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",,,4.45,17.89,4
HCPCS,J0697,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.11,12.55,2
HCPCS,J0698,"CEFOTAXIME SODIUM, PER GM",,,28.33,30.25,2
HCPCS,J0698,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.79,21.22,2
HCPCS,J0699,All drugs or drug agents without specific rate set forth above or herein,,,6.28,6.28,2
HCPCS,J0699,CEFIDEROCOL 1 GRAM IV SOLR,3470.99,2256.14,2.84,14761.0,3
HCPCS,J0699,Drug,,,5.01,5.35,2
HCPCS,J0699,"Injection, cefiderocol, 10 mg",,,4.78,4.78,2
HCPCS,J0699,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J0701,"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg",,,32.13,34.31,2
HCPCS,J0701,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.31,24.07,2
HCPCS,J0702,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0702,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",553.12,359.53,13270.0,14761.0,4
HCPCS,J0702,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",,,11.75,12.54,2
HCPCS,J0702,"Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg (Code price is per 1 mL)",,,14.99,14.99,2
HCPCS,J0702,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.79,8.8,2
HCPCS,J0703,"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg",,,19.52,20.84,2
HCPCS,J0703,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.95,14.62,2
HCPCS,J0706,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J0706,"INJECTION, CAFFEINE CITRATE, 5MG",,,7.95,8.48,2
HCPCS,J0706,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.27,5.95,2
HCPCS,J0710,"INJECTION, CEPHAPRIN SODIUM, UP TO 1 GM",,,9.16,9.78,2
HCPCS,J0710,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.07,6.86,2
HCPCS,J0712,All drugs or drug agents without specific rate set forth above or herein,,,10.82,10.82,2
HCPCS,J0712,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,4.9,14761.0,14
HCPCS,J0712,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",,,2.25,2.4,2
HCPCS,J0712,"Injection, ceftaroline fosamil, 10 mg (For billing prior to 1/1/12 use J3490 or C9282)",,,8.44,8.44,2
HCPCS,J0712,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J0713,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0713,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,8
HCPCS,J0713,CEFTAZIDIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
HCPCS,J0713,INJECTION CEFTAZIDIME PER 500 MG,,,17.62,18.81,2
HCPCS,J0713,"INJECTION, CEFTAZIDIME, PER 500 MG",,,3.73,3.73,2
HCPCS,J0713,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.69,13.2,2
HCPCS,J0714,All drugs or drug agents without specific rate set forth above or herein,,,276.66,276.66,2
HCPCS,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR,5882.34,3823.52,125.24,14761.0,3
HCPCS,J0714,"Injection, ceftazidime and avibactam, 0.5 g/0.125 g (For billing prior to 1/1/16 use C9399 or J3490)",,,189.86,209.9,4
HCPCS,J0714,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,125.92,142.2,2
HCPCS,J0715,INJECTION CEFTIZOXIME SODIUM PER 500 MG,,,16.07,17.15,2
HCPCS,J0715,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.66,12.03,2
HCPCS,J0716,All drugs or drug agents without specific rate set forth above or herein,,,13214.65,13214.65,2
HCPCS,J0716,"INJECTION, CENTRUROIDES IMMUNE F(AB)2, UP TO 120 MILLIGRAMS",,,9717.75,10375.31,2
HCPCS,J0716,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6444.9,7278.08,2
HCPCS,J0717,All drugs or drug agents without specific rate set forth above or herein,,,12.8,12.8,2
HCPCS,J0717,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SC KIT,53994.87,35096.67,5.79,14761.0,11
HCPCS,J0717,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SC SYKT,49552.47,32209.11,5.79,14761.0,3
HCPCS,J0717,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",,,10.59,17.89,4
HCPCS,J0717,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.11,12.55,2
HCPCS,J0720,"INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM",,,14.17,15.12,2
HCPCS,J0720,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.4,10.61,2
HCPCS,J0725,"INJECTION, CHORIONIC GONADOTROPIN PER 1,000 USP",,,43.19,46.11,2
HCPCS,J0725,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.64,32.35,2
HCPCS,J0735,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0735,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,13270.0,14761.0,6
HCPCS,J0735,CLONIDINE (PF) 5000 MCG/10 ML EP SOLN,729.76,474.34,13270.0,14761.0,2
HCPCS,J0735,"INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG",,,129.05,137.78,2
HCPCS,J0735,"Injection, clonidine hydrochloride, 1 mg",,,42.37,42.37,2
HCPCS,J0735,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,85.59,96.65,2
HCPCS,J0739,"Injection, cabotegravir, 1 mg",,,16.41,17.52,2
HCPCS,J0739,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.88,12.29,2
HCPCS,J0740,All drugs or drug agents without specific rate set forth above or herein,,,1452.33,1452.33,2
HCPCS,J0740,CIDOFOVIR 75 MG/ML IV SOLN,9689.76,6298.34,657.46,14761.0,11
HCPCS,J0740,INJECTION CIDOFOVIR 375 MG,,,1879.28,2006.45,2
HCPCS,J0740,"INJECTION, CIDOFOVIR, 375 MG",,,1218.69,1218.69,2
HCPCS,J0740,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1246.36,1407.48,2
HCPCS,J0741,Drug,,,52.69,56.26,2
HCPCS,J0741,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.95,39.46,2
HCPCS,J0742,All drugs or drug agents without specific rate set forth above or herein,,,6.91,6.91,2
HCPCS,J0742,"Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg",,,5.9,6.3,2
HCPCS,J0742,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.91,4.42,2
HCPCS,J0743,IMIPENEM-CILASTATIN 500 MG IV SOLR,388.37,252.44,13270.0,14761.0,6
HCPCS,J0743,"INJECTION, CILASTATIN SODIUM IMIPENEM, PER 250 MG",,,37.83,40.39,2
HCPCS,J0743,"Injection, cilastatin sodium; imipenem, per 250 mg",,,17.81,17.81,2
HCPCS,J0743,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25.09,28.34,2
HCPCS,J0744,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J0744,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
HCPCS,J0744,"INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG",,,4.24,4.24,2
HCPCS,J0744,"INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200MGS",,,35.59,38.0,2
HCPCS,J0744,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.6,26.65,2
HCPCS,J0745,"INJECTION, CODEINE PHOSPHATE",,,2.25,2.4,2
HCPCS,J0745,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J0770,COLISTIN (COLISTIMETHATE NA) 150 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J0770,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",,,126.63,135.2,2
HCPCS,J0770,"Injection, colistimethate sodium, up to 150 mg (Code Price is per 150 mg)",,,30.6,30.6,2
HCPCS,J0770,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,83.98,94.84,2
HCPCS,J0775,All drugs or drug agents without specific rate set forth above or herein,,,195.73,195.73,2
HCPCS,J0775,COLLAGENASE CLOSTRIDIUM HISTO. 0.9 MG IJ SOLR,20482.8,13313.82,88.61,101.9,8
HCPCS,J0775,"INJECTION, COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01 MG",,,96.23,102.74,2
HCPCS,J0775,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,63.82,72.07,2
HCPCS,J0780,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0780,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",,,7.53,21.77,4
HCPCS,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,14
HCPCS,J0780,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.52,15.27,2
HCPCS,J0791,All drugs or drug agents without specific rate set forth above or herein,,,353.56,353.56,2
HCPCS,J0791,CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN,10974.18,7133.215,160.05,184.06,16
HCPCS,J0791,"Injection, crizanlizumab-tmca, 5 mg",,,316.5,337.91,2
HCPCS,J0791,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,209.9,237.04,2
HCPCS,J0795,"INJECTION, CORTICORELIN BOVINE TRIFLUTATE, 1 MICROGRAM ï",,,9.5,10.14,2
HCPCS,J0795,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.3,7.12,2
HCPCS,J0800,CORTICOTROPIN 80 UNITS/ML IJ GEL,1465.56,952.61,13270.0,14761.0,2
HCPCS,J0800,"INJECTION, CORTICOTROPIN, UP TO 40 UNITS",,,217.33,232.04,2
HCPCS,J0800,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,144.14,162.77,2
HCPCS,J0834,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0834,COSYNTROPIN 0.25 MG IJ SOLR,386.47,251.20499999999998,13270.0,14761.0,4
HCPCS,J0834,"INJECTION, COSYNTROPIN (CORTROSYN), 0.25 MG",,,284.02,303.24,2
HCPCS,J0834,"Injection, cosyntropin, 0.25 mg",,,59.63,59.63,2
HCPCS,J0834,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,188.36,212.71,2
HCPCS,J0840,All drugs or drug agents without specific rate set forth above or herein,,,4847.55,4847.55,2
HCPCS,J0840,"INJECTION, CROTALIDAE POLYVALENT IMMUNE FAB (OVINE), UP TO 1 GRAM",,,5417.58,5784.17,2
HCPCS,J0840,"Injection, crotalidae polyvalent immune fab (Ovine), up to 1 gram (Code Price is per 1 vial) (For billing prior to 1/1/12 use J3590 or C9274)",,,4287.96,4287.96,2
HCPCS,J0840,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3592.99,4057.48,2
HCPCS,J0841,All drugs or drug agents without specific rate set forth above or herein,,,2860.96,2860.96,2
HCPCS,J0841,"Injection, crotalidae immune f(ab')2 (equine), 120 mg",,,3251.86,3471.9,2
HCPCS,J0841,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2156.66,2435.47,2
HCPCS,J0850,All drugs or drug agents without specific rate set forth above or herein,,,4992.21,4992.21,2
HCPCS,J0850,INJECTION CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS PER VIAL,,,1798.09,1919.76,2
HCPCS,J0850,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1192.51,1346.67,2
HCPCS,J0875,All drugs or drug agents without specific rate set forth above or herein,,,42.94,42.94,2
HCPCS,J0875,"Injection, dalbavancin",,,39.73,42.42,2
HCPCS,J0875,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.35,29.76,2
HCPCS,J0877,"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg",,,0.35,0.37,2
HCPCS,J0877,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J0878,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J0878,DAPTOMYCIN 350 MG IV SOLR,462.08,300.35,13270.0,14761.0,12
HCPCS,J0878,DAPTOMYCIN 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,4
HCPCS,J0878,"INJECTION, DAPTOMYCIN, 1 MG",,,0.09,0.92,4
HCPCS,J0878,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J0879,"INJECTION, DIFELIKEFALIN, 0.1 MICROGRAM, (FOR ESRD ON DIALYSIS)",,,0.69,0.74,2
HCPCS,J0879,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J0881,All drugs or drug agents without specific rate set forth above or herein,,,8.35,8.35,2
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML IJ SYRG,12967.47,8428.86,3.78,4.35,8
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML IJ SYRG,19451.25,12643.31,3.78,4.35,8
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML IJ SYRG,32418.63,21072.11,3.78,14761.0,11
HCPCS,J0881,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",,,6.43,6.43,2
HCPCS,J0881,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE) ï",,,77.74,83.0,2
HCPCS,J0881,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.56,58.22,2
HCPCS,J0882,All drugs or drug agents without specific rate set forth above or herein,,,8.35,8.35,2
HCPCS,J0882,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (FOR ESRD ON DIALYSIS) ï",,,77.74,83.0,2
HCPCS,J0882,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.56,58.22,2
HCPCS,J0883,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1445.98,939.885,1.57,14761.0,9
HCPCS,J0883,All drugs or drug agents without specific rate set forth above or herein,,,3.46,3.46,2
HCPCS,J0883,"Injection, argatroban, 1 mg (for non-esrd use)",,,12.09,12.91,2
HCPCS,J0883,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.02,9.06,2
HCPCS,J0884,ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN,1445.98,939.885,13270.0,14761.0,4
HCPCS,J0884,"Injection, argatroban, 1 mg (for esrd on dialysis)",,,12.09,12.91,2
HCPCS,J0884,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.02,9.06,2
HCPCS,J0885,All drugs or drug agents without specific rate set forth above or herein,,,20.71,20.71,2
HCPCS,J0885,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",,,19.53,19.53,2
HCPCS,J0885,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS ï",,,29.71,31.73,2
HCPCS,J0885,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.71,22.25,2
HCPCS,J0887,"Injection, epoetin beta, 1 microgram, (for ESRD on dialysis)",,,4.84,5.16,2
HCPCS,J0887,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.21,3.62,2
HCPCS,J0888,All drugs or drug agents without specific rate set forth above or herein,,,3.18,3.18,2
HCPCS,J0888,"Injectin, epoetin beta, 1 microgram, (for non-ESRD use)",,,4.84,5.16,2
HCPCS,J0888,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.21,3.62,2
HCPCS,J0890,"INJECTION, PEGINESATIDE, 0.1 MG (FOR ESRD ON DIALYSIS)",,,28.85,30.8,2
HCPCS,J0890,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.13,21.61,2
HCPCS,J0891,"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)",,,10.54,11.25,2
HCPCS,J0891,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.99,7.89,2
HCPCS,J0892,"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)",,,10.54,11.25,2
HCPCS,J0892,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.99,7.89,2
HCPCS,J0893,"Injection, decitabine (sun pharma) not therapeutically equivalent to j0894, 1 mg",,,13.3,14.2,2
HCPCS,J0893,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.82,9.96,2
HCPCS,J0894,DECITABINE 50 MG IV SOLR,1465.56,952.61,13270.0,14761.0,6
HCPCS,J0894,"INJECTION, DECITABINE, 1 MG",,,3.73,3.73,2
HCPCS,J0894,"INJECTION, DECITABINE, 1 MG ï",,,66.69,71.2,2
HCPCS,J0894,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,44.23,49.94,2
HCPCS,J0895,DEFEROXAMINE 2 GRAM IJ SOLR,576.48,374.71,13270.0,14761.0,8
HCPCS,J0895,DEFEROXAMINE 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J0895,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",,,18.91,18.91,2
HCPCS,J0895,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG.",,,36.11,38.55,2
HCPCS,J0895,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.95,27.04,2
HCPCS,J0896,All drugs or drug agents without specific rate set forth above or herein,,,111.72,111.72,2
HCPCS,J0896,"Injection, luspatercept-aamt, 0.25 mg",,,87.9,99.39,4
HCPCS,J0896,LUSPATERCEPT-AAMT 25 MG SC SOLR,36292.41,23590.07,50.57,58.16,8
HCPCS,J0896,LUSPATERCEPT-AAMT 75 MG SC SOLR,108876.78,70769.91,50.57,58.16,8
HCPCS,J0896,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,61.74,69.72,2
HCPCS,J0897,All drugs or drug agents without specific rate set forth above or herein,,,74.16,74.16,2
HCPCS,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SC SOLN,26016.46,16910.7,33.57,14761.0,11
HCPCS,J0897,DENOSUMAB 60 MG/ML SC SYRG,14145.105,9194.32,33.57,14761.0,11
HCPCS,J0897,"INJECTION, DENOSUMAB, 1 MG",,,49.58,52.94,2
HCPCS,J0897,"Injection, denosumab, 1 mg (For billing prior to 1/1/12 use J3590 or C9272)",,,55.41,55.41,2
HCPCS,J0897,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.88,37.13,2
HCPCS,J0898,"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)",,,10.37,11.07,2
HCPCS,J0898,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.87,7.76,2
HCPCS,J0899,"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)",,,10.37,11.07,2
HCPCS,J0899,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.87,7.76,2
HCPCS,J0945,"INJECTION, BROMPHENIRAMINE MALEATE, PER 10MG",,,2.25,2.4,2
HCPCS,J0945,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J1000,"INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG",,,11.4,12.17,2
HCPCS,J1000,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.56,8.54,2
HCPCS,J1020,"INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG",,,6.05,6.46,2
HCPCS,J1020,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.01,4.53,2
HCPCS,J1030,"INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG",,,12.78,13.65,2
HCPCS,J1030,"Injection, methylprednisolone acetate, 40 mg",,,14.13,14.13,2
HCPCS,J1030,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
HCPCS,J1030,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.48,9.57,2
HCPCS,J1040,"INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG",,,21.08,22.5,2
HCPCS,J1040,"Injection, methylprednisolone acetate, 80 mg",,,21.56,21.56,2
HCPCS,J1040,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
HCPCS,J1040,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.98,15.79,2
HCPCS,J1050,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",,,0.52,0.55,2
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML IM SUSP,1465.56,952.61,13270.0,14761.0,4
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,819.2,532.48,,,0
HCPCS,J1050,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J1071,Inj testosterone cypionate,,,0.17,0.18,2
HCPCS,J1071,"Injection, testosterone cypionate, 1 mg",,,0.07,0.07,2
HCPCS,J1071,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,13270.0,14761.0,4
HCPCS,J1071,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J1094,"INJECTION, DEXAMETHASONE ACETATE, 1 MG",,,0.69,0.74,2
HCPCS,J1094,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J1095,"Injection, dexamethasone 9 percent, intraocular, 1 microgram",,,19.52,20.84,2
HCPCS,J1095,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.95,14.62,2
HCPCS,J1096,All drugs or drug agents without specific rate set forth above or herein,,,322.21,322.21,2
HCPCS,J1096,"Dexamethasone, lacrimal ophthalmic insert, 0.1 mg",,,359.07,383.37,2
HCPCS,J1096,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,238.14,268.92,2
HCPCS,J1097,All drugs or drug agents without specific rate set forth above or herein,,,265.68,265.68,2
HCPCS,J1097,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,205.5,232.07,2
HCPCS,J1097,"phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml",,,309.86,330.82,2
HCPCS,J1100,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1100,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,6
HCPCS,J1100,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,10386.4,6751.16,13270.0,14761.0,8
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,397.96000000000004,258.675,13270.0,14761.0,8
HCPCS,J1100,"INJECTION, DEXAMETHOSONE SODIUM PHOSPHATE,1 MG",,,3.46,3.69,2
HCPCS,J1100,"Injection, dexamethasone sodium phosphate, 1 mg",,,0.26,0.26,2
HCPCS,J1100,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J1110,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,1267.12,823.63,13270.0,14761.0,6
HCPCS,J1110,"INJECTION, DEHYDROERGOTAMINE, UP TO 1 MG",,,73.94,78.94,2
HCPCS,J1110,"Injection, dihydroergotamine mesylate, per 1 mg",,,93.09,93.09,2
HCPCS,J1110,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,49.04,55.38,2
HCPCS,J1120,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,400.64,260.41499999999996,13270.0,14761.0,8
HCPCS,J1120,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",,,61.84,86.51,4
HCPCS,J1120,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.74,60.68,2
HCPCS,J1130,"Injection, diclofenac sodium, 0.5 mg",,,0.52,0.55,2
HCPCS,J1130,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,1086.825,706.435,13270.0,14761.0,6
HCPCS,J1160,DIGOXIN 50 MCG/ML (0.05 MG/ML) PO SOLN,,,13270.0,14761.0,4
HCPCS,J1160,"INJECTION, DIGOXIN, UP TO 0.5 MG",,,4.66,20.7,4
HCPCS,J1160,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.09,3.49,2
HCPCS,J1162,All drugs or drug agents without specific rate set forth above or herein,,,13445.32,13445.32,2
HCPCS,J1162,DIGOXIN IMMUNE FAB 40 MG IV SOLR,40106.88,26069.47,6086.61,14761.0,14
HCPCS,J1162,"INJECTION, DIGOXIN IMMUNE FAB (BOVINE), PER VIAL ï",,,1684.24,1798.2,2
HCPCS,J1162,"Injection, digoxin immune fab (ovine), per vial",,,10505.86,10505.86,2
HCPCS,J1162,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1117.0,1261.4,2
HCPCS,J1165,"INJECTION, PHENYTOIN SODIUM",,,4.15,4.43,2
HCPCS,J1165,"INJECTION, PHENYTOIN SODIUM, PER 50 MG",,,1.38,1.38,2
HCPCS,J1165,PHENYTOIN 50 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J1165,PHENYTOIN SODIUM 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,12
HCPCS,J1165,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.75,3.11,2
HCPCS,J1170,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1170,HYDROMORPHONE (PF) 1 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J1170,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,14
HCPCS,J1170,HYDROMORPHONE (PF) 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J1170,HYDROMORPHONE 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J1170,HYDROMORPHONE 10 MG/ML PCA HIGH DOSE,290.0,188.5,13270.0,14761.0,2
HCPCS,J1170,HYDROMORPHONE 2 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J1170,"INJECTION, HYDROMORPHINE, UP TO 4 MG",,,3.97,4.24,2
HCPCS,J1170,"INJECTION, HYDROMORPHONE, UP TO 4 MG",,,10.09,10.09,2
HCPCS,J1170,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.64,2.98,2
HCPCS,J1180,"INJECTION, DYPHYLLINE, UP TO 500 MG",,,21.25,22.69,2
HCPCS,J1180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.09,15.91,2
HCPCS,J1190,All drugs or drug agents without specific rate set forth above or herein,,,240.66,240.66,2
HCPCS,J1190,DEXRAZOXANE HCL 250 MG IV SOLR,1311.1799999999998,852.265,108.95,14761.0,27
HCPCS,J1190,DEXRAZOXANE HCL 500 MG IV SOLR,2074.3199999999997,1348.31,108.95,14761.0,30
HCPCS,J1190,"INJECTION DEXRAZOXANE HYDROCHLORIDE, PER 250MG",,,528.65,564.42,2
HCPCS,J1190,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",,,237.5,237.5,2
HCPCS,J1190,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,350.6,395.93,2
HCPCS,J1200,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1200,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J1200,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",,,1.77,4.06,4
HCPCS,J1200,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.52,2.85,2
HCPCS,J1201,All drugs or drug agents without specific rate set forth above or herein,,,40.91,40.91,2
HCPCS,J1201,"Injection, cetirizine hydrochloride, 0.5 mg",,,39.98,42.69,2
HCPCS,J1201,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.52,29.94,2
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,552.4,359.05999999999995,13270.0,14761.0,8
HCPCS,J1205,"INJECTION, CHLOROTHIAZIDE SODIUM",,,24.53,26.19,2
HCPCS,J1205,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",,,266.85,266.85,2
HCPCS,J1205,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.27,18.37,2
HCPCS,J1212,All drugs or drug agents without specific rate set forth above or herein,,,1969.17,1969.17,2
HCPCS,J1212,DIMETHYL SULFOXIDE 50 % IS SOLN,10360.0,6734.0,891.43,14761.0,3
HCPCS,J1212,"INJECTION, DMSO, DIMETHYL SULFOXIDE",,,148.23,158.26,2
HCPCS,J1212,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",,,1497.15,1497.15,2
HCPCS,J1212,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,98.31,111.01,2
HCPCS,J1230,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1230,"INJECTION, METHADONE HCL, UP TO 10 MG",,,1.38,1.48,2
HCPCS,J1230,"Injection, methadone HCl, up to 10 mg (Code Price is per 10 mg)",,,43.26,43.26,2
HCPCS,J1230,METHADONE 10 MG/ML IJ SOLN,5475.04,3558.7749999999996,13270.0,14761.0,4
HCPCS,J1230,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.92,1.04,2
HCPCS,J1240,DIMENHYDRINATE 50 MG/ML IJ SOLN,,,13270.0,14761.0,2
HCPCS,J1240,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",,,6.74,7.19,2
HCPCS,J1240,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.47,5.05,2
HCPCS,J1245,DIPYRIDAMOLE 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J1245,"INJECTION, DIPYRIDAMOLE, PER 10 MG",,,61.68,65.85,2
HCPCS,J1245,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.9,46.19,2
HCPCS,J1250,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J1250,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",290.0,188.5,13270.0,14761.0,2
HCPCS,J1250,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",1465.56,952.61,13270.0,14761.0,6
HCPCS,J1250,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250",,,29.71,31.73,2
HCPCS,J1250,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",,,21.65,21.65,2
HCPCS,J1250,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.71,22.25,2
HCPCS,J1260,"INJECTION, DOLASETRON MESYLATE, 10MG (PRIOR TO 01/01/00 CODEWAS FOR 1 MG)",,,38.53,41.13,2
HCPCS,J1260,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25.55,28.85,2
HCPCS,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J1265,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,6
HCPCS,J1265,"INJECTION, DOPAMINE HCL, 40 MG",,,1.7,1.7,2
HCPCS,J1265,"INJECTION, DOPAMINE HCL, 40 MG ï",,,0.86,0.92,2
HCPCS,J1265,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J1267,"INJECTION, DORIPENEM, 10 MG",,,2.25,2.4,2
HCPCS,J1267,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J1270,"INJECTION, DOXERCALCIFEROL, 1MCG",,,13.82,14.76,2
HCPCS,J1270,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.17,10.35,2
HCPCS,J1290,All drugs or drug agents without specific rate set forth above or herein,,,1556.37,1556.37,2
HCPCS,J1290,"INJECTION, ECALLANTIDE, 1 MG",,,706.42,754.22,2
HCPCS,J1290,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,468.5,529.07,2
HCPCS,J1300,All drugs or drug agents without specific rate set forth above or herein,,,617.88,617.88,2
HCPCS,J1300,ECULIZUMAB 300 MG/30 ML IV SOLN,58706.91,38159.49,279.71,14761.0,11
HCPCS,J1300,"INJECTION, ECULIZUMAB, 10 MG",,,461.96,496.3,4
HCPCS,J1300,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,306.38,345.98,2
HCPCS,J1301,All drugs or drug agents without specific rate set forth above or herein,,,60.9,60.9,2
HCPCS,J1301,EDARAVONE 30 MG/100 ML IV SOLN,1465.56,952.61,27.57,14761.0,3
HCPCS,J1301,"Injection, edaravone, 1 mg",,,49.24,52.57,2
HCPCS,J1301,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.65,36.88,2
HCPCS,J1302,All drugs or drug agents without specific rate set forth above or herein,,,49.87,49.87,2
HCPCS,J1302,"Injection, sutimlimab-jome, 10 mg",,,39.07,46.67,4
HCPCS,J1302,SUTIMLIMAB-JOME 50 MG/ML IV SOLN,17258.47,11218.01,22.57,25.96,8
HCPCS,J1302,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.99,32.74,2
HCPCS,J1303,All drugs or drug agents without specific rate set forth above or herein,,,607.2,607.2,2
HCPCS,J1303,"Injection, ravulizumab-cwvz, 10 mg",,,568.97,607.47,2
HCPCS,J1303,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,137173.68,89162.89499999999,274.88,316.11,24
HCPCS,J1303,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,377.35,426.13,2
HCPCS,J1305,Drug,,,416.52,444.71,2
HCPCS,J1305,"Injection, evinacumab-dgnb, 5mg",,,393.94,393.94,2
HCPCS,J1305,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,276.24,311.95,2
HCPCS,J1306,All drugs or drug agents without specific rate set forth above or herein,,,33.52,33.52,2
HCPCS,J1306,INCLISIRAN 284 MG/1.5 ML SC SYRG,30426.75,19777.39,15.17,17.45,16
HCPCS,J1306,"INJECTION, INCLISIRAN, 1 MG",,,30.58,32.65,2
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,26.69,26.69,2
HCPCS,J1306,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.28,22.9,2
HCPCS,J1320,"INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG",,,21.08,22.5,2
HCPCS,J1320,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.98,15.79,2
HCPCS,J1322,All drugs or drug agents without specific rate set forth above or herein,,,808.45,808.45,2
HCPCS,J1322,"Injection, elosulfase alfa, 1 mg (For billing prior to 1/1/15 use C9022 or J3590)",,,569.42,607.95,2
HCPCS,J1322,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,377.64,426.46,2
HCPCS,J1324,"INJECTION, ENFUVIRTIDE, 1 MG ï",,,60.12,64.19,2
HCPCS,J1324,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,39.87,45.03,2
HCPCS,J1325,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1325,EPOPROSTENOL 0.5 MG IV SOLR,405.72,263.72,13270.0,14761.0,4
HCPCS,J1325,EPOPROSTENOL 1.5 MG IV SOLR,1967.3600000000001,1278.7849999999999,13270.0,14761.0,4
HCPCS,J1325,INJECTION EPOPROSTENOL 0.5MG,,,42.33,45.19,2
HCPCS,J1325,"Injection, epoprostenol, 0.5 mg (see J3490 or S0155 for billing epoprostenol diluent)",,,35.1,35.1,2
HCPCS,J1325,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.07,31.7,2
HCPCS,J1327,EPTIFIBATIDE 2 MG/ML IV SOLN,309.92,201.45,13270.0,14761.0,2
HCPCS,J1327,"INJECTION, EPTFIBATIDE, 5MG",,,339.3,362.26,2
HCPCS,J1327,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,225.03,254.12,2
HCPCS,J1330,"INJECTION, ERGONOVINE MALEATE, UP TO 0.2 MG",,,10.54,11.25,2
HCPCS,J1330,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.99,7.89,2
HCPCS,J1335,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1335,ERTAPENEM 1 GRAM IJ SOLR,462.12,300.375,13270.0,14761.0,14
HCPCS,J1335,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,745.36,484.48,,,0
HCPCS,J1335,"INJECTION, ERTAPENEM SODIUM, 500 MG",,,28.51,59.39,4
HCPCS,J1335,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,36.89,41.66,2
HCPCS,J1364,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,970.99,631.145,13270.0,14761.0,6
HCPCS,J1364,"INJECTION, ERTHROMYCIN LACTOBIONATE, PER 500 MG",,,8.64,9.22,2
HCPCS,J1364,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",,,177.62,177.62,2
HCPCS,J1364,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.73,6.47,2
HCPCS,J1380,"INJECTION, ESTRADIOL VALERATE, UP TO 10 MG",,,25.4,27.11,2
HCPCS,J1380,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.84,19.02,2
HCPCS,J1410,All drugs or drug agents without specific rate set forth above or herein,,,1052.9,1052.9,2
HCPCS,J1410,CONJUGATED ESTROGENS 25 MG IJ SOLR,5618.24,3651.86,476.64,14761.0,11
HCPCS,J1410,"INJECTION, ESTROGEN CONJUGATED, UP TO 25MG",,,132.85,141.84,2
HCPCS,J1410,"INJECTION, ESTROGENS, CONJUGATED, PER 25 MG",,,818.37,818.37,2
HCPCS,J1410,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.11,99.5,2
HCPCS,J1426,Drug,,,426.54,455.41,2
HCPCS,J1426,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,282.89,319.46,2
HCPCS,J1427,"Injection, viltolarsen, 10 mg",,,150.33,160.5,2
HCPCS,J1427,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,99.7,112.59,2
HCPCS,J1428,"Injection, eteplirsen, 10 mg (For billing prior to 1/1/18 use J3490 or C9484 for OPPS billing)",,,426.54,455.41,2
HCPCS,J1428,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,282.89,319.46,2
HCPCS,J1429,"Injection, golodirsen, 10 mg",,,426.47,455.33,2
HCPCS,J1429,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,282.84,319.4,2
HCPCS,J1430,All drugs or drug agents without specific rate set forth above or herein,,,1352.44,1352.44,2
HCPCS,J1430,"INJECTION, ETHANOLAMINE OLEATE, 100 MG",,,1042.22,1042.22,2
HCPCS,J1430,"INJECTION, ETHANOLAMINE OLEATE, 100 MG ï",,,149.96,160.1,2
HCPCS,J1430,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,99.45,112.31,2
HCPCS,J1435,"INJECTION, ESTRONE",,,2.42,2.58,2
HCPCS,J1435,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J1436,"INJECTION, ETIDRONATE DISODIUM, PER 300 MG",,,164.47,175.6,2
HCPCS,J1436,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,109.08,123.18,2
HCPCS,J1437,All drugs or drug agents without specific rate set forth above or herein,,,57.91,57.91,2
HCPCS,J1437,"Injection, ferric derisomaltose, 10 mg",,,65.67,70.12,2
HCPCS,J1437,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,43.56,49.19,2
HCPCS,J1438,All drugs or drug agents without specific rate set forth above or herein,,,2175.14,2175.14,2
HCPCS,J1438,ETANERCEPT 25 MG/0.5 ML SC SOLN,14206.4,9234.16,984.67,14761.0,3
HCPCS,J1438,ETANERCEPT 50 MG/ML (1 ML) SC SYRG,1465.56,952.61,984.67,14761.0,3
HCPCS,J1438,"INJECTION, ETANERCEPT, 25 MG",,,362.8,387.35,2
HCPCS,J1438,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,240.61,271.71,2
HCPCS,J1439,All drugs or drug agents without specific rate set forth above or herein,,,3.03,3.03,2
HCPCS,J1439,FERRIC CARBOXYMALTOSE 50 IRON MG/ML IV SOLN,12366.119999999999,8037.98,1.37,14761.0,11
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,3.11,3.32,2
HCPCS,J1439,"Injection, ferric carboxymaltose, 1 mg",,,2.52,2.52,2
HCPCS,J1439,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,J1440,All drugs or drug agents without specific rate set forth above or herein,20482.8,13313.82,174.11,174.11,2
HCPCS,J1440,HB FECAL MICROBIOTA PREP LIQ,20482.8,13313.82,78.82,14761.0,10
HCPCS,J1442,All drugs or drug agents without specific rate set forth above or herein,,,2.74,2.74,2
HCPCS,J1442,"INJECTION, FILGRASTIM (G-CSF), 1 MICROGRAM",,,2.59,2.77,2
HCPCS,J1442,"Injection, filgrastim (G-CSF), excludes biosimilars, 1 microgram",,,2.17,2.17,2
HCPCS,J1442,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J1443,"Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron",,,0.07,0.08,2
HCPCS,J1443,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.05,0.06,2
HCPCS,J1444,"Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron (This code would be used with the JE modifier, when administered via dialysate)",,,0.1,0.11,2
HCPCS,J1444,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.07,0.07,2
HCPCS,J1445,Drug,,,0.52,0.55,2
HCPCS,J1445,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J1446,TBO-FILGRASTIM 300 MCG SC SYRG,2234.88,1452.67,13270.0,14761.0,4
HCPCS,J1447,All drugs or drug agents without specific rate set forth above or herein,,,1.07,1.07,2
HCPCS,J1447,"INJECTION, TBO-FILGRASTIM, 1 MICROGRAM",,,0.95,0.95,2
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,2.25,2.4,2
HCPCS,J1447,TBO-FILGRASTIM 300 MCG SC SYRG,2234.88,1452.67,0.48,14761.0,6
HCPCS,J1447,TBO-FILGRASTIM 480 MCG SC SYRG,3576.64,2324.82,0.48,14761.0,6
HCPCS,J1447,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J1448,Drug,,,12.61,13.46,2
HCPCS,J1448,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.36,9.45,2
HCPCS,J1450,FLUCONAZOLE CUSTOM IVPB IN NACL,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J1450,FLUCONAZOLE CUSTOM IVPB IN NACL DOSES <=800 MG (CSMC),10974.18,7133.215,13270.0,14761.0,2
HCPCS,J1450,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,1465.56,952.61,13270.0,14761.0,4
HCPCS,J1450,FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK,290.0,188.5,,,0
HCPCS,J1450,"INJECTION, FLUCONAZOLE, 200 MG",,,6.15,6.15,2
HCPCS,J1450,"INJECTION, FLUCONAZOLE, 200MG",,,216.81,231.48,2
HCPCS,J1450,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,143.79,162.38,2
HCPCS,J1451,All drugs or drug agents without specific rate set forth above or herein,,,17.72,17.72,2
HCPCS,J1451,FOMEPIZOLE 1 G/ML IV SOLN,8398.08,5458.75,8.02,14761.0,3
HCPCS,J1451,"INJECTION, FOMEPIZOLE, 15 MG ï",,,2.94,3.14,2
HCPCS,J1451,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J1452,"INJECTION, FOMIVIRSEN SODIUM, INTRAOCULAR, 1.65MG",,,2468.05,2635.05,2
HCPCS,J1452,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1636.83,1848.44,2
HCPCS,J1453,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1453,FOSAPREPITANT 150 MG IV SOLR,482.48,313.61,13270.0,14761.0,16
HCPCS,J1453,"INJECTION, FOSAPREPITANT, 1 MG",,,0.3,4.61,4
HCPCS,J1453,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.86,3.23,2
HCPCS,J1454,All drugs or drug agents without specific rate set forth above or herein,,,1869.07,1869.07,2
HCPCS,J1454,"Injection, fosnetupitant 235 mg and palonosetron 0.25 mg",,,1359.45,1451.44,2
HCPCS,J1454,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,901.6,1018.15,2
HCPCS,J1455,All drugs or drug agents without specific rate set forth above or herein,,,138.4,138.4,2
HCPCS,J1455,FOSCARNET 24 MG/ML IV SOLN,5042.0,3277.3,62.65,14761.0,9
HCPCS,J1455,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",,,180.71,192.93,2
HCPCS,J1455,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,119.85,135.34,2
HCPCS,J1456,"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg",,,5.36,5.72,2
HCPCS,J1456,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J1457,"INJECTION, GALLIUM NITRATE, 1 MG",,,3.46,3.69,2
HCPCS,J1457,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J1458,"INJECTION, GALSULFASE, 1 MG ï",,,805.06,859.54,2
HCPCS,J1458,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,533.92,602.95,2
HCPCS,J1459,All drugs or drug agents without specific rate set forth above or herein,,,133.62,133.62,2
HCPCS,J1459,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,8964.8,5827.12,60.49,14761.0,84
HCPCS,J1459,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G LIQUID), 500 MG",,,106.2,106.2,2
HCPCS,J1459,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G.",,,120.07,128.19,2
HCPCS,J1459,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,79.63,89.92,2
HCPCS,J1460,All drugs or drug agents without specific rate set forth above or herein,,,137.12,137.12,2
HCPCS,J1460,"INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC",,,26.78,28.59,2
HCPCS,J1460,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.76,20.06,2
HCPCS,J1551,"INJECTION, IMMUNE GLOBULIN (CUTAQUIG), 100 MG",,,52.52,56.07,2
HCPCS,J1551,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.83,39.33,2
HCPCS,J1554,"Injection, immune globulin (asceniv), 500 mg",,,1211.44,1293.42,2
HCPCS,J1554,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,803.44,907.31,2
HCPCS,J1555,All drugs or drug agents without specific rate set forth above or herein,,,46.27,46.27,2
HCPCS,J1555,"Injection, immune globulin (Cuvitru), 100 mg (For billing prior to 1/1/18 use J3590 or C9399 for OPPS billing)",,,44.74,47.77,2
HCPCS,J1555,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,29.68,33.51,2
HCPCS,J1556,"INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG",,,162.22,173.2,2
HCPCS,J1556,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,107.59,121.5,2
HCPCS,J1557,All drugs or drug agents without specific rate set forth above or herein,,,159.33,159.33,2
HCPCS,J1557,"INJECTION, IMMUNE GLOBULIN, (GAMMAPLEX), INTRAVENOUS, NON- LYOPHILIZED (E.G.LIQUID), 500 MG",,,151.86,162.13,2
HCPCS,J1557,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,100.71,113.73,2
HCPCS,J1558,All drugs or drug agents without specific rate set forth above or herein,,,39.32,39.32,2
HCPCS,J1558,"Injection, immune globulin (xembify), 100 mg",,,45.58,48.67,2
HCPCS,J1558,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.23,34.14,2
HCPCS,J1559,All drugs or drug agents without specific rate set forth above or herein,,,36.4,36.4,2
HCPCS,J1559,"INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG",,,33.52,35.78,2
HCPCS,J1559,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.23,25.1,2
HCPCS,J1560,All drugs or drug agents without specific rate set forth above or herein,,,1371.24,1371.24,2
HCPCS,J1560,"INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC",,,98.65,105.32,2
HCPCS,J1560,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,65.42,73.88,2
HCPCS,J1561,All drugs or drug agents without specific rate set forth above or herein,,,134.24,134.24,2
HCPCS,J1561,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,20152.8,13099.32,60.77,14761.0,38
HCPCS,J1561,IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) IJ SOLN,22392.0,14554.8,60.77,69.89,8
HCPCS,J1561,IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) IJ SOLN,44784.0,29109.6,60.77,69.89,8
HCPCS,J1561,IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) IJ SOLN,13040.4,8476.26,60.77,69.89,16
HCPCS,J1561,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG",,,120.07,128.19,2
HCPCS,J1561,"Injection, immune globulin, (Gamunex-C/Gammaked), non-lyophilized (e.g. liquid), 500 mg",,,109.48,109.48,2
HCPCS,J1561,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,79.63,89.92,2
HCPCS,J1562,"INJECTION, IMMUNE GLOBULIN (VIVAGLOBIN), 100 MG",,,33.34,35.6,2
HCPCS,J1562,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.11,24.97,2
HCPCS,J1566,All drugs or drug agents without specific rate set forth above or herein,,,226.08,226.08,2
HCPCS,J1566,"INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED",,,98.82,105.51,2
HCPCS,J1566,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,65.54,74.01,2
HCPCS,J1568,All drugs or drug agents without specific rate set forth above or herein,,,134.77,134.77,2
HCPCS,J1568,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG",,,141.14,150.7,2
HCPCS,J1568,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.61,105.71,2
HCPCS,J1569,All drugs or drug agents without specific rate set forth above or herein,,,136.68,136.68,2
HCPCS,J1569,IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR,12725.775000000001,8271.755000000001,61.88,14761.0,22
HCPCS,J1569,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID),NON-LYOPHILIZED, (E. G.LIQUID), 500 MG",,,141.66,151.25,2
HCPCS,J1569,"Injection, immune globulin, (Gammagard liquid), non-lyophilized, (e.g. liquid), 500 mg",,,97.08,97.08,2
HCPCS,J1569,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.95,106.1,2
HCPCS,J1570,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J1570,GANCICLOVIR SODIUM 500 MG IV SOLR,609.48,396.16,13270.0,14761.0,10
HCPCS,J1570,"INJECTION, GANCICLOVIR SODIUM, 500 MG",,,98.79,98.79,2
HCPCS,J1570,"INJECTION, GANCICLOVIR SODIUM, CYTOVENE , 500 MG",,,86.03,91.86,2
HCPCS,J1570,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,57.06,64.44,2
HCPCS,J1571,All drugs or drug agents without specific rate set forth above or herein,,,188.85,188.85,2
HCPCS,J1571,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAMUSCULAR, 0.5 ML",,,173.11,184.82,2
HCPCS,J1571,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,114.81,129.65,2
HCPCS,J1572,All drugs or drug agents without specific rate set forth above or herein,,,154.35,154.35,2
HCPCS,J1572,"INJECTION, IMMUNE GLOBULIN, (FLEBOGAMMA), IV, NON-LYOPHILIZED (E.G. LIQUID), 500 MG",,,111.95,119.52,2
HCPCS,J1572,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,74.25,83.84,2
HCPCS,J1573,All drugs or drug agents without specific rate set forth above or herein,,,188.85,188.85,2
HCPCS,J1573,"INJECTION, HEP B IMMUNE GLOBULIN (HEPAGAM B), INTRAVENOUS, 0.5 ML",,,177.77,189.8,2
HCPCS,J1573,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,117.9,133.14,2
HCPCS,J1574,"Injection, ganciclovir sodium (exela) not therapeutically equivalent to j1570, 500 mg",,,133.2,142.21,2
HCPCS,J1574,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.34,99.76,2
HCPCS,J1575,All drugs or drug agents without specific rate set forth above or herein,,,48.14,48.14,2
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,46.99,50.17,2
HCPCS,J1575,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.16,35.19,2
HCPCS,J1580,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1580,GENTAMICIN 40 MG/ML IJ SOLN,330.91999999999996,215.1,13270.0,14761.0,8
HCPCS,J1580,GENTAMICIN IN NACL (ISO-OSM) 100 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J1580,GENTAMICIN IN NACL (ISO-OSM) 120 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J1580,GENTAMICIN IN NACL (ISO-OSM) 60 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J1580,GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J1580,GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J1580,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",,,5.89,10.51,4
HCPCS,J1580,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.53,7.38,2
HCPCS,J1595,All drugs or drug agents without specific rate set forth above or herein,,,475.54,475.54,2
HCPCS,J1595,"INJECTION, GLATIRAMER ACETATE, 20 MG",,,84.13,89.83,2
HCPCS,J1595,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.8,63.01,2
HCPCS,J1599,"INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), NOT OTHERWISE SPECIFIED, 500 MG",,,151.86,162.13,2
HCPCS,J1599,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,100.71,113.73,2
HCPCS,J1600,"INJECTION, GOLD SODIUM THIOMALEATE, UP TO 50 MG",,,26.26,28.04,2
HCPCS,J1600,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.42,19.67,2
HCPCS,J1602,All drugs or drug agents without specific rate set forth above or herein,,,30.53,30.53,2
HCPCS,J1602,GOLIMUMAB 12.5 MG/ML IV SOLN,16755.41,10891.02,13.82,15.89,8
HCPCS,J1602,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",,,61.33,65.48,2
HCPCS,J1602,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE (FOR BILLING PRIOR TO 1/1/14 USE C9399 OR J3590)",,,27.13,27.13,2
HCPCS,J1602,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.67,45.93,2
HCPCS,J1610,All drugs or drug agents without specific rate set forth above or herein,,,528.95,528.95,2
HCPCS,J1610,GLUCAGON 1 MG IJ SOLR,4380.48,2847.31,239.45,14761.0,30
HCPCS,J1610,GLUCAGON 1 MG/ML IJ SOLR,10974.18,7133.215,239.45,14761.0,30
HCPCS,J1610,GLUCAGON HCL 1 MG/ML IJ SOLR,1465.56,952.61,239.45,14761.0,3
HCPCS,J1610,INJECTION GLUCAGON HYDROCHLORIDE PER 1MG,,,107.11,114.36,2
HCPCS,J1610,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",,,414.22,414.22,2
HCPCS,J1610,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,71.04,80.22,2
HCPCS,J1611,"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg",,,443.13,473.11,2
HCPCS,J1611,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,293.89,331.88,2
HCPCS,J1620,"INJECTION, GONADORELIN HYDROCHLORIDE PER 100 MCG",,,472.33,504.29,2
HCPCS,J1620,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,313.25,353.75,2
HCPCS,J1626,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1626,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J1626,"INJECTION GRANISETRON HYDROCHLORIDE, 100 MCG",,,45.95,49.06,2
HCPCS,J1626,"INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG",,,0.84,0.84,2
HCPCS,J1626,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.48,34.42,2
HCPCS,J1627,All drugs or drug agents without specific rate set forth above or herein,,,15.69,15.69,2
HCPCS,J1627,"Injection, granisetron, extended-release, 0.1 mg (For billing prior to 1/1/18 use J3490 or C9486 for OPPS billing)",,,13.48,14.39,2
HCPCS,J1627,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.94,10.09,2
HCPCS,J1628,All drugs or drug agents without specific rate set forth above or herein,,,204.84,204.84,2
HCPCS,J1628,"Injection, guselkumab, 1 mg",,,270.71,289.03,2
HCPCS,J1628,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,179.54,202.75,2
HCPCS,J1630,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J1630,"INJECTION, HALOPERIDOL, UP TO 5 MG",,,3.13,19.92,4
HCPCS,J1630,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.37,13.97,2
HCPCS,J1631,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,735.68,478.19,13270.0,14761.0,2
HCPCS,J1631,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",,,19.3,85.58,4
HCPCS,J1631,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.16,60.04,2
HCPCS,J1632,"Injection, brexanolone, 1 mg",,,198.58,212.01,2
HCPCS,J1632,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,131.7,148.72,2
HCPCS,J1640,All drugs or drug agents without specific rate set forth above or herein,,,88.56,88.56,2
HCPCS,J1640,"INJECTION, HEMIN, 1 MG ï",,,17.79,19.0,2
HCPCS,J1640,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.8,13.33,2
HCPCS,J1642,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1642,HEPARIN BOLUS INJECTION-PEDIATRIC,1465.56,952.61,13270.0,14761.0,4
HCPCS,J1642,"HEPARIN, PORCINE (PF) 1 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
HCPCS,J1642,"HEPARIN, PORCINE (PF) 10 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,4
HCPCS,J1642,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",1465.56,952.61,13270.0,14761.0,8
HCPCS,J1642,"Injection, heparin sodium (heparin lock flush), per 10 units",,,0.05,0.05,2
HCPCS,J1642,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J1643,"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units",,,0.86,0.92,2
HCPCS,J1643,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J1644,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1644,HEPARIN (PORCINE) 1000 UNIT/ML IJ SOLN,290.0,188.5,,,0
HCPCS,J1644,HEPARIN (PORCINE) 1000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J1644,HEPARIN (PORCINE) 10000 UNITS/ML IJ SOLN,290.0,188.5,,,0
HCPCS,J1644,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,26
HCPCS,J1644,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",1465.56,952.61,13270.0,14761.0,2
HCPCS,J1644,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,290.0,188.5,13270.0,14761.0,6
HCPCS,J1644,"HEPARIN 20,000 UNITS/20 ML SYRINGE FOR CRRT DIALYSIS",290.0,188.5,13270.0,14761.0,2
HCPCS,J1644,HEPARIN BOLUS FOR ACS PROTOCOL,1465.56,952.61,13270.0,14761.0,12
HCPCS,J1644,HEPARIN FLUSH INFUSION FOR THROMBOLYSIS (5 UNITS/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J1644,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,8
HCPCS,J1644,HEPARIN SOLUTION 2 UNITS/ML FOR FLUSH INTRAPROCEDURE (CATH LAB ONLY),290.0,188.5,13270.0,14761.0,4
HCPCS,J1644,HEPARIN SOLUTION 5 UNITS/ML FOR INSTRUMENT WASH/RINSE FOR INTRAPROCEDURE (IR ONLY),290.0,188.5,,,0
HCPCS,J1644,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,8
HCPCS,J1644,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN (ADULT FLUSH)",290.0,188.5,,,0
HCPCS,J1644,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN FOR INTRACATHETER",290.0,188.5,13270.0,14761.0,2
HCPCS,J1644,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",1465.56,952.61,13270.0,14761.0,10
HCPCS,J1644,"HEPARIN, PORCINE (PF) 5000 UNIT/0.5 ML IJ SYRG",290.0,188.5,13270.0,14761.0,2
HCPCS,J1644,"HEPARIN, PORCINE (PF) 5000 UNITS/ML IJ SYRG",20482.8,13313.82,,,0
HCPCS,J1644,"INJECTION HEPARIN SODIUM PER 1,000 UNITS",,,1.9,2.03,2
HCPCS,J1644,"Injection, heparin sodium, per 1,000 units",,,0.58,0.58,2
HCPCS,J1644,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.26,1.42,2
HCPCS,J1645,"DALTEPARIN (PORCINE) 10,000 ANTI-XA UNIT/ML SC SYRG",20482.8,13313.82,,,0
HCPCS,J1645,INJECTION DALTEPARIN SODIUM PER 2500 IU,,,344.31,367.61,2
HCPCS,J1645,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,228.35,257.87,2
HCPCS,J1650,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1650,ENOXAPARIN 100 MG/ML IV CUSTOM,290.0,188.5,13270.0,14761.0,2
HCPCS,J1650,ENOXAPARIN 100 MG/ML SC SYRG,370.24,240.66,13270.0,14761.0,6
HCPCS,J1650,ENOXAPARIN 120 MG/0.8 ML SC SYRG,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J1650,ENOXAPARIN 150 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,6
HCPCS,J1650,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,J1650,ENOXAPARIN 40 MG/0.4 ML SC SYRG,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J1650,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,6
HCPCS,J1650,ENOXAPARIN 80 MG/0.8 ML SC SYRG,10386.4,6751.16,13270.0,14761.0,2
HCPCS,J1650,"INJECTION, ENOXAPARIN SODIUM 10 MG",,,38.35,40.95,2
HCPCS,J1650,"INJECTION, ENOXAPARIN SODIUM, 10 MG",,,1.49,1.49,2
HCPCS,J1650,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25.44,28.72,2
HCPCS,J1652,FONDAPARINUX 10 MG/0.8 ML SC SYRG,557.185,362.17,13270.0,14761.0,4
HCPCS,J1652,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,6
HCPCS,J1652,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,549.88,357.42,13270.0,14761.0,6
HCPCS,J1652,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",,,2.4,20.66,4
HCPCS,J1652,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.83,14.49,2
HCPCS,J1655,"INJECTION, TINZAPARIN SODIUM, 1000 UNITS",,,10.02,10.7,2
HCPCS,J1655,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.65,7.5,2
HCPCS,J1670,All drugs or drug agents without specific rate set forth above or herein,,,1600.25,1600.25,2
HCPCS,J1670,"INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS",,,266.57,1272.4,4
HCPCS,J1670,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,724.42,14761.0,11
HCPCS,J1670,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,176.79,199.65,2
HCPCS,J1675,"INJECTION, HISTRELIN ACETATE, 10 MICROGRAMS ï",,,11616.9,12402.97,2
HCPCS,J1675,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7704.43,8700.44,2
HCPCS,J1700,"INJECTION, HYDROCORTISONE ACETATE, UP TO 25 MG",,,23.5,25.09,2
HCPCS,J1700,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.58,17.6,2
HCPCS,J1710,"INJECTION, HYDROCORTONE SODIUM PHOSPHATE, UP TO 50 MG",,,23.5,25.09,2
HCPCS,J1710,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.58,17.6,2
HCPCS,J1720,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1720,HYDROCORTISONE 50 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J1720,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML IJ SOLR,337.92,219.65,13270.0,14761.0,2
HCPCS,J1720,HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML IJ SOLR,1237.76,804.54,13270.0,14761.0,2
HCPCS,J1720,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",,,8.12,39.23,4
HCPCS,J1720,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.39,6.08,2
HCPCS,J1726,All drugs or drug agents without specific rate set forth above or herein,,,39.76,39.76,2
HCPCS,J1726,"Injection, hydroxyprogesterone caproate, (Makena), 10 mg (For billing prior 1/1/18 use J1725 or Q9986)",,,81.54,87.06,2
HCPCS,J1726,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.08,61.07,2
HCPCS,J1729,"Injection, hydroxyprogesterone caproate, Not Otherwise Specified, 10 mg (For billing prior to 1/1/18 use J3490 or Q9985)",,,41.12,43.9,2
HCPCS,J1729,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.27,30.79,2
HCPCS,J1730,"INJECTION, DIAZOXIDE, UP TO 300 MG",,,287.47,306.92,2
HCPCS,J1730,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,190.65,215.3,2
HCPCS,J1738,"Injection, meloxicam, 1 mg",,,8.34,8.91,2
HCPCS,J1738,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.53,6.25,2
HCPCS,J1740,IBANDRONATE 3 MG/3 ML IV SYRG,3652.32,2374.01,,,0
HCPCS,J1740,"INJECTION, IBANDRONATE SODIUM, 1 MG",,,56.3,56.3,2
HCPCS,J1740,"INJECTION, IBANDRONATE SODIUM, 1 MG ï",,,373.68,398.97,2
HCPCS,J1740,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,247.83,279.87,2
HCPCS,J1741,"INJECTION, IBUPROFEN, 100 MG",,,35.76,38.18,2
HCPCS,J1741,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.72,26.78,2
HCPCS,J1742,All drugs or drug agents without specific rate set forth above or herein,,,664.01,664.01,2
HCPCS,J1742,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1312.8,853.32,300.59,14761.0,11
HCPCS,J1742,"INJECTION IBUTILIDE FUMARATE, 1 MG",,,612.09,653.51,2
HCPCS,J1742,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,405.94,458.42,2
HCPCS,J1743,All drugs or drug agents without specific rate set forth above or herein,,,1479.63,1479.63,2
HCPCS,J1743,"INJECTION, IDURSULFASE, 1 MG",,,1193.92,1193.92,2
HCPCS,J1743,"INJECTION, IDURSULFASE, 1 MG ï",,,1216.23,1298.53,2
HCPCS,J1743,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,806.62,910.89,2
HCPCS,J1744,All drugs or drug agents without specific rate set forth above or herein,,,417.11,417.11,2
HCPCS,J1744,ICATIBANT 30 MG/3 ML SC SYRG,14446.755000000001,9390.39,188.82,14761.0,6
HCPCS,J1744,"INJECTION, ICATIBANT, 1 MG",,,604.14,645.02,2
HCPCS,J1744,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,400.67,452.47,2
HCPCS,J1745,All drugs or drug agents without specific rate set forth above or herein,,,88.63,88.63,2
HCPCS,J1745,INFLIXIMAB 100 MG IV SOLR,9243.92,6008.545,40.12,14761.0,11
HCPCS,J1745,"INJECTION, INFLIXIMAB, 10MG",,,158.42,169.14,2
HCPCS,J1745,"Injection, infliximab, excludes biosimilar, 10 mg (Code is to be used for Remicade or Infliximab)",,,70.72,70.72,2
HCPCS,J1745,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,105.07,118.65,2
HCPCS,J1746,All drugs or drug agents without specific rate set forth above or herein,,,211.97,211.97,2
HCPCS,J1746,"Injection, ibalizumab-uiyk, 10 mg",,,151.34,161.58,2
HCPCS,J1746,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,100.37,113.34,2
HCPCS,J1750,All drugs or drug agents without specific rate set forth above or herein,,,48.6,48.6,2
HCPCS,J1750,IRON DEXTRAN 50 MG/ML IJ SOLN,529.06,343.89,22.0,14761.0,22
HCPCS,J1750,"Injection, iron dextran, 50 mg (Code reinstated effective 1/1/09)",,,38.08,44.64,4
HCPCS,J1750,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.73,31.31,2
HCPCS,J1756,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1756,"INJECTION, IRON SUCROSE, 1 MG",,,0.49,1.66,4
HCPCS,J1756,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,663.9,431.54,13270.0,14761.0,6
HCPCS,J1756,IRON SUCROSE 200 MG IRON/10 ML IV SOLN,863.2,561.0799999999999,13270.0,14761.0,2
HCPCS,J1756,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.03,1.16,2
HCPCS,J1786,All drugs or drug agents without specific rate set forth above or herein,,,119.97,119.97,2
HCPCS,J1786,IMIGLUCERASE 400 UNITS IV SOLR,13873.04,9017.48,54.31,62.46,8
HCPCS,J1786,"INJECTION, IMIGLUCERASE, 10 UNITS",,,105.73,112.88,2
HCPCS,J1786,"Injection, imiglucerase, 10 units",,,96.8,96.8,2
HCPCS,J1786,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,70.12,79.19,2
HCPCS,J1790,"INJECTION, DROPERIDOL, UP TO 5 MG",,,13.13,14.02,2
HCPCS,J1790,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.71,9.83,2
HCPCS,J1800,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",,,23.67,25.27,2
HCPCS,J1800,PROPRANOLOL 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J1800,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.7,17.73,2
HCPCS,J1805,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1805,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J1810,"INJECTION, DROPERIDOL AND FENTANYL CITRATE, UP TO 2 ML AMPULE",,,37.66,40.21,2
HCPCS,J1810,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.98,28.21,2
HCPCS,J1815,"INJECTION, INSULIN, PER 5 UNITS",,,0.35,0.37,2
HCPCS,J1815,INSULIN ASPART U-100 100 UNITS/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J1815,INSULIN GLARGINE 100 UNITS/ML SC SOLN,914.24,594.26,13270.0,14761.0,2
HCPCS,J1815,INSULIN GLULISINE U-100 100 UNITS/ML SC SOLN,1257.28,817.23,13270.0,14761.0,2
HCPCS,J1815,INSULIN LISPRO 100 UNITS/ML SC CRTG,1465.56,952.61,13270.0,14761.0,2
HCPCS,J1815,INSULIN LISPRO 100 UNITS/ML SC SOLN,767.84,499.1,13270.0,14761.0,6
HCPCS,J1815,INSULIN LISPRO 100 UNITS/ML SC SOLN (SLIDING SCALE),,,,,0
HCPCS,J1815,INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) SC SUSP,767.84,499.1,13270.0,14761.0,2
HCPCS,J1815,INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SC SUSP,290.0,188.5,13270.0,14761.0,4
HCPCS,J1815,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J1815,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J1815,INSULIN REGULAR HUMAN 100 UNITS/ML IJ SOLN,405.88,263.82,13270.0,14761.0,4
HCPCS,J1815,Other Outpatient Services,293.49,190.76999999999998,,,0
HCPCS,J1815,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J1817,"INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS",,,7.77,8.3,2
HCPCS,J1817,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.16,5.82,2
HCPCS,J1823,"Injection, inebilizumab-cdon, 1 mg",,,1163.88,1242.64,2
HCPCS,J1823,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,771.9,871.69,2
HCPCS,J1826,All drugs or drug agents without specific rate set forth above or herein,,,6060.0,6060.0,2
HCPCS,J1826,"INJECTION, INTERFERON BETA-1A, 30 MCG",,,1815.19,1938.02,2
HCPCS,J1826,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1203.85,1359.48,2
HCPCS,J1830,INJECTION INTERFERON BETA 1B PER .25MG,,,188.65,201.42,2
HCPCS,J1830,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J1830,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,125.12,141.29,2
HCPCS,J1833,All drugs or drug agents without specific rate set forth above or herein,,,2.7,2.7,2
HCPCS,J1833,ISAVUCONAZONIUM SULFATE 372 MG IV SOLR,3582.9399999999996,2328.91,1.22,14761.0,6
HCPCS,J1833,"Injection, isavuconazonium sulfate, 1 mg (For billing prior to 1/1/16 use C9456 or J3490)",,,1.73,1.84,2
HCPCS,J1833,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J1835,"INJECTION, ITRAXONAZOLE, 50MG",,,91.39,97.57,2
HCPCS,J1835,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,60.61,68.45,2
HCPCS,J1840,"INJECTION, KANAMYCIN SULFATE, UP TO 500 MG",,,27.3,29.14,2
HCPCS,J1840,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.1,20.44,2
HCPCS,J1850,"INJECTION, KANAMYCIN SULFATE, UP TO 75 MG",,,11.92,12.73,2
HCPCS,J1850,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.91,8.93,2
HCPCS,J1885,All drugs or drug agents without specific rate set forth above or herein,,,1.88,1.88,2
HCPCS,J1885,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",,,1.07,23.98,4
HCPCS,J1885,KETOROLAC 15 MG/ML IJ SOLN,20482.8,13313.82,0.85,0.98,8
HCPCS,J1885,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,1465.56,952.61,0.85,14761.0,65
HCPCS,J1885,KETOROLAC 30 MG/ML IV PEDIATRIC,1465.56,952.61,0.85,14761.0,50
HCPCS,J1885,KETOROLAC 60 MG/2 ML IM SOLN,20482.8,13313.82,0.85,0.98,8
HCPCS,J1885,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.89,16.82,2
HCPCS,J1890,"INJECTION, CEPHALOTHIN SODIUM, UP TO 1 GRAM",,,24.01,25.64,2
HCPCS,J1890,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.93,17.98,2
HCPCS,J1930,All drugs or drug agents without specific rate set forth above or herein,,,137.45,137.45,2
HCPCS,J1930,"INJECTION, LANREOTIDE, 1 MG",,,69.8,74.52,2
HCPCS,J1930,"Injection, lanreotide, 1 mg (Code re-used by CMS effective 1/1/2009)",,,106.52,106.52,2
HCPCS,J1930,LANREOTIDE 120 MG/0.5 ML SC SYRG,86058.0,55937.7,62.22,14761.0,11
HCPCS,J1930,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,46.29,52.27,2
HCPCS,J1931,All drugs or drug agents without specific rate set forth above or herein,,,106.44,106.44,2
HCPCS,J1931,"INJECTION, LARONIDASE, 0.1 MG",,,59.6,63.64,2
HCPCS,J1931,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,39.53,44.64,2
HCPCS,J1932,"Injection, lanreotide, (cipla), 1 mg",,,197.46,210.83,2
HCPCS,J1932,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,130.96,147.89,2
HCPCS,J1940,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1940,FUROSEMIDE 10 MG/ML IJ SOLN,10386.4,6751.16,13270.0,14761.0,22
HCPCS,J1940,FUROSEMIDE 20 MG HALF-TAB = 10 MG,,,13270.0,14761.0,2
HCPCS,J1940,"INJECTION, FUROSEMIDE, UP TO 20 MG",,,1.26,2.95,4
HCPCS,J1940,Other Outpatient Services,,,,,0
HCPCS,J1940,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.83,2.07,2
HCPCS,J1943,All drugs or drug agents without specific rate set forth above or herein,,,8.78,8.78,2
HCPCS,J1943,"Injection, aripiprazole lauroxil, (aristada initio), 1 mg",,,8.29,8.85,2
HCPCS,J1943,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.5,6.21,2
HCPCS,J1944,All drugs or drug agents without specific rate set forth above or herein,,,8.88,8.88,2
HCPCS,J1944,"Injection, aripiprazole lauroxil, (aristada), 1 mg",,,8.29,8.85,2
HCPCS,J1944,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.5,6.21,2
HCPCS,J1945,"INJECTION, LEPIRUDIN, 50 MG ï",,,323.41,345.29,2
HCPCS,J1945,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,214.49,242.21,2
HCPCS,J1950,All drugs or drug agents without specific rate set forth above or herein,,,4449.53,4449.53,2
HCPCS,J1950,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",,,1197.4,3440.65,4
HCPCS,J1950,LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT,45308.88,29450.77,2014.27,2316.42,8
HCPCS,J1950,LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT,98955.63,64321.16,2014.27,2316.42,8
HCPCS,J1950,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,108989.73,70843.32,2014.27,2316.42,8
HCPCS,J1950,LEUPROLIDE 3.75 MG IM SYKT,15102.81,9816.83,2014.27,14761.0,11
HCPCS,J1950,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,794.13,896.79,2
HCPCS,J1951,Drug,,,334.29,356.91,2
HCPCS,J1951,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,221.7,250.37,2
HCPCS,J1952,"LEUPROLIDE INJECTABLE, CAMCEVI, 1 MG",,,247.57,264.32,2
HCPCS,J1952,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,164.19,185.41,2
HCPCS,J1953,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1953,"INJECTION, LEVETIRACETAM, 10 MG",,,0.15,2.03,4
HCPCS,J1953,LEVETIRACETAM 500 MG/5 ML IV SOLN,1465.56,952.61,13270.0,14761.0,18
HCPCS,J1953,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
HCPCS,J1953,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.26,1.42,2
HCPCS,J1954,"Injection, linezolid (hospira) not therapeutically equivalent to j2020, 200 mg",,,1203.96,1285.43,2
HCPCS,J1954,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,798.48,901.7,2
HCPCS,J1955,"INJECTION LEVOCARNITINE, PER 1 GRAM",,,94.85,101.26,2
HCPCS,J1955,"INJECTION, LEVOCARNITINE, PER 1 G",,,77.67,77.67,2
HCPCS,J1955,LEVOCARNITINE 200 MG/ML IV SOLN,579.52,376.69,13270.0,14761.0,2
HCPCS,J1955,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,62.9,71.03,2
HCPCS,J1956,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J1956,"INJECTION LEVOFLOXACIN, 250MG",,,48.89,52.2,2
HCPCS,J1956,"INJECTION, LEVOFLOXACIN, 250 MG",,,2.0,2.0,2
HCPCS,J1956,LEVOFLOXACIN 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J1956,LEVOFLOXACIN 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J1956,LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J1956,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J1956,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
HCPCS,J1956,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.43,36.62,2
HCPCS,J1960,"INJECTION, LEVORPHANOL TARTRATE, UP TO 2 MG",,,8.98,9.59,2
HCPCS,J1960,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.96,6.73,2
HCPCS,J1980,"INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG",,,19.35,20.66,2
HCPCS,J1980,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.83,14.49,2
HCPCS,J1990,"INJECTION, CHLORDIAZEPOXIDE HCL, UP TO 100 MG",,,58.57,62.53,2
HCPCS,J1990,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,38.84,43.86,2
HCPCS,J2001,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2001,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",,,0.07,2.03,4
HCPCS,J2001,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),877.78,570.5550000000001,13270.0,14761.0,22
HCPCS,J2001,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY BLUE TRAY,290.0,188.5,,,0
HCPCS,J2001,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY WHITE TRAY,,,,,0
HCPCS,J2001,LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE (PF) 40 MG/ML (4 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE 1% (BUFFERED) INJ. SOLUTION,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE 10 MG/ML (1 %) IJ SOLN (CC),290.0,188.5,13270.0,14761.0,4
HCPCS,J2001,LIDOCAINE HCL 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,LIDOCAINE IN 5 % DEXTROSE (PF) 4 MG/ML (0.4 %) IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J2001,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.26,1.42,2
HCPCS,J2010,"INJECTION, LINCOMYCIN HCL, UP TO 300 MG",,,12.61,13.46,2
HCPCS,J2010,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.36,9.45,2
HCPCS,J2020,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2020,"INJECTION, LINEZOLID, 200 MG",,,7.25,7.25,2
HCPCS,J2020,"INJECTION, LINEZOLID, 200MGS",,,94.15,100.53,2
HCPCS,J2020,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,374.4,243.36,13270.0,14761.0,10
HCPCS,J2020,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,62.44,70.52,2
HCPCS,J2021,"Injection, linezolid (hospira) not therapeutically equivalent to j2020, 200 mg",,,56.32,60.13,2
HCPCS,J2021,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,37.35,42.18,2
HCPCS,J2060,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2060,"INJECTION, LORAZEPAM, (ATIVAN) 2 MG",,,29.71,31.73,2
HCPCS,J2060,"INJECTION, LORAZEPAM, 2 MG",,,2.47,2.47,2
HCPCS,J2060,LORAZEPAM 2 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J2060,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.71,22.25,2
HCPCS,J2062,"Loxapine for inhalation, 1 mg",,,39.91,42.61,2
HCPCS,J2062,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.47,29.89,2
HCPCS,J2150,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2150,"INJECTION, MANNITOL, 25% IN 50 ML",,,5.71,11.99,4
HCPCS,J2150,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J2150,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.45,8.41,2
HCPCS,J2170,"INJECTION, MECASERMIN, 1 MG ï",,,31.27,33.39,2
HCPCS,J2170,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.74,23.42,2
HCPCS,J2175,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",,,16.06,16.06,2
HCPCS,J2175,"INJECTION, MEPERIDINE PER 100 MG",,,1.55,1.66,2
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML IJ SOLN,290.0,188.5,,,0
HCPCS,J2175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.03,1.16,2
HCPCS,J2180,"INJECTION, MEPERIDINE AND PROMETHAZINE HCL, UP TO 50 MG",,,20.39,21.77,2
HCPCS,J2180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.52,15.27,2
HCPCS,J2182,All drugs or drug agents without specific rate set forth above or herein,,,83.72,83.72,2
HCPCS,J2182,"Injection, mepolizumab, 1 mg",,,68.59,73.23,2
HCPCS,J2182,"Injection, mepolizumab, 1 mg (For billing prior to 1/1/17 use J3590 or C9473 for OPPS billing)",,,67.08,67.08,2
HCPCS,J2182,MEPOLIZUMAB 100 MG SC SOLR,27498.06,17873.74,37.9,43.58,8
HCPCS,J2182,MEPOLIZUMAB 100 MG/ML SC SYRG,20482.8,13313.82,37.9,43.58,8
HCPCS,J2182,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,45.49,51.37,2
HCPCS,J2184,"Injection, meropenem (b. braun) not therapeutically equivalent to j2185, 100 mg",,,9.5,10.14,2
HCPCS,J2184,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.3,7.12,2
HCPCS,J2185,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2185,"INJECTION, MEROPENEM, 100 MG",,,1.0,13.65,4
HCPCS,J2185,MEROPENEM 1 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,8
HCPCS,J2185,MEROPENEM 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,8
HCPCS,J2185,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.48,9.57,2
HCPCS,J2186,All drugs or drug agents without specific rate set forth above or herein,,,5.76,5.76,2
HCPCS,J2186,"Injection, meropenem and vaborbactam, 10mg/10mg, (20mg)",,,4.32,4.61,2
HCPCS,J2186,MEROPENEM-VABORBACTAM 2 GRAM IV SOLR,3110.4,2021.76,2.61,14761.0,6
HCPCS,J2186,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.86,3.23,2
HCPCS,J2210,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2210,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",,,9.16,43.1,4
HCPCS,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,304.255,197.765,13270.0,14761.0,6
HCPCS,J2210,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.07,6.86,2
HCPCS,J2212,"INJECTION, METHYLNALTREXONE, 0.1 MG",,,1.04,1.11,2
HCPCS,J2212,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.6800000000003,1553.29,13270.0,14761.0,4
HCPCS,J2212,METHYLNALTREXONE 8 MG/0.4 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,2
HCPCS,J2212,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J2247,"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg",,,3.97,4.24,2
HCPCS,J2247,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.64,2.98,2
HCPCS,J2248,"INJECTION, MICAFUNGIN SODIUM, 1 MG",,,1.66,1.66,2
HCPCS,J2248,"INJECTION, MICAFUNGIN SODIUM, 1 MG ï",,,5.36,5.72,2
HCPCS,J2248,MICAFUNGIN 100 MG IV SOLR,432.32,281.01,13270.0,14761.0,10
HCPCS,J2248,MICAFUNGIN 100 MG/100 ML D5W VIAL-TO-BAG IVPB,2787.68,1811.99,13270.0,14761.0,2
HCPCS,J2248,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J2250,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2250,"INJECTION, MIDAZOLAM HYDROCHLORIDE PER 1 MG",,,2.25,2.4,2
HCPCS,J2250,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",,,0.3,0.3,2
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2250,MIDAZOLAM (PF) 5 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J2250,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J2250,MIDAZOLAM 1 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,20
HCPCS,J2250,MIDAZOLAM 5 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,14
HCPCS,J2250,MORPHINE INJECTION - PEDS < 1 YEAR,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J2250,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J2251,"Injection, midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250, per 1 mg",,,1.04,1.11,2
HCPCS,J2251,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J2260,"INJECTION, MILRINONE LACTATE, PER 5 MG",,,3.43,3.43,2
HCPCS,J2260,"INJECTION, MILRIONONE LACTATE 5 ML",,,83.44,89.09,2
HCPCS,J2260,MILRINONE 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J2260,MILRINONE IN 0.9% NACL 20 MG/50 ML (0.4 MG/ML) INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
HCPCS,J2260,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J2260,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,20482.8,13313.82,,,0
HCPCS,J2260,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.34,62.49,2
HCPCS,J2265,All drugs or drug agents without specific rate set forth above or herein,,,7.12,7.12,2
HCPCS,J2265,"INJECTION, MINOCYCLINE HYDROCHLORIDE, 1 MG",,,1.38,1.48,2
HCPCS,J2265,MINOCYCLINE 100 MG IV SOLR,4008.0,2605.2,3.22,14761.0,6
HCPCS,J2265,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.92,1.04,2
HCPCS,J2270,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2270,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",,,1.73,1.84,2
HCPCS,J2270,"Injection, morphine sulfate, up to 10 mg (Code Price is per 10 mg)",,,10.26,10.26,2
HCPCS,J2270,MORPHINE (PF) 30 MG/30 ML (1 MG/ML) IV PCAS,290.0,188.5,13270.0,14761.0,4
HCPCS,J2270,MORPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2270,MORPHINE 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2270,MORPHINE 2 MG/ML IV SYRG,1465.56,952.61,13270.0,14761.0,6
HCPCS,J2270,MORPHINE 25 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J2270,MORPHINE 4 MG/ML IJ SYRG,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J2270,MORPHINE 4 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J2270,MORPHINE 5 MG/ML HIGH DOSE PCA CONTINUOUS DOSE(BASAL),,,13270.0,14761.0,2
HCPCS,J2270,MORPHINE 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J2270,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J2272,"Injection, morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270, up to 10 mg",,,8.12,8.67,2
HCPCS,J2272,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.39,6.08,2
HCPCS,J2274,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2274,In morphine preservativ free,,,31.1,33.2,2
HCPCS,J2274,"Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg",,,24.73,24.73,2
HCPCS,J2274,MORPHINE (PF) 0.5 MG/ML IJ SOLN,360.68,234.44,13270.0,14761.0,8
HCPCS,J2274,MORPHINE (PF) 1 MG/ML IJ SOLN,431.36,280.38,13270.0,14761.0,6
HCPCS,J2274,MORPHINE (PF) 25 MG/ML IJ SOLN,4996.799999999999,3247.92,13270.0,14761.0,2
HCPCS,J2274,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.62,23.29,2
HCPCS,J2278,All drugs or drug agents without specific rate set forth above or herein,,,26.54,26.54,2
HCPCS,J2278,"INJECTION, ZICONOTIDE, 1 MICROGRAM",,,19.88,19.88,2
HCPCS,J2278,"INJECTION, ZICONOTIDE, 1 MICROGRAM ï",,,17.28,18.45,2
HCPCS,J2278,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.46,12.94,2
HCPCS,J2280,"INJECTION, MOXIFLOXACIN, 100 MG",,,20.72,26.01,4
HCPCS,J2280,MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML IV PGBK,656.0,426.4,13270.0,14761.0,2
HCPCS,J2280,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.16,18.24,2
HCPCS,J2281,"Injection, moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280, 100 mg",,,30.58,32.65,2
HCPCS,J2281,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.28,22.9,2
HCPCS,J2300,"INJECTION, NALBUPHINE HCL PER MG",,,42.15,45.01,2
HCPCS,J2300,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",,,6.17,6.17,2
HCPCS,J2300,NALBUPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2300,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.96,31.57,2
HCPCS,J2310,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2310,"INJECTION, NALOXONE HYDROCHLORIDE PER 1 MG",,,10.54,11.25,2
HCPCS,J2310,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",,,16.04,16.04,2
HCPCS,J2310,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J2310,NALOXONE 0.4 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
HCPCS,J2310,NALOXONE 1 MG/ML IJ SYRG,301.15999999999997,195.755,13270.0,14761.0,8
HCPCS,J2310,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.99,7.89,2
HCPCS,J2311,"Injection, naloxone hydrochloride (zimhi), 1 mg",,,33.34,35.6,2
HCPCS,J2311,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.11,24.97,2
HCPCS,J2315,All drugs or drug agents without specific rate set forth above or herein,,,11.32,11.32,2
HCPCS,J2315,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",,,5.18,5.53,2
HCPCS,J2315,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.44,3.88,2
HCPCS,J2320,"INJECTION, NANDROLONE DECANOATE, UP TO 50 MG",,,16.41,17.52,2
HCPCS,J2320,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.88,12.29,2
HCPCS,J2323,All drugs or drug agents without specific rate set forth above or herein,,,66.44,66.44,2
HCPCS,J2323,"INJECTION, NATALIZUMAB, 1 MG",,,53.78,53.78,2
HCPCS,J2323,"INJECTION, NATALIZUMAB, 1MG",,,20.21,21.58,2
HCPCS,J2323,NATALIZUMAB 300 MG/15 ML IV SOLN,68301.72,44396.12,30.08,34.59,8
HCPCS,J2323,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.41,15.14,2
HCPCS,J2325,"INJECTION, NESIRITIDE, 0.1 MG ï",,,75.15,80.24,2
HCPCS,J2325,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,49.84,56.28,2
HCPCS,J2326,All drugs or drug agents without specific rate set forth above or herein,,,3388.49,3388.49,2
HCPCS,J2326,"Injection, nusinersen, 0.1 mg (For billing prior to 1/1/18 use J3490 or C9489 for OPPS billing)",,,2776.43,2964.3,2
HCPCS,J2326,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1841.35,2079.39,2
HCPCS,J2327,All drugs or drug agents without specific rate set forth above or herein,,,40.25,40.25,2
HCPCS,J2327,"Injection, risankizumab-rzaa, intravenous, 1 mg",,,33.77,43.35,4
HCPCS,J2327,RISANKIZUMAB-RZAA 60 MG/ML IV SOLN,86978.16,56535.8,18.22,20.95,8
HCPCS,J2327,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.93,30.41,2
HCPCS,J2350,All drugs or drug agents without specific rate set forth above or herein,,,164.48,164.48,2
HCPCS,J2350,"Injection, ocrelizumab, 1 mg (For billing prior to 1/1/18 use J3590 or C9494 for OPPS billing) (Code re-used by CMS 1/1/18)",,,131.4,154.2,4
HCPCS,J2350,OCRELIZUMAB 30 MG/ML IV SOLN,185768.64,120749.62,74.46,14761.0,11
HCPCS,J2350,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,95.79,108.17,2
HCPCS,J2353,All drugs or drug agents without specific rate set forth above or herein,,,591.06,591.06,2
HCPCS,J2353,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",,,216.81,463.63,4
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 10 MG IM SSRR",25999.68,16899.79,267.57,307.71,8
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 20 MG IM SSRR",34064.0,22141.6,267.57,14761.0,14
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 30 MG IM SSRR",51008.16,33155.3,267.57,14761.0,19
HCPCS,J2353,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,143.79,162.38,2
HCPCS,J2354,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",,,2.61,12.73,4
HCPCS,J2354,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,12
HCPCS,J2354,OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN,330.08000000000004,214.555,13270.0,14761.0,4
HCPCS,J2354,OCTREOTIDE ACETATE 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2354,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J2354,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.91,8.93,2
HCPCS,J2355,"INJECTION OPRELVEKIN, 5MG",,,600.17,640.78,2
HCPCS,J2355,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,398.04,449.49,2
HCPCS,J2356,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",,,46.13,49.25,2
HCPCS,J2356,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.59,34.55,2
HCPCS,J2357,All drugs or drug agents without specific rate set forth above or herein,,,105.33,105.33,2
HCPCS,J2357,"INJECTION, OMALIZUMAB, 5 MG",,,42.15,86.79,4
HCPCS,J2357,OMALIZUMAB 150 MG SC SOLR,12037.02,7824.0599999999995,47.68,14761.0,11
HCPCS,J2357,OMALIZUMAB 150 MG/ML SC SYRG,12037.02,7824.0599999999995,47.68,14761.0,11
HCPCS,J2357,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.96,31.57,2
HCPCS,J2358,All drugs or drug agents without specific rate set forth above or herein,,,8.02,8.02,2
HCPCS,J2358,"INJECTION, OLANZAPINE, LONG-ACTING, 1 MG",,,7.08,7.56,2
HCPCS,J2358,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.7,5.3,2
HCPCS,J2360,"INJECTION, ORPHENADRINE, UP TO 60 MG",,,43.71,46.67,2
HCPCS,J2360,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.99,32.74,2
HCPCS,J2370,"INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML",,,5.01,5.35,2
HCPCS,J2370,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,897.0999999999999,583.115,13270.0,14761.0,12
HCPCS,J2370,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J2400,CHLOROPROCAINE (PF) 20 MG/ML (2 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J2400,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,13270.0,14761.0,4
HCPCS,J2400,CHLOROPROCAINE 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
HCPCS,J2400,"INJECTION, CHLOROPROCAINE HCL",,,41.81,44.64,2
HCPCS,J2400,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.73,31.31,2
HCPCS,J2401,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2401,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,13270.0,14761.0,2
HCPCS,J2401,"Injection, chloroprocaine hydrochloride, per 1 mg",,,0.07,0.18,4
HCPCS,J2401,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J2402,"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg",,,0.86,0.92,2
HCPCS,J2402,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J2405,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2405,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",,,0.21,0.21,2
HCPCS,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J2405,ONDANSETRON HCL 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2405,"ONDANSETRON HYDROCHLORIDE, PER 1 MG",,,15.03,16.05,2
HCPCS,J2405,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.97,11.26,2
HCPCS,J2406,Drug,,,108.49,115.83,2
HCPCS,J2406,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,71.95,81.26,2
HCPCS,J2407,All drugs or drug agents without specific rate set forth above or herein,,,78.28,78.28,2
HCPCS,J2407,"Injection, oritavancin",,,64.44,68.8,2
HCPCS,J2407,ORITAVANCIN 400 MG IV SOLR,17269.65,11225.27,35.44,40.75,8
HCPCS,J2407,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,42.74,48.26,2
HCPCS,J2410,"INJECTION, OXYMORPHONE HCL, UP TO 1 MG",,,8.64,9.22,2
HCPCS,J2410,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.73,6.47,2
HCPCS,J2425,All drugs or drug agents without specific rate set forth above or herein,,,93.5,93.5,2
HCPCS,J2425,"INJECTION, PALIFERMIN, 50 MICROGRAMS ï",,,30.58,32.65,2
HCPCS,J2425,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.28,22.9,2
HCPCS,J2426,All drugs or drug agents without specific rate set forth above or herein,,,40.6,40.6,2
HCPCS,J2426,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE, 1 MG",,,16.93,18.08,2
HCPCS,J2426,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,1465.56,952.61,18.38,14761.0,3
HCPCS,J2426,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.23,12.68,2
HCPCS,J2430,"INJECTION, PAMIDRONATE DISODIUM PER 30 MG",,,657.87,702.39,2
HCPCS,J2430,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",,,19.51,19.51,2
HCPCS,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN,488.0,317.2,13270.0,14761.0,4
HCPCS,J2430,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,436.31,492.71,2
HCPCS,J2440,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",,,3.63,3.87,2
HCPCS,J2440,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J2440,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.41,2.72,2
HCPCS,J2460,"INJECTION, OXYTETRACYCLINE HCL, UP TO 50 MG",,,3.46,3.69,2
HCPCS,J2460,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J2469,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2469,"INJECTION, PALONOSETRON HCL, 25 MCG",,,1.86,80.79,4
HCPCS,J2469,PALONOSETRON 0.25 MG/5 ML IV SOLN,309.0,200.85,13270.0,14761.0,10
HCPCS,J2469,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,50.18,56.67,2
HCPCS,J2501,"INJECTION, PARICALCITOL, 1 MCG",,,1.47,13.28,4
HCPCS,J2501,PARICALCITOL 2 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J2501,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.25,9.32,2
HCPCS,J2502,All drugs or drug agents without specific rate set forth above or herein,,,1319.87,1319.87,2
HCPCS,J2502,"Injection, pasireotide long acting, 1 mg (Code Price is based on Median pricing methodology due to flat pricing) (For billing prior to 1/1/16 use C9454 or J3490)",,,717.65,766.21,2
HCPCS,J2502,PASIREOTIDE PAMOATE 60 MG IM SUSR,171609.21,111545.99,597.49,687.12,16
HCPCS,J2502,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,475.95,537.48,2
HCPCS,J2503,"INJECTION, PEGAPTANIB SODIUM, 0.3 MG ï",,,2762.61,2949.54,2
HCPCS,J2503,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1832.18,2069.04,2
HCPCS,J2504,"INJECTION, PEGADEMASE BOVINE, 25 IU ï",,,362.1,386.61,2
HCPCS,J2504,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,240.15,271.2,2
HCPCS,J2505,"INJECTION, PEGFILGRASTIM, 6 MG",,,6552.61,6996.0,2
HCPCS,J2505,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4345.75,4907.56,2
HCPCS,J2506,All drugs or drug agents without specific rate set forth above or herein,,,85.67,85.67,2
HCPCS,J2506,Drug,,,1425.62,1522.08,2
HCPCS,J2506,"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg",,,111.44,111.44,2
HCPCS,J2506,PEGFILGRASTIM 6 MG/0.6 ML SC OBISYRINGE,38865.87,25262.82,38.78,14761.0,11
HCPCS,J2506,PEGFILGRASTIM 6 MG/0.6 ML SC SYRG,38865.87,25262.82,38.78,14761.0,11
HCPCS,J2506,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,945.48,1067.71,2
HCPCS,J2507,All drugs or drug agents without specific rate set forth above or herein,,,9578.08,9578.08,2
HCPCS,J2507,"INJECTION, PEGLOTICASE, 1 MG",,,766.36,818.22,2
HCPCS,J2507,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,508.26,573.97,2
HCPCS,J2510,All drugs or drug agents without specific rate set forth above or herein,,,112.61,112.61,2
HCPCS,J2510,"INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS",,,21.25,22.69,2
HCPCS,J2510,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.09,15.91,2
HCPCS,J2513,"INJECTION, PENTASTARCH, 10% SOLUTION, 100 ML ï",,,33.86,36.15,2
HCPCS,J2513,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.46,25.36,2
HCPCS,J2515,"INJECTION, PENTOBARBITAL SODIUM",,,5.53,5.9,2
HCPCS,J2515,PENTOBARBITAL SODIUM 50 MG/ML IJ SOLN,14973.6,9732.84,13270.0,14761.0,6
HCPCS,J2515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.67,4.14,2
HCPCS,J2540,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",,,1.7,5.72,4
HCPCS,J2540,PENICILLIN G POTASSIUM 3 MILLION UNITS IN 0.9% NACL 50ML,1465.56,952.61,13270.0,14761.0,4
HCPCS,J2540,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J2540,PENICILLIN G SODIUM 5 MILLION UNITS IJ SOLR,584.56,379.96,13270.0,14761.0,4
HCPCS,J2540,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J2543,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2543,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1GM/0.125 GRAMS(1.125 GRAMS)",,,13.48,14.39,2
HCPCS,J2543,"Injection, piperacillin sodium/tazobactam sodium, 1 g/0.125 g (1.125 g)",,,2.59,2.59,2
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,20
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,14
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM IVPB VIAL 2.25 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,10386.4,6751.16,13270.0,14761.0,4
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J2543,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.94,10.09,2
HCPCS,J2545,PENTAMIDINE 300 MG IN SOLR,2013.6,1308.84,13270.0,14761.0,2
HCPCS,J2545,"PENTAMIDINE ISETHIONATE, INHAL SOL, FDA-APPRVD FINAL PROD, NON-COMPOUNDED, ADMIN'D THRU DME, UNIT DOSE FORM, PER 300 MG",,,243.76,260.26,2
HCPCS,J2545,"Pentamidine isethionate, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 300 mg",,,114.82,114.82,2
HCPCS,J2545,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,161.67,182.57,2
HCPCS,J2547,All drugs or drug agents without specific rate set forth above or herein,,,4.62,4.62,2
HCPCS,J2547,"Injection, peramivir, 1 mg (For billing prior to 1/1/16 use C9451 or J3490)",,,4.15,4.43,2
HCPCS,J2547,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.75,3.11,2
HCPCS,J2550,"INJECTION, PROMETHAZINE HCL, UP TO 50 MG",,,2.42,2.58,2
HCPCS,J2550,PROMETHAZINE 25 MG/ML IJ SOLN,,,13270.0,14761.0,2
HCPCS,J2550,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J2560,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",,,8.29,69.11,4
HCPCS,J2560,PHENOBARBITAL SODIUM 130 MG/ML IJ SOLN,584.37,379.84,13270.0,14761.0,4
HCPCS,J2560,PHENOBARBITAL SODIUM 65 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2560,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.5,6.21,2
HCPCS,J2562,All drugs or drug agents without specific rate set forth above or herein,,,138.83,138.83,2
HCPCS,J2562,"INJECTION, PLERIXAFOR, 1 MG",,,694.15,741.12,2
HCPCS,J2562,"Injection, plerixafor, 1 mg (For billing prior to 1/1/10 use J3490 or C9252)",,,380.19,380.19,2
HCPCS,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SC SOLN,20482.8,13313.82,62.85,72.27,8
HCPCS,J2562,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,460.37,519.88,2
HCPCS,J2590,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2590,"INJECTION, OXYTOCIN, UP TO 10 UNITS",,,2.42,2.58,2
HCPCS,J2590,OXYTOCIN 10 UNITS/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J2590,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J2597,All drugs or drug agents without specific rate set forth above or herein,,,14.91,14.91,2
HCPCS,J2597,DESMOPRESSIN 4 MCG/ML IJ SOLN,2489.44,1618.14,6.75,14761.0,77
HCPCS,J2597,INJECTION DESMOPRESSIN ACETAT PER 1 MCG,,,49.75,53.12,2
HCPCS,J2597,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",,,13.91,13.91,2
HCPCS,J2597,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.0,37.26,2
HCPCS,J2650,"INJECTION, PREDNISOLONE ACETATE, UP TO 1 ML",,,2.25,2.4,2
HCPCS,J2650,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J2675,"INJECTION, PROGESTERONE PER 50 MG",,,8.64,9.22,2
HCPCS,J2675,"Injection, progesterone, per 50 mg (Code reinstated effective 01/01/2003)",,,2.0,2.0,2
HCPCS,J2675,PROGESTERONE 50 MG/ML IM OIL,20482.8,13313.82,,,0
HCPCS,J2675,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.73,6.47,2
HCPCS,J2680,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",,,20.12,142.21,4
HCPCS,J2680,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.34,99.76,2
HCPCS,J2690,All drugs or drug agents without specific rate set forth above or herein,,,1502.02,1502.02,2
HCPCS,J2690,"INJECTION, PROCAINAMIDE HCL, UP TO 1 G",,,321.75,321.75,2
HCPCS,J2690,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",,,81.89,87.43,2
HCPCS,J2690,PROCAINAMIDE 100 MG/ML IJ SOLN,965.92,627.85,679.95,14761.0,14
HCPCS,J2690,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.31,61.33,2
HCPCS,J2700,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",,,2.31,8.12,4
HCPCS,J2700,OXACILLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,6
HCPCS,J2700,OXACILLIN 2 GRAM IJ SOLR,316.0,205.4,13270.0,14761.0,10
HCPCS,J2700,OXACILLIN IVPB VIAL 1 G/50 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J2700,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.04,5.69,2
HCPCS,J2704,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2704,"INJECTION, PROPOFOL, 10 MG",,,0.28,0.28,2
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.35,0.37,2
HCPCS,J2704,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,16
HCPCS,J2704,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J2710,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2710,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",,,27.81,29.7,2
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,4
HCPCS,J2710,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.45,20.83,2
HCPCS,J2720,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2720,"INJECTION, PROTAMINE SULFATE, PER 10 MG",,,3.64,3.64,2
HCPCS,J2720,"INJECTION, PROTAMINE SULFATE, UP TO 5 ML",,,11.57,12.36,2
HCPCS,J2720,PROTAMINE 10 MG/ML IV SOLN,389.0,252.85,13270.0,14761.0,4
HCPCS,J2720,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.68,8.67,2
HCPCS,J2724,All drugs or drug agents without specific rate set forth above or herein,,,41.4,41.4,2
HCPCS,J2724,"INJECTION, PROTEIN C CONCENTRATE, INTRAVENOUS, HUMAN, 10IU",,,31.96,34.12,2
HCPCS,J2724,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.2,23.94,2
HCPCS,J2725,INJECTION PROTIRLIN PER 250 MCG,,,57.01,60.87,2
HCPCS,J2725,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,37.81,42.7,2
HCPCS,J2730,"INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM",,,240.83,257.12,2
HCPCS,J2730,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,159.72,180.37,2
HCPCS,J2760,All drugs or drug agents without specific rate set forth above or herein,,,1009.81,1009.81,2
HCPCS,J2760,"INJECTION, PHENTOLAINE MESYLATE, UP TO 5 MG",,,77.74,83.0,2
HCPCS,J2760,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",,,982.54,982.54,2
HCPCS,J2760,PHENTOLAMINE 5 MG IJ SOLR,5847.12,3800.625,457.13,14761.0,6
HCPCS,J2760,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.56,58.22,2
HCPCS,J2765,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2765,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",,,2.4,7.56,4
HCPCS,J2765,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J2765,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.7,5.3,2
HCPCS,J2770,All drugs or drug agents without specific rate set forth above or herein,,,11.72,11.72,2
HCPCS,J2770,"INJECTION, QUINURISTIN/DALFOPRISTIN, 500MG",,,265.19,283.13,2
HCPCS,J2770,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,175.87,198.61,2
HCPCS,J2777,"Injection, faricimab-svoa, 0.1 mg",,,97.26,103.85,2
HCPCS,J2777,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,64.51,72.85,2
HCPCS,J2778,All drugs or drug agents without specific rate set forth above or herein,,,377.21,377.21,2
HCPCS,J2778,"INJECTION,RANIBIZUMAB,0.1 MG",,,1082.86,1156.13,2
HCPCS,J2778,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,718.16,811.0,2
HCPCS,J2779,"INJECTION, RANIBIZUMAB, VIA INTRAVITREAL IMPLANT (SUSVIMO), 0.1 MG",,,213.19,227.61,2
HCPCS,J2779,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,141.39,159.66,2
HCPCS,J2780,"INJECTION, RANITIDINE HYDROCHLORIDE, 25MG",,,4.49,4.8,2
HCPCS,J2780,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.98,3.36,2
HCPCS,J2783,All drugs or drug agents without specific rate set forth above or herein,,,1021.29,1021.29,2
HCPCS,J2783,"INJECTION, RASBURICASE, 0.5 MG",,,275.9,807.64,4
HCPCS,J2783,RASBURICASE 1.5 MG IV SOLR,9457.845000000001,6147.595,462.33,14761.0,17
HCPCS,J2783,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,182.98,206.63,2
HCPCS,J2785,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2785,"INJECTION, REGADENOSON, 0.1 MG",,,31.4,150.14,4
HCPCS,J2785,REGADENOSON 0.4 MG/5 ML IV SYRG,3842.4,2497.56,13270.0,14761.0,4
HCPCS,J2785,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.26,105.32,2
HCPCS,J2786,All drugs or drug agents without specific rate set forth above or herein,,,28.36,28.36,2
HCPCS,J2786,"Injection, reslizumab, 1 mg",,,22.29,23.79,2
HCPCS,J2786,"Injection, reslizumab, 1 mg (For billing prior to 1/1/17 use J3590 or C9481 for OPPS billing)",,,22.36,22.36,2
HCPCS,J2786,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.78,16.69,2
HCPCS,J2787,"Riboflavin 5'-phosphate, ophthalmic solution, up to 3 mL",,,3798.3,4055.32,2
HCPCS,J2787,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2519.07,2844.72,2
HCPCS,J2788,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, MINIDOSE, 50 MICROGRAMS (250 I.U.)",,,96.75,103.29,2
HCPCS,J2788,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,64.16,72.46,2
HCPCS,J2790,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",,,266.57,284.61,2
HCPCS,J2790,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,176.79,199.65,2
HCPCS,J2791,All drugs or drug agents without specific rate set forth above or herein,784.6,509.99,,,0
HCPCS,J2791,HB RHOPHYLAC INJECTION 100 IU,784.6,509.99,13270.0,14761.0,4
HCPCS,J2791,"INJECTION,RHO(D) IMMUNE GLOBULIN (HUMAN),(RHOPHYLAC), INTRAMUSCULAR OR",784.6,509.99,26.95,28.77,2
HCPCS,J2791,"Injection, Rho(D) immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 IU (see also 90384 and 90386 for CPT billing requirements)",784.6,509.99,10.61,10.61,2
HCPCS,J2791,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG FOR OB",784.6,509.99,,,0
HCPCS,J2791,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",784.6,509.99,17.87,20.18,2
HCPCS,J2792,All drugs or drug agents without specific rate set forth above or herein,,,94.45,94.45,2
HCPCS,J2792,"INJECTION RHO D IMMUNE GLOBULIN INTRAVENOUS HUMAN SOLVENT DETERGENT, 100 IU",,,58.57,62.53,2
HCPCS,J2792,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,38.84,43.86,2
HCPCS,J2793,"INJECTION, RILONACEPT, 1 MG",,,60.64,64.74,2
HCPCS,J2793,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.22,45.42,2
HCPCS,J2794,All drugs or drug agents without specific rate set forth above or herein,,,31.08,31.08,2
HCPCS,J2794,"INJECTION, RISPERIDONE, LONG ACTING, 0.5 MG",,,24.7,26.38,2
HCPCS,J2794,"Injection, risperidone (risperdal consta), 0.5 mg",,,26.71,26.71,2
HCPCS,J2794,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.38,18.5,2
HCPCS,J2795,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2795,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",,,0.17,0.17,2
HCPCS,J2795,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1MG",,,0.52,0.55,2
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,10
HCPCS,J2795,ROPIVACAINE 0.2 % EPIDURAL (L&D),290.0,188.5,13270.0,14761.0,2
HCPCS,J2795,ROPIVACAINE 0.2 % PERIPHERAL NERVE BLOCK INFUSION,454.4,295.36,13270.0,14761.0,2
HCPCS,J2795,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
HCPCS,J2795,ROPIVACAINE 0.2% IN 0.9% NACL 500 ML FOR PERIPHERAL NERVE CATETHER,686.4,446.16,13270.0,14761.0,4
HCPCS,J2795,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.15 % EP SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J2795,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J2796,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2796,"INJECTION, ROMIPLOSTIM, 10 MICROGRAMS",,,115.58,123.4,2
HCPCS,J2796,"Injection, romiplostim, 10 micrograms (For billing prior to 1/1/10 use J3590 or C9245)",,,211.17,211.17,2
HCPCS,J2796,ROMIPLOSTIM 125 MCG SC SOLR,20973.6,13632.84,13270.0,14761.0,2
HCPCS,J2796,ROMIPLOSTIM 250 MCG SC SOLR,23594.94,15336.71,13270.0,14761.0,2
HCPCS,J2796,ROMIPLOSTIM 500 MCG SC SOLR,47189.79,30673.36,13270.0,14761.0,2
HCPCS,J2796,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,76.65,86.56,2
HCPCS,J2797,"Injection, rolapitant, 0.5 mg",,,2.42,2.58,2
HCPCS,J2797,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J2798,All drugs or drug agents without specific rate set forth above or herein,,,33.53,33.53,2
HCPCS,J2798,"Injection, risperidone, (perseris), 0.5 mg",,,27.91,29.8,2
HCPCS,J2798,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.51,20.91,2
HCPCS,J2800,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2800,"INJECTION, METHOCARBAMOL, UP TO 10 ML",,,11.75,12.54,4
HCPCS,J2800,METHOCARBAMOL 100 MG/ML IJ SOLN,353.72,229.92,13270.0,14761.0,12
HCPCS,J2800,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.79,8.8,2
HCPCS,J2805,"INJECTION, SINCALIDE, 5 MICROGRAMS",,,292.7,292.7,2
HCPCS,J2805,"INJECTION, SINCALIDE, 5 MICROGRAMS ï",,,143.39,153.09,2
HCPCS,J2805,SINCALIDE 5 MCG IJ SOLR,1983.73,1289.42,13270.0,14761.0,2
HCPCS,J2805,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,95.1,107.39,2
HCPCS,J2810,"INJECTION, THEOPHYLLINE, PER 40MG",,,0.69,0.74,2
HCPCS,J2810,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J2820,All drugs or drug agents without specific rate set forth above or herein,,,165.79,165.79,2
HCPCS,J2820,"INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG",,,130.44,130.44,2
HCPCS,J2820,"INJECTION,SARGRAMOSTIM(GM-CSF),50 MCG(PRIOR TO 1997 250 MCG)(ONLY AVAILABLE IN 250 MCG SINGLE-USE VIALS)",,,339.82,362.81,2
HCPCS,J2820,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,225.37,254.51,2
HCPCS,J2840,All drugs or drug agents without specific rate set forth above or herein,,,1483.74,1483.74,2
HCPCS,J2840,"Injection, sebelipase alfa, 1 mg",,,1332.67,1422.85,2
HCPCS,J2840,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,883.84,998.1,2
HCPCS,J2850,All drugs or drug agents without specific rate set forth above or herein,,,117.1,117.1,2
HCPCS,J2850,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM ï",,,56.49,60.32,2
HCPCS,J2850,SECRETIN (HUMAN) 16 MCG IV SOLR,10281.6,6683.04,53.01,14761.0,11
HCPCS,J2850,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,37.47,42.31,2
HCPCS,J2860,All drugs or drug agents without specific rate set forth above or herein,,,432.05,432.05,2
HCPCS,J2860,HB MISCELLANEOUS PHARMACY,1465.56,952.61,195.58,224.92,16
HCPCS,J2860,"Injection, siltuximab, 10 mg (Code re-used by CMS effective 1/1/16) (For billing prior to 1/1/16 use C9455 or J3590)",,,228.73,244.21,2
HCPCS,J2860,Inpatient Services,1465.56,952.61,,,0
HCPCS,J2860,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J2860,SILTUXIMAB 400 MG IV SOLR,10974.18,7133.215,195.58,224.92,16
HCPCS,J2860,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,151.7,171.31,2
HCPCS,J2910,"INJECTION, AUROTHIOGLUCOSE, UP TO 50 MG",,,37.32,39.84,2
HCPCS,J2910,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.75,27.95,2
HCPCS,J2916,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J2916,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",,,5.22,20.47,4
HCPCS,J2916,SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN,474.08,308.15,,,0
HCPCS,J2916,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.72,14.36,2
HCPCS,J2920,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG",,,5.01,9.21,4
HCPCS,J2920,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML IJ SOLR,290.0,188.5,13270.0,14761.0,4
HCPCS,J2920,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J2930,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG",,,13.13,14.02,2
HCPCS,J2930,"Injection, methylprednisolone sodium succinate, up to 125 mg",,,12.94,12.94,2
HCPCS,J2930,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J2930,METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML IV SOLR,690.88,449.07,13270.0,14761.0,2
HCPCS,J2930,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,509.92,331.45,13270.0,14761.0,8
HCPCS,J2930,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,13270.0,14761.0,6
HCPCS,J2930,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,325.0,211.25,13270.0,14761.0,6
HCPCS,J2930,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.71,9.83,2
HCPCS,J2940,"INJECTION, SOMATREM, 1MG",,,108.84,116.2,2
HCPCS,J2940,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,72.18,81.51,2
HCPCS,J2941,All drugs or drug agents without specific rate set forth above or herein,,,134.56,134.56,2
HCPCS,J2941,"INJECTION, SOMATROPIN, 1MG",,,108.84,116.2,2
HCPCS,J2941,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,72.18,81.51,2
HCPCS,J2950,"INJECTION, PROMAZINE HCL, UP TO 25 MG",,,3.97,4.24,2
HCPCS,J2950,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.64,2.98,2
HCPCS,J2993,All drugs or drug agents without specific rate set forth above or herein,,,7638.85,7638.85,2
HCPCS,J2993,"INJECTION, RETEPLASE , 18.8MG",,,3393.52,3623.15,2
HCPCS,J2993,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2250.62,2541.57,2
HCPCS,J2997,ALTEPLASE 2 MG CATH SOLR,2760.32,1794.21,113.9,14761.0,11
HCPCS,J2997,ALTEPLASE 2 MG CATH SOLR (PEDIATRIC),73793.7,47965.9,113.9,14761.0,3
HCPCS,J2997,ALTEPLASE 50 MG IV SOLR,36896.85,23982.95,113.9,14761.0,14
HCPCS,J2997,All drugs or drug agents without specific rate set forth above or herein,,,251.6,251.6,2
HCPCS,J2997,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",,,195.67,195.67,2
HCPCS,J2997,"INJECTION, ALTEPLASE RECOMBINANT, 1MG",,,83.44,89.09,2
HCPCS,J2997,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.34,62.49,2
HCPCS,J2998,"INJECTION, PLASMINOGEN, HUMAN-TVMH, 1 MG",,,79.99,85.4,2
HCPCS,J2998,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.05,59.91,2
HCPCS,J3000,"INJECTION, STREPTOMYCIN, UP TO 1 GM",,,14.34,15.31,2
HCPCS,J3000,"Injection, streptomycin, up to 1 gram",,,71.52,71.52,2
HCPCS,J3000,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.51,10.74,2
HCPCS,J3010,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3010,FENTANYL 10 MCG/ML IV PEDIATRIC,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,26
HCPCS,J3010,FENTANYL PCA HIGH DOSE,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3010,"INJECTION, FENTANYL CITRATE, 0.1 MG",,,2.12,2.77,4
HCPCS,J3010,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J3030,"INJECTION, SUMATRIPTAN SUCCINATE 6 MG",,,65.65,70.09,2
HCPCS,J3030,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,323.88,210.51999999999998,13270.0,14761.0,6
HCPCS,J3030,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,43.54,49.17,2
HCPCS,J3031,"Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)",,,7.5,8.01,2
HCPCS,J3031,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.98,5.62,2
HCPCS,J3032,All drugs or drug agents without specific rate set forth above or herein,,,51.42,51.42,2
HCPCS,J3032,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,16993.35,11045.68,23.28,26.77,8
HCPCS,J3032,"Injection, eptinezumab-jjmr, 1 mg",,,39.72,42.56,4
HCPCS,J3032,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.43,29.85,2
HCPCS,J3060,All drugs or drug agents without specific rate set forth above or herein,,,117.12,117.12,2
HCPCS,J3060,"INJECTION, TALIGLUCERACE ALFA, 10 UNITS",,,79.3,84.66,2
HCPCS,J3060,"INJECTION, TALIGLUCERASE ALFA, 10 UNITS",,,99.02,99.02,2
HCPCS,J3060,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,52.59,59.39,2
HCPCS,J3070,"INJECTION, PENTAZOCINE HCL, 30MG",,,67.72,72.3,2
HCPCS,J3070,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,44.91,50.72,2
HCPCS,J3090,All drugs or drug agents without specific rate set forth above or herein,,,4.98,4.98,2
HCPCS,J3090,Inj tedizolid phosphate,,,3.11,3.32,2
HCPCS,J3090,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,J3095,All drugs or drug agents without specific rate set forth above or herein,,,17.54,17.54,2
HCPCS,J3095,"INJECTION, TELEVANCIN, 10 MG",,,5.53,5.9,2
HCPCS,J3095,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.67,4.14,2
HCPCS,J3101,All drugs or drug agents without specific rate set forth above or herein,,,433.84,433.84,2
HCPCS,J3101,"INJECTION, TENECTEPLASE, 1 MG",,,133.54,336.71,4
HCPCS,J3101,TENECTEPLASE 50 MG IV SOLR,69575.04,45223.78,196.4,14761.0,6
HCPCS,J3101,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.57,100.02,2
HCPCS,J3105,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3105,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",,,17.14,17.14,2
HCPCS,J3105,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG.",,,13.13,14.02,2
HCPCS,J3105,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J3105,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.71,9.83,2
HCPCS,J3110,"INJECTION, TERIPARATIDE, 10 MCG",,,19.52,20.84,2
HCPCS,J3110,TERIPARATIDE 20 MCG/DOSE (620MCG/2.48ML) SC PNIJ,10574.035,6873.12,13270.0,14761.0,4
HCPCS,J3110,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.95,14.62,2
HCPCS,J3111,All drugs or drug agents without specific rate set forth above or herein,,,30.72,30.72,2
HCPCS,J3111,"Injection, romosozumab-aqqg, 1 mg",,,23.59,26.19,4
HCPCS,J3111,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SC SYRG,20482.8,13313.82,13.91,16.0,8
HCPCS,J3111,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SC SYRG,11830.14,7689.59,13.91,14761.0,11
HCPCS,J3111,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.27,18.37,2
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.17,0.18,2
HCPCS,J3121,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J3145,All drugs or drug agents without specific rate set forth above or herein,,,5.35,5.35,2
HCPCS,J3145,"Injection, testosterone undecanoate, 1 mg",,,2.94,3.14,2
HCPCS,J3145,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J3230,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3230,CHLORPROMAZINE 25 MG/ML IJ SOLN,338.72,220.17,13270.0,14761.0,8
HCPCS,J3230,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",,,22.8,24.35,2
HCPCS,J3230,"Injection, chlorpromazine HCl, up to 50 mg",,,65.5,65.5,2
HCPCS,J3230,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.12,17.08,2
HCPCS,J3240,All drugs or drug agents without specific rate set forth above or herein,,,5702.97,5702.97,2
HCPCS,J3240,"INJECTION, THYROTROPIN ALPHA, 0.9MG, PROVIDED IN 1.1MG VIAL",,,1325.07,1414.73,2
HCPCS,J3240,"Injection,thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial (Code Price is per 1 vial)",,,4444.66,4444.66,2
HCPCS,J3240,THYROTROPIN ALFA 0.9 MG IM SOLR,10974.18,7133.215,2581.7,14761.0,22
HCPCS,J3240,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,878.8,992.41,2
HCPCS,J3241,All drugs or drug agents without specific rate set forth above or herein,,,945.9,945.9,2
HCPCS,J3241,"Injection, teprotumumab-trbw, 10 mg",,,721.28,848.05,4
HCPCS,J3241,TEPROTUMUMAB-TRBW 500 MG IV SOLR,153158.58,99553.08,428.2,492.43,8
HCPCS,J3241,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,526.79,594.89,2
HCPCS,J3243,"INJECTION, TIGECYCLINE, 1 MG",,,1.61,1.61,2
HCPCS,J3243,"INJECTION, TIGECYCLINE, 1 MG ï",,,2.59,2.77,2
HCPCS,J3243,TIGECYCLINE 50 MG IV SOLR,455.08000000000004,295.79999999999995,13270.0,14761.0,8
HCPCS,J3243,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J3244,"Injection, tigecycline (accord) not therapeutically equivalent to j3243, 1 mg",,,6.74,7.19,2
HCPCS,J3244,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.47,5.05,2
HCPCS,J3245,All drugs or drug agents without specific rate set forth above or herein,,,373.87,373.87,2
HCPCS,J3245,"Injection, tildrakizumab, 1 mg",,,2473.23,2640.59,2
HCPCS,J3245,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1640.27,1852.32,2
HCPCS,J3246,"INJECTION, TIROFIBAN HCL, 0.25 MG",,,9.51,9.51,2
HCPCS,J3246,"INJECTION, TIROFIBAN HCL, 0.25MG",,,2.25,2.4,2
HCPCS,J3246,TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN,1804.0,1172.6,13270.0,14761.0,2
HCPCS,J3246,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J3250,"INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG",,,12.27,105.2,4
HCPCS,J3250,TRIMETHOBENZAMIDE 100 MG/ML IM SOLN,722.24,469.46,13270.0,14761.0,2
HCPCS,J3250,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.13,9.19,2
HCPCS,J3260,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3260,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",,,5.85,19.18,4
HCPCS,J3260,TOBRAMYCIN 1.2 G SOLN FOR MIXTURE (INTRAPROCEDURE),959.04,623.38,13270.0,14761.0,2
HCPCS,J3260,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3260,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.44,188.785,13270.0,14761.0,6
HCPCS,J3260,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.92,13.46,2
HCPCS,J3262,All drugs or drug agents without specific rate set forth above or herein,,,16.4,16.4,2
HCPCS,J3262,"INJECTION, TOCILIZUMAB, 1 MG",,,8.81,9.41,2
HCPCS,J3262,"Injection, tocilizumab, 1 mg (For billing prior to 1/1/11 use J3590 or C9264)",,,13.45,13.45,2
HCPCS,J3262,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN,21246.56,13810.26,7.42,14761.0,11
HCPCS,J3262,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,42493.12,27620.53,7.42,14761.0,11
HCPCS,J3262,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,8498.56,5524.06,7.42,14761.0,11
HCPCS,J3262,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.84,6.6,2
HCPCS,J3265,INJECTION TORSEMIDE 10 MG/ML,,,8.81,9.41,2
HCPCS,J3265,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.84,6.6,2
HCPCS,J3280,"INJECTION, THIETHYLPERAZINE MALEATE, UP TO 10 MG",,,12.78,13.65,2
HCPCS,J3280,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.48,9.57,2
HCPCS,J3285,All drugs or drug agents without specific rate set forth above or herein,,,153.53,153.53,2
HCPCS,J3285,"INJECTION, TREPROSTINIL, 1 MG",,,123.99,123.99,2
HCPCS,J3285,"INJECTION, TREPROSTINIL, 1 MG ï",,,144.43,154.2,2
HCPCS,J3285,TREPROSTINIL SODIUM 1 MG/ML IJ SOLN,3352.86,2179.36,69.5,14761.0,9
HCPCS,J3285,TREPROSTINIL SODIUM 10 MG/ML IJ SOLN,39997.98,25998.69,69.5,14761.0,3
HCPCS,J3285,TREPROSTINIL SODIUM 2.5 MG/ML IJ SOLN,1465.56,952.61,69.5,14761.0,3
HCPCS,J3285,TREPROSTINIL SODIUM 5 MG/ML IJ SOLN,17416.35,11320.625,69.5,14761.0,14
HCPCS,J3285,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,95.79,108.17,2
HCPCS,J3299,"INJECTION, TRIAMCINOLONE ACETONIDE (XIPERE), 1 MG",,,122.14,130.41,2
HCPCS,J3299,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.01,91.48,2
HCPCS,J3300,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG",,,8.64,9.22,2
HCPCS,J3300,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.73,6.47,2
HCPCS,J3301,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3301,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",,,27.81,29.7,2
HCPCS,J3301,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, PER 10 MG",,,2.07,2.07,2
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,1086.94,706.51,13270.0,14761.0,10
HCPCS,J3301,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.45,20.83,2
HCPCS,J3302,"INJECTION TRIAMCINOLONE DIACETATE, PER 5 MG",,,2.25,2.4,2
HCPCS,J3302,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J3303,"INJECTION TRIAMCINOLONE HEXACETONIDE, PER 5 MG",,,6.22,6.64,2
HCPCS,J3303,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.12,4.66,2
HCPCS,J3304,All drugs or drug agents without specific rate set forth above or herein,,,48.81,48.81,2
HCPCS,J3304,"Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg",,,38.58,50.72,4
HCPCS,J3304,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,9058.72,5888.17,22.1,14761.0,27
HCPCS,J3304,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.51,35.58,2
HCPCS,J3305,INJECTION TRIMETREXATE GLUCORONATE PER 25 MG,,,333.25,355.8,2
HCPCS,J3305,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,221.02,249.59,2
HCPCS,J3310,"INJECTION, PERPHENAZINE, UP TO 5 MG",,,16.76,17.89,2
HCPCS,J3310,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.11,12.55,2
HCPCS,J3315,All drugs or drug agents without specific rate set forth above or herein,,,1283.79,1283.79,2
HCPCS,J3315,"INJECTION, TRIPTORELIN PAMOATE, 3.75 MG",,,909.48,1036.61,4
HCPCS,J3315,TRIPTORELIN PAMOATE 11.25 MG IM SUSR,18866.97,12263.53,581.16,668.34,8
HCPCS,J3315,TRIPTORELIN PAMOATE 3.75 MG IM SUSR,11180.48,7267.31,581.16,668.34,8
HCPCS,J3315,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,643.92,727.16,2
HCPCS,J3316,All drugs or drug agents without specific rate set forth above or herein,,,9402.97,9402.97,2
HCPCS,J3316,"Injection, triptorelin, extended-release, 3.75 mg",,,7285.46,7778.44,2
HCPCS,J3316,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4831.78,5456.42,2
HCPCS,J3320,"INJECTION, SPECTINOMYCIN DIHYDROCHLORIDE, UP TO 2 GM",,,62.71,66.96,2
HCPCS,J3320,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.59,46.97,2
HCPCS,J3355,"INJECTION, UROFOLLITROPIN, 75 IU ï",,,211.29,225.58,2
HCPCS,J3355,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,140.13,158.24,2
HCPCS,J3357,All drugs or drug agents without specific rate set forth above or herein,,,439.86,439.86,2
HCPCS,J3357,"INJECTION, USTEKINUMAB, 1 MG",,,289.72,309.32,2
HCPCS,J3357,USTEKINUMAB 90 MG/ML SC SYRG,233470.62,151755.9,199.12,14761.0,11
HCPCS,J3357,"Ustekinumab, for subcutaneous injection, 1 mg",,,338.55,338.55,2
HCPCS,J3357,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,192.14,216.98,2
HCPCS,J3358,All drugs or drug agents without specific rate set forth above or herein,,,35.67,35.67,2
HCPCS,J3358,USTEKINUMAB 130 MG/26 ML IV SOLN,18211.52,11837.49,16.15,18.57,8
HCPCS,J3358,"Ustekinumab, for intravenous injection, 1 mg (For billing prior to 1/1/18 use Q9989)",,,27.73,35.05,4
HCPCS,J3358,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.77,24.58,2
HCPCS,J3360,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3360,DIAZEPAM 5 MG/ML IJ SYRG,354.78,230.61,13270.0,14761.0,4
HCPCS,J3360,"INJECTION, DIAZEPAM, UP TO 5 MG",,,8.81,12.03,4
HCPCS,J3360,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.84,6.6,2
HCPCS,J3364,"INJECTION, UROKINASE, 5000 I.U. VIAL",,,147.19,157.15,2
HCPCS,J3364,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,97.62,110.24,2
HCPCS,J3365,"INJECTION, IV, UROKINASE, 250,000 I.U. VIAL",,,1211.05,1292.99,2
HCPCS,J3365,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,803.18,907.01,2
HCPCS,J3370,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3370,"INJECTION, VANCOMYCIN HCL, 500 MG",,,5.09,5.09,2
HCPCS,J3370,"INJECTION, VANCOMYCIN HCL, UP TO 500 MG",,,41.12,43.9,2
HCPCS,J3370,VANCOMYCIN 1.25 GRAM IV SOLR,290.69,188.95,13270.0,14761.0,2
HCPCS,J3370,VANCOMYCIN 10 GRAM IV SOLR,417.6,271.44,13270.0,14761.0,2
HCPCS,J3370,VANCOMYCIN 1000 MG IV SOLR,10386.4,6751.16,13270.0,14761.0,10
HCPCS,J3370,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3370,VANCOMYCIN 5 GRAM IV SOLR,739.76,480.845,13270.0,14761.0,10
HCPCS,J3370,VANCOMYCIN 500 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,12
HCPCS,J3370,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,8
HCPCS,J3370,VANCOMYCIN 750 MG/250 ML IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J3370,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.27,30.79,2
HCPCS,J3371,"Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg",,,21.42,22.87,2
HCPCS,J3371,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.21,16.04,2
HCPCS,J3372,"Injection, vancomycin hcl (xellia) not therapeutically equivalent to j3370, 500 mg",,,20.39,21.77,2
HCPCS,J3372,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.52,15.27,2
HCPCS,J3380,All drugs or drug agents without specific rate set forth above or herein,,,61.23,61.23,2
HCPCS,J3380,"Injection, vedolizumab",,,42.84,45.74,2
HCPCS,J3380,"Injection, vedolizumab, 1 mg",,,48.51,48.51,2
HCPCS,J3380,VEDOLIZUMAB 300 MG IV SOLR,84239.19,54755.47,27.72,14761.0,11
HCPCS,J3380,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.41,32.09,2
HCPCS,J3385,All drugs or drug agents without specific rate set forth above or herein,,,1018.28,1018.28,2
HCPCS,J3385,"INJECTION, VELAGLUCERASE ALFA, 100 UNITS",,,899.56,960.43,2
HCPCS,J3385,"Injection, velaglucerase alfa, 100 units (For billing prior to 1/1/11 use J3490 or C9271)",,,807.95,807.95,2
HCPCS,J3385,VELAGLUCERASE ALFA 400 UNITS IV SOLR,11862.16,7710.4,460.97,530.11,8
HCPCS,J3385,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,596.6,673.72,2
HCPCS,J3396,All drugs or drug agents without specific rate set forth above or herein,,,31.73,31.73,2
HCPCS,J3396,"INJECTION, VERTEPORFIN, 0.1 MG",,,25.05,26.75,2
HCPCS,J3396,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.61,18.76,2
HCPCS,J3397,"Injection, vestronidase alfa-vjbk, 1 mg",,,563.72,601.86,2
HCPCS,J3397,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,373.86,422.19,2
HCPCS,J3398,All drugs or drug agents without specific rate set forth above or herein,,,8484.19,8484.19,2
HCPCS,J3398,"Injection, voretigene neparvovec-rzyl, 1 billion vector genomes",,,7552.03,8063.05,2
HCPCS,J3398,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5008.58,5656.07,2
HCPCS,J3399,All drugs or drug agents without specific rate set forth above or herein,,,6570170.77,6570170.77,2
HCPCS,J3399,"Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes",,,5664060.0,6047325.0,2
HCPCS,J3399,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3756456.0,4242078.0,2
HCPCS,J3400,"INJECTION, TRIFLUPROMAZINE HCL, UP TO 20 MG",,,32.13,34.31,2
HCPCS,J3400,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.31,24.07,2
HCPCS,J3410,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",,,28.16,30.07,2
HCPCS,J3410,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.68,21.09,2
HCPCS,J3411,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3411,"INJECTION, THIAMINE HCL, 100 MG",,,2.25,5.41,4
HCPCS,J3411,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J3411,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J3415,"INJECTION, PYRIDOXINE HCL, 100 MG",,,7.43,32.61,4
HCPCS,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3415,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.93,5.56,2
HCPCS,J3420,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3420,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,14
HCPCS,J3420,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1,000 MCG",,,3.17,3.17,2
HCPCS,J3420,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",,,6.91,7.38,2
HCPCS,J3420,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.58,5.18,2
HCPCS,J3430,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3430,"INJECTION, PHYTONADIONE (VITAMIN K) PER 1 MG",,,6.36,6.36,2
HCPCS,J3430,"INJECTION, VITAMIN K, PHYTONADIONE, MENADIONE, MENADIOL SODIUM DIPHOSPHATE, FOR 1 MG",,,11.57,12.36,2
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 10 MG/ML IJ SOLN,335.89,218.32999999999998,13270.0,14761.0,4
HCPCS,J3430,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.68,8.67,2
HCPCS,J3465,"INJECTION, VORICONAZOLE, 10 MG",,,2.54,13.1,4
HCPCS,J3465,VORICONAZOLE 200 MG IV SOLR,307.08000000000004,199.6,13270.0,14761.0,6
HCPCS,J3465,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.13,9.19,2
HCPCS,J3470,"INJECTION, HYALURONIDASE, UP TO 150 UNITS",,,48.2,51.46,2
HCPCS,J3470,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.97,36.1,2
HCPCS,J3471,"INJECTION, HYALURONIDASE, BOVINE, PRESERVATIVE FREE, PER 1 USP UNIT (UP TO 999 USP UNITS) ï",,,0.35,0.37,2
HCPCS,J3471,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J3472,"INJECTION, HYALURONIDASE, BOVINE, PRESERVATIVE FREE, PER 1000 USP UNITS ï",,,360.9,385.32,2
HCPCS,J3472,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,239.35,270.29,2
HCPCS,J3473,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,13270.0,14761.0,4
HCPCS,J3473,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",,,0.79,1.29,4
HCPCS,J3473,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J3475,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3475,INJECTION MAGNESIUM SULFATE PER 500 MG,,,1.04,1.11,2
HCPCS,J3475,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",,,1.51,1.51,2
HCPCS,J3475,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3475,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J3475,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,10
HCPCS,J3475,MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP,290.0,188.5,13270.0,14761.0,4
HCPCS,J3475,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,J3475,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML ANES-INTRAOP,290.0,188.5,,,0
HCPCS,J3475,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,8
HCPCS,J3475,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J3480,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3480,"INJECTION, POTASSIUM CHLORIDE PER 2 MEQ",,,1.73,1.84,2
HCPCS,J3480,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",,,0.26,0.26,2
HCPCS,J3480,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3480,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3480,POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3480,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,6
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML IN 0.9% NACL PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML IN D5W PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,18
HCPCS,J3480,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,1465.56,952.61,13270.0,14761.0,6
HCPCS,J3480,POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3480,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
HCPCS,J3480,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,993.5799999999999,645.825,13270.0,14761.0,8
HCPCS,J3480,POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML IV PGBK,322.2,209.43,13270.0,14761.0,6
HCPCS,J3480,POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J3480,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,354.4,230.36,13270.0,14761.0,8
HCPCS,J3480,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J3480,POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3480,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,6
HCPCS,J3480,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3480,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J3485,"INJECTION, ZIDOVUDINE, 10 MG",,,3.34,3.34,2
HCPCS,J3485,"INJECTION, ZIDOVUDINE, 10MG",,,2.59,2.77,2
HCPCS,J3485,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J3485,ZIDOVUDINE 10 MG/ML IV SOLN,435.2,282.88,13270.0,14761.0,2
HCPCS,J3486,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",,,21.45,52.01,4
HCPCS,J3486,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32.31,36.49,2
HCPCS,J3486,ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR,625.225,406.395,13270.0,14761.0,4
HCPCS,J3489,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3489,"INJECTION, ZOLEDRONIC ACID, 1 MG",,,15.85,486.76,4
HCPCS,J3489,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,302.37,341.45,2
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,521.76,339.14,13270.0,14761.0,8
HCPCS,J3489,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,540.5,351.325,,,0
HCPCS,J3490,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,ALFENTANIL 500 MCG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J3490,ALPROSTADIL 500 MCG/ML IJ SOLN,1698.6999999999998,1104.155,13270.0,14761.0,4
HCPCS,J3490,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,AMINO AC 8 %-D14W-ELECTROLYTES 8-14 % IV SOLP,640.0,416.0,13270.0,14761.0,4
HCPCS,J3490,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,AMINOPHYLLINE 250 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,AMINOPHYLLINE 500 MG/20 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3490,AMIODARONE 150MG-D5W 150ML CSHS,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,AMIODARONE IV INFUSION (1 MG/ML),290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,AMPICILLIN-SULBACTAM 1.5 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,J3490,ANAKINRA 100 MG/0.67 ML SC SYRG,3370.95,2191.12,13270.0,14761.0,4
HCPCS,J3490,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,12538.08,8149.75,13270.0,14761.0,2
HCPCS,J3490,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1445.98,939.885,13270.0,14761.0,6
HCPCS,J3490,ARGININE HCL (L-ARGININE) 10 % IV SOLP,624.0,405.6,13270.0,14761.0,2
HCPCS,J3490,ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN,4033.6,2621.84,13270.0,14761.0,2
HCPCS,J3490,ASPIRIN ORAL SUSPENSION 1 MG/ML PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,AZITHROMYCIN 200 MG/5 ML PO SUSR,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3490,AZTREONAM 1 GRAM IJ SOLR,368.51,239.53,13270.0,14761.0,8
HCPCS,J3490,AZTREONAM 2 GRAM IJ SOLR,779.0550000000001,506.39,13270.0,14761.0,6
HCPCS,J3490,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3490,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",1465.56,952.61,,,0
HCPCS,J3490,BICARB DIALY SOLN 11 WITHOUT K CA (2.5 MEQ/L) -MG (1.5 MEQ/L) HD SOLN,640.0,416.0,13270.0,14761.0,2
HCPCS,J3490,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HD SOLN,720.0,468.0,13270.0,14761.0,2
HCPCS,J3490,BIVALIRUDIN 250 MG IV SOLR,920.52,598.335,13270.0,14761.0,2
HCPCS,J3490,BLINATUMOMAB 35 MCG IV SOLR,46301.85,30096.2,13270.0,14761.0,2
HCPCS,J3490,BUMETANIDE 0.25 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,28
HCPCS,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,16
HCPCS,J3490,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,1465.56,952.61,13270.0,14761.0,18
HCPCS,J3490,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,14
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,BUPRENORPHINE 10 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3490,CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) IJ SOLN,447.36,290.78,13270.0,14761.0,4
HCPCS,J3490,CALCIUM CHLORIDE 10% SYRINGE,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,J3490,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,572.8,372.32,13270.0,14761.0,10
HCPCS,J3490,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,592.86,385.36,13270.0,14761.0,8
HCPCS,J3490,CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PF SOLN,1072.0,696.8,13270.0,14761.0,2
HCPCS,J3490,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,8
HCPCS,J3490,CEFEPIME 2 GRAM IJ SOLR,10386.4,6751.16,13270.0,14761.0,8
HCPCS,J3490,CEFEPIME IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CEFIDEROCOL 1 GRAM IV SOLR,3470.99,2256.14,13270.0,14761.0,2
HCPCS,J3490,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,13270.0,14761.0,4
HCPCS,J3490,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR,2364.96,1537.22,13270.0,14761.0,2
HCPCS,J3490,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,CISATRACURIUM 10 MG/ML CONC. IV SOLN,1200.6399999999999,780.4150000000001,13270.0,14761.0,10
HCPCS,J3490,CISATRACURIUM 2 MG/ML IV SOLN,350.03999999999996,227.525,13270.0,14761.0,20
HCPCS,J3490,CLADRIBINE 10 MG/10 ML IV SOLN,1337.92,869.65,13270.0,14761.0,6
HCPCS,J3490,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,6
HCPCS,J3490,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J3490,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
HCPCS,J3490,COCAINE 4 % NA SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J3490,COLISTIN (COLISTIMETHATE NA) 150 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CORTICOTROPIN 80 UNITS/ML IJ GEL,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,CYCLOSPORINE 0.05 % OP DPET,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,CYCLOSPORINE 250 MG/5 ML IV SOLN,1242.7,807.755,13270.0,14761.0,4
HCPCS,J3490,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,8
HCPCS,J3490,DANTROLENE 20 MG IV SOLR,1040.0,676.0,13270.0,14761.0,6
HCPCS,J3490,DESMOPRESSIN 4 MCG/ML IJ SOLN,2500.32,1625.21,13270.0,14761.0,10
HCPCS,J3490,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,364.2,236.73,13270.0,14761.0,10
HCPCS,J3490,DEXRAZOXANE HCL 250 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,DEXRAZOXANE HCL 500 MG IV SOLR,5480.959999999999,3562.625,13270.0,14761.0,4
HCPCS,J3490,DEXTROSE 50 % IN WATER (D50W) IV SOLP BAG,,,13270.0,14761.0,2
HCPCS,J3490,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,J3490,DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML MISC SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J3490,DILTIAZEM HCL 5 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,18
HCPCS,J3490,DIMENHYDRINATE 50 MG/ML IJ SOLN,,,,,0
HCPCS,J3490,DOXYCYCLINE (VIBRAMYCIN) 100 MG/250 ML D5W VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,DOXYCYCLINE HYCLATE 100 MG IV SOLR,10386.4,6751.16,13270.0,14761.0,6
HCPCS,J3490,ELECTROLYTE-A IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,ENALAPRILAT 1.25 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3490,EPHEDRINE SULFATE 50 MG/ML IV SOLN,890.74,578.98,13270.0,14761.0,18
HCPCS,J3490,EPINEPHRINE HCL IN 5% DEXTROSE 8 MG/250 ML (32 MCG/ML) IV SOLN,920.0,598.0,13270.0,14761.0,2
HCPCS,J3490,EPINEPHRINE IN D5W 8 MG/250ML (0.032 MG/ML)IV PREMIX,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,EPOPROSTENOL 0.5 MG IV SOLR,405.72,263.72,13270.0,14761.0,4
HCPCS,J3490,EPOPROSTENOL 1.5 MG IV SOLR,1042.72,677.77,13270.0,14761.0,2
HCPCS,J3490,ERTAPENEM 1 GRAM IJ SOLR,924.635,601.01,13270.0,14761.0,6
HCPCS,J3490,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,462.12,300.375,13270.0,14761.0,4
HCPCS,J3490,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,"ESMOLOL IN STERILE WATER 2,000 MG/100 ML (20 MG/ML) IV SOLP",1513.6,983.84,13270.0,14761.0,2
HCPCS,J3490,"ESMOLOL IN STERILE WATER 2,500 MG/250 ML (10 MG/ML) IV SOLP",1504.0,977.6,13270.0,14761.0,2
HCPCS,J3490,ESTRADIOL 1.25 GRAM/ACTUATION TD GLPM,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,ETHYL ALCOHOL 99 % IA SOLN,12223.92,7945.55,13270.0,14761.0,2
HCPCS,J3490,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,12
HCPCS,J3490,"FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR",22500.0,14625.0,13270.0,14761.0,2
HCPCS,J3490,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J3490,FAT EMULSION 20 % IV EMUL,684.0,444.6,13270.0,14761.0,4
HCPCS,J3490,FLUCONAZOLE 2 MG/ML IN NS IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,FLUCONAZOLE CUSTOM IVPB IN NACL,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3490,FLUMAZENIL 0.1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3490,FLUOROURACIL 5 G/100 ML IV SOLN,822.4,534.56,,,0
HCPCS,J3490,FOLIC ACID 5 MG/ML IJ SOLN,395.36,256.985,13270.0,14761.0,4
HCPCS,J3490,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,FOSPHENYTOIN 100 MG PE/2 ML IJ SOLN,361.63,235.06,13270.0,14761.0,2
HCPCS,J3490,FOSPHENYTOIN 500 MG PE/10 ML IJ SOLN,1808.16,1175.3,13270.0,14761.0,4
HCPCS,J3490,GANCICLOVIR SODIUM 500 MG IV SOLR,609.48,396.16,13270.0,14761.0,10
HCPCS,J3490,GLUTARALDEHYDE (GLUTARALD) SOLUTION 3%,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,24
HCPCS,J3490,HB IV SOLUTION - HYDRATION,0.01,0.01,13270.0,14761.0,2
HCPCS,J3490,HB MISCELLANEOUS PHARMACY,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN,357.0,232.05,13270.0,14761.0,4
HCPCS,J3490,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML IJ SOLR,337.92,219.65,13270.0,14761.0,2
HCPCS,J3490,HYDROXOCOBALAMIN 5 GRAM IV SOLR,8171.5,5311.475,13270.0,14761.0,4
HCPCS,J3490,IDARUBICIN 1 MG/ML IV SOLN,743.2,483.08,13270.0,14761.0,6
HCPCS,J3490,IMIPENEM-CILASTATIN 500 MG IV SOLR,486.74,316.38,13270.0,14761.0,2
HCPCS,J3490,IMIPENEM-CILASTATIN 500 MG/100 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J3490,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,5068.48,3294.51,13270.0,14761.0,2
HCPCS,J3490,INDOCYANINE GREEN 25 MG IJ SOLR,1918.08,1246.755,13270.0,14761.0,4
HCPCS,J3490,INDOMETHACIN 50 MG PR SUPP,96896.64,62982.82,13270.0,14761.0,2
HCPCS,J3490,INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) IV SOLN,297.6,193.44,13270.0,14761.0,2
HCPCS,J3490,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,IPRATROPIUM BROMIDE 0.02 % IN SOLN,1465.56,952.61,13270.0,14761.0,16
HCPCS,J3490,ISAVUCONAZONIUM SULFATE 372 MG IV SOLR,3582.9399999999996,2328.91,13270.0,14761.0,4
HCPCS,J3490,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,1440.8400000000001,936.545,13270.0,14761.0,6
HCPCS,J3490,KETAMINE 10 MG/ML IJ SOLN,295.04,191.78,13270.0,14761.0,2
HCPCS,J3490,KETAMINE 50 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,10
HCPCS,J3490,LABETALOL 5 MG/ML IV SOLN,902.22,586.44,13270.0,14761.0,22
HCPCS,J3490,LEVOFLOXACIN 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,LEVONORGESTREL 1.5 MG PO TABS,290.0,188.5,,,0
HCPCS,J3490,LEVOTHYROXINE 100 MCG IV SOLR,1359.42,883.62,13270.0,14761.0,8
HCPCS,J3490,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,32
HCPCS,J3490,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,J3490,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,10386.4,6751.16,13270.0,14761.0,10
HCPCS,J3490,LIDOCAINE 1% (BUFFERED) INJ. SOLUTION,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,10386.4,6751.16,13270.0,14761.0,2
HCPCS,J3490,LIDOCAINE HCL 2 % MM SOLN,10974.18,7133.215,13270.0,14761.0,8
HCPCS,J3490,LIDOCAINE HCL 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
HCPCS,J3490,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,417.6,271.44,,,0
HCPCS,J3490,LIDOCAINE HCL 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",290.91999999999996,189.1,13270.0,14761.0,6
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,20
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 2 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,LINEZOLID 2 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,374.4,243.36,13270.0,14761.0,10
HCPCS,J3490,MANNITOL 20 % 20 % IV SOLP,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3490,MELPHALAN HCL-BETADEX SBES 50 MG IV SOLR,9643.14,6268.04,13270.0,14761.0,2
HCPCS,J3490,MEROPENEM 1 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3490,MEROPENEM 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3490,METHOHEXITAL 500 MG IJ SOLR,1372.96,892.42,,,0
HCPCS,J3490,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J3490,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,1465.56,952.61,13270.0,14761.0,10
HCPCS,J3490,METRONIDAZOLE 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,12
HCPCS,J3490,MILRINONE 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J3490,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3490,"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1091.92,709.75,13270.0,14761.0,12
HCPCS,J3490,NETARSUDIL-LATANOPROST 0.02-0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,NICARDIPINE 25 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3490,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,NITROGLYCERIN IN D5W 50 MG/250 ML (0.2 MG/ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3490,NOREPINEPHRINE (LEVOPHED)(0.032MG/ML) 8 MG IN D5W 250 ML,380.0,247.0,13270.0,14761.0,2
HCPCS,J3490,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,16
HCPCS,J3490,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J3490,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3490,OLANZAPINE 10 MG IM SOLR,514.72,334.57,13270.0,14761.0,8
HCPCS,J3490,Other Outpatient Services,408.45,265.49,,,0
HCPCS,J3490,PANTOPRAZOLE 40 MG IV SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,J3490,PANTOPRAZOLE ORAL SUSPENSION 2 MG/ML,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,J3490,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,18540.36,12051.235,,,0
HCPCS,J3490,PENICILLIN G SODIUM 5 MILLION UNITS IJ SOLR,584.56,379.96,13270.0,14761.0,4
HCPCS,J3490,PENTAMIDINE 300 MG IJ SOLR,1133.51,736.78,,,0
HCPCS,J3490,PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,736.0,478.4,13270.0,14761.0,4
HCPCS,J3490,PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,800.0,520.0,13270.0,14761.0,4
HCPCS,J3490,PHENOBARBITAL 10 MG/ML IV IN NS PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,16
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J3490,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J3490,POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,18
HCPCS,J3490,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,10386.4,6751.16,13270.0,14761.0,4
HCPCS,J3490,POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,521.6,339.04,13270.0,14761.0,8
HCPCS,J3490,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J3490,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,777.36,505.28499999999997,13270.0,14761.0,10
HCPCS,J3490,POVIDONE-IODINE 10 % TP SOLN,10386.4,6751.16,13270.0,14761.0,2
HCPCS,J3490,PRISMASATE BK 4/0 CA+,,,13270.0,14761.0,2
HCPCS,J3490,PRISMASATE BK 4/2.5 CA+,,,13270.0,14761.0,2
HCPCS,J3490,PROPOFOL 10 MG/ML BOLUS,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,14
HCPCS,J3490,PYRIDOSTIGMINE BROMIDE 5 MG/ML IJ SOLN,448.8,291.72,13270.0,14761.0,2
HCPCS,J3490,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,RASBURICASE 1.5 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,REMIFENTANIL 2 MG IV SOLR,1917.22,1246.19,13270.0,14761.0,2
HCPCS,J3490,RIFAMPIN 600 MG IV SOLR,1933.12,1256.53,13270.0,14761.0,6
HCPCS,J3490,ROCURONIUM 10 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,30
HCPCS,J3490,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,ROPIVACAINE 0.2 % PERIPHERAL NERVE BLOCK INFUSION,454.4,295.36,13270.0,14761.0,2
HCPCS,J3490,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.15 % EP SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,ROTIGOTINE 2 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,1807.6,1174.94,13270.0,14761.0,2
HCPCS,J3490,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.4,188.76,13270.0,14761.0,10
HCPCS,J3490,SODIUM BICARBONATE (STRAIGHT DRUG) IV INFUSION,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3490,SODIUM BICARBONATE 4.2 % IV SOLN,320.32,208.20999999999998,13270.0,14761.0,6
HCPCS,J3490,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,6
HCPCS,J3490,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,SODIUM BICARBONATE 8.4 % IV SOLN,917.98,596.685,13270.0,14761.0,10
HCPCS,J3490,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,8
HCPCS,J3490,SODIUM CHLORIDE 3 % IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,SODIUM CHLORIDE 3% IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J3490,SODIUM CHLORIDE 7 % IN NEBU,1465.56,952.61,13270.0,14761.0,4
HCPCS,J3490,SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML PO SOLN,,,13270.0,14761.0,6
HCPCS,J3490,SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J3490,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,348.48,226.51,13270.0,14761.0,10
HCPCS,J3490,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN,1161.66,755.08,,,0
HCPCS,J3490,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IV SOLN,1584.0,1029.6,,,0
HCPCS,J3490,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IVPB,1584.0,1029.6,13270.0,14761.0,2
HCPCS,J3490,STERILE TALC 4 GRAM PL SUSR,2092.7799999999997,1360.305,13270.0,14761.0,4
HCPCS,J3490,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
HCPCS,J3490,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,13270.0,14761.0,4
HCPCS,J3490,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,400.8,260.52,13270.0,14761.0,12
HCPCS,J3490,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,323.88,210.51999999999998,13270.0,14761.0,2
HCPCS,J3490,TAFLUPROST (PF) 0.0015 % OP DPET,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,TERIPARATIDE 20 MCG/DOSE (600MCG/2.4ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3490,TETRACAINE HCL (PF) 1 % (10 MG/ML) IJ SOLN,1075.46,699.05,,,0
HCPCS,J3490,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J3490,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J3490,TRACE ELEMENTS (TRALEMENT) ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN,,,13270.0,14761.0,4
HCPCS,J3490,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,16
HCPCS,J3490,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",290.0,188.5,13270.0,14761.0,2
HCPCS,J3490,TRIMETHOBENZAMIDE 100 MG/ML IM SOLN,722.24,469.46,13270.0,14761.0,2
HCPCS,J3490,TUBERCULIN PPD 5 TUB. UNIT /0.1 ML ID SOLN,1641.28,1066.83,13270.0,14761.0,4
HCPCS,J3490,UNCLASSIFIED DRUGS,,,,,0
HCPCS,J3490,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J3490,VASOPRESSIN 0.2 UNITS/ML IV SOLN,596.8,387.92,13270.0,14761.0,2
HCPCS,J3490,VASOPRESSIN 0.4 UNITS/ML IV SOLN,1342.4,872.56,13270.0,14761.0,2
HCPCS,J3490,VASOPRESSIN 20 UNITS/ML IV SOLN,1329.07,863.895,13270.0,14761.0,10
HCPCS,J3490,VECURONIUM BROMIDE 10 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,14
HCPCS,J3490,VERAPAMIL 2.5 MG/ML IV SOLN,310.66,201.93,13270.0,14761.0,12
HCPCS,J3490,VITAMIN A PALMITATE 50000 UNITS/ML IM SOLN,20482.8,13313.82,,,0
HCPCS,J3490,VORICONAZOLE 200 MG IV SOLR,307.08000000000004,199.6,13270.0,14761.0,6
HCPCS,J3490,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,,,0
HCPCS,J3490,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,,,0
HCPCS,J3490,ZINC SULFATE 5 MG/ML IV SOLN,667.44,433.84,13270.0,14761.0,2
HCPCS,J3520,ENDRATE ETHYLENEDIAMINE-TETRA-ACETIC ACID (EDTA),,,2.25,2.4,2
HCPCS,J3520,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J3535,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J3535,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J3535,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION IN HFAB,1631.98,1060.79,13270.0,14761.0,2
HCPCS,J3535,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION IN HFAB,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3535,BUDESONIDE 90 MCG/ACTUATION IN AEPB,1472.8,957.32,13270.0,14761.0,2
HCPCS,J3535,BUDESONIDE-GLYCOPYR-FORMOTEROL 160-9-4.8 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3535,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,,,259.14,276.68,2
HCPCS,J3535,FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,2
HCPCS,J3535,FLUTICASONE FUROATE-VILANTEROL 200-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,2
HCPCS,J3535,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3535,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,8
HCPCS,J3535,IPRATROPIUM BROMIDE 17 MCG/ACTUATION IN HFAA,2287.02,1486.56,13270.0,14761.0,2
HCPCS,J3535,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
HCPCS,J3535,LEVALBUTEROL TARTRATE 45 MCG/ACTUATION IN HFAA,486.72,316.37,13270.0,14761.0,4
HCPCS,J3535,Other Outpatient Services,877.78,570.5550000000001,,,0
HCPCS,J3535,SALMETEROL 50 MCG/DOSE IN DSDV,3156.48,2051.71,13270.0,14761.0,2
HCPCS,J3535,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,1913.93,1244.055,13270.0,14761.0,4
HCPCS,J3535,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,171.86,194.08,2
HCPCS,J3590,All drugs or drug agents without specific rate set forth above or herein,387.29,251.74,,,0
HCPCS,J3590,DUPILUMAB 200 MG/1.14 ML SC SYRG,16742.74,10882.78,,,0
HCPCS,J3590,HB MISCELLANEOUS PHARMACY,387.29,251.74,13270.0,14761.0,2
HCPCS,J3590,HB TERM FECAL MICROBIOTA TRANSPLANTATION 30 CC,387.29,251.74,,,0
HCPCS,J3590,IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN,22846.05,14849.93,13270.0,14761.0,2
HCPCS,J3590,INFLIXIMAB-AXXQ 100 MG IV SOLR,6335.52,4118.09,13270.0,14761.0,2
HCPCS,J3590,INSULIN LISPRO 100 UNITS/ML SC SOLN,387.29,251.74,13270.0,14761.0,6
HCPCS,J3590,Other Outpatient Services,387.29,251.74,,,0
HCPCS,J3590,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,16597.92,10788.65,,,0
HCPCS,J3590,PORACTANT ALFA 240 MG/3 ML ITL SUSP,12262.08,7970.35,13270.0,14761.0,4
HCPCS,J3590,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,13270.0,14761.0,4
HCPCS,J3590,RISANKIZUMAB-RZAA 60 MG/ML IV SOLN,86978.16,56535.8,,,0
HCPCS,J3590,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,,,0
HCPCS,J3590,TENECTEPLASE 50 MG IV SOLR,69575.04,45223.78,13270.0,14761.0,4
HCPCS,J3590,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,13270.0,14761.0,2
HCPCS,J3590,THROMBIN (RECOMBINANT) 5000 UNITS TP SOLR,924.32,600.81,13270.0,14761.0,2
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,387.29,251.74,,,0
HCPCS,J3590,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",387.29,251.74,,,0
HCPCS,J7030,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,16
HCPCS,J7030,All drugs or drug agents without specific rate set forth above or herein,0.01,0.01,,,0
HCPCS,J7030,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,10
HCPCS,J7030,HB IV SOLUTION - HYDRATION,0.01,0.01,,,0
HCPCS,J7030,"INFUSION, NORMAL SALINE SOLUTION, 1000 CC",0.01,0.01,24.7,26.38,2
HCPCS,J7030,Other Outpatient Services,0.01,0.01,,,0
HCPCS,J7030,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",0.01,0.01,16.38,18.5,2
HCPCS,J7040,HB IV SOLUTION - HYDRATION,0.01,0.01,,,0
HCPCS,J7040,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT)",,,28.33,30.25,2
HCPCS,J7040,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,8
HCPCS,J7040,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,48
HCPCS,J7040,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,6
HCPCS,J7040,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.79,21.22,2
HCPCS,J7042,5% DEXTROSE / NORMAL SALINE (500 ML = 1 UNIT),,,43.36,46.3,2
HCPCS,J7042,D10 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
HCPCS,J7042,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,8
HCPCS,J7042,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,6
HCPCS,J7042,DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP,,,13270.0,14761.0,2
HCPCS,J7042,DEXTROSE 5%-1/4 NORMAL SALINE IV SOLP,,,13270.0,14761.0,4
HCPCS,J7042,LACTATED RINGERS IRRIGATION INTRAPROCEDURE,,,13270.0,14761.0,4
HCPCS,J7042,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.76,32.48,2
HCPCS,J7050,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",,,22.11,23.61,2
HCPCS,J7050,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,18
HCPCS,J7050,SODIUM CHLORIDE 0.9% IV MINI BAG PLUS 100 ML,,,13270.0,14761.0,4
HCPCS,J7050,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.67,16.56,2
HCPCS,J7060,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,26
HCPCS,J7060,5% DEXTROSE / WATER (500 ML = 1 UNIT),,,24.7,26.38,2
HCPCS,J7060,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,6
HCPCS,J7060,DEXTROSE 20 % IN WATER (D20W) 20 % IV SOLP,,,13270.0,14761.0,2
HCPCS,J7060,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,14
HCPCS,J7060,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.38,18.5,2
HCPCS,J7070,"INFUSION, D5W, 1000 CC",,,26.61,28.41,2
HCPCS,J7070,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.64,19.93,2
HCPCS,J7100,DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP,528.0,343.2,13270.0,14761.0,4
HCPCS,J7100,DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP,440.0,286.0,13270.0,14761.0,4
HCPCS,J7100,"INFUSION, DEXTRAN 40, 500 ML",,,306.99,327.77,2
HCPCS,J7100,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,203.6,229.92,2
HCPCS,J7110,"INFUSION, DEXTRAN 75, 500 ML",,,199.88,213.41,2
HCPCS,J7110,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,132.56,149.7,2
HCPCS,J7120,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,10
HCPCS,J7120,"RINGERS LACTATE INFUSION, UP TO 1000 CC",,,29.02,30.99,2
HCPCS,J7120,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.25,21.74,2
HCPCS,J7121,"5% dextrose in lactated ringers infusion, up to 1,000 cc",,,2.59,2.77,2
HCPCS,J7121,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,8
HCPCS,J7121,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J7131,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7131,"HYPERTONIC SALINE SOLUTION, 1 ML",,,0.17,0.18,2
HCPCS,J7131,SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP,290.0,188.5,,,0
HCPCS,J7131,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,6
HCPCS,J7131,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,1465.56,952.61,13270.0,14761.0,8
HCPCS,J7131,SODIUM CHLORIDE 5% FOR APHERESIS ONLY,290.0,188.5,13270.0,14761.0,2
HCPCS,J7131,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J7168,All drugs or drug agents without specific rate set forth above or herein,,,6.17,6.17,2
HCPCS,J7168,Drug,,,7.26,7.75,2
HCPCS,J7168,"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) IV SOLR",28800.0,18720.0,2.79,14761.0,6
HCPCS,J7168,HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) IV SOLR,14400.0,9360.0,2.79,14761.0,6
HCPCS,J7168,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.81,5.43,2
HCPCS,J7169,All drugs or drug agents without specific rate set forth above or herein,,,363.06,363.06,2
HCPCS,J7169,"FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR",22500.0,14625.0,164.36,14761.0,3
HCPCS,J7169,"Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg",,,733.0,782.6,2
HCPCS,J7169,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,486.13,548.97,2
HCPCS,J7170,All drugs or drug agents without specific rate set forth above or herein,,,145.29,145.29,2
HCPCS,J7170,"Injection, emicizumab-kxwh, 0.5 mg",,,132.16,141.1,2
HCPCS,J7170,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,87.65,98.98,2
HCPCS,J7175,All drugs or drug agents without specific rate set forth above or herein,,,25.06,25.06,2
HCPCS,J7175,"Injection, factor x, (human), 1 i.u.",,,20.56,21.95,2
HCPCS,J7175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.63,15.4,2
HCPCS,J7177,All drugs or drug agents without specific rate set forth above or herein,,,3.06,3.06,2
HCPCS,J7177,"FIBRINOGEN 1 GRAM (700 MG- 1,300 MG) IV SOLR",290.0,188.5,1.38,14761.0,3
HCPCS,J7177,"Injection, human fibrinogen concentrate (fibryga), 1 mg (Price is per 1mg. Product contains approximately 1 gram (900-1300mg))",,,2.42,3.14,4
HCPCS,J7177,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7178,All drugs or drug agents without specific rate set forth above or herein,,,3.98,3.98,2
HCPCS,J7178,"INJECTION, HUMAN FIBRINOGEN CONCENTRATE, 1 MG",,,2.42,2.58,2
HCPCS,J7178,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,J7179,All drugs or drug agents without specific rate set forth above or herein,,,5.15,5.15,2
HCPCS,J7179,"Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco",,,5.36,5.72,2
HCPCS,J7179,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J7180,All drugs or drug agents without specific rate set forth above or herein,,,27.94,27.94,2
HCPCS,J7180,"INJECTION, FACTOR XIII (ANTIHEMOPHILIC FACTOR, HUMAN), 1 I.U.",,,20.73,22.13,2
HCPCS,J7180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.75,15.53,2
HCPCS,J7181,All drugs or drug agents without specific rate set forth above or herein,,,47.46,47.46,2
HCPCS,J7181,"Injection, factor XIII A-subunit, (recombinant), per IU For billing prior to 1/1/15 use C9134 or J3590)",,,35.42,37.81,2
HCPCS,J7181,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.49,26.52,2
HCPCS,J7182,All drugs or drug agents without specific rate set forth above or herein,,,3.79,3.79,2
HCPCS,J7182,"Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu",,,5.18,5.53,2
HCPCS,J7182,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.44,3.88,2
HCPCS,J7183,All drugs or drug agents without specific rate set forth above or herein,,,3.52,3.52,2
HCPCS,J7183,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMAN), WILATE, 1 I.U. VWF:RCO",,,3.11,3.32,2
HCPCS,J7183,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,J7185,All drugs or drug agents without specific rate set forth above or herein,,,4.08,4.08,2
HCPCS,J7185,"INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U",,,3.63,3.87,2
HCPCS,J7185,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.41,2.72,2
HCPCS,J7186,All drugs or drug agents without specific rate set forth above or herein,,,3.37,3.37,2
HCPCS,J7186,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",,,3.11,3.32,2
HCPCS,J7186,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,J7187,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV SOLR",32321.4,21008.91,1.74,14761.0,20
HCPCS,J7187,ANTIHEMOPHILIC FACTOR-VWF 250-600 UNIT IV SOLR,11040.0,7176.0,1.74,14761.0,10
HCPCS,J7187,"ANTIHEMOPHILIC FACTOR-VWF 500-1,200 UNIT IV SOLR",22080.0,14352.0,1.74,14761.0,20
HCPCS,J7187,All drugs or drug agents without specific rate set forth above or herein,,,3.84,3.84,2
HCPCS,J7187,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",,,2.94,3.14,2
HCPCS,J7187,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU, VWF:RCO",,,2.96,2.96,2
HCPCS,J7187,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7188,All drugs or drug agents without specific rate set forth above or herein,,,8.86,8.86,2
HCPCS,J7188,"Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU (Code re-used by CMS effective 1/1/16) (For billing prior to 1/1/16 use C9399 or J7199)",,,13.82,14.76,2
HCPCS,J7188,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.17,10.35,2
HCPCS,J7189,All drugs or drug agents without specific rate set forth above or herein,,,6.92,6.92,2
HCPCS,J7189,COAGULATION FACTOR VIIA RECOMB 1 MG IV SOLR,19846.785,12900.41,3.13,14761.0,20
HCPCS,J7189,COAGULATION FACTOR VIIA RECOMB 2 MG IV SOLR,29452.17,19143.91,3.13,14761.0,13
HCPCS,J7189,COAGULATION FACTOR VIIA RECOMB 5 MG IV SOLR,20482.8,13313.82,3.13,3.6,8
HCPCS,J7189,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), PER 1 MICROGRAM ï",,,3.46,3.69,2
HCPCS,J7189,"Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram",,,5.34,5.34,2
HCPCS,J7189,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J7190,All drugs or drug agents without specific rate set forth above or herein,,,3.22,3.22,2
HCPCS,J7190,"FACTOR VIII, VIRAL INACTIVATED, PER UNIT",,,2.76,2.95,2
HCPCS,J7190,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.83,2.07,2
HCPCS,J7191,FACTOR VIII (ANTIHEMOPHILIC FACTOR (PORCINE ) PER I.U.,,,4.84,5.16,2
HCPCS,J7191,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.21,3.62,2
HCPCS,J7192,"ANTIHEMOPHIL FVIII,FULL LENGTH 1,000 (+/-) UNIT IV SOLR",19040.0,12376.0,1.93,14761.0,10
HCPCS,J7192,"ANTIHEMOPHIL FVIII,FULL LENGTH 2,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.93,2.22,8
HCPCS,J7192,All drugs or drug agents without specific rate set forth above or herein,,,4.26,4.26,2
HCPCS,J7192,"FACTOR VIII, (ANTI-HEMOPHILIC FACTOR(RECOMBINANT) PER I.U.",,,2.94,3.14,2
HCPCS,J7192,"Factor VIII (antihemophilic factor, recombinant) per IU, not otherwise specified (Effective 9/1/18 Code Price is based on Median Pricing Methodology)",,,3.34,3.34,2
HCPCS,J7192,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7193,All drugs or drug agents without specific rate set forth above or herein,,,3.88,3.88,2
HCPCS,J7193,"COAGULATION FACTOR IX 1,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.75,14761.0,3
HCPCS,J7193,"FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER IU",,,2.91,2.91,2
HCPCS,J7193,"FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT)PER IU",,,2.94,3.14,2
HCPCS,J7193,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7194,All drugs or drug agents without specific rate set forth above or herein,,,4.54,4.54,2
HCPCS,J7194,"FACTOR IX CPLX(PCC)NO4,3FACTOR 1,000 (+/-) UNIT IV SOLR",21138.665,13740.130000000001,2.06,14761.0,9
HCPCS,J7194,"FACTOR IX CPLX(PCC)NO4,3FACTOR 500 (+/-) UNIT IV SOLR",10720.0,6968.0,2.06,14761.0,3
HCPCS,J7194,"FACTOR IX, COMPLEX, HEAT-TREATED, PER I.U.",,,1.04,1.11,2
HCPCS,J7194,"FACTOR IX, COMPLEX, PER IU",,,3.54,3.54,2
HCPCS,J7194,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J7195,All drugs or drug agents without specific rate set forth above or herein,,,5.09,5.09,2
HCPCS,J7195,"FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU",,,2.94,3.14,2
HCPCS,J7195,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7196,"INJECTION, ANTITHROMBIN RECOMBINANT, 50 I.U.",,,259.83,277.41,2
HCPCS,J7196,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,172.32,194.6,2
HCPCS,J7197,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT IV SOLR,35241.28,22906.83,4.8,14761.0,3
HCPCS,J7197,"ANTITHROMBIN III (HUMAN), PER I.U.",,,3.11,3.32,2
HCPCS,J7197,"ANTITHROMBIN III (HUMAN), PER IU",,,8.51,8.51,2
HCPCS,J7197,All drugs or drug agents without specific rate set forth above or herein,,,10.6,10.6,2
HCPCS,J7197,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,J7198,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",80800.0,52520.0,2.92,14761.0,3
HCPCS,J7198,"ANTI-INHIBITOR COAGULANT CMPLX 700-1,300 UNIT IV SOLR",32320.0,21008.0,2.92,14761.0,3
HCPCS,J7198,"ANTI-INHIBITOR, PER I.U.",,,3.46,3.69,2
HCPCS,J7198,"ANTI-INHIBITOR, PER IU",,,4.99,4.99,2
HCPCS,J7198,All drugs or drug agents without specific rate set forth above or herein,,,6.45,6.45,2
HCPCS,J7198,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,J7200,Factor ix recombinan rixubis,,,3.8,4.06,2
HCPCS,J7200,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.52,2.85,2
HCPCS,J7201,All drugs or drug agents without specific rate set forth above or herein,,,9.88,9.88,2
HCPCS,J7201,Factor ix fc fusion recomb,,,7.6,8.12,2
HCPCS,J7201,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.04,5.69,2
HCPCS,J7202,All drugs or drug agents without specific rate set forth above or herein,,,13.9,13.9,2
HCPCS,J7202,"Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.",,,11.4,12.17,2
HCPCS,J7202,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.56,8.54,2
HCPCS,J7203,All drugs or drug agents without specific rate set forth above or herein,,,12.56,12.56,2
HCPCS,J7203,"Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu",,,10.71,11.44,2
HCPCS,J7203,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.1,8.02,2
HCPCS,J7204,All drugs or drug agents without specific rate set forth above or herein,,,5.96,5.96,2
HCPCS,J7204,"Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu",,,6.12,6.53,2
HCPCS,J7204,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.06,4.58,2
HCPCS,J7205,All drugs or drug agents without specific rate set forth above or herein,,,6.45,6.45,2
HCPCS,J7205,Factor viii fc fusion recomb,,,5.36,5.72,2
HCPCS,J7205,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J7207,All drugs or drug agents without specific rate set forth above or herein,,,5.76,5.76,2
HCPCS,J7207,"Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.",,,5.36,5.72,2
HCPCS,J7207,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J7208,All drugs or drug agents without specific rate set forth above or herein,,,6.71,6.71,2
HCPCS,J7208,"Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.",,,6.15,6.56,2
HCPCS,J7208,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.08,4.6,2
HCPCS,J7209,All drugs or drug agents without specific rate set forth above or herein,,,3.42,3.42,2
HCPCS,J7209,"Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.",,,4.49,4.8,2
HCPCS,J7209,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.98,3.36,2
HCPCS,J7210,All drugs or drug agents without specific rate set forth above or herein,,,4.02,4.02,2
HCPCS,J7210,"Injection, factor VIII, (antihemophilic factor, recombinant), (Afstyla), 1 IU (For billing prior to 1/1/18 use J7199 or C9140 for OPPS billing)",,,4.32,4.61,2
HCPCS,J7210,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.86,3.23,2
HCPCS,J7211,All drugs or drug agents without specific rate set forth above or herein,,,4.06,4.06,2
HCPCS,J7211,"Injection, factor VIII, (antihemophilic factor, recombinant), (Kovaltry), 1 IU (For billing prior to 1/1/18 use J7192)",,,4.49,4.8,2
HCPCS,J7211,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.98,3.36,2
HCPCS,J7212,"Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram",,,6.05,6.46,2
HCPCS,J7212,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.01,4.53,2
HCPCS,J7294,Drug,,,5570.82,5947.77,2
HCPCS,J7294,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3694.62,4172.25,2
HCPCS,J7295,Drug,,,374.54,399.89,2
HCPCS,J7295,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,248.4,280.51,2
HCPCS,J7296,LEVONORGESTREL 17.5 MCG/24 HR (5 YRS) 19.5 MG IU IUD,19434.08,12632.15,,,0
HCPCS,J7296,"Levonorgestrel-releasing intrauterine contraceptive system, (Kyleena), 19.5 mg (For billing prior to 1/1/18 use Q9984)",,,2287.86,2442.67,2
HCPCS,J7296,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1517.33,1713.49,2
HCPCS,J7297,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7297,LEVONORGESTREL 20.4 MCG/24 HR (8 YRS) 52 MG IU IUD,14907.68,9689.99,13270.0,14761.0,2
HCPCS,J7297,"Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration",,,1665.92,1778.65,2
HCPCS,J7297,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1104.86,1247.69,2
HCPCS,J7298,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7298,LEVONORGESTREL 20 MCG/24 HOURS (8 YRS) 52 MG IU IUD,19434.08,12632.15,,,0
HCPCS,J7298,"Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 5 year duration",,,2160.36,2306.55,2
HCPCS,J7298,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1432.77,1618.0,2
HCPCS,J7300,COPPER 380 SQUARE MM IU IUD,9765.0,6347.25,13270.0,14761.0,2
HCPCS,J7300,INTRAUTERINE COPPER CONTRACEPTIVE,,,802.12,856.4,2
HCPCS,J7300,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,531.98,600.75,2
HCPCS,J7301,LEVONORGESTREL 14 MCG/24 HR (3 YRS) 13.5 MG IU IUD,16182.08,10518.35,,,0
HCPCS,J7301,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (SKYLA), 13.5 MG",,,1733.3,1850.59,2
HCPCS,J7301,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1149.54,1298.15,2
HCPCS,J7303,"CONTRACEPTIVE SUPPLY, HORMONE CONTAINING VAGINAL RING, EACH",,,143.74,153.46,2
HCPCS,J7303,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,95.33,107.65,2
HCPCS,J7304,"CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH",,,46.65,49.8,2
HCPCS,J7304,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.94,34.93,2
HCPCS,J7306,"LEVONORGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANTS AND SUPPLIES",,,167.06,178.36,2
HCPCS,J7306,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,110.79,125.12,2
HCPCS,J7307,"ETONGESTREL (CONTRACEPTIVE)IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",,,1452.05,1550.3,2
HCPCS,J7307,ETONOGESTREL 68 MG SD IMPL,10406.52,6764.24,13270.0,14761.0,4
HCPCS,J7307,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,963.01,1087.51,2
HCPCS,J7308,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20% SINGLE UNIT DOSE",,,262.25,280.0,2
HCPCS,J7308,All drugs or drug agents without specific rate set forth above or herein,,,1091.92,1091.92,2
HCPCS,J7308,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,173.93,196.41,2
HCPCS,J7309,"METHYL AMINOLEVULINATE (MAL) FOR TOPICAL ADMINISTRATION, 16.8%, 1 GRAM",,,182.61,194.96,2
HCPCS,J7309,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,121.11,136.76,2
HCPCS,J7310,GANCICLOVIR LONG ACT IMPLANT,,,12340.25,13175.26,2
HCPCS,J7310,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8184.16,9242.18,2
HCPCS,J7311,All drugs or drug agents without specific rate set forth above or herein,,,917.28,917.28,2
HCPCS,J7311,"FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT ï",,,48644.38,51935.96,2
HCPCS,J7311,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,32261.39,36432.04,2
HCPCS,J7312,All drugs or drug agents without specific rate set forth above or herein,,,565.59,565.59,2
HCPCS,J7312,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",,,493.06,526.42,2
HCPCS,J7312,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,327.0,369.27,2
HCPCS,J7313,All drugs or drug agents without specific rate set forth above or herein,,,1362.61,1362.61,2
HCPCS,J7313,Fluocinol acet intravit imp,,,1234.54,1318.08,2
HCPCS,J7313,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,818.76,924.61,2
HCPCS,J7314,All drugs or drug agents without specific rate set forth above or herein,,,1452.25,1452.25,2
HCPCS,J7314,"Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mg",,,1276.3,1362.66,2
HCPCS,J7314,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,846.45,955.88,2
HCPCS,J7315,"MITOMYCIN, OPTHALMIC, 0. 2 MG",,,326.34,348.43,2
HCPCS,J7315,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,216.43,244.41,2
HCPCS,J7316,"INJECTION, OCRIPLASMIN, 0.125 MG",,,2632.17,2810.28,2
HCPCS,J7316,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1745.68,1971.36,2
HCPCS,J7318,All drugs or drug agents without specific rate set forth above or herein,,,19.25,19.25,2
HCPCS,J7318,"Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg",,,43.36,46.3,2
HCPCS,J7318,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.76,32.48,2
HCPCS,J7320,All drugs or drug agents without specific rate set forth above or herein,,,16.22,16.22,2
HCPCS,J7320,"Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg",,,24.53,26.19,2
HCPCS,J7320,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.27,18.37,2
HCPCS,J7321,"HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE",,,322.02,343.81,2
HCPCS,J7321,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,213.57,241.18,2
HCPCS,J7322,All drugs or drug agents without specific rate set forth above or herein,,,47.99,47.99,2
HCPCS,J7322,"Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg",,,44.4,47.4,2
HCPCS,J7322,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,29.45,33.25,2
HCPCS,J7323,All drugs or drug agents without specific rate set forth above or herein,,,333.68,333.68,2
HCPCS,J7323,"HYALURONAN OR DERIVATIVE, EUFLEXXA, FOR INTRAARTICULAR INJ, PER DOSE",,,339.99,363.0,2
HCPCS,J7323,"Hyaluronan or derivative, Euflexxa, for intra-articular injection, per dose (20 mg/2 mL) (Note: Total dose regimen = 3 injections)",,,279.93,279.93,2
HCPCS,J7323,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IX SYRG,20482.8,13313.82,151.06,173.71,16
HCPCS,J7323,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,225.49,254.64,2
HCPCS,J7324,All drugs or drug agents without specific rate set forth above or herein,,,338.09,338.09,2
HCPCS,J7324,"HYALURONAN OR DERIVATIVE, ORTHOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",,,580.47,619.75,2
HCPCS,J7324,"Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose (30 mg/2 mL) (Note: Total dose regimen = 3 - 4 injections)",,,287.27,287.27,2
HCPCS,J7324,SODIUM HYALURONATE (VISCOSUP) 30 MG/2 ML IX SYRG,20482.8,13313.82,153.05,176.01,8
HCPCS,J7324,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,384.98,434.74,2
HCPCS,J7325,All drugs or drug agents without specific rate set forth above or herein,,,25.18,25.18,2
HCPCS,J7325,"HYALURON OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULARE INJECTION, 1 MG",,,39.04,41.69,2
HCPCS,J7325,HYLAN G-F 20 16 MG/2 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
HCPCS,J7325,HYLAN G-F 20 48 MG/6 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
HCPCS,J7325,"Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg (For billing prior to 1/1/10 see J7322 for Synvisc and J3490 for Synvisc-One)",,,20.07,20.07,2
HCPCS,J7325,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25.89,29.24,2
HCPCS,J7326,All drugs or drug agents without specific rate set forth above or herein,,,1470.16,1470.16,2
HCPCS,J7326,"HYALURONAN OR DERIVATIVE, GEL-ONE, FOR INTRA-ARTICULAR INJECTION, PER DOSE",,,1093.56,3272.67,4
HCPCS,J7326,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IX SYRG",10974.18,7133.215,665.53,14761.0,19
HCPCS,J7326,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2032.91,2295.71,2
HCPCS,J7327,All drugs or drug agents without specific rate set forth above or herein,,,1879.13,1879.13,2
HCPCS,J7327,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IX SYRG",20482.8,13313.82,850.67,978.27,8
HCPCS,J7327,"Hyaluronan or derivative, Monovisc, for intra-articular injection, per dose (For billing prior to 1/1/15 use C9399 or J3490) (Dose 88 mg/4 mL) (Note: Total dose regimen = 1 dose)",,,1570.93,1570.93,2
HCPCS,J7327,Monovisc inj per dose,,,2598.83,2774.68,2
HCPCS,J7327,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1723.57,1946.38,2
HCPCS,J7328,"Hyaluronan or derivative, gel-syn, for intra-articular injection, 0.1 mg",,,5.48,5.85,2
HCPCS,J7328,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.63,4.1,2
HCPCS,J7329,All drugs or drug agents without specific rate set forth above or herein,,,18.33,18.33,2
HCPCS,J7329,"Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg",,,18.14,19.37,2
HCPCS,J7329,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.03,13.59,2
HCPCS,J7330,"AUTOLOGOUS CULTURED CHONDROCYTES,IMPLANT",,,139274.62,148698.79,2
HCPCS,J7330,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,92368.19,104309.24,2
HCPCS,J7331,"HYALURONAN OR DERIVATIVE, SYNOJOYNT, FOR INTRA-ARTICULAR INJECTION, 1 MG",,,62.02,66.22,2
HCPCS,J7331,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.13,46.45,2
HCPCS,J7332,All drugs or drug agents without specific rate set forth above or herein,,,28.49,28.49,2
HCPCS,J7332,"Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg",,,65.18,69.59,2
HCPCS,J7332,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,43.23,48.82,2
HCPCS,J7336,All drugs or drug agents without specific rate set forth above or herein,,,9.15,9.15,2
HCPCS,J7336,Capsaicin 8% patch,,,6.91,7.38,2
HCPCS,J7336,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.58,5.18,2
HCPCS,J7340,All drugs or drug agents without specific rate set forth above or herein,,,646.56,646.56,2
HCPCS,J7340,Carbidopa 5 mg/levodopa 20 mg enteral suspension (Code re-used by CMS effective 1/1/16),,,5.36,5.72,2
HCPCS,J7340,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J7342,"Installation, ciprofloxacin otic suspension, 6 mg",,,75.5,80.6,2
HCPCS,J7342,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,50.07,56.54,2
HCPCS,J7345,All drugs or drug agents without specific rate set forth above or herein,,,4.74,4.74,2
HCPCS,J7345,"Aminolevulinic acid HCl for topical administration, 10% gel, 10 mg (For billing prior to 1/1/18 use J3490) (Code re-used by CMS 1/1/18) (Code Price is per 10 mg of gel, tube contains total of 2g (2,00",,,3.63,3.87,2
HCPCS,J7345,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.41,2.72,2
HCPCS,J7351,All drugs or drug agents without specific rate set forth above or herein,,,577.25,577.25,2
HCPCS,J7351,"Injection, bimatoprost, intracameral implant, 1 microgram",,,519.76,554.93,2
HCPCS,J7351,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,344.71,389.27,2
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,7526.12,8035.38,2
HCPCS,J7352,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4991.39,5636.66,2
HCPCS,J7402,"Mometasone furoate sinus implant, (sinuva), 10 micrograms",,,27.1,28.93,2
HCPCS,J7402,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.97,20.3,2
HCPCS,J7500,"AZATHIOPRINE (E.G., IMURAN) - ORAL, TAB, 50 MG, 100S EA",,,268.47,286.64,2
HCPCS,J7500,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,J7500,AZATHIOPRINE ORAL SUSPENSION 50 MG/ML,1465.56,952.61,13270.0,14761.0,2
HCPCS,J7500,"AZATHIOPRINE, ORAL, 50 MG",,,10.03,10.03,2
HCPCS,J7500,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,178.05,201.07,2
HCPCS,J7501,"AZATHIOPRINE (E.G., IMURAN) - PARENTERAL, VIAL, 100 MG., 20 ML EACH",,,209.39,223.55,2
HCPCS,J7501,All drugs or drug agents without specific rate set forth above or herein,,,648.25,648.25,2
HCPCS,J7501,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,138.87,156.82,2
HCPCS,J7502,CYCLOSPORINE - ORAL 100 MG,,,12.44,13.28,2
HCPCS,J7502,CYCLOSPORINE 100 MG PO CAPS,10974.18,7133.215,13270.0,14761.0,4
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG PO CAPS,1675.2,1088.88,13270.0,14761.0,8
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG/ML PO SOLN,8693.6,5650.84,13270.0,14761.0,2
HCPCS,J7502,"CYCLOSPORINE, ORAL, 100 MG",,,4.99,4.99,2
HCPCS,J7502,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.25,9.32,2
HCPCS,J7503,TACROLIMUS 0.75 MG PO TB24,4337.84,2819.5950000000003,13270.0,14761.0,4
HCPCS,J7503,TACROLIMUS 1 MG PO TB24,2669.76,1735.34,13270.0,14761.0,2
HCPCS,J7503,TACROLIMUS 4 MG PO TB24,4449.6,2892.24,13270.0,14761.0,2
HCPCS,J7503,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG (CODE RE-USED BY CMS EFFECTIVE 1/1/16)",,,3.8,3.8,2
HCPCS,J7503,"Tacrolimus, extended release, (Envarsus XR), oral, 0.25 mg (Code re-used by CMS effective 1/1/16)",,,2.59,2.77,2
HCPCS,J7503,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.72,1.94,2
HCPCS,J7504,ANTITHYMOCYTE GLOBULIN (EQUINE) (ATGAM) SKIN TEST,290.0,188.5,4941.46,14761.0,3
HCPCS,J7504,All drugs or drug agents without specific rate set forth above or herein,,,10915.69,10915.69,2
HCPCS,J7504,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITYMOCYTE GLOBULIN (E.G., ATGAM) - PARENTERAL, AMP, 50 MG.ML, 5 ML EA",,,678.77,724.7,2
HCPCS,J7504,"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN",41429.705,26929.309999999998,4941.46,14761.0,6
HCPCS,J7504,"Lymphocyte immune globulin, anti-thymocyte globulin, equine, parenteral, 250 mg",,,7897.82,7897.82,2
HCPCS,J7504,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,450.17,508.37,2
HCPCS,J7505,"MUROMONAB-CD3, PARENTAL, 5 MG",,,1906.58,2035.59,2
HCPCS,J7505,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1264.46,1427.93,2
HCPCS,J7507,Other Outpatient Services,1995.2,1296.88,,,0
HCPCS,J7507,TACROLIMUS 0.5 MG PO CAPS,1772.8000000000002,1152.32,13270.0,14761.0,4
HCPCS,J7507,TACROLIMUS 1 MG PO CAPS,1590.38,1033.7450000000001,13270.0,14761.0,14
HCPCS,J7507,TACROLIMUS 5 MG PO CAPS,12315.2,8004.88,13270.0,14761.0,6
HCPCS,J7507,TACROLIMUS ORAL PER 1 MG,,,10.19,10.88,2
HCPCS,J7507,"Tacrolimus, immediate release, oral, per 1 mg",,,0.52,0.52,2
HCPCS,J7507,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.76,7.63,2
HCPCS,J7508,TACROLIMUS 0.5 MG PO CP24,501.6,326.04,13270.0,14761.0,2
HCPCS,J7508,TACROLIMUS 1 MG PO CP24,1003.2,652.08,13270.0,14761.0,2
HCPCS,J7508,TACROLIMUS 5 MG PO CP24,5016.48,3260.71,13270.0,14761.0,2
HCPCS,J7508,"TACROLIMUS, EXTENDED RELEASE, ORAL, 0.1 MG",,,1.04,1.11,2
HCPCS,J7508,"Tacrolimus, extended release, (Astagraf XL), oral, 0.1 mg (For billing prior to 1/1/14 use J7599) (Code re-used by CMS 1/1/14) (Code description changed effective 1/1/16) - see new description",,,1.21,1.21,2
HCPCS,J7508,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J7509,METHYLPREDNISOLONE 4 MG PO DSPK,,,13270.0,14761.0,6
HCPCS,J7509,METHYLPREDNISOLONE 4 MG PO DSPK - ADDITIONAL DAYS,,,13270.0,14761.0,2
HCPCS,J7509,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,12
HCPCS,J7509,METHYLPREDNISOLONE ORAL PER 4 MG,,,1.04,1.11,2
HCPCS,J7509,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J7510,PREDNISOLONE 5 MG PO TABS,12246.380000000001,7960.145,13270.0,14761.0,4
HCPCS,J7510,PREDNISOLONE ORAL PER 5 MG,,,1.21,1.29,2
HCPCS,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) PO SOLN,,,13270.0,14761.0,2
HCPCS,J7510,"PREDNISOLONE, ORAL, PER 5 MG",,,0.93,0.93,2
HCPCS,J7510,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J7511,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,12538.08,8149.75,1191.32,14761.0,3
HCPCS,J7511,All drugs or drug agents without specific rate set forth above or herein,,,2631.63,2631.63,2
HCPCS,J7511,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",,,2042.98,2042.98,2
HCPCS,J7511,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25MG",,,654.07,698.33,2
HCPCS,J7511,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,433.78,489.86,2
HCPCS,J7512,CONJUGATED ESTROGENS 0.625 MG PO TABS,,,13270.0,14761.0,2
HCPCS,J7512,PREDNISONE 1 MG PO TABS,,,13270.0,14761.0,6
HCPCS,J7512,PREDNISONE 10 MG PO TABS,,,13270.0,14761.0,6
HCPCS,J7512,PREDNISONE 2.5 MG PO TABS,,,13270.0,14761.0,4
HCPCS,J7512,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,8
HCPCS,J7512,PREDNISONE 5 MG PO TABS,,,13270.0,14761.0,4
HCPCS,J7512,PREDNISONE 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
HCPCS,J7512,PREDNISONE 5 MG/ML PO CONC,,,13270.0,14761.0,2
HCPCS,J7512,"Prednisone, immediate release or delayed release, oral, 1 mg",,,0.52,0.55,2
HCPCS,J7512,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J7513,"DACLIZUMAB, PARENTERAL, 25 MG",,,1035.52,1105.59,2
HCPCS,J7513,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,686.77,775.55,2
HCPCS,J7515,CYCLOSPORINE 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
HCPCS,J7515,CYCLOSPORINE MODIFIED 25 MG PO CAPS,450.24,292.655,13270.0,14761.0,12
HCPCS,J7515,"CYCLOSPORINE, ORAL 25MG",,,2.94,3.14,2
HCPCS,J7515,"CYCLOSPORINE, ORAL, 25 MG",,,1.84,1.84,2
HCPCS,J7515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J7516,"CYCLOSPORIN, PARENTERAL, 250MG",,,72.04,76.92,2
HCPCS,J7516,CYCLOSPORINE 250 MG/5 ML IV SOLN,1242.7,807.755,13270.0,14761.0,8
HCPCS,J7516,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,47.78,53.95,2
HCPCS,J7517,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7517,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,16056.32,10436.61,13270.0,14761.0,2
HCPCS,J7517,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,610.4,396.76,13270.0,14761.0,12
HCPCS,J7517,MYCOPHENOLATE MOFETIL 500 MG PO TABS,1485.8,965.77,13270.0,14761.0,6
HCPCS,J7517,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",,,0.42,1.29,4
HCPCS,J7517,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J7517,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J7518,MYCOPHENOLATE SODIUM 180 MG PO TBEC,896.9399999999999,583.01,13270.0,14761.0,8
HCPCS,J7518,MYCOPHENOLATE SODIUM 360 MG PO TBEC,8009.58,5206.225,13270.0,14761.0,8
HCPCS,J7518,"MYCOPHENOLIC ACID, ORAL, 180 MG",,,1.38,8.12,4
HCPCS,J7518,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.04,5.69,2
HCPCS,J7520,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7520,Other Outpatient Services,290.0,188.5,,,0
HCPCS,J7520,SIROLIMUS 0.5 MG PO TABS,16135.2,10487.880000000001,13270.0,14761.0,4
HCPCS,J7520,SIROLIMUS 1 MG PO TABS,25765.8,16747.77,13270.0,14761.0,6
HCPCS,J7520,SIROLIMUS 1 MG/ML PO SOLN,29280.96,19032.62,13270.0,14761.0,2
HCPCS,J7520,SIROLIMUS 2 MG PO TABS,15702.4,10206.56,13270.0,14761.0,2
HCPCS,J7520,"SIROLIMUS, ORAL, 1 MG",,,5.87,5.87,2
HCPCS,J7520,"SIROLIMUS, ORAL, 1MG",,,46.77,49.93,2
HCPCS,J7520,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,31.02,35.03,2
HCPCS,J7525,All drugs or drug agents without specific rate set forth above or herein,,,700.79,700.79,2
HCPCS,J7525,TACROLIMUS 5 MG/ML IV SOLN,1476.42,959.67,317.24,14761.0,3
HCPCS,J7525,"TACROLIMUS, PARENTERAL, 5 MG",,,546.99,546.99,2
HCPCS,J7525,"TACROLIMUS, PARENTERAL, 5MG",,,294.04,313.93,2
HCPCS,J7525,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,195.01,220.22,2
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,4858.6,3158.09,13270.0,14761.0,8
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,314.22,204.24,13270.0,14761.0,6
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,19168.149999999998,12459.3,13270.0,14761.0,4
HCPCS,J7527,"EVEROLIMUS, ORAL, 0. 25 MG",,,15.89,16.97,2
HCPCS,J7527,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.54,11.9,2
HCPCS,J7605,"ARFORMOTEROL,INHALATION SOLUTION,FDA APPROVED FINAL PRODUCT,NON-COMPOUNDED",,,12.78,13.65,2
HCPCS,J7605,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.48,9.57,2
HCPCS,J7606,"FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOS",,,13.82,14.76,2
HCPCS,J7606,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.17,10.35,2
HCPCS,J7608,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,J7608,ACETYLCYSTEINE 200 MG/ML (20 %) ORAL/INHALATION SOLN,338.91999999999996,220.3,13270.0,14761.0,4
HCPCS,J7608,"ACETYLCYSTEINE, INHALATION SOL FDA-APPROVED FINAL PROD, NONCOMPOUNDED, ADMINI THRU DME, UNIT DOSE FORM, PER 10 MCG",,,17.62,18.81,2
HCPCS,J7608,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",,,15.01,15.01,2
HCPCS,J7608,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.69,13.2,2
HCPCS,J7609,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,J7609,"ALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",,,0.35,0.37,2
HCPCS,J7609,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J7610,"ALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",,,4.84,5.16,2
HCPCS,J7610,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.21,3.62,2
HCPCS,J7611,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,J7611,ALBUTEROL SULFATE 5 MG/ML IN NEBU,715.52,465.09,13270.0,14761.0,2
HCPCS,J7611,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,0.35,0.37,2
HCPCS,J7611,"Albuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, concentrated form, 1 mg (Code reinstated effective 4/1/2008)",,,0.32,0.32,2
HCPCS,J7611,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J7612,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,3.28,3.5,2
HCPCS,J7612,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J7612,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.18,2.46,2
HCPCS,J7613,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,10
HCPCS,J7613,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,1.04,1.11,2
HCPCS,J7613,"Albuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, 1 mg (Code reinstated effective 4/1/2008)",,,0.09,0.09,2
HCPCS,J7613,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7613,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J7613,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J7614,LEVALBUTEROL HCL 0.31 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,J7614,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
HCPCS,J7614,LEVALBUTEROL HCL 1.25 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J7614,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,3.28,3.5,2
HCPCS,J7614,"Levalbuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, 0.5 mg (Code reinstated effective 4/1/2008)",,,0.09,0.09,2
HCPCS,J7614,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.18,2.46,2
HCPCS,J7615,"LEVALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",,,5.87,6.27,2
HCPCS,J7615,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.9,4.4,2
HCPCS,J7620,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED",,,9.67,10.33,2
HCPCS,J7620,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",,,0.37,0.37,2
HCPCS,J7620,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7620,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,8
HCPCS,J7620,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.42,7.25,2
HCPCS,J7622,"BECLOMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH",,,0.69,0.74,2
HCPCS,J7622,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7624,"BETAMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,24.7,26.38,2
HCPCS,J7624,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,16.38,18.5,2
HCPCS,J7626,BUDESONIDE 0.25 MG IN NBSP,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,J7626,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,1.73,1.84,2
HCPCS,J7626,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",,,2.22,2.22,2
HCPCS,J7626,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J7627,"BUDESONIDE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,1.73,1.84,2
HCPCS,J7627,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J7628,"BITOLTEROL MESYLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED",,,0.69,0.74,2
HCPCS,J7628,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7629,"BITOLTEROL MESYLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED",,,0.86,0.92,2
HCPCS,J7629,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J7631,CROMOLYN 20 MG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
HCPCS,J7631,"CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MG",,,0.86,0.92,2
HCPCS,J7631,"CROMOLYN SODIUM, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT-DOSE FORM, PER 10 MILLIGRAMS",,,2.26,2.26,2
HCPCS,J7631,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J7633,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,",,,22.46,23.98,2
HCPCS,J7633,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.89,16.82,2
HCPCS,J7635,"ATROPINE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME,",,,0.52,0.55,2
HCPCS,J7635,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J7636,"ATROPINE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,1.04,1.11,2
HCPCS,J7636,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J7637,"DEXAMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,0.35,0.37,2
HCPCS,J7637,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J7638,"DEXAMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,0.69,0.74,2
HCPCS,J7638,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7639,DORNASE ALFA 1 MG/ML IN SOLN,1994.2,1296.23,13270.0,14761.0,4
HCPCS,J7639,DORNASE ALFA 1 MG/ML VIA CHEST TUBE,1994.2,1296.23,,,0
HCPCS,J7639,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM,",,,34.03,36.34,2
HCPCS,J7639,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",,,114.52,114.52,2
HCPCS,J7639,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.57,25.49,2
HCPCS,J7641,"FLUNISOLIDE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,1.73,1.84,2
HCPCS,J7641,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,J7642,"GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,8.47,9.04,2
HCPCS,J7642,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.61,6.34,2
HCPCS,J7643,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,16
HCPCS,J7643,"GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,9.85,10.51,2
HCPCS,J7643,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.53,7.38,2
HCPCS,J7644,IPRATROPIUM BROMIDE 0.02 % IN SOLN,1465.56,952.61,13270.0,14761.0,16
HCPCS,J7644,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,8.81,9.41,2
HCPCS,J7644,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",,,0.7,0.7,2
HCPCS,J7644,Other Outpatient Services,290.0,188.5,,,0
HCPCS,J7644,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.84,6.6,2
HCPCS,J7645,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MG",,,0.17,0.18,2
HCPCS,J7645,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J7648,"ISOETHARINE HCL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,0.17,0.18,2
HCPCS,J7648,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.11,0.13,2
HCPCS,J7649,"ISOETHARINE HCL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,0.52,0.55,2
HCPCS,J7649,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.34,0.39,2
HCPCS,J7650,"ISOETHARINE HCL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MG",,,0.86,0.92,2
HCPCS,J7650,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J7658,"ISOPROTERENOL HCL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,0.86,0.92,2
HCPCS,J7658,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J7659,"ISOPROTERENOL HCL, INHALATION SOLUTION, FDA-APPROVED, FINAL PRODUCT",,,1.21,1.29,2
HCPCS,J7659,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J7660,"ISOPROTERENOL HCL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MG",,,4.84,5.16,2
HCPCS,J7660,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.21,3.62,2
HCPCS,J7665,"MANNITOL, ADMINISTERED THROUGH AN INHALER, 5 MG",,,12.44,13.28,2
HCPCS,J7665,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.25,9.32,2
HCPCS,J7667,REVEFENACIN 175 MCG/3 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
HCPCS,J7668,"METAPROTERENOL SULFATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,0.69,0.74,2
HCPCS,J7668,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7669,"METAPROTERENOL SULFATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT",,,2.25,2.4,2
HCPCS,J7669,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.49,1.68,2
HCPCS,J7670,"METAPROTERENOL SULFATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MG",,,0.69,0.74,2
HCPCS,J7670,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7674,All Other Outpatient Services,20482.8,13313.82,,,0
HCPCS,J7674,All Oupatient,20482.8,13313.82,,,0
HCPCS,J7674,All Outpatient Hospital Services,20482.8,13313.82,,,0
HCPCS,J7674,CSMC OPED,20482.8,13313.82,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 100 MG IN SOLR,1237.31,804.25,,,0
HCPCS,J7674,"METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION THROUGH A NEBULIZER, PER 1 MG",,,1.21,1.89,4
HCPCS,J7674,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J7676,PENTAMIDINE 300 MG IJ SOLR,1133.51,736.78,13270.0,14761.0,4
HCPCS,J7677,"Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through DME, 1 microgram",,,0.57,0.61,2
HCPCS,J7677,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.38,0.43,2
HCPCS,J7680,"TERBUTALINE SULFATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED",,,5.36,5.72,2
HCPCS,J7680,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,J7681,"TERBUTALINE SULFATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED",,,5.87,6.27,2
HCPCS,J7681,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.9,4.4,2
HCPCS,J7682,TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML IN NEBU,1465.56,952.61,13270.0,14761.0,6
HCPCS,J7682,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED",,,119.9,128.01,2
HCPCS,J7682,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",,,47.93,47.93,2
HCPCS,J7682,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,79.52,89.8,2
HCPCS,J7683,"TRIAMCINOLONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,0.35,0.37,2
HCPCS,J7683,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.23,0.26,2
HCPCS,J7684,"TRIAMCINOLONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME",,,0.69,0.74,2
HCPCS,J7684,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,J7686,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) IN NEBU,51746.21,33635.04,13270.0,14761.0,2
HCPCS,J7686,"TREPROSTINIL INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT,NON-COMPOUNDED,UNIT DOSAGE 1.74 MG ADMINISTRATED THRU D",,,1133.13,1209.81,2
HCPCS,J7686,"Treprostinil, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, 1.74 mg (For billing prior to 1/1/11 use J7699)",,,1606.01,1606.01,2
HCPCS,J7686,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,751.5,848.66,2
HCPCS,J7799,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,12
HCPCS,J7799,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,16
HCPCS,J7799,DEXTROSE 20 % IN WATER (D20W) 20 % IV SOLP,,,13270.0,14761.0,2
HCPCS,J7999,ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J7999,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J7999,"Compounded drug, not otherwise classified",,,,,0
HCPCS,J7999,EPINEPHRINE HCL IN 5% DEXTROSE 8 MG/250 ML (32 MCG/ML) IV SOLN,920.0,598.0,13270.0,14761.0,2
HCPCS,J7999,EPINEPHRINE IN D5W 8 MG/250ML (0.032 MG/ML)IV PREMIX,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J7999,HYDROMORPHONE (PF)-0.9 % NACL 1 MG/ML IV SPCA,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J7999,KETAMINE 50 MG/ML (1 ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
HCPCS,J7999,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,6
HCPCS,J7999,"MIDAZOLAM IN NACL,ISO-OSMO(PF) 1 MG/ML IV SOLN",1465.56,952.61,13270.0,14761.0,2
HCPCS,J7999,NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J7999,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J7999,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
HCPCS,J7999,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % EP SOLN,2048.0,1331.2,13270.0,14761.0,2
HCPCS,J7999,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,J7999,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,,,0
HCPCS,J8498,PROMETHAZINE 12.5 MG PR SUPP,290.0,188.5,13270.0,14761.0,2
HCPCS,J8498,PROMETHAZINE 25 MG PR SUPP,1465.56,952.61,13270.0,14761.0,4
HCPCS,J8499,LITHIUM CARBONATE 150 MG PO CAPS,,,13270.0,14761.0,2
HCPCS,J8501,APREPITANT 125 MG PO CAPS,3008.96,1955.82,13270.0,14761.0,2
HCPCS,J8501,APREPITANT 80 MG PO CAPS,2050.56,1332.86,13270.0,14761.0,6
HCPCS,J8501,"APREPITANT, ORAL, 5 MG",,,9.3,15.12,4
HCPCS,J8501,Other Outpatient Services,2374.56,1543.46,,,0
HCPCS,J8501,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.4,10.61,2
HCPCS,J8510,All drugs or drug agents without specific rate set forth above or herein,,,231.63,231.63,2
HCPCS,J8510,"BUSULFAN, ORAL, 2MG",,,62.44,66.67,2
HCPCS,J8510,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.41,46.76,2
HCPCS,J8515,"CABERGOLINE, ORAL, 0.25 MG ï",,,7.8,8.33,2
HCPCS,J8515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.17,5.84,2
HCPCS,J8520,"CAPECITABINE, ORAL, 150 MG",,,0.54,0.54,2
HCPCS,J8520,"CAPECITABINE, ORAL, 150MG",,,3.16,3.37,2
HCPCS,J8520,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.1,2.37,2
HCPCS,J8521,CAPECITABINE 500 MG PO TABS,1224.3,795.7950000000001,13270.0,14761.0,4
HCPCS,J8521,"CAPECITABINE, ORAL, 500 MG",,,1.26,1.26,2
HCPCS,J8521,"CAPECITABLINE, ORAL, 500MG",,,5.6,5.98,2
HCPCS,J8521,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.72,4.2,2
HCPCS,J8530,CYCLOPHOSPHAMIDE 25 MG PO CAPS,7706.4,5009.16,13270.0,14761.0,2
HCPCS,J8530,CYCLOPHOSPHAMIDE 50 MG PO CAPS,13226.4,8597.16,13270.0,14761.0,4
HCPCS,J8530,CYCLOPHOSPHAMIDE ORAL 25 MG,,,4.32,4.61,2
HCPCS,J8530,"CYCLOPHOSPHAMIDE, ORAL, 25 MG",,,1.35,1.35,2
HCPCS,J8530,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.86,3.23,2
HCPCS,J8540,DEXAMETHASONE 0.5 MG PO TABS,,,13270.0,14761.0,2
HCPCS,J8540,DEXAMETHASONE 4 MG PO TABS,,,13270.0,14761.0,6
HCPCS,J8540,"DEXAMETHASONE, ORAL, 0.25 MG ï",,,0.86,0.92,2
HCPCS,J8540,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,J8560,"ETOPOSIDE, ORAL, 50 MG",,,168.46,168.46,2
HCPCS,J8560,"PRESCRIPTION DRUG, ETOPOSIDE ORAL 50 MG",,,98.3,104.95,2
HCPCS,J8560,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,65.19,73.62,2
HCPCS,J8562,"FLUDARABINE PHOSPHATE, ORAL, 10 MG ï",,,205.58,219.5,2
HCPCS,J8562,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,136.35,153.97,2
HCPCS,J8565,"GEFITINIB, ORAL, 250 MG",,,146.33,156.23,2
HCPCS,J8565,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,97.05,109.59,2
HCPCS,J8597,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED ï",,,,,0
HCPCS,J8597,DRONABINOL 5 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
HCPCS,J8597,ONDANSETRON 4 MG PO TBDL,290.0,188.5,,,0
HCPCS,J8597,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,,,0
HCPCS,J8600,MELPHALAN ORAL 2 MG,,,11.57,12.36,2
HCPCS,J8600,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.68,8.67,2
HCPCS,J8610,METHOTREXATE ORAL 2.5 MG,,,7.43,7.93,2
HCPCS,J8610,METHOTREXATE SODIUM 2.5 MG PO TABS,2416.2,1570.53,13270.0,14761.0,4
HCPCS,J8610,"METHOTREXATE, ORAL, 2.5 MG",,,0.58,0.58,2
HCPCS,J8610,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.93,5.56,2
HCPCS,J8650,"NABILONE, ORAL, 1 MG",,,44.57,47.59,2
HCPCS,J8650,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,29.56,33.38,2
HCPCS,J8655,All drugs or drug agents without specific rate set forth above or herein,,,1100.91,1100.91,2
HCPCS,J8655,Netupitant palonosetron oral,,,1332.15,1422.29,2
HCPCS,J8655,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,883.5,997.71,2
HCPCS,J8670,All drugs or drug agents without specific rate set forth above or herein,,,4.35,4.35,2
HCPCS,J8670,"Rolapitant, oral, 1 mg",,,7.77,8.3,2
HCPCS,J8670,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.16,5.82,2
HCPCS,J8700,"TEMOZOLMIDE, ORAL 5MG",,,7.95,8.48,2
HCPCS,J8700,TEMOZOLOMIDE 100 MG PO CAPS,350.45,227.79,13270.0,14761.0,2
HCPCS,J8700,TEMOZOLOMIDE 140 MG PO CAPS,536.94,349.01,13270.0,14761.0,2
HCPCS,J8700,TEMOZOLOMIDE 20 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
HCPCS,J8700,TEMOZOLOMIDE 5 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
HCPCS,J8700,"TEMOZOLOMIDE, ORAL, 5 MG",,,0.63,0.63,2
HCPCS,J8700,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.27,5.95,2
HCPCS,J8705,"TOPOTECAN, ORAL, 0.25 MG",,,183.13,195.52,2
HCPCS,J8705,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,121.45,137.15,2
HCPCS,J8999,DASATINIB 100 MG PO TABS,272001.6,176801.04,13270.0,14761.0,2
HCPCS,J8999,IMATINIB 100 MG PO TABS,1627.2,1057.68,13270.0,14761.0,6
HCPCS,J8999,IMATINIB 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,2
HCPCS,J8999,NILOTINIB 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
HCPCS,J8999,PRESCRIPTION DRUG ORAL CHEMOTHERAPEURTIC NOS,,,,,0
HCPCS,J8999,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,,,0
HCPCS,J9000,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9000,DOXORUBICIN 2 MG/ML IV SOLN,521.6,339.04,13270.0,14761.0,18
HCPCS,J9000,DOXORUBICIN 50 MG IV SOLR (FOR CHEMOEMBOLIZATION),3166.08,2057.95,13270.0,14761.0,2
HCPCS,J9000,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",,,7.2,141.47,4
HCPCS,J9000,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,87.88,99.24,2
HCPCS,J9015,ALDESLEUKIN PER SINGLE USE VIAL,,,1738.14,1855.75,2
HCPCS,J9015,All drugs or drug agents without specific rate set forth above or herein,,,14581.75,14581.75,2
HCPCS,J9015,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1152.75,1301.77,2
HCPCS,J9017,ARSENIC TRIOXIDE 1 MG/ML IV SOLN,4654.88,3025.67,8.96,14761.0,11
HCPCS,J9017,ARSENIC TRIOXIDE 2 MG/ML IV SOLN,969.02,629.86,8.96,10.31,8
HCPCS,J9017,All drugs or drug agents without specific rate set forth above or herein,,,19.8,19.8,2
HCPCS,J9017,"INJECTION, ARSENIC TRIOXIDE, 1 MG",,,34.71,78.39,4
HCPCS,J9017,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,48.69,54.99,2
HCPCS,J9019,"INJECTION, ASPARAGINASE (ERWINAZE), 1,000 IU",,,848.08,905.47,2
HCPCS,J9019,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,562.45,635.17,2
HCPCS,J9020,"INJECTION, ASPARAGINASE, NOT OTHERWISE SPECIFIED, 10000 UNITS",,,146.5,156.41,2
HCPCS,J9020,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,97.16,109.72,2
HCPCS,J9021,All drugs or drug agents without specific rate set forth above or herein,,,145.2,145.2,2
HCPCS,J9021,Quality Measures,,,116.96,124.87,2
HCPCS,J9021,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,77.57,87.6,2
HCPCS,J9022,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",101266.38,65823.15,107.39,123.5,8
HCPCS,J9022,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,70886.47,46076.21,107.39,14761.0,11
HCPCS,J9022,All drugs or drug agents without specific rate set forth above or herein,,,237.22,237.22,2
HCPCS,J9022,HB MISCELLANEOUS PHARMACY,1465.56,952.61,107.39,123.5,16
HCPCS,J9022,"Injection, atezolizumab, 10 mg (For billing prior to 1/1/18 use J9999 or C9483 for OPPS billing)",,,186.95,204.37,4
HCPCS,J9022,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J9022,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,126.95,143.36,2
HCPCS,J9023,AVELUMAB 20 MG/ML IV SOLN,30976.64,20134.82,118.51,14761.0,11
HCPCS,J9023,All drugs or drug agents without specific rate set forth above or herein,,,261.79,261.79,2
HCPCS,J9023,"Injection, avelumab, 10 mg (For billing prior to 1/1/18 use J9999 or C9491 for OPPS billing)",,,203.13,217.28,4
HCPCS,J9023,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,134.97,152.42,2
HCPCS,J9025,AZACITIDINE 100 MG IJ SOLR,588.96,382.82500000000005,13270.0,14761.0,8
HCPCS,J9025,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9025,"INJECTION, AZACITIDINE, 1 MG",,,0.77,0.77,2
HCPCS,J9025,"INJECTION, AZACITIDINE, 1 MG ï",,,10.02,10.7,2
HCPCS,J9025,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.65,7.5,2
HCPCS,J9027,All drugs or drug agents without specific rate set forth above or herein,,,39.55,39.55,2
HCPCS,J9027,"INJECTION, CLOFARABINE, 1 MG",,,47.01,47.01,2
HCPCS,J9027,"INJECTION, CLOFARABINE, 1 MG ï",,,312.35,333.49,2
HCPCS,J9027,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,207.15,233.93,2
HCPCS,J9030,BCG LIVE 50 MG IS SUSR,2632.96,1711.42,,,0
HCPCS,J9030,"BCG live intravesical instillation, 1 mg",,,6.36,8.93,4
HCPCS,J9030,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.55,6.27,2
HCPCS,J9032,All drugs or drug agents without specific rate set forth above or herein,,,137.77,137.77,2
HCPCS,J9032,"Injection, belinostat, 10mg",,,82.23,87.8,2
HCPCS,J9032,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.54,61.59,2
HCPCS,J9033,All drugs or drug agents without specific rate set forth above or herein,,,14.94,14.94,2
HCPCS,J9033,"INJECTION, BENDAMUSTINE HCL, 1 MG",,,50.1,53.49,2
HCPCS,J9033,"Injection, bendamustine HCl (Treanda), 1 mg",,,20.21,20.21,2
HCPCS,J9033,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,33.23,37.52,2
HCPCS,J9034,All drugs or drug agents without specific rate set forth above or herein,,,35.61,35.61,2
HCPCS,J9034,BENDAMUSTINE 25 MG/ML IV SOLN,12446.1,8089.97,16.12,14761.0,11
HCPCS,J9034,"Injection, bendamustine HCl (Bendeka), 1 mg",,,32.45,32.45,2
HCPCS,J9034,"Injection, bendamustine hcl (bendeka), 1 mg",,,62.02,66.22,2
HCPCS,J9034,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.13,46.45,2
HCPCS,J9035,All drugs or drug agents without specific rate set forth above or herein,,,199.98,199.98,2
HCPCS,J9035,BEVACIZUMAB 25 MG/ML IV SOLN,31877.600000000002,20720.44,90.53,14761.0,19
HCPCS,J9035,"INJECTION, BEVACIZUMAB, 10 MG",,,152.72,163.05,4
HCPCS,J9035,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,101.29,114.38,2
HCPCS,J9036,All drugs or drug agents without specific rate set forth above or herein,,,75.73,75.73,2
HCPCS,J9036,"Injection, bendamustine hydrochloride, (Belrapzo/bendamustine), 1 mg",,,69.3,73.99,2
HCPCS,J9036,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,45.96,51.9,2
HCPCS,J9037,All drugs or drug agents without specific rate set forth above or herein,,,128.67,128.67,2
HCPCS,J9037,BELANTAMAB MAFODOTIN-BLMF 100 MG IV SOLR,20482.8,13313.82,58.25,66.99,8
HCPCS,J9037,"Injection, belantamab mafodontin-blmf, 0.5 mg",,,110.29,117.76,2
HCPCS,J9037,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,73.15,82.6,2
HCPCS,J9039,All drugs or drug agents without specific rate set forth above or herein,,,418.58,418.58,2
HCPCS,J9039,BLINATUMOMAB 35 MCG IV KIT,46301.85,30096.2,189.49,14761.0,22
HCPCS,J9039,"INJECTION, BLINATUMOMAB, 1 MICROGRAM (FOR BILLING PRIOR TO 1/1/16 USE C9449 OR J9999)",,,320.11,320.11,2
HCPCS,J9039,"Injection, blinatumomab, 1 microgram (For billing prior to 1/1/16 use C9449 or J9999)",,,253.96,271.14,2
HCPCS,J9039,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,168.43,190.2,2
HCPCS,J9040,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9040,BLEOMYCIN 15 UNITS IJ SOLR,299.28,194.53,13270.0,14761.0,6
HCPCS,J9040,BLEOMYCIN 30 UNITS IJ SOLR,737.44,479.34,,,0
HCPCS,J9040,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",,,46.23,770.63,4
HCPCS,J9040,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,478.7,540.58,2
HCPCS,J9041,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9041,BORTEZOMIB 3.5 MG IJ SOLR,520.96,338.62,13270.0,14761.0,10
HCPCS,J9041,"INJECTION, BORTEZOMIB, 0.1 MG",,,4.31,81.16,4
HCPCS,J9041,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,50.41,56.93,2
HCPCS,J9042,All drugs or drug agents without specific rate set forth above or herein,,,659.75,659.75,2
HCPCS,J9042,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,109800.0,71370.0,298.67,14761.0,11
HCPCS,J9042,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",,,248.26,265.05,2
HCPCS,J9042,"Injection, brentuximab vedotin, 1 mg (For billing prior to 1/1/13 use C9287 or J9999)",,,507.13,507.13,2
HCPCS,J9042,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,164.65,185.93,2
HCPCS,J9043,All drugs or drug agents without specific rate set forth above or herein,,,595.39,595.39,2
HCPCS,J9043,CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN,129228.48,83998.51,269.53,14761.0,14
HCPCS,J9043,"INJECTION, CABAZITAXEL, 1 MG",,,359.0,383.29,2
HCPCS,J9043,"Injection, cabazitaxel, 1 mg (For billing prior to 1/1/12 use J9999 or C9276)",,,462.79,462.79,2
HCPCS,J9043,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,238.09,268.87,2
HCPCS,J9044,"Injection, bortezomib, not otherwise specified, 0.1 mg",,,122.14,130.41,2
HCPCS,J9044,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.01,91.48,2
HCPCS,J9045,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9045,CARBOPLATIN 10 MG/ML IV SOLN,655.68,426.19,13270.0,14761.0,22
HCPCS,J9045,"INJECTION, CARBOPLATIN, 50 MG",,,7.93,339.39,4
HCPCS,J9045,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,210.82,238.07,2
HCPCS,J9046,"Injection, bortezomib, (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg",,,122.14,130.41,2
HCPCS,J9046,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.01,91.48,2
HCPCS,J9047,All drugs or drug agents without specific rate set forth above or herein,,,136.37,136.37,2
HCPCS,J9047,CARFILZOMIB 10 MG IV SOLR,8732.96,5676.42,61.73,14761.0,11
HCPCS,J9047,CARFILZOMIB 30 MG IV SOLR,14736.87,9578.97,61.73,70.99,8
HCPCS,J9047,CARFILZOMIB 60 MG IV SOLR,29473.65,19157.87,61.73,14761.0,11
HCPCS,J9047,"INJECTION, CARFILZOMIB, 1 MG",,,73.6,78.58,2
HCPCS,J9047,"INJECTION, CARFILZOMIB, 1 MG (FOR BILLING PRIOR TO 1/1/14 USE C9295 OR J9999)",,,103.54,103.54,2
HCPCS,J9047,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,48.81,55.12,2
HCPCS,J9048,"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg",,,122.14,130.41,2
HCPCS,J9048,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.01,91.48,2
HCPCS,J9049,"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg",,,21.6,23.06,2
HCPCS,J9049,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.32,16.17,2
HCPCS,J9050,All drugs or drug agents without specific rate set forth above or herein,,,910.1,910.1,2
HCPCS,J9050,CARMUSTINE 100 MG IV SOLR,2798.0,1818.6999999999998,412.0,14761.0,17
HCPCS,J9050,"INJECTION, CARMUSTINE, 100 MG",,,297.67,596.96,4
HCPCS,J9050,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,197.41,222.94,2
HCPCS,J9055,All drugs or drug agents without specific rate set forth above or herein,,,207.61,207.61,2
HCPCS,J9055,CETUXIMAB 100 MG/50 ML IV SOLN,11986.4,7791.16,93.99,108.08,8
HCPCS,J9055,CETUXIMAB 200 MG/100 ML IV SOLN,13484.7,8765.06,93.99,108.08,8
HCPCS,J9055,"INJECTION, CETUXIMAB, 10 MG",,,133.37,162.12,4
HCPCS,J9055,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.45,99.89,2
HCPCS,J9057,All drugs or drug agents without specific rate set forth above or herein,,,255.3,255.3,2
HCPCS,J9057,"Injection, copanlisib, 1 mg",,,203.17,216.91,2
HCPCS,J9057,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,134.74,152.16,2
HCPCS,J9060,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9060,CISPLATIN 1 MG/ML IV SOLN,484.8,315.12,13270.0,14761.0,18
HCPCS,J9060,"CISPLATIN, 10 MG VIAL",,,106.77,113.99,2
HCPCS,J9060,"Injection, cisplatin, powder or solution, per 10 mg",,,8.88,8.88,2
HCPCS,J9060,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,70.81,79.96,2
HCPCS,J9061,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,32817.14,21331.14,25.74,29.6,8
HCPCS,J9061,All drugs or drug agents without specific rate set forth above or herein,,,56.86,56.86,2
HCPCS,J9061,Drug - Oncology,,,45.44,48.51,2
HCPCS,J9061,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.13,34.03,2
HCPCS,J9063,"Injection, mirvetuximab soravtansine-gynx, 1 mg",,,144.5,144.5,2
HCPCS,J9065,All drugs or drug agents without specific rate set forth above or herein,,,39.18,39.18,2
HCPCS,J9065,CLADRIBINE 10 MG/10 ML IV SOLN,1341.6,872.04,17.74,14761.0,14
HCPCS,J9065,INJECTION CLADRIBINE PER 1MG,,,137.69,147.01,2
HCPCS,J9065,"INJECTION, CLADRIBINE, PER 1 MG",,,34.69,34.69,2
HCPCS,J9065,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,91.32,103.12,2
HCPCS,J9070,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1733.2800000000002,1126.63,13270.0,14761.0,8
HCPCS,J9070,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,3638.88,2365.2749999999996,13270.0,14761.0,8
HCPCS,J9070,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1127.84,733.1,13270.0,14761.0,10
HCPCS,J9070,"CYCLOPHOSPHAMIDE, 10 CC OR 100 MG",,,14.68,15.68,2
HCPCS,J9070,"CYCLOPHOSPHAMIDE, 100 MG",,,44.31,44.31,2
HCPCS,J9070,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.74,11.0,2
HCPCS,J9071,"INJECTION, CYCLOPHOSPHAMIDE, (AUROMEDICS), 5 MG",,,9.67,10.33,2
HCPCS,J9071,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.42,7.25,2
HCPCS,J9098,"INJECTION, CYTARABINE LIPOSOME, 10 MG",,,868.64,927.41,2
HCPCS,J9098,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,576.09,650.56,2
HCPCS,J9100,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9100,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,J9100,CYTARABINE (PF) 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,J9100,"INJECTION, CYTARABINE, 100 MG",,,2.14,18.45,4
HCPCS,J9100,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.46,12.94,2
HCPCS,J9118,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,232056.99,150837.04,13270.0,14761.0,2
HCPCS,J9118,"Injection, calaspargase pegol-mknl, 10 units",,,160.28,184.42,4
HCPCS,J9118,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,114.56,129.37,2
HCPCS,J9119,All drugs or drug agents without specific rate set forth above or herein,,,77.68,77.68,2
HCPCS,J9119,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,95460.81,62049.53,35.16,40.44,8
HCPCS,J9119,"Injection, cemiplimab-rwlc, 1 mg",,,60.4,75.1,4
HCPCS,J9119,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,46.65,52.68,2
HCPCS,J9120,All drugs or drug agents without specific rate set forth above or herein,,,776.04,776.04,2
HCPCS,J9120,DACTINOMYCIN 0.5 MG IV SOLR,6544.24,4253.755,351.31,14761.0,49
HCPCS,J9120,"INJECTION, DACTINOMYCIN, 0.5 MG",,,32.48,1470.95,4
HCPCS,J9120,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.54,24.32,2
HCPCS,J9130,DACARBAZINE 200 MG IV SOLR,1465.56,952.61,13270.0,14761.0,6
HCPCS,J9130,"DACARBAZINE, 100 MG",,,8.21,36.52,4
HCPCS,J9130,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.69,25.62,2
HCPCS,J9144,All drugs or drug agents without specific rate set forth above or herein,,,141.41,141.41,2
HCPCS,J9144,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SC SOLN",89752.73,58339.27,64.02,14761.0,11
HCPCS,J9144,"Injection, daratumumab, 10 mg and hyaluronidase-fihj",,,107.86,119.71,4
HCPCS,J9144,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,74.36,83.97,2
HCPCS,J9145,All drugs or drug agents without specific rate set forth above or herein,,,179.11,179.11,2
HCPCS,J9145,DARATUMUMAB 20 MG/ML IV SOLN,17451.675,11343.59,81.08,14761.0,22
HCPCS,J9145,HB MISCELLANEOUS PHARMACY,10974.18,7133.215,81.08,93.25,16
HCPCS,J9145,"Injection, daratumumab, 10 mg",,,123.35,131.7,2
HCPCS,J9145,"Injection, daratumumab, 10 mg (For billing prior to 1/1/17 use J9999 or C9476 for OPPS billing)",,,135.68,135.68,2
HCPCS,J9145,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J9145,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,81.81,92.38,2
HCPCS,J9150,All drugs or drug agents without specific rate set forth above or herein,,,67.21,67.21,2
HCPCS,J9150,DAUNORUBICIN 5 MG/ML IV SOLN,1132.075,735.845,30.43,14761.0,6
HCPCS,J9150,"INJECTION, DAUNORUBICIN, 10 MG",,,78.44,222.08,4
HCPCS,J9150,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,137.95,155.78,2
HCPCS,J9151,"INJECTION, DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG",,,167.92,179.29,2
HCPCS,J9151,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,111.37,125.77,2
HCPCS,J9153,All drugs or drug agents without specific rate set forth above or herein,,,667.01,667.01,2
HCPCS,J9153,DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR,94095.0,61161.75,301.95,347.24,8
HCPCS,J9153,"Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine",,,483.56,516.28,4
HCPCS,J9153,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,320.7,362.16,2
HCPCS,J9155,All drugs or drug agents without specific rate set forth above or herein,,,11.49,11.49,2
HCPCS,J9155,DEGARELIX 120 MG SC SOLR,17040.96,11076.625,5.2,14761.0,22
HCPCS,J9155,DEGARELIX 80 MG SC SOLR,13882.119999999999,9023.38,5.2,14761.0,19
HCPCS,J9155,"INJECTION, DEGARELIX, 1 MG",,,1.04,1.11,2
HCPCS,J9155,"Injection, degarelix, 1 mg (For billing prior to 1/1/10 use J9999 or C9399)",,,9.21,9.21,2
HCPCS,J9155,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,J9160,"INJECTION, DENILEUKIN DIFTITOX, 300 MICROGRAMS",,,2829.81,3021.29,2
HCPCS,J9160,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1876.75,2119.38,2
HCPCS,J9165,"INJECTION, DIETHYLSTILBESTROL DIPHOSPHATE, 250 MG",,,33.69,35.97,2
HCPCS,J9165,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.34,25.23,2
HCPCS,J9171,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9171,DOCETAXEL 20 MG/2 ML (10 MG/ML) IV SOLN,20482.8,13313.82,,,0
HCPCS,J9171,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,1131.455,735.4449999999999,13270.0,14761.0,8
HCPCS,J9171,HB MISCELLANEOUS PHARMACY,1465.56,952.61,,,0
HCPCS,J9171,"INJECTION, DOCETAXEL, 1 MG",,,51.66,55.15,2
HCPCS,J9171,"Injection, docetaxel, 1 mg",,,2.2,2.2,2
HCPCS,J9171,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J9171,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.26,38.69,2
HCPCS,J9173,All drugs or drug agents without specific rate set forth above or herein,,,225.04,225.04,2
HCPCS,J9173,DURVALUMAB 50 MG/ML IV SOLN,41767.685,27148.995,101.88,14761.0,19
HCPCS,J9173,"Injection, durvalumab, 10 mg",,,177.49,199.57,4
HCPCS,J9173,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,123.97,140.0,2
HCPCS,J9175,"INJECTION, ELLIOTTS' B SOLUTION, 1 ML ï",,,9.16,9.78,2
HCPCS,J9175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.07,6.86,2
HCPCS,J9176,All drugs or drug agents without specific rate set forth above or herein,,,20.84,20.84,2
HCPCS,J9176,ELOTUZUMAB 300 MG IV SOLR,20480.94,13312.61,9.44,14761.0,11
HCPCS,J9176,ELOTUZUMAB 400 MG IV SOLR,27307.62,17749.95,9.44,10.85,8
HCPCS,J9176,"Injection, elotuzumab, 1 mg",,,15.72,16.78,2
HCPCS,J9176,"Injection, elotuzumab, 1 mg (For billing prior to 1/1/17 use J9999 or C9477 for OPPS billing)",,,16.22,16.22,2
HCPCS,J9176,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.43,11.77,2
HCPCS,J9177,All drugs or drug agents without specific rate set forth above or herein,,,101.06,101.06,2
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,25281.0,16432.65,45.75,52.61,8
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,37921.5,24648.98,45.75,52.61,8
HCPCS,J9177,"Injection, enfortumab vedotin-ejfv, 0.25 mg",,,73.03,77.97,2
HCPCS,J9177,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,48.43,54.69,2
HCPCS,J9178,"INJECTION, EPIRUBICIN HCL, 2 MG",,,69.45,74.15,2
HCPCS,J9178,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,46.06,52.01,2
HCPCS,J9179,All drugs or drug agents without specific rate set forth above or herein,,,373.49,373.49,2
HCPCS,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN,12690.0,8248.5,169.08,14761.0,11
HCPCS,J9179,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",,,233.57,249.38,2
HCPCS,J9179,"Injection, eribulin mesylate, 0.1 mg (For billing prior to 1/1/12 use J9999 or C9280)",,,294.71,294.71,2
HCPCS,J9179,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,154.91,174.93,2
HCPCS,J9181,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9181,ETOPOSIDE (STRAIGHT DRUG) IVPB,1465.56,952.61,13270.0,14761.0,2
HCPCS,J9181,ETOPOSIDE 20 MG/ML IV SOLN,515.4,335.01,13270.0,14761.0,6
HCPCS,J9181,"INJECTION, ETOPOSIDE, 10 MG",,,2.2,37.44,4
HCPCS,J9181,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,23.26,26.27,2
HCPCS,J9185,All drugs or drug agents without specific rate set forth above or herein,,,369.01,369.01,2
HCPCS,J9185,FLUDARABINE 50 MG IV SOLR,1394.72,906.57,167.05,14761.0,11
HCPCS,J9185,FLUDARABINE 50 MG/2 ML IV SOLN,10549.4,6857.11,167.05,14761.0,19
HCPCS,J9185,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",,,382.56,815.64,4
HCPCS,J9185,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,506.66,572.15,2
HCPCS,J9190,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9190,FLUOROURACIL 1 GRAM/20 ML IV SOLN,917.5799999999999,596.425,13270.0,14761.0,4
HCPCS,J9190,FLUOROURACIL 2.5 GRAM/50 ML IV SOLN,366.2,238.03,,,0
HCPCS,J9190,FLUOROURACIL 5 G/100 ML IV SOLN,822.4,534.56,13270.0,14761.0,6
HCPCS,J9190,FLUOROURACIL 500 MG/10 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,J9190,"INJECTION, FLUOROURACIL, 500 MG",,,5.01,7.07,4
HCPCS,J9190,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.32,3.75,2
HCPCS,J9198,All drugs or drug agents without specific rate set forth above or herein,,,110.79,110.79,2
HCPCS,J9198,"Injection, gemcitabine hydrochloride, (infugem), 100 mg",,,101.29,108.14,2
HCPCS,J9198,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,67.17,75.86,2
HCPCS,J9199,"Injection, gemcitabine hydrochloride (infugem), 200 mg",,,202.65,216.36,2
HCPCS,J9199,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,134.4,151.77,2
HCPCS,J9200,All drugs or drug agents without specific rate set forth above or herein,,,10611.98,10611.98,2
HCPCS,J9200,FLOXURIDINE 0.5 GRAM IJ SOLR,27197.534999999996,17678.4,4803.97,5524.57,16
HCPCS,J9200,"INJECTION, FLOXURIDINE, 500 MG",,,303.02,8184.98,4
HCPCS,J9200,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,200.97,226.95,2
HCPCS,J9201,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9201,GEMCITABINE 1 GRAM IV SOLR,510.28,331.68,13270.0,14761.0,6
HCPCS,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,361.71000000000004,235.11,13270.0,14761.0,4
HCPCS,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN,591.65,384.57500000000005,13270.0,14761.0,2
HCPCS,J9201,GEMCITABINE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
HCPCS,J9201,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN,10386.4,6751.16,,,0
HCPCS,J9201,"INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG",,,282.98,302.13,2
HCPCS,J9201,"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg",,,8.02,8.02,2
HCPCS,J9201,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,187.68,211.94,2
HCPCS,J9202,All drugs or drug agents without specific rate set forth above or herein,,,1856.04,1856.04,2
HCPCS,J9202,GOSERELIN 10.8 MG SC IMPL,26280.18,17082.12,840.22,966.25,8
HCPCS,J9202,GOSERELIN 3.6 MG SC IMPL,16822.4,10934.56,840.22,14761.0,11
HCPCS,J9202,GOSERELIN ACETATE IMPLANT PER 3.6 MG,,,1160.08,1238.58,2
HCPCS,J9202,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",,,1339.25,1339.25,2
HCPCS,J9202,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,769.38,868.84,2
HCPCS,J9203,All drugs or drug agents without specific rate set forth above or herein,,,631.75,631.75,2
HCPCS,J9203,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,90405.0,58763.25,285.99,14761.0,3
HCPCS,J9203,"Injection, gemtuzumab ozogamicin, 0.1 mg (For billing prior to 1/1/18 use J9999 or C9399 for OPPS billing)",,,485.63,518.49,4
HCPCS,J9203,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,322.07,363.71,2
HCPCS,J9204,All drugs or drug agents without specific rate set forth above or herein,,,656.98,656.98,2
HCPCS,J9204,"Injection, mogamulizumab-kpkc, 1 mg",,,505.1,539.28,2
HCPCS,J9204,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,334.99,378.29,2
HCPCS,J9205,All drugs or drug agents without specific rate set forth above or herein,,,178.14,178.14,2
HCPCS,J9205,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,26154.0,17000.1,80.64,14761.0,11
HCPCS,J9205,"Injection, irinotecan liposome, 1 mg",,,100.37,107.17,2
HCPCS,J9205,"Injection, irinotecan liposome, 1 mg (For billing prior to 1/1/17 use J9999 or C9474 for OPPS billing)",,,136.39,136.39,2
HCPCS,J9205,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,66.57,75.17,2
HCPCS,J9206,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9206,"INJECTION, IRINOTECAN, 20 MG",,,4.27,379.04,4
HCPCS,J9206,IRINOTECAN 100 MG/5 ML IV SOLN,290.68,188.94,13270.0,14761.0,10
HCPCS,J9206,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,235.45,265.89,2
HCPCS,J9207,All drugs or drug agents without specific rate set forth above or herein,,,368.74,368.74,2
HCPCS,J9207,"INJECTION, IXABEPILONE, 1 MG",,,170.69,281.64,4
HCPCS,J9207,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,113.2,127.84,2
HCPCS,J9208,IFOSFAMIDE 1 GRAM IV SOLR,648.88,421.775,13270.0,14761.0,6
HCPCS,J9208,IFOSFAMIDE 3 GRAM IV SOLR,1282.08,833.35,13270.0,14761.0,4
HCPCS,J9208,"INJECTION, IFOSFAMIDE, 1 GRAM",,,58.83,375.54,4
HCPCS,J9208,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,233.28,263.43,2
HCPCS,J9209,"INJECTION, MESNA, 200 MG",,,3.0,99.97,4
HCPCS,J9209,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,10
HCPCS,J9209,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,62.1,70.13,2
HCPCS,J9210,All drugs or drug agents without specific rate set forth above or herein,,,1039.81,1039.81,2
HCPCS,J9210,"Injection, emapalumab-lzsg, 1 mg",,,900.13,961.04,2
HCPCS,J9210,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,596.97,674.15,2
HCPCS,J9211,IDARUBICIN 1 MG/ML IV SOLN,743.2,483.08,13270.0,14761.0,2
HCPCS,J9211,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",,,94.41,1164.8,4
HCPCS,J9211,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,723.55,817.09,2
HCPCS,J9212,"INTERFERON, ALFACON-1 RECOMBINANT 1 MCG",,,10.19,10.88,2
HCPCS,J9212,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.76,7.63,2
HCPCS,J9213,"INJECTION, INTERFERON, ALFA-2A, RECOMBINANT, 3 MILLION UNITS",,,83.79,89.46,2
HCPCS,J9213,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.57,62.75,2
HCPCS,J9214,"INJECTION, INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS",,,31.62,33.75,2
HCPCS,J9214,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.97,23.68,2
HCPCS,J9215,"INJECTION, INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU",,,20.56,21.95,2
HCPCS,J9215,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,13.63,15.4,2
HCPCS,J9216,"INJECTION, INTERFERON, GAMMA 1-B, 3 MILLION UNITS",,,789.86,843.31,2
HCPCS,J9216,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,523.84,591.56,2
HCPCS,J9217,All drugs or drug agents without specific rate set forth above or herein,,,485.51,485.51,2
HCPCS,J9217,LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT,53991.9,35094.74,219.79,14761.0,11
HCPCS,J9217,LEUPROLIDE (4 MONTH) 30 MG IM SYKT,71989.47,46793.16,219.79,252.76,8
HCPCS,J9217,LEUPROLIDE 7.5 MG (1 MONTH) SC SYRG,1401.28,910.83,219.79,14761.0,11
HCPCS,J9217,LEUPROLIDE 7.5 MG IM SYKT,17997.48,11698.36,219.79,252.76,8
HCPCS,J9217,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",,,398.69,398.69,2
HCPCS,J9217,"LEUPROLIDE ACETATE, FOR DEPOT SUSPENSION, 7.5 MG",,,1429.93,1526.69,2
HCPCS,J9217,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,948.35,1070.94,2
HCPCS,J9218,LEUPROLIDE 1 MG/0.2ML FOR PEDS STIM TEST,8312.46,5403.1,,,0
HCPCS,J9218,"LEUPROLIDE ACETATE, PER 1 MG",,,30.23,245.13,4
HCPCS,J9218,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,152.27,171.96,2
HCPCS,J9219,"LEUPROLIDE ACETATE IMPLANT, 65MG (NEW 2001 CODE)",,,12625.3,13479.61,2
HCPCS,J9219,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8373.21,9455.68,2
HCPCS,J9223,All drugs or drug agents without specific rate set forth above or herein,,,560.04,560.04,2
HCPCS,J9223,"Injection, lurbinectedin, 0.1 mg",,,441.92,471.82,2
HCPCS,J9223,LURBINECTEDIN 4 MG IV SOLR,20482.8,13313.82,253.53,291.55,8
HCPCS,J9223,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,293.09,330.97,2
HCPCS,J9225,"HISTERLIN IMPLANT (VANTAS), 50 MG",,,13327.22,14229.03,2
HCPCS,J9225,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8838.74,9981.38,2
HCPCS,J9226,All drugs or drug agents without specific rate set forth above or herein,,,124741.22,124741.22,2
HCPCS,J9226,HISTRELIN 50 MG (65 MCG/DAY) IL KIT,451634.58,293562.48,56469.54,64939.98,8
HCPCS,J9226,"HISTRELIN IMPLANT (SUPPRELIN LA), 50 MG",,,98025.0,98025.0,2
HCPCS,J9226,"HISTRELIN IMPLANT (SUPPRELIN LA), 50MG",,,38871.0,41501.25,2
HCPCS,J9226,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25779.6,29112.3,2
HCPCS,J9227,All drugs or drug agents without specific rate set forth above or herein,,,214.68,214.68,2
HCPCS,J9227,ISATUXIMAB-IRFC 20 MG/ML IV SOLN,20482.8,13313.82,97.19,111.76,16
HCPCS,J9227,"Injection, isatuximab-irfc, 10 mg",,,177.6,189.61,2
HCPCS,J9227,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,117.78,133.01,2
HCPCS,J9228,All drugs or drug agents without specific rate set forth above or herein,,,486.54,486.54,2
HCPCS,J9228,HB MISCELLANEOUS PHARMACY,1465.56,952.61,220.25,253.29,8
HCPCS,J9228,"INJECTION, IPILIMUMAB, 1 MG",,,319.78,341.42,2
HCPCS,J9228,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,199736.63999999998,129828.815,220.25,14761.0,19
HCPCS,J9228,"Injection, ipilimumab, 1 mg (For billing prior to 1/1/12 use J9999 or C9284)",,,379.16,379.16,2
HCPCS,J9228,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J9228,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,212.08,239.5,2
HCPCS,J9229,All drugs or drug agents without specific rate set forth above or herein,,,7203.45,7203.45,2
HCPCS,J9229,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,206172.0,134011.8,3260.96,14761.0,11
HCPCS,J9229,"Injection, inotuzumab ozogamicin, 0.1 mg",,,5538.17,5912.91,4
HCPCS,J9229,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3672.96,4147.79,2
HCPCS,J9230,"INJECTION, MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG",,,28.16,30.07,2
HCPCS,J9230,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.68,21.09,2
HCPCS,J9245,All drugs or drug agents without specific rate set forth above or herein,,,422.32,422.32,2
HCPCS,J9245,INJECTION MELPALAN HCL 50 MG,,,1023.26,1092.5,2
HCPCS,J9245,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,678.63,766.37,2
HCPCS,J9246,All drugs or drug agents without specific rate set forth above or herein,,,47.73,47.73,2
HCPCS,J9246,"Injection, melphalan (evomela), 1 mg",,,36.25,113.83,4
HCPCS,J9246,MELPHALAN HCL-BETADEX SBES 50 MG IV SOLR,9643.14,6268.04,21.61,14761.0,11
HCPCS,J9246,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,70.71,79.85,2
HCPCS,J9247,Drug,,,1266.16,1351.83,2
HCPCS,J9247,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,839.73,948.28,2
HCPCS,J9250,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,309.12,200.93,13270.0,14761.0,18
HCPCS,J9250,METHOTREXATE SODIUM 25 MG/ML IJ SOLN,10433.96,6782.075,13270.0,14761.0,2
HCPCS,J9250,"METHOTREXATE SODIUM MIX, 2 CC OR 5 MG",,,2.94,3.14,2
HCPCS,J9250,"METHOTREXATE SODIUM, 5 MG",,,0.67,0.67,2
HCPCS,J9250,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,J9260,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9260,METHOTREXATE SODIUM (PF) 1 GRAM IJ SOLR,938.56,610.06,13270.0,14761.0,6
HCPCS,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,309.12,200.93,13270.0,14761.0,16
HCPCS,J9260,"METHOTREXATE SODIUM MIX, 2 CC OR 50 MG",,,39.56,42.24,2
HCPCS,J9260,"METHOTREXATE SODIUM, 50 MG",,,6.66,6.66,2
HCPCS,J9260,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,26.24,29.63,2
HCPCS,J9261,All drugs or drug agents without specific rate set forth above or herein,,,199.49,199.49,2
HCPCS,J9261,"INJECTION, NELARABINE, 50 MG",,,222.17,244.05,4
HCPCS,J9261,NELARABINE 250 MG/50 ML IV SOLN,3922.4,2549.56,90.31,14761.0,3
HCPCS,J9261,NELARABINE 250 MG/50 ML IVPB,7274.4,4728.36,90.31,14761.0,19
HCPCS,J9261,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,147.34,166.39,2
HCPCS,J9262,All drugs or drug agents without specific rate set forth above or herein,,,11.09,11.09,2
HCPCS,J9262,"INJECTION, OMACETAXINE MEPESUCCINATE, 0.01 MG",,,6.39,6.82,2
HCPCS,J9262,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.24,4.79,2
HCPCS,J9263,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9263,"INJECTION, OXALIPLATIN, 0.5 MG",,,0.17,23.61,4
HCPCS,J9263,OXALIPLATIN 100 MG/20 ML IV SOLN,365.28,237.435,13270.0,14761.0,14
HCPCS,J9263,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,517.72,336.52,13270.0,14761.0,2
HCPCS,J9263,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.67,16.56,2
HCPCS,J9264,All drugs or drug agents without specific rate set forth above or herein,,,36.7,36.7,2
HCPCS,J9264,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",,,31.42,31.42,2
HCPCS,J9264,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG ï",,,23.84,25.45,2
HCPCS,J9264,PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR,13249.26,8612.02,16.62,14761.0,11
HCPCS,J9264,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.81,17.86,2
HCPCS,J9266,All drugs or drug agents without specific rate set forth above or herein,,,74460.76,74460.76,2
HCPCS,J9266,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",,,3337.38,56694.88,4
HCPCS,J9266,PEGASPARGASE 750 UNITS/ML IJ SOLN,229844.16,149398.7,13270.0,38764.09,11
HCPCS,J9266,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2213.38,2499.52,2
HCPCS,J9267,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,J9267,"INJECTION, PACLITAXEL, 1 MG",,,0.23,0.23,2
HCPCS,J9267,PACLITAXEL 6 MG/ML IV CONC,567.8399999999999,369.095,13270.0,14761.0,16
HCPCS,J9267,Paclitaxel injection,,,1.21,1.29,2
HCPCS,J9267,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,J9268,All drugs or drug agents without specific rate set forth above or herein,,,6991.46,6991.46,2
HCPCS,J9268,"INJECTION, PENTOSTATIN, 10 MG",,,4296.71,4587.46,2
HCPCS,J9268,"INJECTION, PENTOSTATIN, PER 10 MG",,,4998.78,4998.78,2
HCPCS,J9268,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2849.62,3218.01,2
HCPCS,J9269,All drugs or drug agents without specific rate set forth above or herein,,,932.55,932.55,2
HCPCS,J9269,"Injection, tagraxofusp-erzs, 10 micrograms",,,715.84,764.28,2
HCPCS,J9269,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,474.75,536.13,2
HCPCS,J9270,"INJECTION, PLICAMYCIN, 2.5 MG",,,219.41,234.25,2
HCPCS,J9270,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,145.51,164.32,2
HCPCS,J9271,All drugs or drug agents without specific rate set forth above or herein,,,160.13,160.13,2
HCPCS,J9271,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,48
HCPCS,J9271,"INJECTION, PEMBROLIZUMAB, 1 MG (FOR BILLING PRIOR TO 1/1/16 USE C9027 OR J9999)",,,122.57,122.57,2
HCPCS,J9271,Inj pembrolizumab,,,115.06,122.84,2
HCPCS,J9271,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,J9271,PEMBROLIZUMAB 25 MG/ML IV SOLN,20482.8,13313.82,72.49,14761.0,30
HCPCS,J9271,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,76.31,86.17,2
HCPCS,J9272,Drug - Oncology,,,552.83,590.24,2
HCPCS,J9272,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,366.64,414.04,2
HCPCS,J9273,All drugs or drug agents without specific rate set forth above or herein,,,499.51,499.51,2
HCPCS,J9273,"INJECTION, TISOTUMAB VEDOTIN-TFTV, 1 MG",,,407.37,434.93,2
HCPCS,J9273,"Injection, tisotumab vedotin-tftv, 1 mg",,,370.12,370.12,2
HCPCS,J9273,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,64107.0,41669.55,226.12,14761.0,18
HCPCS,J9273,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,270.17,305.1,2
HCPCS,J9274,All drugs or drug agents without specific rate set forth above or herein,,,590.71,590.71,2
HCPCS,J9274,"Injection, tebentafusp-tebn, 1 microgram",,,459.45,533.8,4
HCPCS,J9274,TEBENTAFUSP-TEBN 100 MCG/0.5 ML IV SOLN,184320.0,119808.0,267.41,14761.0,18
HCPCS,J9274,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,331.58,374.45,2
HCPCS,J9280,All drugs or drug agents without specific rate set forth above or herein,,,116.92,116.92,2
HCPCS,J9280,"INJECTION, MITOMYCIN, 5 MG",,,318.4,339.94,2
HCPCS,J9280,"Injection, mitomycin, 5 mg",,,139.3,139.3,2
HCPCS,J9280,MITOMYCIN 20 MG IV SOLR,1968.62,1279.6,52.93,14761.0,41
HCPCS,J9280,MITOMYCIN 5 MG IV SOLR,1997.8400000000001,1298.6,52.93,14761.0,22
HCPCS,J9280,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,211.16,238.46,2
HCPCS,J9281,"Mitomycin pyelocalyceal instillation, 1 mg",,,712.29,760.49,2
HCPCS,J9281,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,472.4,533.47,2
HCPCS,J9285,"Injection, olaratumab, 10 mg (For billing prior to 1/1/18 use J9999 or C9485 for OPPS billing)",,,125.77,134.28,2
HCPCS,J9285,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,83.41,94.19,2
HCPCS,J9293,All drugs or drug agents without specific rate set forth above or herein,,,150.32,150.32,2
HCPCS,J9293,"INJECTION, MITOXANTRONE HCL, PER 5 MG (PRIOR TO 1/1/95 IT WAS 20 MG)",,,622.45,664.57,2
HCPCS,J9293,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",,,95.83,95.83,2
HCPCS,J9293,MITOXANTRONE 2 MG/ML IV CONC,1669.28,1085.03,68.05,14761.0,9
HCPCS,J9293,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,412.82,466.18,2
HCPCS,J9295,All drugs or drug agents without specific rate set forth above or herein,,,15.76,15.76,2
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,13.3,14.2,2
HCPCS,J9295,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.82,9.96,2
HCPCS,J9298,All drugs or drug agents without specific rate set forth above or herein,,,523.89,523.89,2
HCPCS,J9298,"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg",,,456.26,487.13,2
HCPCS,J9298,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,20482.8,13313.82,237.16,272.73,8
HCPCS,J9298,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,302.6,341.71,2
HCPCS,J9299,All drugs or drug agents without specific rate set forth above or herein,,,87.33,87.33,2
HCPCS,J9299,"INJECTION, NIVOLUMAB, 1 MG (FOR BILLING PRIOR TO 1/1/16 USE C9453 OR J9999)",,,68.37,68.37,2
HCPCS,J9299,"Injection, nivolumab",,,64.96,69.35,2
HCPCS,J9299,NIVOLUMAB 100 MG/10 ML IV SOLN,29202.39,18981.55,39.53,14761.0,11
HCPCS,J9299,NIVOLUMAB 120 MG/12 ML IV SOLN,35042.98,22777.94,39.53,45.46,8
HCPCS,J9299,NIVOLUMAB 240 MG/24 ML IV SOLN,70085.95,45555.87,39.53,14761.0,11
HCPCS,J9299,NIVOLUMAB 40 MG/4 ML IV SOLN,11681.03,7592.67,39.53,14761.0,11
HCPCS,J9299,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,43.08,48.65,2
HCPCS,J9301,All drugs or drug agents without specific rate set forth above or herein,,,205.16,205.16,2
HCPCS,J9301,"Injection, obinutuzumab, 10 mg (For billing prior to 1/1/15 use C9021 or J9999)",,,154.69,154.69,2
HCPCS,J9301,OBINUTUZUMAB 1000 MG/40 ML IV SOLN,77514.48,50384.41,92.88,14761.0,11
HCPCS,J9301,Obinutuzumab inj,,,137.52,146.82,2
HCPCS,J9301,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,91.2,102.99,2
HCPCS,J9302,All drugs or drug agents without specific rate set forth above or herein,,,175.92,175.92,2
HCPCS,J9302,"INJECTION, OFATUMUMAB, 10 MG ï",,,117.3,125.24,2
HCPCS,J9302,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,77.8,87.85,2
HCPCS,J9303,All drugs or drug agents without specific rate set forth above or herein,,,438.25,438.25,2
HCPCS,J9303,"INJECTION, PANITUMUMAB, 10 MG",,,222.17,331.3,4
HCPCS,J9303,PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN,37974.375,24683.345,198.39,14761.0,19
HCPCS,J9303,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,147.34,166.39,2
HCPCS,J9304,All drugs or drug agents without specific rate set forth above or herein,,,139.81,139.81,2
HCPCS,J9304,Drug - Oncology,,,196.6,209.9,2
HCPCS,J9304,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,130.39,147.24,2
HCPCS,J9305,All drugs or drug agents without specific rate set forth above or herein,,,11.51,11.51,2
HCPCS,J9305,"INJECTION, PEMETREXED, 10 MG",,,108.32,115.65,2
HCPCS,J9305,"Injection, pemetrexed, not otherwise specified, 10 mg",,,9.6,9.6,2
HCPCS,J9305,PEMETREXED DISODIUM 100 MG IV SOLR,1200.32,780.21,5.21,14761.0,46
HCPCS,J9305,PEMETREXED DISODIUM 500 MG IV SOLR,1639.84,1065.9,5.21,14761.0,47
HCPCS,J9305,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,71.84,81.13,2
HCPCS,J9306,All drugs or drug agents without specific rate set forth above or herein,,,44.33,44.33,2
HCPCS,J9306,"INJECTION, PERTUZUMAB, 1 MG",,,25.91,27.67,2
HCPCS,J9306,"INJECTION, PERTUZUMAB, 1 MG (FOR BILLING PRIOR TO 1/1/14 USE C9292 OR J9999)",,,33.92,33.92,2
HCPCS,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,61384.43,39899.88,20.07,14761.0,11
HCPCS,J9306,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.19,19.41,2
HCPCS,J9307,All drugs or drug agents without specific rate set forth above or herein,,,1028.09,1028.09,2
HCPCS,J9307,"INJECTION, PRALATREXATE, 1 MG",,,416.52,444.71,2
HCPCS,J9307,"Injection, pralatrexate, 1 mg (For billing prior to 1/1/11 use J9999 or C9259)",,,635.82,635.82,2
HCPCS,J9307,PRALATREXATE 40 MG/2 ML (20 MG/ML) IV SOLN,133376.22,86694.54,465.41,14761.0,11
HCPCS,J9307,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,276.24,311.95,2
HCPCS,J9308,All drugs or drug agents without specific rate set forth above or herein,,,195.49,195.49,2
HCPCS,J9308,"INJECTION, RAMUCIRUMAB, 5 MG (FOR BILLING PRIOR TO 1/1/16 USE C9025 OR J9999)",,,154.48,154.48,2
HCPCS,J9308,"Injection, ramucirumab",,,135.96,145.16,2
HCPCS,J9308,RAMUCIRUMAB 10 MG/ML IV SOLN,39726.72,25822.37,88.5,14761.0,22
HCPCS,J9308,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,90.17,101.83,2
HCPCS,J9309,All drugs or drug agents without specific rate set forth above or herein,,,356.98,356.98,2
HCPCS,J9309,"Injection, polatuzumab vedotin-piiq, 1 mg",,,285.57,304.9,2
HCPCS,J9309,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,189.39,213.88,2
HCPCS,J9311,All drugs or drug agents without specific rate set forth above or herein,,,101.61,101.61,2
HCPCS,J9311,"Injection, rituximab 10 mg and hyaluronidase",,,82.26,133.73,4
HCPCS,J9311,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SC SOLN",52612.65,34198.22,46.0,52.9,8
HCPCS,J9311,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,83.07,93.81,2
HCPCS,J9312,All drugs or drug agents without specific rate set forth above or herein,,,212.66,212.66,2
HCPCS,J9312,"Injection, rituximab, 10 mg",,,174.17,267.45,4
HCPCS,J9312,RITUXIMAB 10 MG/ML IV CONC,26306.56,17099.265,96.27,14761.0,22
HCPCS,J9312,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,166.14,187.61,2
HCPCS,J9313,All drugs or drug agents without specific rate set forth above or herein,,,64.35,64.35,2
HCPCS,J9313,"Injection, moxetumomab pasudotox-tdfk, 0.01 mg",,,58.81,62.79,2
HCPCS,J9313,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,39.0,44.05,2
HCPCS,J9314,"Injection, pemetrexed (Teva) not therapeutically equivalent to J9305, 10 mg",,,52.86,56.44,2
HCPCS,J9314,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.06,39.59,2
HCPCS,J9315,"INJECTION, ROMIDEPSIN, 1 MG",,,562.68,600.75,2
HCPCS,J9315,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,373.17,421.42,2
HCPCS,J9316,All drugs or drug agents without specific rate set forth above or herein,,,177.62,177.62,2
HCPCS,J9316,"Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg",,,147.46,200.87,4
HCPCS,J9316,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SC SOLN",125248.82,81411.73,80.41,92.47,8
HCPCS,J9316,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SC SOLN,83495.88,54272.32,80.41,92.47,8
HCPCS,J9316,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,124.77,140.9,2
HCPCS,J9317,All drugs or drug agents without specific rate set forth above or herein,,,95.36,95.36,2
HCPCS,J9317,"Injection, sacituzumab govitecan-hziy, 2.5 mg",,,74.46,79.5,4
HCPCS,J9317,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,22619.16,14702.45,43.17,14761.0,11
HCPCS,J9317,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,49.38,55.77,2
HCPCS,J9318,Drug,,,85.17,90.93,2
HCPCS,J9318,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,56.49,63.79,2
HCPCS,J9319,All drugs or drug agents without specific rate set forth above or herein,,,82.14,82.14,2
HCPCS,J9319,Drug,,,85.17,90.93,2
HCPCS,J9319,"Injection, romidepsin, lyophilized, 0.1 mg",,,70.28,70.28,2
HCPCS,J9319,ROMIDEPSIN 10 MG/2 ML IV SOLR,28787.85,18712.1,37.19,42.76,8
HCPCS,J9319,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,56.49,63.79,2
HCPCS,J9320,"INJECTION, STREPTOZOCIN, 1 GRAM",,,296.63,316.7,2
HCPCS,J9320,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,196.73,222.16,2
HCPCS,J9325,All drugs or drug agents without specific rate set forth above or herein,,,193.54,193.54,2
HCPCS,J9325,"Injection, talimogene laherparepvec, per 1 million plaque forming units",,,117.3,125.24,2
HCPCS,J9325,"Injection, talimogene laherparepvec, per 1 million plaque forming units (For billing prior to 1/1/17 use J9999 or C9472 for OPPS billing)",,,146.44,146.44,2
HCPCS,J9325,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,77.8,87.85,2
HCPCS,J9328,All drugs or drug agents without specific rate set forth above or herein,,,28.6,28.6,2
HCPCS,J9328,"INJECTION, TEMOZOLOMIDE, 1 MG",,,12.61,13.46,2
HCPCS,J9328,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.36,9.45,2
HCPCS,J9330,All drugs or drug agents without specific rate set forth above or herein,,,88.6,88.6,2
HCPCS,J9330,"INJECTION, TEMSIROLIMUS, 1 MG",,,68.16,68.16,2
HCPCS,J9330,"INJECTION, TEMSIROLIMUS, 1 MG (CODE REINSTATED)",,,128.02,136.68,2
HCPCS,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR,7546.77,4905.4,40.11,46.12,24
HCPCS,J9330,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,84.9,95.88,2
HCPCS,J9331,All drugs or drug agents without specific rate set forth above or herein,,,314.13,314.13,2
HCPCS,J9331,"INJECTION, SIROLIMUS PROTEIN-BOUND PARTICLES, 1 MG",,,180.88,193.12,2
HCPCS,J9331,"Injection, sirolimus protein-bound particles, 1 mg",,,240.33,240.33,2
HCPCS,J9331,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR,71806.77,46674.4,142.21,163.54,8
HCPCS,J9331,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,119.96,135.47,2
HCPCS,J9332,All drugs or drug agents without specific rate set forth above or herein,,,89.58,89.58,2
HCPCS,J9332,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,55713.42,36213.72,40.55,46.64,8
HCPCS,J9332,"INJECTION, EFGARTIGIMOD ALFA-FCAB, 2MG",,,79.3,84.66,2
HCPCS,J9332,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,52.59,59.39,2
HCPCS,J9340,All drugs or drug agents without specific rate set forth above or herein,,,574.92,574.92,2
HCPCS,J9340,"INJECTION, THIOTEPA, 15 MG",,,273.65,552.43,4
HCPCS,J9340,THIOTEPA 15 MG IJ SOLR,2720.56,1768.365,260.26,14761.0,6
HCPCS,J9340,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,181.49,204.95,2
HCPCS,J9347,All drugs or drug agents without specific rate set forth above or herein,,,372.57,372.57,2
HCPCS,J9347,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,365180.4,237367.26,168.66,193.96,8
HCPCS,J9348,Drug,,,1404.71,1499.76,2
HCPCS,J9348,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,931.62,1052.05,2
HCPCS,J9349,All drugs or drug agents without specific rate set forth above or herein,,,37.71,37.71,2
HCPCS,J9349,"Injection, tafasitamab-cxix, 2 mg",,,29.91,34.15,4
HCPCS,J9349,TAFASITAMAB-CXIX 200 MG IV SOLR,12316.5,8005.73,17.07,19.63,8
HCPCS,J9349,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,21.21,23.96,2
HCPCS,J9350,All drugs or drug agents without specific rate set forth above or herein,,,1747.92,1747.92,2
HCPCS,J9350,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,9988.0,6492.2,791.27,909.96,8
HCPCS,J9351,"INJECTION, TOPOTECAN, 0.1 MG",,,74.81,79.87,2
HCPCS,J9351,"Injection, topotecan, 0.1 mg",,,1.72,1.72,2
HCPCS,J9351,TOPOTECAN 4 MG IV SOLR,11284.84,7335.1449999999995,13270.0,14761.0,2
HCPCS,J9351,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,49.61,56.03,2
HCPCS,J9352,All drugs or drug agents without specific rate set forth above or herein,,,997.99,997.99,2
HCPCS,J9352,"Injection, trabectedin, 0.1 mg",,,719.72,768.42,2
HCPCS,J9352,"Injection, trabectedin, 0.1 mg (For billing prior to 1/1/17 use J9999 or C9480 for OPPS billing)",,,744.15,744.15,2
HCPCS,J9352,TRABECTEDIN 1 MG IV SOLR,31031.82,20170.68,451.78,519.55,8
HCPCS,J9352,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,477.32,539.03,2
HCPCS,J9353,Drug,,,110.74,118.23,2
HCPCS,J9353,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,73.44,82.94,2
HCPCS,J9354,ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR,35906.67,23339.34,50.36,14761.0,11
HCPCS,J9354,ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR,57450.6,37342.89,50.36,14761.0,11
HCPCS,J9354,All drugs or drug agents without specific rate set forth above or herein,,,111.25,111.25,2
HCPCS,J9354,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",,,73.94,78.94,2
HCPCS,J9354,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG (FOR BILLING PRIOR TO 1/1/14 USE C9131 OR J9999)",,,84.38,84.38,2
HCPCS,J9354,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,49.04,55.38,2
HCPCS,J9355,All drugs or drug agents without specific rate set forth above or herein,,,214.38,214.38,2
HCPCS,J9355,"INJECTION, TRASTUZUMAB, 10 MG",,,133.37,142.4,2
HCPCS,J9355,"Injection, trastuzumab, excludes biosimilar, 10 mg",,,176.95,176.95,2
HCPCS,J9355,TRASTUZUMAB 150 MG IV SOLR,14025.78,9116.76,97.05,111.61,8
HCPCS,J9355,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.45,99.89,2
HCPCS,J9356,All drugs or drug agents without specific rate set forth above or herein,,,175.45,175.45,2
HCPCS,J9356,"Injection, trastuzumab, 10 mg and Hyaluronidase-oysk",,,145.17,221.74,4
HCPCS,J9356,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SC SOLN",42077.16,27350.15,79.43,91.34,8
HCPCS,J9356,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,137.74,155.54,2
HCPCS,J9357,All drugs or drug agents without specific rate set forth above or herein,,,3952.86,3952.86,2
HCPCS,J9357,"INJECTION, VALRUBICIN, INTRAVESICAL, 200 MG",,,1231.43,1314.76,2
HCPCS,J9357,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,816.7,922.28,2
HCPCS,J9358,All drugs or drug agents without specific rate set forth above or herein,,,76.5,76.5,2
HCPCS,J9358,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,55713.42,36213.72,34.63,39.82,8
HCPCS,J9358,FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR,26412.75,17168.29,34.63,14761.0,11
HCPCS,J9358,"Injection, fam-trastuzumab deruxtecan-nxki, 1 mg",,,62.09,66.3,2
HCPCS,J9358,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.18,46.51,2
HCPCS,J9359,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",,,482.35,514.98,2
HCPCS,J9359,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,319.9,361.25,2
HCPCS,J9360,"INJECTION, VINBLASTINE SULFATE, 1 MG",,,9.27,11.44,4
HCPCS,J9360,VINBLASTINE 1 MG/ML IV SOLN,793.28,515.63,13270.0,14761.0,2
HCPCS,J9360,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.1,8.02,2
HCPCS,J9370,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,J9370,"VINCRISTINE SULFATE, 1 MG",,,16.99,16.99,2
HCPCS,J9370,"VINCRISTINE SULFATE, 1 MG/1 ML (1 ML VIAL)",,,89.14,95.18,2
HCPCS,J9370,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,59.12,66.76,2
HCPCS,J9371,"INJECTION, VINCRISTINE SULFATE LIPOSOME, 1 MG",,,5197.66,5549.36,2
HCPCS,J9371,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3447.13,3892.77,2
HCPCS,J9380,All drugs or drug agents without specific rate set forth above or herein,,,87.96,87.96,2
HCPCS,J9380,"Injection, teclistamab-cqyv, 0.5 mg (Code reused effective 7/1/2023)",,,67.83,67.83,2
HCPCS,J9380,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,39.82,14761.0,3
HCPCS,J9381,All drugs or drug agents without specific rate set forth above or herein,,,101.51,101.51,2
HCPCS,J9390,"INJECTION, VINORELBINE TARTRATE, 10 MG",,,254.13,271.33,2
HCPCS,J9390,"INJECTION, VINORELBINE TARTRATE, PER 10 MG",,,16.32,16.32,2
HCPCS,J9390,VINORELBINE 50 MG/5 ML IV SOLN,924.24,600.755,13270.0,14761.0,2
HCPCS,J9390,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,168.54,190.33,2
HCPCS,J9393,"Injection, fulvestrant (teva) not therapeutically equivalent to j9395, 25 mg",,,53.38,57.0,2
HCPCS,J9393,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,35.4,39.98,2
HCPCS,J9394,"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg",,,133.2,142.21,2
HCPCS,J9394,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.34,99.76,2
HCPCS,J9395,All drugs or drug agents without specific rate set forth above or herein,,,20.65,20.65,2
HCPCS,J9395,FULVESTRANT 250 MG/5 ML IM SYRG,1379.36,896.58,9.35,14761.0,105
HCPCS,J9395,"INJECTION, FULVESTRANT, 25 MG",,,18.58,233.33,4
HCPCS,J9395,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,144.94,163.68,2
HCPCS,J9400,All drugs or drug agents without specific rate set forth above or herein,,,17.89,17.89,2
HCPCS,J9400,"INJECTION, ZIV-AFLIBERCEPT, 1 MG",,,42.67,45.56,2
HCPCS,J9400,"INJECTION, ZIV-AFLIBERCEPT, 1 MG (FOR BILLING PRIOR TO 1/1/14 USE C9296 OR J9999)",,,16.02,16.02,2
HCPCS,J9400,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.3,31.96,2
HCPCS,J9600,All drugs or drug agents without specific rate set forth above or herein,,,65657.69,65657.69,2
HCPCS,J9600,"INJECTION, PORFIMER SODIUM, 75 MG",,,6990.91,7463.95,2
HCPCS,J9600,PORFIMER 75 MG IV SOLR,209907.0,136439.55,13270.0,34181.23,11
HCPCS,J9600,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4636.43,5235.81,2
HCPCS,J9999,ANASTROZOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,J9999,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
HCPCS,J9999,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,154815.2,100629.88,13270.0,14761.0,2
HCPCS,J9999,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,13270.0,14761.0,2
HCPCS,J9999,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,13270.0,14761.0,2
HCPCS,L0140,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,116.0,75.4,,,0
HCPCS,L0172,HB CERV COLLAR THERMOPL FOAM 2PC,854.69,555.55,13270.0,14761.0,2
HCPCS,L0174,HB CERV COLLAR SEMIRIG THERMO2PC,1546.92,1005.49,13270.0,14761.0,2
HCPCS,L0450,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,100.0,65.0,,,0
HCPCS,L0464,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,2390.0,1553.5,13270.0,14761.0,2
HCPCS,L0470,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,1543.0,1002.95,,,0
HCPCS,L0472,HB TLSO RIGID FRAME HYPEREX PRE,2124.78,1381.11,,,0
HCPCS,L0484,HB TLSO RIGID PLASTIC CUSTOM FAB,6429.9,4179.43,13270.0,14761.0,2
HCPCS,L0486,HB TLSO RIGIDLINED CUST FAB TWO,6863.2,4461.08,13270.0,14761.0,2
HCPCS,L0627,HB LO SAGITT RIGID PANEL PREFAB,1756.85,1141.95,13270.0,14761.0,2
HCPCS,L0630,HB SLO POST RIGID PANEL PREFAB,887.71,577.01,13270.0,14761.0,2
HCPCS,L0633,HB LSO FLEXION CONTROL PREFAB,1322.93,859.9,13270.0,14761.0,2
HCPCS,L0635,HB SLO SAGIT RIGID PANEL PREFAB,3975.54,2584.1,13270.0,14761.0,2
HCPCS,L0636,HB LSO SAGITTAL RIGID PANEL CUST.,5959.81,3873.87,13270.0,14761.0,2
HCPCS,L0700,HB CTLSO A-P-L CONTROL MOLDED,7987.85,5192.1,13270.0,14761.0,2
HCPCS,L1005,HB TENSION BASED SCOLIOSIS ORTHO,9611.1,6247.22,13270.0,14761.0,2
HCPCS,L1100,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,385.0,250.25,,,0
HCPCS,L1240,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,188.0,122.2,,,0
HCPCS,L1685,HB POST-OP HIP ABDUCT CUSTOM FAB,5196.91,3377.99,13270.0,14761.0,2
HCPCS,L1820,HB KO ELAS W CONDYLE PADS & JNTS,851.26,553.32,13270.0,14761.0,2
HCPCS,L1820,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,851.26,553.32,,,0
HCPCS,L1830,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,99.0,64.35,,,0
HCPCS,L1832,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,1318.0,856.7,,,0
HCPCS,L1906,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,291.0,189.15,,,0
HCPCS,L1920,HB AFO SNGL UPRIGHT W/ADJUST STOP,1541.28,1001.83,13270.0,14761.0,4
HCPCS,L1990,HB AFT DOUBLE SOLID STIRRUP CALF,2309.19,1500.97,13270.0,14761.0,2
HCPCS,L2270,HB VARUS/VALGUS STRAP PADDED,451.32,293.35,13270.0,14761.0,2
HCPCS,L2340,HB PRE-TIBIAL SHELL MOLDED,2314.57,1504.47,13270.0,14761.0,2
HCPCS,L2405,HB KNEE JOINT DROP LOCK EA JOINT,542.96,352.92,13270.0,14761.0,2
HCPCS,L2810,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,189.0,122.85,,,0
HCPCS,L2820,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,210.0,136.5,13270.0,14761.0,2
HCPCS,L2830,HB SOFT INTERFACE ABOVE KNEE MOLD,705.04,458.28,13270.0,14761.0,2
HCPCS,L2850,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,136.0,88.4,,,0
HCPCS,L3332,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,140.0,91.0,,,0
HCPCS,L3660,HB ABDUCT RESTRAINER CANVAS & WEB,675.73,439.22,13270.0,14761.0,2
HCPCS,L3670,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,268.0,174.2,,,0
HCPCS,L3720,HB EO MOTIONDOUBLE UPRIGHT CUSTOM,3154.67,2050.53,13270.0,14761.0,2
HCPCS,L3908,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,142.0,92.3,,,0
HCPCS,L3931,HB WHFO NONTORSION JOINT PREFAB,1083.76,704.44,13270.0,14761.0,2
HCPCS,L3960,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,1477.0,960.05,,,0
HCPCS,L3980,HB UPPER EXT FX ORTHOSIS HUMERAL,1670.76,1085.99,13270.0,14761.0,2
HCPCS,L3995,HB MISCELLANEOUS PROSTHETIC/ORTHOTIC,68.0,44.2,,,0
HCPCS,L4350,HB ANKLE CONTROL ORTHOSIS PREFAB,676.24,439.55,13270.0,14761.0,2
HCPCS,L8047,HB NASAL SEPTAL PROSTHESIS,1727.95,1123.17,,,0
HCPCS,L8604,HB DEFLUX INJECTION 1ML,19790.6,12863.89,,,0
HCPCS,L8606,HB SYNTHETIC IMPLANT URINARY 1,2165.52,1407.59,13270.0,14761.0,2
HCPCS,L8609,HB MISCELLANEOUS IMPLANT,28362.1,18435.36,13270.0,14761.0,2
HCPCS,L8613,HB MISCELLANEOUS IMPLANT,4025.34,2616.47,,,0
HCPCS,L8614,HB MISCELLANEOUS IMPLANT,224278.0,145780.7,13270.0,14761.0,2
HCPCS,L8627,HB MISCELLANEOUS IMPLANT,19799.1,12869.41,,,0
HCPCS,L8679,HB MISCELLANEOUS IMPLANT,19799.1,12869.41,,,0
HCPCS,L8690,HB MISCELLANEOUS IMPLANT,35845.8,23299.77,,,0
HCPCS,L8690,HB MISCELLANEOUS SUPPLY,35845.8,23299.77,,,0
HCPCS,L8699,HB MISCELLANEOUS IMPLANT,16258.6,10568.09,13270.0,14761.0,6
HCPCS,M0220,"HB CILGAV & TIXAGEV INFUSION, ADMIN & MONITOR",693.86,451.01,187.4,215.51,16
HCPCS,M0220,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,M0221,"HB CILGAVIMAB INFUSION, ADMIN & MONITOR",514.99,334.74,13270.0,14761.0,2
HCPCS,M0222,"HB BEBTELOVIMAB INFUSION, ADMIN & MONITOR",514.99,334.74,436.44,14761.0,18
HCPCS,M0222,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,M0239,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,M0240,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,M0243,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,M0245,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,P2028,"CEPHALIN FLOCULATION, BLOOD",,,26.34,41.95,2
HCPCS,P2028,Laboratory Services,,,418.23,418.27,2
HCPCS,P2029,"CONGO RED, BLOOD",,,26.34,41.95,2
HCPCS,P2029,Laboratory Services,,,32.64,32.64,2
HCPCS,P2031,HAIR ANALYSIS (EXCLUDING ARSENIC),,,26.34,41.95,2
HCPCS,P2031,Laboratory Services,,,520.61,520.66,2
HCPCS,P2033,Laboratory Services,,,32.64,32.64,2
HCPCS,P2033,"THYMOL TURBIDITY, BLOOD",,,26.34,41.95,2
HCPCS,P2038,Laboratory Services,,,37.8,37.8,2
HCPCS,P2038,"MUCOPROTEIN, BLOOD (SEROMUCOID) (MEDICAL NECESSITY PROCEDURE)",,,12.48,12.48,2
HCPCS,P3000,Laboratory Services,,,79.49,79.5,2
HCPCS,P3000,"SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNICIAN UNDER PHYSICIAN SUPERVISION",,,42.43,42.43,2
HCPCS,P3000,"SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS; BY TECHNICIAN UNDER PHYSICIAN SUPERVISION",,,56.91,90.64,2
HCPCS,P3001,Laboratory Services,,,171.82,171.84,2
HCPCS,P3001,"SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS; REQUIRING INTERPRETATION BY PHYSICIAN",,,56.91,90.64,2
HCPCS,P7001,"CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY",,,62.85,100.1,2
HCPCS,P7001,Laboratory Services,,,117.42,117.43,2
HCPCS,P9010,BLOOD,719.5,467.68,,,0
HCPCS,P9012,HB PROCESS CRYOPRECIPITATE,363.32,236.16,79.16,14761.0,10
HCPCS,P9019,BLOOD,289.0,187.85,,,0
HCPCS,P9022,BLOOD,2204.49,1432.92,,,0
HCPCS,P9022,HB PROCESS PCK RBC WASHED,2204.49,1432.92,494.18,14761.0,10
HCPCS,P9023,"Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit (Code Price is per 1 mL)",,,2.27,2.42,2
HCPCS,P9023,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.51,1.7,2
HCPCS,P9036,BLOOD,3175.68,2064.19,,,0
HCPCS,P9037,BLOOD,2345.85,1524.8,,,0
HCPCS,P9037,HB PROCESS PLT PHERS LEUKO RED-OS,2345.85,1524.8,841.32,14761.0,10
HCPCS,P9038,BLOOD,846.5,550.23,,,0
HCPCS,P9038,HB PROCESS PACKED RBC,846.5,550.23,185.81,14761.0,10
HCPCS,P9040,BLOOD,992.22,644.94,,,0
HCPCS,P9040,HB PROCESS PCK RBC LEUKOREDUCED-OS,992.22,644.94,318.52,14761.0,10
HCPCS,P9041,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",1060.0,689.0,13270.0,14761.0,22
HCPCS,P9041,"Infusion, albumin (human), 5%, 50 mL",,,86.9,92.78,2
HCPCS,P9041,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,57.63,65.08,2
HCPCS,P9043,All drugs or drug agents without specific rate set forth above or herein,,,22.2,22.2,2
HCPCS,P9043,"Infusion, plasma protein fraction (human), 5%, 50 mL",,,60.02,64.08,2
HCPCS,P9043,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,39.81,44.95,2
HCPCS,P9044,All drugs or drug agents without specific rate set forth above or herein,,,405.17,405.17,2
HCPCS,P9045,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",936.0,608.4,66.09,14761.0,108
HCPCS,P9045,All drugs or drug agents without specific rate set forth above or herein,,,145.99,145.99,2
HCPCS,P9045,BLOOD,,,,,0
HCPCS,P9045,"Infusion, albumin (human), 5%, 250 mL",,,222.17,237.2,2
HCPCS,P9045,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,147.34,166.39,2
HCPCS,P9046,All drugs or drug agents without specific rate set forth above or herein,,,58.4,58.4,2
HCPCS,P9046,"Infusion, albumin (human), 25%, 20 mL",,,77.74,83.0,2
HCPCS,P9046,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.56,58.22,2
HCPCS,P9047,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1008.8,655.72,13270.0,14761.0,26
HCPCS,P9047,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,P9047,BLOOD,,,,,0
HCPCS,P9047,"Infusion, albumin (human), 25%, 50 mL",,,215.95,230.56,2
HCPCS,P9047,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,143.22,161.74,2
HCPCS,P9048,All drugs or drug agents without specific rate set forth above or herein,,,202.78,202.78,2
HCPCS,P9048,"Infusion, plasma protein fraction (human), 5%, 250 mL",,,140.97,150.51,2
HCPCS,P9048,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.49,105.58,2
HCPCS,P9050,BLOOD,1933.0,1256.45,,,0
HCPCS,P9056,BLOOD,2429.75,1579.34,,,0
HCPCS,P9056,"HB WHOLE BLOOD, LEUKOREDUCED, IRRADIATED, EACH UNIT",2429.75,1579.34,104.81,14761.0,10
HCPCS,P9057,BLOOD,3127.21,2032.69,,,0
HCPCS,P9059,BLOOD,366.17,238.01,,,0
HCPCS,P9059,"HB PROCESS PLAS, FRZ 8-24HR CS",366.17,238.01,88.52,14761.0,10
HCPCS,P9073,BLOOD,2348.7,1526.65,,,0
HCPCS,P9073,"HB PLATELETS, PHERESIS, PATHOGEN REDUCED EACH UNIT",2348.7,1526.65,731.27,14761.0,10
HCPCS,P9100,Pathogen(s) test for platelets,,,77.41,77.41,2
HCPCS,P9612,"CATHETERIZATION FOR COLLECTION OF SPECIMEN, SINGLE PATIENT, ALL PLACES OF SERVICE",,,20.8,20.8,2
HCPCS,P9615,CATHETERIZATION FOR COLLECTION OF SPECIMEN (S) (MULTIPLE PATIENTS),,,20.8,72.1,4
HCPCS,Q0035,CARDIOKYMOGRAPHY,,,98.19,156.37,2
HCPCS,Q0081,INFUSION THERAPY,,,2148.0,2209.0,2
HCPCS,Q0091,HB SCREENING PAP CERV/VAG,486.73,316.37,30.49,35.07,8
HCPCS,Q0091,"SCREENING PAPANICOLAOU SMEAR; OBTAINING,PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",486.73,316.37,261.7,416.78,2
HCPCS,Q0111,Laboratory Services,,,32.14,32.14,2
HCPCS,Q0111,"WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS",,,42.43,42.43,2
HCPCS,Q0111,"WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKINS SPECIMENS",,,37.39,59.55,2
HCPCS,Q0112,ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS,,,14.14,59.55,4
HCPCS,Q0112,Laboratory Services,,,32.14,32.14,2
HCPCS,Q0113,Laboratory Services,,,40.69,40.69,2
HCPCS,Q0113,PINWORM EXAMINATIONS,,,10.82,10.82,2
HCPCS,Q0113,PINWORN EXAMINATIONS,,,47.45,75.57,2
HCPCS,Q0114,FERN TEST,293.73,190.92,24.13,99.82,4
HCPCS,Q0114,Laboratory Services,293.73,190.92,53.77,53.78,2
HCPCS,Q0115,Laboratory Services,,,74.46,74.47,2
HCPCS,Q0115,POST COITAL QUALITATIVE EXAMINATIONS OF VAGINAL OR CERVICAL MUCOUS,,,86.78,138.21,2
HCPCS,Q0115,"POST-COITAL DIRECT, QUALITATIVE EXAMINATIONS OF VAGINAL OR CERVICAL MUCOUS",,,61.57,61.57,2
HCPCS,Q0138,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,2238.63,1455.105,0.42,14761.0,22
HCPCS,Q0138,"INJECTION , FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG ( NON-ESRD USE)",,,2.07,2.21,2
HCPCS,Q0138,"Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use) (For billing prior to 1/1/10 use J3490 or C9399)",,,0.79,0.79,2
HCPCS,Q0138,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.37,1.55,2
HCPCS,Q0139,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (FOR ESDR ON DIALYSIS)",,,2.07,2.21,2
HCPCS,Q0139,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.37,1.55,2
HCPCS,Q0144,"Azithromycin dihydrate, oral, capsule/powder, 1 g (Code deleted as of January 1, 2002) (Code reinstated effective July 1, 2002)",,,64.71,69.09,2
HCPCS,Q0144,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,42.92,48.47,2
HCPCS,Q0161,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,8
HCPCS,Q0161,CHLORPROMAZINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Q0161,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,8
HCPCS,Q0161,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",,,1.21,1.29,2
HCPCS,Q0161,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.8,0.91,2
HCPCS,Q0162,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI- EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN",,,13.3,14.2,2
HCPCS,Q0162,ONDANSETRON 4 MG PO TBDL,1465.56,952.61,13270.0,14761.0,6
HCPCS,Q0162,ONDANSETRON 8 MG PO TBDL,20482.8,13313.82,,,0
HCPCS,Q0162,ONDANSETRON HCL 4 MG PO TABS,514.6,334.49,13270.0,14761.0,6
HCPCS,Q0162,ONDANSETRON HCL 8 MG PO TABS,1202.38,781.5450000000001,13270.0,14761.0,6
HCPCS,Q0162,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.82,9.96,2
HCPCS,Q0163,"DIPHENHYDRAMINE HCI, 50MG,ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC,TREATMENT NOT TO EXCEED A 48 HR DOSAGE REGIMEN",,,0.2,0.21,2
HCPCS,Q0163,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO ELIX,,,13270.0,14761.0,2
HCPCS,Q0163,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO LIQD,,,13270.0,14761.0,2
HCPCS,Q0163,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,10
HCPCS,Q0163,DIPHENHYDRAMINE HCL 50 MG PO CAPS,,,13270.0,14761.0,2
HCPCS,Q0163,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.13,0.15,2
HCPCS,Q0164,PROCHLORPERAZINE MALEATE 5 MG PO HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
HCPCS,Q0164,PROCHLORPERAZINE MALEATE 5 MG PO TABS,,,13270.0,14761.0,4
HCPCS,Q0164,"PROCHLORPERAZINE MALEATE, 5MG, ORAL FDA APPROVED PRESCRIPTIO ANTI-EMETIC, FOR US AS A COMPLETE THERAPEUTIC SUB FOR AN IV",,,1.31,1.4,2
HCPCS,Q0164,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.87,0.98,2
HCPCS,Q0166,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,Q0166,GRANISETRON HCL 1 MG PO TABS,681.64,443.065,13270.0,14761.0,4
HCPCS,Q0166,"GRANISETRON HCL,1MG,ORAL,FDA APPROV RESCRIP ANTI-EMETICFOR COMP THERAP SUB/ TIME OF CHEMO,NOT TO EXCEED A 24 HR DOSAGE",,,130.51,139.34,2
HCPCS,Q0166,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,86.55,97.74,2
HCPCS,Q0167,"DRONABINAL, 2.5MG , ORAL, FDA APPROVED PRESCRIPTION ANTIEMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV A",,,12.96,13.83,2
HCPCS,Q0167,DRONABINOL 2.5 MG PO CAPS,1533.0,996.45,13270.0,14761.0,4
HCPCS,Q0167,"Dronabinol, 2.5 mg oral, FDA-approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at time of chemotherapy treatment, not to exceed a 48-hour dosage reg",,,1.79,1.79,2
HCPCS,Q0167,Other Outpatient Services,1465.56,952.61,,,0
HCPCS,Q0167,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.59,9.7,2
HCPCS,Q0169,PROMETHAZINE 12.5 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Q0169,"PROMETHAZINE HCL, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE",,,1.11,1.19,2
HCPCS,Q0169,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.74,0.83,2
HCPCS,Q0175,PERPHENAZINE 2 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Q0175,"PERPHENZAINE,4 MG, ORAL FDA APPROVED PRESCRIPTION ANTI-EMETIC,FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV",,,2.42,2.58,2
HCPCS,Q0175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,Q0177,"HYDROXYZINE PAMOATE,25 MG,ORAL FDA APPROVED PRESCRIPTION ANTI-EMETIC,FOR USE AS A COMPLET THERAPEUTIC SUBSTITUTE FOR IV",,,0.57,0.61,2
HCPCS,Q0177,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.38,0.43,2
HCPCS,Q0180,"DOLASETRON MESYLATE, 100 MG, ORAL, FDA APPROVED PRESCRIPTIONANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUB FOR IV",,,175.67,187.56,2
HCPCS,Q0180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,116.51,131.57,2
HCPCS,Q0221,CILGAVIMAB 150 MG/1.5 ML IM SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Q0221,TIXAGEVIMAB 150 MG/1.5 ML IM SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Q0222,BEBTELOVIMAB 175 MG/2 ML (87.5 MG/ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Q0247,Drug,,,5597.42,5976.18,2
HCPCS,Q0247,"Injection, sotrovimab, 500 mg (NDC inactive as of 5/9/2023)",,,0.02,0.02,2
HCPCS,Q0247,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3712.26,4192.17,2
HCPCS,Q0479,HB HEARTMATE II & III MPU,50739.1,32980.42,13270.0,14761.0,2
HCPCS,Q0481,HB HM POCKET CONTROLLER,26387.4,17151.81,13270.0,14761.0,2
HCPCS,Q0495,"HB HM, UNVRSL BATTERY CHARGER",31154.35,20250.33,13270.0,14761.0,2
HCPCS,Q0497,"HB HM, BATTERY CLIP SET",6188.77,4022.7,13270.0,14761.0,2
HCPCS,Q0498,HB HW SHOULDER PACK,3774.05,2453.13,13270.0,14761.0,2
HCPCS,Q0499,"HB HMGG, CONSOLIDATED BAG",1941.03,1261.67,13270.0,14761.0,2
HCPCS,Q0501,HB HM GG SHOWER BAG,2531.78,1645.66,,,0
HCPCS,Q0506,"HB BATTERY, LITHIUM-ION 14VL SET",6011.16,3907.25,13270.0,14761.0,2
HCPCS,Q0508,"HB HMGG, TRAVEL CASE",2813.08,1828.5,13270.0,14761.0,2
HCPCS,Q0508,HB MISCELLANEOUS SUPPLY,2813.08,1828.5,13270.0,14761.0,2
HCPCS,Q0515,"INJECTION, SERMORELIN ACETATE, 1 MICROGRAM ï",,,82.23,87.8,2
HCPCS,Q0515,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54.54,61.59,2
HCPCS,Q2004,"IRRIGATION SOLUTION FOR TREATMENT OF BLADDER CALCUL, FOR EXAMPLE RENACIDIN",,,254.9,272.14,2
HCPCS,Q2004,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,169.05,190.9,2
HCPCS,Q2009,FOSPHENYTOIN 100 MG PE/2 ML IJ SOLN,361.63,235.06,13270.0,14761.0,2
HCPCS,Q2009,FOSPHENYTOIN 500 MG PE/10 ML IJ SOLN,1808.16,1175.3,13270.0,14761.0,2
HCPCS,Q2009,"INJECTION, FOSPHENYTOIN, 50 MG",,,23.15,24.72,2
HCPCS,Q2009,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.35,17.34,2
HCPCS,Q2017,"INJECTION, TENIPOSIDE, 50 MG",,,562.68,600.75,2
HCPCS,Q2017,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,373.17,421.42,2
HCPCS,Q2028,All drugs or drug agents without specific rate set forth above or herein,,,2.75,2.75,2
HCPCS,Q2028,"INJECTION, SCULPTRA, 0.5 MG",,,1.73,1.84,2
HCPCS,Q2028,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.15,1.29,2
HCPCS,Q2035,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER FOR INTRAMUSCULAR USE (A",,,29.02,30.99,2
HCPCS,Q2035,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.25,21.74,2
HCPCS,Q2036,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER FOR INTRAMUSCULAR USE (F",,,17.45,18.63,2
HCPCS,Q2036,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.57,13.07,2
HCPCS,Q2037,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER FOR INTRAMUSCULAR USE (F",,,30.92,33.02,2
HCPCS,Q2037,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.51,23.16,2
HCPCS,Q2038,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER FOR INTRAMUSCULAR USE (F",,,29.37,31.36,2
HCPCS,Q2038,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.48,22.0,2
HCPCS,Q2039,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUAL 3 YRS AND OLDER (NOT OTHERWISE SPECIFIED)",,,29.02,30.99,2
HCPCS,Q2039,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.25,21.74,2
HCPCS,Q2041,All drugs or drug agents without specific rate set forth above or herein,1700090.0,1105058.5,1346307.49,1346307.49,2
HCPCS,Q2041,"Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose (For billing prior to 4/1/18 ",1700090.0,1105058.5,994209.1,1061483.37,2
HCPCS,Q2041,CAR-T Cell Therapy,1700090.0,1105058.5,,,0
HCPCS,Q2041,Cellular Immunotherapy Hospital Services,1700090.0,1105058.5,150960.0,185700.0,3
HCPCS,Q2041,HB AXICABTAGENE CILOLEUCEL CAR+ VIABLE T CELLS,1700090.0,1105058.5,13270.0,609464.69,5
HCPCS,Q2041,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1700090.0,1105058.5,659368.5,744609.44,2
HCPCS,Q2042,All drugs or drug agents without specific rate set forth above or herein,1542630.0,1002709.5,1455608.61,1455608.61,2
HCPCS,Q2042,CAR-T Cell Therapy,1542630.0,1002709.5,,,0
HCPCS,Q2042,Cellular Immunotherapy Hospital Services,1542630.0,1002709.5,150960.0,185700.0,3
HCPCS,Q2042,HB TISAGENLECLEUCEL CAR+ VIABLE T CELLS,1542630.0,1002709.5,13270.0,14761.0,2
HCPCS,Q2042,Tisagenlecleucel car-pos t,1542630.0,1002709.5,,,0
HCPCS,Q2042,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1542630.0,1002709.5,,,0
HCPCS,Q2043,All drugs or drug agents without specific rate set forth above or herein,,,151325.99,151325.99,2
HCPCS,Q2043,"SIPULEUCEL-T, MINIMUM OF 50 MILLION AUTOLOGOUS CD54+ CELLS ACTIVATED WITH PAP-GM-CSF, INCLUDING LEUKAPHERESIS AND ALL OT",,,82628.69,88219.85,2
HCPCS,Q2043,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,54800.1,61884.47,2
HCPCS,Q2049,"Injection, doxorubicin hydrochloride, liposomal, imported Lipodox, 10 mg",,,1278.6,1365.11,2
HCPCS,Q2049,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,847.98,957.6,2
HCPCS,Q2050,All drugs or drug agents without specific rate set forth above or herein,,,366.05,366.05,2
HCPCS,Q2050,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",4457.4,2897.31,165.71,14761.0,73
HCPCS,Q2050,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG - SEE ALSO J9002",,,1291.38,1378.76,2
HCPCS,Q2050,"Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg",,,187.99,187.99,2
HCPCS,Q2050,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,856.46,967.18,2
HCPCS,Q2053,"Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose (Code Price is for drug onl",1559710.0,1013811.5,994209.12,1061483.4,2
HCPCS,Q2053,CAR-T Cell Therapy,1559710.0,1013811.5,,,0
HCPCS,Q2053,Cellular Immunotherapy Hospital Services,1559710.0,1013811.5,150960.0,185700.0,3
HCPCS,Q2053,HB BREXUCABTAGENE AUTOLEUCEL CAR+ VIABLE T CELLS,1559710.0,1013811.5,13270.0,659463.97,10
HCPCS,Q2053,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1559710.0,1013811.5,659368.51,744609.46,2
HCPCS,Q2054,CAR-T Cell Therapy,1793840.0,1165996.0,,,0
HCPCS,Q2054,Cellular Immunotherapy Hospital Services,1793840.0,1165996.0,150960.0,185700.0,3
HCPCS,Q2054,Drug - Cellular Immunotherapy CAR T,1793840.0,1165996.0,1093630.06,1167631.77,2
HCPCS,Q2054,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1793840.0,1165996.0,725305.38,819070.42,2
HCPCS,Q2055,Drug - Oncology,1783580.0,1159327.0,1118152.13,1193813.15,2
HCPCS,Q2055,HB IDECABTAGENE VICLEUCEL CAR+ VIABLE T CELLS,1783580.0,1159327.0,13270.0,14761.0,2
HCPCS,Q2055,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1783580.0,1159327.0,741568.64,837436.14,2
HCPCS,Q2056,"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose (C",1762460.0,1145599.0,1239429.65,1323297.05,2
HCPCS,Q2056,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1762460.0,1145599.0,822000.99,928266.52,2
HCPCS,Q3014,HB TELEHEALTH ORIGINATING SITE FACILITY FEE,485.73,315.72,13270.0,14761.0,4
HCPCS,Q3027,All drugs or drug agents without specific rate set forth above or herein,,,154.67,154.67,2
HCPCS,Q3027,"INJECTION, INTERFERON BETA-1A, 1 MCG FOR INTRAMUSCULAR USE",,,100.89,107.72,2
HCPCS,Q3027,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,66.91,75.56,2
HCPCS,Q3028,"INJECTION, INTERFERON BETA-1A, 1 MCG FOR SUBCUTANEOUS USE",,,41.98,44.82,2
HCPCS,Q3028,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,27.84,31.44,2
HCPCS,Q4074,"ILOPROST, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP",,,165.33,176.52,2
HCPCS,Q4074,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,109.65,123.82,2
HCPCS,Q4081,"INJECTION, EPOETIN ALFA, 100 UNITS (FOR ESRD ON DIALYSIS)",,,3.46,3.69,2
HCPCS,Q4081,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.29,2.59,2
HCPCS,Q4100,HB MISCELLANEOUS IMPLANT,586.08,380.95,13270.0,14761.0,2
HCPCS,Q4100,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",586.08,380.95,,,0
HCPCS,Q4100,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",586.08,380.95,,,0
HCPCS,Q4101,"SKIN SUBSTITUTE, APLIGRAF, PER SQUARE CENTIMETER",,,91.56,97.76,2
HCPCS,Q4101,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,60.73,68.58,2
HCPCS,Q4102,"SKIN SUBSTITUTE, OASIS WOUND MATRIX, PER SQUARE CENTIMETER",,,7.77,8.3,2
HCPCS,Q4102,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.16,5.82,2
HCPCS,Q4103,"SKIN SUBSTITUTE, OASIS BURN MATRIX, PER SQUARE CENTIMETER",,,7.08,7.56,2
HCPCS,Q4103,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,4.7,5.3,2
HCPCS,Q4104,HB HUMAN TISSUE BILAYER (BMWD) 2X2,2877.98,1870.69,13270.0,14761.0,4
HCPCS,Q4104,HB HUMAN TISSUE BILAYER (BMWD) 4X5,2877.98,1870.69,13270.0,14761.0,2
HCPCS,Q4104,"SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER",2877.98,1870.69,33.34,35.6,2
HCPCS,Q4104,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",2877.98,1870.69,22.11,24.97,2
HCPCS,Q4105,"SKIN SUBSTITUTE, INTEGRA DERMAL REGENERATION TEMPLATE (DRT), PER SQUARE CENTIMETER",,,33.34,35.6,2
HCPCS,Q4105,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.11,24.97,2
HCPCS,Q4106,"SKIN SUBSTITUTE, DERMAGRAFT, PER SQUARE CENTIMETER",,,94.85,101.26,2
HCPCS,Q4106,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,62.9,71.03,2
HCPCS,Q4107,"SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER",909.19,590.97,224.76,239.97,2
HCPCS,Q4107,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",909.19,590.97,149.06,168.33,2
HCPCS,Q4108,HB MISCELLANEOUS IMPLANT,19799.1,12869.41,13270.0,14761.0,2
HCPCS,Q4108,"SKIN SUBSTITUTE, INTEGRA MATRIX, PER SQUARE CENTIMETER",,,33.34,35.6,2
HCPCS,Q4108,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,22.11,24.97,2
HCPCS,Q4110,"SKIN SUBSTITUTE, PRIMATRIX, PER SQUARE CENTIMETER",,,93.29,99.6,2
HCPCS,Q4110,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,61.87,69.87,2
HCPCS,Q4113,"ALLOGRAFT, GRAFTJACKET EXPRESS, INJECTABLE, 1CC",,,1993.65,2128.55,2
HCPCS,Q4113,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1322.21,1493.14,2
HCPCS,Q4114,"INTEGRA FLOWABLE WOUND MATRIX, INJECTABLE, 1CC",,,1925.06,2055.33,2
HCPCS,Q4114,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1276.72,1441.77,2
HCPCS,Q4116,HB HUMAN TISSUE ALLODERM 8X16,330.21,214.63,,,0
HCPCS,Q4116,HB MISCELLANEOUS IMPLANT,330.21,214.63,13270.0,14761.0,6
HCPCS,Q4116,"SKIN SUBSTITUTE, ALLODERM, PER SQ CM",330.21,214.63,,,0
HCPCS,Q4116,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",330.21,214.63,,,0
HCPCS,Q4117,"HYALOMATRIX, PER SQUARE CENTIMETER",,,62.56,66.8,2
HCPCS,Q4117,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.49,46.86,2
HCPCS,Q4118,HB MISCELLANEOUS IMPLANT,28.71,18.66,13270.0,14761.0,4
HCPCS,Q4118,"MATRISTEM MICROMATRIX, 1 MG",28.71,18.66,8.54,9.12,2
HCPCS,Q4118,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",28.71,18.66,5.66,6.4,2
HCPCS,Q4122,"DERMACELL, PER SQUARE CENTIMETER",,,256.13,273.46,2
HCPCS,Q4122,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,169.87,191.83,2
HCPCS,Q4123,"ALLOSKIN RT, PER SQUARE CENTIMETER",,,231.4,247.06,2
HCPCS,Q4123,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,153.47,173.31,2
HCPCS,Q4124,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",,,5.36,5.72,2
HCPCS,Q4124,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.55,4.01,2
HCPCS,Q4125,"ARTHROFLEX, PER SQUARE CENTIMETER",497.95,323.66,,,0
HCPCS,Q4125,HB MISCELLANEOUS IMPLANT,497.95,323.66,13270.0,14761.0,4
HCPCS,Q4125,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",497.95,323.66,,,0
HCPCS,Q4126,"MEMODERM, DERMASPAN, TRANZGRAFT OR INTEGUPLY,PER SQUARE CENTIMETER",,,216.57,231.22,2
HCPCS,Q4126,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,143.63,162.2,2
HCPCS,Q4127,"TALYMED, PER SQUARE CENTIMETER",,,83.69,89.35,2
HCPCS,Q4127,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,55.5,62.68,2
HCPCS,Q4128,"FLEX HD, ALLOPATCH HD, OR MATRIX HD, PER SQUARE CENTIMETER",279.06,181.39,,,0
HCPCS,Q4128,HB ALLOGRAFT FLEXHD 8X16CM,279.06,181.39,,,0
HCPCS,Q4128,HB HUMAN TISSUE ALLODERM 8X16,330.21,214.63,,,0
HCPCS,Q4128,HB MISCELLANEOUS IMPLANT,279.06,181.39,13270.0,14761.0,4
HCPCS,Q4128,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",279.06,181.39,,,0
HCPCS,Q4130,"STRATTICE TM, PER SQUARE CENTIMETER",294.25,191.26,,,0
HCPCS,Q4130,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",294.25,191.26,,,0
HCPCS,Q4132,"GRAFIX CORE, PER SQUARE CENTIMETER",,,391.99,418.52,2
HCPCS,Q4132,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,259.97,293.58,2
HCPCS,Q4133,"GRAFIX PRIME, PER SQUARE CENTIMETER",,,391.99,418.52,2
HCPCS,Q4133,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,259.97,293.58,2
HCPCS,Q4145,"EpiFix, injectable, 1 mg",,,55.63,59.39,2
HCPCS,Q4145,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,36.89,41.66,2
HCPCS,Q4148,HB MISCELLANEOUS IMPLANT,1979.75,1286.84,13270.0,14761.0,4
HCPCS,Q4149,"EXCELLAGEN, 0.1 CC",,,79.99,85.4,2
HCPCS,Q4149,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,53.05,59.91,2
HCPCS,Q4152,"DermaPure, per square centimeter (Code Price is based on median pricing methodology)",,,255.51,272.8,2
HCPCS,Q4152,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,169.46,191.36,2
HCPCS,Q4154,"BIOVANCE, per square centimeter (Code Price is based on median pricing methodology)",,,780.36,833.16,2
HCPCS,Q4154,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,517.54,584.45,2
HCPCS,Q4156,"NEOX 100, per square centimeter (Code Price is based on median pricing methodology)",,,396.48,423.31,2
HCPCS,Q4156,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,262.95,296.95,2
HCPCS,Q4158,"Kerecis Omega3, per square centimeter (Code Price is based on Median Pricing Methodology)",,,409.34,437.04,2
HCPCS,Q4158,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,271.48,306.58,2
HCPCS,Q4159,"Affinity, per square centimeter",,,1620.66,1730.33,2
HCPCS,Q4159,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1074.84,1213.79,2
HCPCS,Q4166,HB MISCELLANEOUS IMPLANT,325.1,211.32,13270.0,14761.0,2
HCPCS,Q4167,"Truskin, per sq cm",,,140.63,150.14,2
HCPCS,Q4167,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,93.26,105.32,2
HCPCS,Q4174,"Palingen or Promatrx, 0.36 mg per 0.25 cc (Code Price is based on Median Pricing Methodology)",,,3318.47,3543.02,2
HCPCS,Q4174,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2200.84,2485.36,2
HCPCS,Q4175,"Miroderm, per square centimeter (Code Price is based on Median Pricing Methodology)",,,172.14,183.79,2
HCPCS,Q4175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,114.17,128.93,2
HCPCS,Q4180,"Revita, per square centimeter",,,375.41,400.81,2
HCPCS,Q4180,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,248.97,281.16,2
HCPCS,Q5101,All drugs or drug agents without specific rate set forth above or herein,,,1.0,1.0,2
HCPCS,Q5101,FILGRASTIM-SNDZ 300 MCG IJ SYRG,2126.84,1382.4450000000002,0.45,14761.0,22
HCPCS,Q5101,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.875,2211.87,0.45,14761.0,30
HCPCS,Q5101,Inj filgrastim g-csf biosim,,,2.42,2.58,2
HCPCS,Q5101,"Injection, filgrastim-sndz, biosimilar, (Zarxio), 1 microgram",,,0.58,0.58,2
HCPCS,Q5101,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.6,1.81,2
HCPCS,Q5102,"Inj., infliximab biosimilar",,,252.23,269.3,2
HCPCS,Q5102,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,167.28,188.91,2
HCPCS,Q5103,All drugs or drug agents without specific rate set forth above or herein,,,37.46,37.46,2
HCPCS,Q5103,INFLIXIMAB-DYYB 100 MG IV SOLR,6708.32,4360.41,16.96,14761.0,11
HCPCS,Q5103,"Injection, infliximab-dyyb, biosimilar, (Inflectra), 10 mg",,,27.67,269.3,4
HCPCS,Q5103,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,167.28,188.91,2
HCPCS,Q5104,All drugs or drug agents without specific rate set forth above or herein,,,74.77,74.77,2
HCPCS,Q5104,INFLIXIMAB-ABDA 100 MG IV SOLR,20482.8,13313.82,33.85,38.92,16
HCPCS,Q5104,"Injection, infliximab-abda, biosimilar, (Renflexis), 10 mg",,,200.75,214.33,2
HCPCS,Q5104,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,133.14,150.35,2
HCPCS,Q5105,All drugs or drug agents without specific rate set forth above or herein,,,2.1,2.1,2
HCPCS,Q5105,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,1082.135,703.3900000000001,0.95,14761.0,14
HCPCS,Q5105,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,0.95,14761.0,14
HCPCS,Q5105,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,344.775,224.105,0.95,14761.0,14
HCPCS,Q5105,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,432.85,281.34999999999997,0.95,14761.0,14
HCPCS,Q5105,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,4328.545,2813.5550000000003,0.95,14761.0,11
HCPCS,Q5105,"Injection, epoetin alfa, biosimilar, (Retacrit) (for ESRD on dialysis), 100 units",,,2.94,3.14,2
HCPCS,Q5105,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.95,2.2,2
HCPCS,Q5106,All drugs or drug agents without specific rate set forth above or herein,,,20.95,20.95,2
HCPCS,Q5106,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,1082.135,703.3900000000001,9.49,14761.0,22
HCPCS,Q5106,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,9.49,14761.0,14
HCPCS,Q5106,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,344.775,224.105,9.49,14761.0,14
HCPCS,Q5106,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,432.85,281.34999999999997,9.49,14761.0,14
HCPCS,Q5106,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,4328.545,2813.5550000000003,9.49,14761.0,19
HCPCS,Q5106,"Injection, epoetin alfa, biosimilar, (Retacrit) (for non-ESRD use), 1000 units",,,29.42,31.41,2
HCPCS,Q5106,"Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units",,,16.67,16.67,2
HCPCS,Q5106,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,19.51,22.03,2
HCPCS,Q5107,All drugs or drug agents without specific rate set forth above or herein,,,73.13,73.13,2
HCPCS,Q5107,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,25482.69,16563.75,33.1,14761.0,22
HCPCS,Q5107,Inj mvasi 10 mg,,,200.4,213.96,2
HCPCS,Q5107,"Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg",,,46.69,46.69,2
HCPCS,Q5107,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,132.91,150.09,2
HCPCS,Q5108,All drugs or drug agents without specific rate set forth above or herein,,,372.8,372.8,2
HCPCS,Q5108,"Injection, pegfilgrastim-jmdb, biosimilar, (Fulphila), 0.5 mg (Code becomes payable by Medicare effective for claims with dates of service on or after 7/12/18)",,,927.38,990.13,2
HCPCS,Q5108,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SC SYRG,20482.8,13313.82,168.77,194.08,8
HCPCS,Q5108,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,615.04,694.55,2
HCPCS,Q5109,"Injection, ixifi, 10 mg",,,280.22,299.18,2
HCPCS,Q5109,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,185.84,209.87,2
HCPCS,Q5110,All drugs or drug agents without specific rate set forth above or herein,,,0.74,0.74,2
HCPCS,Q5110,"Injection, filgrastim-aafi, biosimilar, (Nivestym), 1 microgram",,,1.9,2.03,2
HCPCS,Q5110,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.26,1.42,2
HCPCS,Q5111,All drugs or drug agents without specific rate set forth above or herein,,,394.38,394.38,2
HCPCS,Q5111,"Injection, Pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg",,,927.38,990.13,2
HCPCS,Q5111,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,615.04,694.55,2
HCPCS,Q5112,All drugs or drug agents without specific rate set forth above or herein,,,93.97,93.97,2
HCPCS,Q5112,"Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mg",,,235.37,251.3,2
HCPCS,Q5112,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,156.1,176.28,2
HCPCS,Q5113,All drugs or drug agents without specific rate set forth above or herein,,,166.24,166.24,2
HCPCS,Q5113,"Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mg",,,249.22,266.08,2
HCPCS,Q5113,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,165.28,186.65,2
HCPCS,Q5114,All drugs or drug agents without specific rate set forth above or herein,,,148.97,148.97,2
HCPCS,Q5114,"Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mg",,,234.66,250.54,2
HCPCS,Q5114,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,155.63,175.75,2
HCPCS,Q5115,All drugs or drug agents without specific rate set forth above or herein,,,92.4,92.4,2
HCPCS,Q5115,"Injection, rituximab-abbs, biosimilar, (Truxima), 10 mg",,,69.74,240.63,4
HCPCS,Q5115,RITUXIMAB-ABBS 10 MG/ML IV SOLN,24579.36,15976.585,41.83,48.11,16
HCPCS,Q5115,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,149.47,168.8,2
HCPCS,Q5116,All drugs or drug agents without specific rate set forth above or herein,,,52.73,52.73,2
HCPCS,Q5116,"Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg",,,23.98,229.77,4
HCPCS,Q5116,TRASTUZUMAB-QYYP 420 MG IV SOLR,19222.68,12494.74,23.87,14761.0,30
HCPCS,Q5116,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,142.73,161.18,2
HCPCS,Q5117,All drugs or drug agents without specific rate set forth above or herein,,,66.93,66.93,2
HCPCS,Q5117,"Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg",,,17.2,250.54,4
HCPCS,Q5117,TRASTUZUMAB-ANNS 150 MG IV SOLR,11176.56,7264.76,30.3,34.84,8
HCPCS,Q5117,TRASTUZUMAB-ANNS 420 MG IV SOLR,31294.08,20341.15,30.3,34.84,8
HCPCS,Q5117,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,155.63,175.75,2
HCPCS,Q5118,All drugs or drug agents without specific rate set forth above or herein,,,64.88,64.88,2
HCPCS,Q5118,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,18926.08,12301.949999999999,29.37,14761.0,22
HCPCS,Q5118,"Injection, bevacizumab-bvzr, biosimilar, (Zirabev), 10 mg",,,37.11,174.57,4
HCPCS,Q5118,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,108.44,122.46,2
HCPCS,Q5119,All drugs or drug agents without specific rate set forth above or herein,,,61.72,61.72,2
HCPCS,Q5119,"Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg",,,33.73,204.0,4
HCPCS,Q5119,RITUXIMAB-PVVR 10 MG/ML IV SOLN,24362.88,15835.869999999999,27.94,14761.0,22
HCPCS,Q5119,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,126.72,143.1,2
HCPCS,Q5120,All drugs or drug agents without specific rate set forth above or herein,,,953.79,953.79,2
HCPCS,Q5120,"Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg",,,871.94,930.95,2
HCPCS,Q5120,PEGFILGRASTIM-BMEZ 6 MG/0.6 ML SC SYRG,20482.8,13313.82,431.78,496.54,8
HCPCS,Q5120,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,578.28,653.04,2
HCPCS,Q5121,All drugs or drug agents without specific rate set forth above or herein,,,58.56,58.56,2
HCPCS,Q5121,INFLIXIMAB-AXXQ 100 MG IV SOLR,6335.52,4118.09,26.51,14761.0,11
HCPCS,Q5121,"Injection, infliximab-axxq, biosimilar, (avsola), 10 mg",,,53.91,142.29,4
HCPCS,Q5121,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,88.39,99.81,2
HCPCS,Q5122,All drugs or drug agents without specific rate set forth above or herein,,,265.57,265.57,2
HCPCS,Q5122,"Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg",,,871.75,930.73,2
HCPCS,Q5122,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,578.15,652.89,2
HCPCS,Q5123,Drug,,,191.07,204.0,2
HCPCS,Q5123,"Injection, rituximab-arrx, biosimilar, (riabni), 10 mg",,,82.61,82.61,2
HCPCS,Q5123,RITUXIMAB-ARRX 10 MG/ML IV SOLN,25644.96,16669.225,48.12,55.34,16
HCPCS,Q5123,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,126.72,143.1,2
HCPCS,Q5125,"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram",,,1.38,1.48,2
HCPCS,Q5125,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.92,1.04,2
HCPCS,Q9949,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
HCPCS,Q9950,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML (CODE RE-USED BY CMS EFFECTIVE 1/1/16)",,,41.59,41.59,2
HCPCS,Q9950,SULFUR HEXAFLUORIDE MICROSPHR 25 MG IV SUSR,20482.8,13313.82,13270.0,14761.0,2
HCPCS,Q9950,Standard imaging - nuclear medicine,,,77.22,82.45,2
HCPCS,Q9950,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,51.22,57.84,2
HCPCS,Q9953,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),2282.76,1483.79,13270.0,14761.0,6
HCPCS,Q9953,"Injection, iron-based magnetic resonance contrast agent, per ml",,,71.7,76.55,2
HCPCS,Q9953,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,47.55,53.7,2
HCPCS,Q9954,"Oral magnetic resonance contrast agent, per 100 ml",,,27.99,29.88,2
HCPCS,Q9954,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,18.56,20.96,2
HCPCS,Q9955,"Injection, perflexane lipid microspheres, per ml",,,293.69,313.57,2
HCPCS,Q9955,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,194.78,219.96,2
HCPCS,Q9956,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,Q9956,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",,,92.7,92.7,2
HCPCS,Q9956,"Injection, octafluoropropane microspheres, per ml",,,113.85,121.55,2
HCPCS,Q9956,PERFLUTREN PROTEIN-A MICROSPHR 0.22 MG/ML IV SUSP,20482.8,13313.82,13270.0,14761.0,2
HCPCS,Q9956,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,75.51,85.27,2
HCPCS,Q9957,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,Q9957,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",,,92.7,92.7,2
HCPCS,Q9957,"Injection, perflutren lipid microspheres, per ml",,,152.89,163.24,2
HCPCS,Q9957,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,20482.8,13313.82,13270.0,14761.0,4
HCPCS,Q9957,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,101.4,114.51,2
HCPCS,Q9958,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),307.68,199.99,13270.0,14761.0,10
HCPCS,Q9958,DIATRIZOATE MEGLUMINE 30 % UR SOLN,20482.8,13313.82,13270.0,14761.0,2
HCPCS,Q9958,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",,,0.19,0.19,2
HCPCS,Q9958,"High osmolar contrast material, up to 149 mg/mL iodine concentration, per mL",,,0.3,0.32,2
HCPCS,Q9958,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.2,0.22,2
HCPCS,Q9960,"High osmolar contrast material, 200-249 mg/mL iodine concentration, per mL (All NDCs inactive as of 7/8/2020)",,,0.39,0.42,2
HCPCS,Q9960,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.26,0.3,2
HCPCS,Q9961,"High osmolar contrast material, 250-299 mg/mL iodine concentration, per mL",,,0.69,0.74,2
HCPCS,Q9961,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,Q9962,"High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml",,,0.69,0.74,2
HCPCS,Q9962,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,Q9963,DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % PO SOLN,300.52,195.34,13270.0,14761.0,6
HCPCS,Q9963,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",,,0.47,0.47,2
HCPCS,Q9963,"High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml",,,0.69,0.74,2
HCPCS,Q9963,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,Q9965,IOHEXOL 180 MG IODINE/ML IT SOLN,20482.8,13313.82,13270.0,14761.0,4
HCPCS,Q9965,"LOW OSMOLAR CONTRAST MATERIAL, 100-199 MG/ML IODINE CONCENTRATION, PER ML",,,0.86,3.0,4
HCPCS,Q9965,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.57,0.65,2
HCPCS,Q9966,IOHEXOL 240 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,4
HCPCS,Q9966,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",,,0.82,1.11,4
HCPCS,Q9966,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,Q9967,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,8
HCPCS,Q9967,IOHEXOL 300 MG IODINE/ML IV SOLN,1342.2,872.43,13270.0,14761.0,4
HCPCS,Q9967,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),463.36,301.18,13270.0,14761.0,14
HCPCS,Q9967,IOHEXOL 300 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Q9967,IOHEXOL 350 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,10
HCPCS,Q9967,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,10974.18,7133.215,13270.0,14761.0,4
HCPCS,Q9967,IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN,,,13270.0,14761.0,2
HCPCS,Q9967,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",,,0.26,1.11,4
HCPCS,Q9967,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.69,0.78,2
HCPCS,Q9968,INDOCYANINE GREEN 25 MG IJ SOLR,1918.08,1246.755,10.63,14761.0,30
HCPCS,Q9968,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG.",,,0.69,0.74,2
HCPCS,Q9968,ISOSULFAN BLUE 1 % SC SOLN,15656.72,10176.87,10.63,14761.0,27
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,10974.18,7133.215,10.63,14761.0,19
HCPCS,Q9968,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.46,0.52,2
HCPCS,Q9969,"TC-99M FROM NON-HIGHLY ENRICHED URANIUM SOURCE, FULL COST RECOVERY ADD-ON, PER STUDY DOSE",1.01,0.66,,,0
HCPCS,Q9969,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",1.01,0.66,,,0
HCPCS,Q9982,Flutemetamol f18 diagnostic,,,8795.9,9391.09,2
HCPCS,Q9982,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5833.52,6587.66,2
HCPCS,Q9983,Florbetaben f18 diagnostic,,,2487.74,2656.08,2
HCPCS,Q9983,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1649.89,1863.19,2
HCPCS,Q9991,All drugs or drug agents without specific rate set forth above or herein,,,5344.61,5344.61,2
HCPCS,Q9991,"Injection, buprenorphine extended-release (Sublocade), less than or equal to 100 mg (For billing prior to 7/1/18 use J3490 or C9399 for Hospital OPPS use) (Code Price is per 100 mg)",,,4643.07,4957.25,2
HCPCS,Q9991,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3079.33,3477.41,2
HCPCS,Q9992,All drugs or drug agents without specific rate set forth above or herein,,,5344.61,5344.61,2
HCPCS,Q9992,"Injection, buprenorphine extended-release (Sublocade), greater than 100 mg (For billing prior to 7/1/18 use J3490 or C9399 for Hospital OPPS use) (Code Price is per 300 mg)",,,4643.07,4957.25,2
HCPCS,Q9992,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3079.33,3477.41,2
HCPCS,S0012,BUTORPHANOL TARTRATE NAS SPRAY 25MG,,,317.16,338.62,2
HCPCS,S0012,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,210.35,237.54,2
HCPCS,S0013,"Esketamine, nasal spray, 1 mg",,,141.98,151.59,2
HCPCS,S0013,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,94.17,106.34,2
HCPCS,S0014,TACRINE HYDROCHLORIDE 10 MG,,,11.67,12.46,2
HCPCS,S0014,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,7.74,8.74,2
HCPCS,S0017,INJ AMINOCAPROIC ACID 5 GMS,,,37.14,39.66,2
HCPCS,S0017,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.63,27.82,2
HCPCS,S0020,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,10386.4,6751.16,13270.0,14761.0,16
HCPCS,S0020,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,14
HCPCS,S0020,BUPIVACAINE 0.25% INFUSION (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,4
HCPCS,S0020,BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,S0020,"BUPIVICAIN HYDROCHLORIDE, INJECTION, 30 ML",,,12.81,13.68,2
HCPCS,S0020,Other Outpatient Services,290.0,188.5,,,0
HCPCS,S0020,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.49,9.59,2
HCPCS,S0021,"CEFTOPERAZONE SODIUM, INJECTION, 1 GRAM",,,37.76,40.32,2
HCPCS,S0021,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,25.04,28.28,2
HCPCS,S0023,"INJECTION, CIMETIDINE HYDROCHLORIDE, 300MG",,,7.95,8.48,2
HCPCS,S0023,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.27,5.95,2
HCPCS,S0028,"INJECTION, FAMOTIDINE, 20 MG",,,2.47,2.64,2
HCPCS,S0028,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.64,1.85,2
HCPCS,S0030,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,12
HCPCS,S0030,"METRONIDAZOLE, INJECTION, 500 MG",,,79.35,84.72,2
HCPCS,S0030,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,52.62,59.43,2
HCPCS,S0032,"NAFCILLIN SODIUM, INJECTION, 2 GRAMS",,,16.56,17.68,2
HCPCS,S0032,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.98,12.4,2
HCPCS,S0034,"OFLOXACIN, INJECTION, 400 MG",,,61.9,66.09,2
HCPCS,S0034,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,41.05,46.36,2
HCPCS,S0039,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,S0039,"SULFAMETHOXZOLE AND TRIMETHOPRIM, INJECTION 10 ML",,,18.26,19.5,2
HCPCS,S0039,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.11,13.68,2
HCPCS,S0040,"TICARCILLIN DISODIUM AND CLAVULANATE POTASSIUM, INJECTION 3.1 GRAMS",,,37.41,39.95,2
HCPCS,S0040,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,24.81,28.02,2
HCPCS,S0073,AZTREONAM 1 GRAM IJ SOLR,368.51,239.53,13270.0,14761.0,6
HCPCS,S0073,AZTREONAM 2 GRAM IJ SOLR,779.0550000000001,506.39,13270.0,14761.0,6
HCPCS,S0073,"AZTREONAM, INJECTION, 500 MG",,,22.68,24.22,2
HCPCS,S0073,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.04,16.99,2
HCPCS,S0074,"CEFOTETAN DISODIUM, INJECTION, 500 MG",,,17.65,18.84,2
HCPCS,S0074,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,11.7,13.22,2
HCPCS,S0077,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
HCPCS,S0077,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,S0077,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,S0077,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,4
HCPCS,S0077,"INJECTION,CLINDAMYCIN PHOSPHATE 300 MG",,,19.37,20.68,2
HCPCS,S0077,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,12.85,14.51,2
HCPCS,S0078,"FOSPHENYTOIN SODIUM, INJECTION, 750 MG",,,138.26,147.61,2
HCPCS,S0078,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,91.69,103.55,2
HCPCS,S0080,INJECTION PENTAMIDINE ISETHIONATE 300 MG,,,113.28,120.95,2
HCPCS,S0080,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,75.13,84.84,2
HCPCS,S0081,"PIPERACILLIN SODIUM, INJECTION, 500 MG",,,10.41,11.12,2
HCPCS,S0081,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,6.91,7.8,2
HCPCS,S0088,IMATINIB 100 MG,,,167.36,178.68,2
HCPCS,S0088,IMATINIB 100 MG PO TABS,1627.2,1057.68,13270.0,14761.0,2
HCPCS,S0088,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,110.99,125.34,2
HCPCS,S0090,SILDENAFIL CITRATE 25 MG,,,69.42,74.12,2
HCPCS,S0090,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,46.04,52.0,2
HCPCS,S0091,"GRANISETRON HCI, 1MG",,,409.49,437.2,2
HCPCS,S0091,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,271.58,306.69,2
HCPCS,S0092,"INJECTION, HYDROMORPHONE HCI,250MG(LOADING DOSE FOR INFUSIONPUMP)",,,180.93,193.17,2
HCPCS,S0092,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,119.99,135.51,2
HCPCS,S0093,"INJECTION MORPHINE SULPHATE, 500MG(LOADING DOSE FOR INFUSIONPUMP)",,,86.01,91.83,2
HCPCS,S0093,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,57.04,64.42,2
HCPCS,S0104,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.93,2.18,2
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,2.91,3.11,2
HCPCS,S0106,"Bupropion HCl sustained release tablet, 150 mg, per bottle of 60 tablets",,,43.19,46.11,2
HCPCS,S0106,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,28.64,32.35,2
HCPCS,S0108,MERCAPTOPURINE 50 MG PO TABS,1181.6,768.04,13270.0,14761.0,2
HCPCS,S0108,"MERCAPTOPURINE, ORAL, 50 MG",,,16.36,17.47,2
HCPCS,S0108,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.85,12.25,2
HCPCS,S0109,METHADONE 10 MG PO TABS,334.6,217.49,13270.0,14761.0,4
HCPCS,S0109,"Methadone, oral, 5 mg",,,0.81,0.87,2
HCPCS,S0109,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.54,0.61,2
HCPCS,S0117,"Tretinoin, topical, 5 grams",,,23.45,25.03,2
HCPCS,S0117,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.55,17.56,2
HCPCS,S0119,All drugs or drug agents without specific rate set forth above or herein,,,,,0
HCPCS,S0119,ONDANSETRON 4 MG PO TBDL,1465.56,952.61,13270.0,14761.0,6
HCPCS,S0119,ONDANSETRON 8 MG PO TBDL,20482.8,13313.82,,,0
HCPCS,S0119,ONDANSETRON HCL 4 MG PO TABS,514.6,334.49,13270.0,14761.0,6
HCPCS,S0119,ONDANSETRON HCL 8 MG PO TABS,939.2,610.48,13270.0,14761.0,4
HCPCS,S0119,"ONDANSETRON, ORAL, 4 MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDICARE STATUTE, USE HCPCS Q CODE)",,,51.38,54.86,2
HCPCS,S0119,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.08,38.48,2
HCPCS,S0122,INJ MENOTROPINS 75IU,,,356.7,380.84,2
HCPCS,S0122,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,236.57,267.15,2
HCPCS,S0126,"INJ FOLLITROPIN, ALFA 75IU",,,196.87,210.19,2
HCPCS,S0126,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,130.57,147.45,2
HCPCS,S0128,"INJ FOLLITROPIN, BETA 75IU",,,434.71,464.13,2
HCPCS,S0128,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,288.31,325.58,2
HCPCS,S0132,INJ GANIRELIX ACETATE 250MCG,,,488.98,522.07,2
HCPCS,S0132,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,324.3,366.22,2
HCPCS,S0136,"CLOZAPINE, MG 25",,,5.16,5.51,2
HCPCS,S0136,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.42,3.86,2
HCPCS,S0137,"DIDANOSINE, 25 MG",,,3.09,3.29,2
HCPCS,S0137,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.05,2.31,2
HCPCS,S0138,"FINASTERIDE, 5 MG",,,12.51,13.36,2
HCPCS,S0138,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,8.3,9.37,2
HCPCS,S0139,"MINOXIDIL, 10 MG",,,5.16,5.51,2
HCPCS,S0139,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.42,3.86,2
HCPCS,S0145,"Injection, pegylated interferon alfa-2a, 180 mcg per mL (Code Price is per 180 mcg)",,,2722.72,2906.96,2
HCPCS,S0145,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,9031.74,5870.63,13270.0,14761.0,4
HCPCS,S0145,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1805.73,2039.17,2
HCPCS,S0148,"INJECTION, PEGYLATED INTERFERON ALFA-2B, 10 MCS",,,259.36,276.91,2
HCPCS,S0148,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,172.01,194.25,2
HCPCS,S0155,STERILE DILUTANT FOR EPOPROSTENOL 50 ML,,,31.34,33.46,2
HCPCS,S0155,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,20.79,23.47,2
HCPCS,S0156,EXEMESTANE 25 MG,,,51.63,55.12,2
HCPCS,S0156,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,34.24,38.67,2
HCPCS,S0157,BECAPLERMIN GEL 0.01% 0.5 GM,,,96.72,103.27,2
HCPCS,S0157,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,64.15,72.44,2
HCPCS,S0160,"Dextroamphetamine sulfate, 5 mg",,,0.54,0.58,2
HCPCS,S0160,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.36,0.41,2
HCPCS,S0164,"INJECTION, PANTOPRAZOLE SODIUM, 40 MG ï",,,61.08,65.22,2
HCPCS,S0164,PANTOPRAZOLE 40 MG IV SOLR,1465.56,952.61,13270.0,14761.0,10
HCPCS,S0164,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,40.51,45.75,2
HCPCS,S0166,"Injection, olanzapine, 2.5 mg",,,23.32,24.9,2
HCPCS,S0166,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,15.47,17.47,2
HCPCS,S0169,"Calcitriol, 0.25 microgram",,,2.84,3.03,2
HCPCS,S0169,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.88,2.13,2
HCPCS,S0170,ANASTROZOLE ORAL 1MG,,,45.78,48.88,2
HCPCS,S0170,Other Outpatient Services,290.0,188.5,,,0
HCPCS,S0170,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,30.36,34.29,2
HCPCS,S0171,BUMETANIDE (BUMEX) 25MG IN 100ML (STRAIGHT DRUG) INFUSION,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,S0171,BUMETANIDE 0.25 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,18
HCPCS,S0171,"INJECTION, BUMETANIDE, 0.5 MG",,,1.75,1.87,2
HCPCS,S0171,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.16,1.31,2
HCPCS,S0172,"CHLORAMBUCIL, ORAL, 2 MG",,,14.73,15.73,2
HCPCS,S0172,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.77,11.03,2
HCPCS,S0174,DOLASETRON MESYLATE ORAL 50 MG,,,239.77,255.99,2
HCPCS,S0174,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,159.02,179.57,2
HCPCS,S0175,FLUTAMIDE ORAL 125 MG,,,8.37,8.93,2
HCPCS,S0175,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.55,6.27,2
HCPCS,S0176,HYDROXYUREA ORAL 500 MG,,,5.13,5.48,2
HCPCS,S0176,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.4,3.84,2
HCPCS,S0178,LOMUSTINE ORAL 10 MG,,,44.13,47.11,2
HCPCS,S0178,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,29.27,33.05,2
HCPCS,S0179,MEGESTROL 20 MG PO TABS,,,13270.0,14761.0,2
HCPCS,S0179,MEGESTROL ACETATE ORAL 20 MG,,,2.64,2.82,2
HCPCS,S0179,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.75,1.98,2
HCPCS,S0182,PROCARBAZINE HCL ORAL 50 MG,,,222.81,237.89,2
HCPCS,S0182,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,147.77,166.87,2
HCPCS,S0183,PROCHORPERAZINE MALEATE ORAL 5 MG,,,2.37,2.53,2
HCPCS,S0183,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.57,1.77,2
HCPCS,S0187,TAMOXIFEN 10 MG PO TABS,1083.98,704.585,13270.0,14761.0,2
HCPCS,S0187,TAMOXIFEN CITRATE ORAL 10 MG,,,7.55,8.06,2
HCPCS,S0187,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,5.01,5.66,2
HCPCS,S0189,"TESTOSTERONE PELLET, 75MG",,,4.76,5.09,2
HCPCS,S0189,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.16,3.57,2
HCPCS,S0190,MIFEPRISTONE 200 MG PO TABS,688.0,447.2,13270.0,14761.0,2
HCPCS,S0190,MIFEPRISTONE ORAL 200MG,,,199.91,213.44,2
HCPCS,S0190,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,132.58,149.72,2
HCPCS,S0191,"MISOPROSTOL, ORAL, 200 MCG",,,4.81,5.14,2
HCPCS,S0191,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.19,3.6,2
HCPCS,S0194,"Dialysis/stress vitamin supplement, oral, 100 capsules",,,26.26,28.04,2
HCPCS,S0194,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,17.42,19.67,2
HCPCS,S1091,"Stent, non-coronary, temporary, with delivery system (propel)",,,3598.34,3841.83,2
HCPCS,S1091,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2386.45,2694.97,2
HCPCS,S2054,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
HCPCS,S2065,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,1
HCPCS,S2065,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,2
HCPCS,S2065,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,3
HCPCS,S2065,Transplant: Kidney/Pancreas,,,130000.0,130000.0,1
HCPCS,S2083,HB GASTRIC LAP BAND ADJUSTMENT,6195.29,4026.94,,,0
HCPCS,S2115,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
HCPCS,S2118,Outpatient Surgery Group 6 Global Rate,,,34526.0,35549.0,2
HCPCS,S2152,Outpatient Surgery Group 7 Global Rate,,,36188.0,39001.0,2
HCPCS,S2350,Outpatient Surgery Group 5 Global Rate,,,32992.0,34883.0,2
HCPCS,S2351,Outpatient Surgery Group 2 Global Rate,,,14322.0,15354.0,2
HCPCS,S2400,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2401,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2402,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2403,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2404,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2405,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S2409,Outpatient Surgery Group 8 Global Rate,,,41579.0,42988.0,2
HCPCS,S3620,HB NEWBORN METABOLIC SCREENING PANEL,176.25,114.56,13270.0,14761.0,4
HCPCS,S3620,Laboratory Services,176.25,114.56,24.09,24.09,2
HCPCS,S3620,"NEWBORN METABOLIC SCREENING PANEL,INCL TEST KIT, POSTAGE ANDLAB TESTS SPEC, EG GALACT, HEMO, ELECTRO, HYDROXYPRO, PKU...",176.25,114.56,,,0
HCPCS,S3630,Laboratory Services,,,24.46,24.47,2
HCPCS,S3645,Laboratory Services,,,116.29,116.3,2
HCPCS,S3650,Laboratory Services,,,1240.72,1240.84,2
HCPCS,S3652,Laboratory Services,,,448.1,448.14,2
HCPCS,S3655,Laboratory Services,,,986.07,986.17,2
HCPCS,S3845,Laboratory Services,,,1243.99,1244.11,2
HCPCS,S3854,Laboratory Services,,,16658.34,16660.01,2
HCPCS,S3861,Laboratory Services,,,14291.37,14292.81,2
HCPCS,S3865,Laboratory Services,,,27250.39,27253.13,2
HCPCS,S3866,Laboratory Services,,,4433.19,4433.64,2
HCPCS,S3870,Laboratory Services,,,2246.09,2246.32,2
HCPCS,S4991,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,3.52,3.97,2
HCPCS,S4993,Contraceptive pills for birth control (Code Price is based on median pricing per tablet effective 4/1/10),,,3.11,3.32,2
HCPCS,S4993,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.06,2.33,2
HCPCS,S5010,"5% DEXTROSE AND 45% NORMAL SALINE, 1000ML",,,4.17,4.45,2
HCPCS,S5010,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,2.77,3.12,2
HCPCS,S5012,"5% DEXTROSE WITH POTASSIUM CHLORIDE, 1000ML",,,15.35,16.39,2
HCPCS,S5012,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,10.18,11.5,2
HCPCS,S5013,"5% DEXTROSE/45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 1000ML",,,14.71,15.7,2
HCPCS,S5013,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,9.76,11.02,2
HCPCS,S5014,"5% DEXTROSE/0.45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 1500ML",,,22.06,23.56,2
HCPCS,S5014,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,14.63,16.52,2
HCPCS,S5550,"INSULIN, RAPID ONSET; 5 UNITS",,,1.6,1.71,2
HCPCS,S5550,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.06,1.2,2
HCPCS,S5551,"INSULIN, MOST RAPID ONSET; 5 UNITS",,,2.32,2.48,2
HCPCS,S5551,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.54,1.74,2
HCPCS,S5552,"INSULIN, INTERMEDIATE ACTING ; 5 UNITS",,,1.01,1.08,2
HCPCS,S5552,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,0.67,0.76,2
HCPCS,S5553,"INSULIN, LONG ACTING; 5 UNITS",,,2.17,2.32,2
HCPCS,S5553,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,1.44,1.63,2
HCPCS,S5561,"INSULIN DELIVERY DEVICE, REUSABLE PEN; 3 ML SIZE",,,147.59,157.57,2
HCPCS,S5561,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,97.88,110.53,2
HCPCS,S5566,INSULIN CARTRIDGE FOR USE IN INSULIN DELIVERY DEVICE OTHER THAN PUMP 300 UNITS,,,169.13,180.58,2
HCPCS,S5566,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,112.17,126.67,2
HCPCS,S5570,"INSULIN DELIVERY DEVICE, DISPOSABLE PEN; 1.5 ML SIZE",,,345.35,368.72,2
HCPCS,S5570,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,229.04,258.65,2
HCPCS,S5571,"INSULIN DELIVERY DEVICE, DISPOSABLE PEN, 3 ML SIZE",,,166.1,177.34,2
HCPCS,S5571,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,110.16,124.4,2
HCPCS,S8037,MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP),,,3691.68,5879.37,2
HCPCS,S8085,FLUORINE-18 FLUORODEOXYGLUCOSE (F-18 FDG) IMAGING USING DUAL-HEAD COINCIDENCE DETECTION SYSTEM (NON-DEDICATED PET SCAN),,,832.95,889.31,2
HCPCS,S8085,PET Scan,,,4155.27,4200.53,2
HCPCS,S8085,"WP RADIOPHARM, DRUG AND VACCINE FEE SCHEDULE",,,552.42,623.84,2
HCPCS,S9443,HB LACTATION CLASS,300.69,195.45,13270.0,14761.0,2
HCPCS,S9445,HB PT EDUCATION NOC INDIV,513.32,333.66,,,0
HCPCS,U0001,CDC 2019 novel coronavirus (2019-ncov) real-time RT-PCR diagnostic panel,,,116.88,186.15,2
HCPCS,U0001,Laboratory Services,,,225.9,225.93,2
HCPCS,U0002,"2019-nCov Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets)",,,301.68,480.45,2
HCPCS,U0002,Laboratory Services,,,322.69,322.73,2
HCPCS,U0003,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high th",,,440.96,702.28,2
HCPCS,U0004,"2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-0",,,440.96,702.28,2
HCPCS,U0005,"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, makin",,,146.99,234.09,2
HCPCS,X5556,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,X6366,INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN (PRL 1772 & 2600 ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,X6894,HYDROCORTISONE 50 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7500,HB ED FACILITY LEVEL 5,8738.51,5680.03,763.42,877.94,8
HCPCS,Z7500,"HB EST PATIENT, LEVEL 1",1037.19,674.17,,,0
HCPCS,Z7500,"HB EST. PATIENT, LEVEL 2",,,,,0
HCPCS,Z7500,HB TELEHEALTH ORIGINATING SITE FACILITY FEE,485.73,315.72,,,0
HCPCS,Z7502,HB ED FACILITY LEVEL 1,8738.51,5680.03,109.64,126.08,8
HCPCS,Z7502,HB ED FACILITY LEVEL 2,8738.51,5680.03,197.19,226.77,8
HCPCS,Z7502,HB ED FACILITY LEVEL 3 W/PROC,8738.51,5680.03,344.78,396.5,8
HCPCS,Z7502,HB ED FACILITY LEVEL 4 W/PROC,8738.51,5680.03,530.23,609.76,8
HCPCS,Z7502,HB ED FACILITY LEVEL 5,8738.51,5680.03,763.42,877.94,8
HCPCS,Z7502,"HB EST PATIENT, LEVEL 1",1037.19,674.17,,,0
HCPCS,Z7502,"HB EST. PATIENT, LEVEL 2",1037.19,674.17,,,0
HCPCS,Z7502,"HB TRAUMA, MID LEVEL RESPONSE",39402.8,25611.82,1647.6,1894.73,8
HCPCS,Z7512,HB HOURLY EXT RECOVERY,540.0,351.0,,,0
HCPCS,Z7512,HB PHASE I PACU 1ST HOUR,7105.64,4618.67,,,0
HCPCS,Z7512,HB PHASE I PACU EA ADDL MIN,113.83,73.99,,,0
HCPCS,Z7512,HB PHASE II PACU 1ST HOUR,2777.42,1805.32,,,0
HCPCS,Z7512,HB PHASE II PACU EA ADDL MIN,28.47,18.51,,,0
HCPCS,Z7610,ABACAVIR 300 MG PO TABS,2083.0,1353.95,13270.0,14761.0,4
HCPCS,Z7610,ACETAMINOPHEN 80 MG PO CHEW,,,13270.0,14761.0,2
HCPCS,Z7610,ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ACETAMINOPHEN-CODEINE 300-30 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ACETAZOLAMIDE 250 MG PO TABS,2952.0,1918.8,13270.0,14761.0,4
HCPCS,Z7610,ACETIC ACID (BULK) 5 % MISC LIQD,312.0,202.8,,,0
HCPCS,Z7610,ACETIC ACID 4% TOPICAL SOLN INTRAPROCEDURE,20482.8,13313.82,,,0
HCPCS,Z7610,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,Z7610,ACETYLCYSTEINE 200 MG/ML (20 %) ORAL/INHALATION SOLN,338.91999999999996,220.3,13270.0,14761.0,4
HCPCS,Z7610,ACYCLOVIR 200 MG PO CAPS,585.0,380.25,13270.0,14761.0,4
HCPCS,Z7610,ACYCLOVIR 200 MG/5 ML PO SUSP,938.43,609.98,13270.0,14761.0,10
HCPCS,Z7610,ACYCLOVIR 800 MG PO TABS,869.0,564.85,13270.0,14761.0,4
HCPCS,Z7610,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
HCPCS,Z7610,ALBENDAZOLE 200 MG PO TABS,1192.48,775.11,13270.0,14761.0,2
HCPCS,Z7610,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,ALENDRONATE 35 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,ALPRAZOLAM 0.25 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,ALPRAZOLAM 0.5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,AMANTADINE HCL 100 MG PO CAPS,1110.6,721.89,13270.0,14761.0,4
HCPCS,Z7610,AMANTADINE HCL 50 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AMBRISENTAN 10 MG PO TABS,13671.599999999999,8886.539999999999,13270.0,14761.0,2
HCPCS,Z7610,AMINOCAPROIC ACID 500 MG PO TABS,2053.74,1334.93,13270.0,14761.0,4
HCPCS,Z7610,AMLODIPINE BENZOATE 1 MG/ML PO SUSP,8748.0,5686.2,13270.0,14761.0,2
HCPCS,Z7610,AMMONIUM LACTATE 12 % TP LOTN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AMOXICILLIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AMOXICILLIN 250 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AMOXICILLIN 500 MG PO CAPS,457.0,297.05,13270.0,14761.0,4
HCPCS,Z7610,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,894.4,581.36,13270.0,14761.0,16
HCPCS,Z7610,APIXABAN 2.5 MG PO TABS,1789.44,1163.135,13270.0,14761.0,4
HCPCS,Z7610,APIXABAN 5 MG PO TABS,1789.44,1163.135,13270.0,14761.0,4
HCPCS,Z7610,APRACLONIDINE 0.5 % OP DROP,695.2,451.88,,,0
HCPCS,Z7610,ARIPIPRAZOLE 10 MG PO TABS,408.96,265.82,13270.0,14761.0,4
HCPCS,Z7610,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,ARIPIPRAZOLE 2 MG PO TABS,3109.92,2021.45,13270.0,14761.0,6
HCPCS,Z7610,ARIPIPRAZOLE 5 MG PO TABS,3264.2,2121.73,13270.0,14761.0,4
HCPCS,Z7610,ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OP DROP,941.22,611.79,13270.0,14761.0,4
HCPCS,Z7610,ATORVASTATIN 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,ATORVASTATIN 20 MG PO TABS,296.2,192.53,13270.0,14761.0,4
HCPCS,Z7610,ATORVASTATIN 40 MG PO TABS,345.6,224.64,13270.0,14761.0,2
HCPCS,Z7610,ATORVASTATIN 80 MG PO TABS,1148.78,746.7049999999999,13270.0,14761.0,10
HCPCS,Z7610,ATOVAQUONE 750 MG/5 ML PO SUSP,446.08,289.95,13270.0,14761.0,10
HCPCS,Z7610,AZATHIOPRINE 50 MG HALF-TAB = 25 MG,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,AZITHROMYCIN 250 MG PO TABS,935.5999999999999,608.14,13270.0,14761.0,10
HCPCS,Z7610,AZITHROMYCIN 600 MG PO TABS,1762.62,1145.7,13270.0,14761.0,4
HCPCS,Z7610,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,Z7610,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,290.0,188.5,,,0
HCPCS,Z7610,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OIPK",529.92,344.45,13270.0,14761.0,2
HCPCS,Z7610,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OP OINT",290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,BACLOFEN 25 MG/5 ML (5 MG/ML) PO SUSP,10821.12,7033.73,13270.0,14761.0,2
HCPCS,Z7610,BACLOFEN 5 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,BALANCED SALT SOLN NO.2 IRRIG. IO SOLN,,,13270.0,14761.0,2
HCPCS,Z7610,BARICITINIB 1 MG PO TABS,40233.12,26151.53,13270.0,14761.0,2
HCPCS,Z7610,BARICITINIB 2 MG PO TABS,43614.24,28349.26,13270.0,14761.0,2
HCPCS,Z7610,BECAPLERMIN 0.01 % TP GEL,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION IN HFAB,1631.98,1060.79,13270.0,14761.0,2
HCPCS,Z7610,BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,BELUMOSUDIL 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,BENZOCAINE 20 % MM SPRA,647.975,421.18000000000006,13270.0,14761.0,2
HCPCS,Z7610,BENZOCAINE-MENTHOL 20-0.5 % TP AERO,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MM GEL,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,BENZOYL PEROXIDE 5 % TP GEL,290.0,188.5,,,0
HCPCS,Z7610,BICALUTAMIDE 50 MG PO TABS,1051.2,683.28,13270.0,14761.0,2
HCPCS,Z7610,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG PO TABS,62850.24,40852.66,13270.0,14761.0,2
HCPCS,Z7610,BISOPROLOL FUMARATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,BRIVARACETAM 10 MG/ML PO SOLN,21960.0,14274.0,13270.0,14761.0,2
HCPCS,Z7610,BRIVARACETAM 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,BUDESONIDE 0.25 MG IN NBSP,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,BUDESONIDE 0.5 MG IN NBSP,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,BUDESONIDE 3 MG PO CECX,3292.8,2140.3199999999997,13270.0,14761.0,4
HCPCS,Z7610,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,454.7,295.56,13270.0,14761.0,2
HCPCS,Z7610,BUPRENORPHINE HCL 2 MG SL SUBL,306.52,199.24,13270.0,14761.0,8
HCPCS,Z7610,BUPRENORPHINE HCL 8 MG SL SUBL,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,393.4,255.71,13270.0,14761.0,6
HCPCS,Z7610,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,596.16,387.5,13270.0,14761.0,2
HCPCS,Z7610,BUPROPION HCL 150 MG PO TB24,315.15999999999997,204.85500000000002,13270.0,14761.0,6
HCPCS,Z7610,BUPROPION HCL 300 MG PO TB24,991.68,644.59,13270.0,14761.0,4
HCPCS,Z7610,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,642.6,417.69,13270.0,14761.0,6
HCPCS,Z7610,CABERGOLINE 0.5 MG PO TABS,580.99,377.64,13270.0,14761.0,2
HCPCS,Z7610,CAFFEINE CITRATE 20 MG/ML ORAL SOLUTION PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CALCITONIN (SALMON) 200 UNIT/ACTUATION NA SPRY,543.99,353.59,13270.0,14761.0,2
HCPCS,Z7610,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,8
HCPCS,Z7610,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,13270.0,14761.0,4
HCPCS,Z7610,CAPSAICIN 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CAPTOPRIL ORAL SUSPENSION 1 MG/ML,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PF SOLN",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,CEFUROXIME AXETIL 250 MG PO TABS,290.0,188.5,,,0
HCPCS,Z7610,CEFUROXIME AXETIL 500 MG PO TABS,1302.72,846.77,13270.0,14761.0,2
HCPCS,Z7610,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,CEPHALEXIN 250 MG/5 ML PO SUSR,342.4,222.56,13270.0,14761.0,2
HCPCS,Z7610,CEPHALEXIN 500 MG PO CAPS,1064.0,691.6,13270.0,14761.0,6
HCPCS,Z7610,CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG PO CAPS,633.6,411.84,13270.0,14761.0,2
HCPCS,Z7610,CHLORPROMAZINE 100 MG PO TABS,20482.8,13313.82,,,0
HCPCS,Z7610,CHLORTHALIDONE 25 HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
HCPCS,Z7610,CINACALCET 30 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CINACALCET 60 MG PO TABS,432.0,280.8,13270.0,14761.0,2
HCPCS,Z7610,CINACALCET 90 MG PO TABS,581.28,377.83,13270.0,14761.0,2
HCPCS,Z7610,CIPROFLOXACIN 250 MG/5 ML PO SUMC,1944.0,1263.6,13270.0,14761.0,2
HCPCS,Z7610,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,CIPROFLOXACIN HCL 250 MG PO TABS,4382.4,2848.56,13270.0,14761.0,2
HCPCS,Z7610,CIPROFLOXACIN HCL 500 MG PO TABS,459.2,298.48,13270.0,14761.0,8
HCPCS,Z7610,CLARITHROMYCIN 500 MG PO TABS,1104.96,718.225,13270.0,14761.0,4
HCPCS,Z7610,CLINDAMYCIN HCL 150 MG PO CAPS,313.8,203.97,13270.0,14761.0,6
HCPCS,Z7610,CLINDAMYCIN PALMITATE HCL 75 MG/5 ML PO SOLR,406.4,264.16,13270.0,14761.0,2
HCPCS,Z7610,CLINDAMYCIN PHOSPHATE 1 % TP SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CLOBAZAM 2.5 MG/ML PO SUSP,23352.96,15179.42,13270.0,14761.0,2
HCPCS,Z7610,CLOBETASOL 0.05 % TP CREA,,,13270.0,14761.0,2
HCPCS,Z7610,CLONAZEPAM 0.25 MG PO TBDL,826.56,537.26,13270.0,14761.0,6
HCPCS,Z7610,CLONAZEPAM 0.5 MG PO TABS,553.0,359.45,13270.0,14761.0,4
HCPCS,Z7610,CLONAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CLONAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,CLONIDINE 0.1 MG/24 HR TD PTWK,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,CLONIDINE 0.2 MG/24 HR TD PTWK,392.8,255.32,13270.0,14761.0,2
HCPCS,Z7610,CLONIDINE 0.3 MG/24 HR TD PTWK,499.49,324.67,13270.0,14761.0,2
HCPCS,Z7610,CLONIDINE ORAL SUSPENSION 10 MCG/ML,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Z7610,CLOPIDOGREL 300 MG PO TABS,3287.04,2136.58,13270.0,14761.0,6
HCPCS,Z7610,CLOPIDOGREL 75 MG PO TABS,429.0,278.85,13270.0,14761.0,6
HCPCS,Z7610,CLOPIDOGREL ORAL SUSPENSION 5 MG/ML PEDIATRIC (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,CLOTRIMAZOLE 1 % TP CREA,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,CLOTRIMAZOLE 10 MG MM TROC,3077.76,2000.54,13270.0,14761.0,6
HCPCS,Z7610,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,COBICISTAT 150 MG PO TABS,4691.52,3049.49,13270.0,14761.0,2
HCPCS,Z7610,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,COLCHICINE 0.6 HALF-TAB = 0.3 MG,,,13270.0,14761.0,2
HCPCS,Z7610,COLCHICINE 0.6 MG PO TABS,1184.7,770.0550000000001,13270.0,14761.0,10
HCPCS,Z7610,CONJUGATED ESTROGENS 0.625 MG/GRAM VA CREA,6869.76,4465.34,13270.0,14761.0,2
HCPCS,Z7610,COPPER 380 SQUARE MM IU IUD,9765.0,6347.25,13270.0,14761.0,2
HCPCS,Z7610,CYCLOPENTOLATE 1 % OP DROP,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OP DROP,476.0,309.4,13270.0,14761.0,2
HCPCS,Z7610,CYCLOPHOSPHAMIDE 25 MG PO CAPS,4248.0,2761.2,13270.0,14761.0,2
HCPCS,Z7610,CYCLOPHOSPHAMIDE 50 MG PO CAPS,13226.4,8597.16,13270.0,14761.0,2
HCPCS,Z7610,CYCLOSPORINE MODIFIED 100 MG/ML PO SOLN,8693.6,5650.84,13270.0,14761.0,2
HCPCS,Z7610,CYCLOSPORINE MODIFIED 25 MG PO CAPS,354.76,230.595,13270.0,14761.0,6
HCPCS,Z7610,DABIGATRAN ETEXILATE 150 MG PO CAPS,2809.92,1826.45,13270.0,14761.0,2
HCPCS,Z7610,DABRAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,DAPAGLIFLOZIN PROPANEDIOL 10 MG PO TABS,8940.0,5811.0,13270.0,14761.0,2
HCPCS,Z7610,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,8940.0,5811.0,13270.0,14761.0,2
HCPCS,Z7610,DARUNAVIR 800 MG PO TABS,32172.0,20911.8,13270.0,14761.0,2
HCPCS,Z7610,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG PO TABS,70316.16,45705.5,13270.0,14761.0,2
HCPCS,Z7610,DEFERASIROX 250 MG PO TBDP,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,DEFERASIROX 500 MG PO TBDP,1465.56,952.61,13270.0,14761.0,4
HCPCS,Z7610,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,460.8,299.52,13270.0,14761.0,2
HCPCS,Z7610,DEXAMETHASONE 4 MG/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP DROP,803.36,522.18,13270.0,14761.0,2
HCPCS,Z7610,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
HCPCS,Z7610,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,DEXTROAMPHETAMINE-AMPHETAMINE 7.5 MG PO TABS,1291.2,839.28,13270.0,14761.0,2
HCPCS,Z7610,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,8
HCPCS,Z7610,DIAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,DIAZEPAM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,DIAZOXIDE 50 MG/ML PO SUSP,6891.36,4479.38,13270.0,14761.0,2
HCPCS,Z7610,DIBUCAINE 1 % TP OINT,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,DICLOFENAC SODIUM 1 % TP GEL,297.6,193.44,13270.0,14761.0,6
HCPCS,Z7610,DIGOXIN 250 MCG (0.25 MG) PO TABS,,,13270.0,14761.0,4
HCPCS,Z7610,DILTIAZEM HCL 120 MG PO CP24,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,DILTIAZEM HCL 180 MG PO CP24,290.44,188.785,13270.0,14761.0,4
HCPCS,Z7610,DILTIAZEM HCL 240 MG PO CP24,893.3399999999999,580.67,13270.0,14761.0,4
HCPCS,Z7610,DILTIAZEM HCL 360 MG PO CP24,532.8,346.32,13270.0,14761.0,2
HCPCS,Z7610,DINOPROSTONE 10 MG VA INSR,7811.04,5077.18,13270.0,14761.0,4
HCPCS,Z7610,"DIPHEN-LIDOCAINE-MAG,AL-SIMETH 25-200-400-40 MG/30ML MM MWSH",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,868.0,564.2,13270.0,14761.0,10
HCPCS,Z7610,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,DIVALPROEX 125 MG PO CDRS,1121.6,729.04,13270.0,14761.0,6
HCPCS,Z7610,DIVALPROEX 125 MG PO TBEC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,DIVALPROEX 250 MG PO TB24,1804.8,1173.12,13270.0,14761.0,2
HCPCS,Z7610,DIVALPROEX 250 MG PO TBEC,597.0,388.05,13270.0,14761.0,8
HCPCS,Z7610,DIVALPROEX 500 MG PO TBEC,769.0,499.85,13270.0,14761.0,8
HCPCS,Z7610,DOLUTEGRAVIR 50 MG PO TABS,34661.76,22530.14,13270.0,14761.0,2
HCPCS,Z7610,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,4
HCPCS,Z7610,DORZOLAMIDE 2 % OP DROP,398.36,258.935,13270.0,14761.0,4
HCPCS,Z7610,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1493.98,971.085,13270.0,14761.0,8
HCPCS,Z7610,DOXYCYCLINE HYCLATE 50 MG PO CAPS,301.6,196.04,13270.0,14761.0,2
HCPCS,Z7610,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,DRONABINOL 2.5 MG PO CAPS,1533.0,996.45,13270.0,14761.0,4
HCPCS,Z7610,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
HCPCS,Z7610,DULOXETINE 20 MG PO CPDR,431.56,280.515,13270.0,14761.0,4
HCPCS,Z7610,DULOXETINE 30 MG PO CPDR,1465.56,952.61,13270.0,14761.0,8
HCPCS,Z7610,DULOXETINE 60 MG PO CPDR,1872.0,1216.8,13270.0,14761.0,4
HCPCS,Z7610,EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG PO TABS,3577.92,2325.65,13270.0,14761.0,2
HCPCS,Z7610,ELECTROLYTE-A IV SOLP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ELOTUZUMAB 400 MG IV SOLR,27307.62,17749.95,,,0
HCPCS,Z7610,ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG PO TABS,62850.24,40852.66,13270.0,14761.0,2
HCPCS,Z7610,EMPAGLIFLOZIN 10 MG PO TABS,4472.16,2906.9,13270.0,14761.0,2
HCPCS,Z7610,EMPAGLIFLOZIN 25 MG PO TABS,4472.16,2906.9,13270.0,14761.0,2
HCPCS,Z7610,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,956.46,621.6949999999999,13270.0,14761.0,4
HCPCS,Z7610,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG PO TABS,32830.08,21339.55,13270.0,14761.0,2
HCPCS,Z7610,ENALAPRIL MALEATE 10 MG PO TABS,1113.58,723.825,13270.0,14761.0,4
HCPCS,Z7610,ENALAPRIL MALEATE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ENALAPRIL MALEATE 20 MG PO TABS,868.8,564.72,13270.0,14761.0,4
HCPCS,Z7610,ENALAPRIL MALEATE 5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,ENTACAPONE 200 MG PO TABS,894.4,581.36,13270.0,14761.0,2
HCPCS,Z7610,ENTECAVIR 0.05 MG/ML PO SOLN,14320.32,9308.21,13270.0,14761.0,2
HCPCS,Z7610,ENTECAVIR 0.5 MG PO TABS,964.32,626.81,13270.0,14761.0,6
HCPCS,Z7610,EPINEPHRINE HCL 1 MG/ML NA SOLN,10974.18,7133.215,13270.0,14761.0,2
HCPCS,Z7610,EPLERENONE 25 MG PO TABS,326.88,212.47,13270.0,14761.0,2
HCPCS,Z7610,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) PO DROP",,,13270.0,14761.0,2
HCPCS,Z7610,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,Z7610,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML PO SUSR,3640.0,2366.0,13270.0,14761.0,2
HCPCS,Z7610,ESCITALOPRAM OXALATE 20 MG PO TABS,1104.0,717.6,13270.0,14761.0,8
HCPCS,Z7610,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,,,0
HCPCS,Z7610,ESTRADIOL 0.025 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,ESTRADIOL 0.05 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,6
HCPCS,Z7610,ESTRADIOL 0.1 MG/24 HR TD PTWK,647.72,421.02,13270.0,14761.0,4
HCPCS,Z7610,ETHAMBUTOL 400 MG PO TABS,1036.0,673.4000000000001,13270.0,14761.0,4
HCPCS,Z7610,ETHIODIZED OIL 48% IJ OIL,20482.8,13313.82,,,0
HCPCS,Z7610,ETRAVIRINE 100 MG PO TABS,22329.6,14514.24,13270.0,14761.0,2
HCPCS,Z7610,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,4858.6,3158.09,13270.0,14761.0,6
HCPCS,Z7610,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,314.22,204.24,13270.0,14761.0,6
HCPCS,Z7610,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,19168.149999999998,12459.3,13270.0,14761.0,4
HCPCS,Z7610,EZETIMIBE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
HCPCS,Z7610,FAMOTIDINE 40 MG/5 ML (8 MG/ML) PO SUSR,447.2,290.68,13270.0,14761.0,2
HCPCS,Z7610,FAT EMULSION 20 % IV PEDS,664.0,431.6,13270.0,14761.0,6
HCPCS,Z7610,FEBUXOSTAT 40 MG PO TABS,2605.0,1693.25,13270.0,14761.0,4
HCPCS,Z7610,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,583.92,379.545,13270.0,14761.0,4
HCPCS,Z7610,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,323.56,210.315,13270.0,14761.0,4
HCPCS,Z7610,FENTANYL 100 MCG/HR TD PT72,410.82,267.03,13270.0,14761.0,8
HCPCS,Z7610,FENTANYL 12 MCG/HR TD PT72,750.28,487.68,13270.0,14761.0,6
HCPCS,Z7610,FENTANYL 25 MCG/HR TD PT72,531.52,345.49,13270.0,14761.0,8
HCPCS,Z7610,FENTANYL 50 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,FENTANYL 75 MCG/HR TD PT72,892.3050000000001,579.995,13270.0,14761.0,4
HCPCS,Z7610,FERRIC CITRATE 210 MG IRON PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,FERRIC SUBSULFATE 259 MG/G TP SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,FIDAXOMICIN 200 MG PO TABS,74248.96,48261.82,13270.0,14761.0,2
HCPCS,Z7610,FINASTERIDE (PROSCAR) ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,FLUCONAZOLE 10 MG/ML PO SUSR,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,FLUCONAZOLE 100 MG PO TABS,988.0,642.2,13270.0,14761.0,6
HCPCS,Z7610,FLUCONAZOLE 200 MG PO TABS,2477.6,1610.44,13270.0,14761.0,4
HCPCS,Z7610,FLUCONAZOLE 50 MG PO TABS,310.08,201.55,13270.0,14761.0,2
HCPCS,Z7610,FLUCYTOSINE 250 MG PO CAPS,13416.48,8720.71,13270.0,14761.0,4
HCPCS,Z7610,FLUCYTOSINE 500 MG PO CAPS,25344.96,16474.225,13270.0,14761.0,4
HCPCS,Z7610,FLUOCINONIDE 0.05 % TP OINT,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,2
HCPCS,Z7610,FLUTICASONE FUROATE-VILANTEROL 200-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,2
HCPCS,Z7610,FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE IN DSDV,339.25,220.51,13270.0,14761.0,2
HCPCS,Z7610,FLUTICASONE PROPIONATE 110 MCG/ACTUATION IN HFAA,1396.09,907.4549999999999,13270.0,14761.0,4
HCPCS,Z7610,FLUTICASONE PROPIONATE 220 MCG/ACTUATION IN HFAA,2615.425,1700.03,13270.0,14761.0,4
HCPCS,Z7610,FLUTICASONE PROPIONATE 44 MCG/ACTUATION IN HFAA,1228.2649999999999,798.37,13270.0,14761.0,4
HCPCS,Z7610,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,FORTIFIED TOBRAMYCIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,FORTIFIED VANCOMYCIN 50 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,GABAPENTIN 300 MG/6 ML (6 ML) PO SOLN,,,13270.0,14761.0,6
HCPCS,Z7610,"GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TP SPGE",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,GENTAMICIN 0.1 % TP CREA,585.84,380.8,13270.0,14761.0,2
HCPCS,Z7610,GENTAMICIN 0.1 % TP OINT,588.72,382.67,13270.0,14761.0,2
HCPCS,Z7610,GILTERITINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,GLECAPREVIR-PIBRENTASVIR 100-40 MG PO TABS,7027.68,4567.99,,,0
HCPCS,Z7610,GLYCERIN (ADULT) PR SUPP,,,13270.0,14761.0,2
HCPCS,Z7610,"HB ADHESIVE, SKIN",442.0,287.3,,,0
HCPCS,Z7610,HB AMBULATORY CARDIAC ZIO PATCH,2126.41,1382.17,,,0
HCPCS,Z7610,HB ANCHOR /SCREW 7,19592.1,12734.86,,,0
HCPCS,Z7610,HB ANES-CAT 1 - EA ADDL MIN,126.45,82.19,,,0
HCPCS,Z7610,HB ANES-CAT 1-BASIC - 1ST HOUR,12286.0,7985.9,,,0
HCPCS,Z7610,HB ANES-CAT 1-BASIC OUTLYING AREA,7443.08,4838.0,,,0
HCPCS,Z7610,HB BATTERY PACK,2983.28,1939.13,,,0
HCPCS,Z7610,HB BLOOD ADMIN SET Y TYPE,284.01,184.61,,,0
HCPCS,Z7610,HB BONE CEMENT 1,976.04,634.43,,,0
HCPCS,Z7610,HB BONE FIDUCIALS,1039.17,675.46,,,0
HCPCS,Z7610,HB CABLE TESTING LEAD,1795.05,1166.78,,,0
HCPCS,Z7610,"HB CABLES, ELECTRODE STERILE",4167.52,2708.89,,,0
HCPCS,Z7610,HB CANNULA AND STYLET 1,2256.92,1467.0,,,0
HCPCS,Z7610,"HB CANNULA, STEREOTACTIC",2782.24,1808.46,,,0
HCPCS,Z7610,HB CATH EP <19 ELECTRODES,5688.95,3697.82,,,0
HCPCS,Z7610,HB CATH EP ABLATION NON 3D,19444.75,12639.09,,,0
HCPCS,Z7610,HB CATH ULTRASOUND ACUNAV,14551.7,9458.61,,,0
HCPCS,Z7610,HB CATHETER PH IMPEDANCE,1613.63,1048.86,,,0
HCPCS,Z7610,"HB DRILL BIT, DISPOSABLE 3",1894.34,1231.32,,,0
HCPCS,Z7610,HB ESU INSULATED COATED BLADE,147.29,95.74,,,0
HCPCS,Z7610,HB GUIDE WIRE PTCA,1822.65,1184.72,,,0
HCPCS,Z7610,HB IMPEDANCE PROBE,1874.88,1218.67,,,0
HCPCS,Z7610,HB INTRO/SHEATH EP FLEXCATH,8148.66,5296.63,,,0
HCPCS,Z7610,HB INTRO/SHEATH FIXED NON PEEL,2004.64,1303.02,,,0
HCPCS,Z7610,"HB INTRODUCER/SHEATH,NONGDNG 1",2814.08,1829.15,,,0
HCPCS,Z7610,HB JENA VALVE (G150035),296350.0,192627.5,13270.0,14761.0,2
HCPCS,Z7610,"HB KIT, WOUND CLEASING",348.74,226.68,,,0
HCPCS,Z7610,"HB LEAD, NEUROSTIMULATOR",30232.4,19651.06,,,0
HCPCS,Z7610,"HB NEEDLE, BIOPSY/ASP/LOC/INJ",484.54,314.95,,,0
HCPCS,Z7610,HB PADS R2 EP STUDY,878.72,571.17,,,0
HCPCS,Z7610,"HB SCALPEL, SURGICAL 1",44.58,28.98,,,0
HCPCS,Z7610,HB SCREWDRIVER MIDFACE,2295.87,1492.32,,,0
HCPCS,Z7610,"HB SURGIFOAM, ABSORBABLE SPONGE 2",532.65,346.22,,,0
HCPCS,Z7610,HB TERM BLOOD PUMP SET W/FILT 7',2334.97,1517.73,,,0
HCPCS,Z7610,"HB TOOL, DISSECTING 1",1139.1,740.41,,,0
HCPCS,Z7610,"HB TOOL, TUNNELING",2652.54,1724.15,,,0
HCPCS,Z7610,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP BOLUS FROM BAG,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HEPARIN (PORCINE) IN NACL 500 UNITS/500ML NS FOR CONGENITAL HEART ECMO FLUSH FROM BAG,1160.0,754.0,13270.0,14761.0,2
HCPCS,Z7610,HIV POST EXPOSURE PROPHYLAXIS KIT,4758.34,3092.92,,,0
HCPCS,Z7610,HOMEOPATHIC PRODUCTS TP OINT,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,Z7610,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,13270.0,14761.0,2
HCPCS,Z7610,HYDRALAZINE ORAL SUSPENSION 4 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,596.8,387.92,13270.0,14761.0,6
HCPCS,Z7610,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,609.6,396.24,13270.0,14761.0,8
HCPCS,Z7610,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,453.0,294.45,13270.0,14761.0,4
HCPCS,Z7610,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) PO SYRP,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,HYDROCORTISONE 1 % TP CREA,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,HYDROCORTISONE 1 % TP LOTN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HYDROCORTISONE 1 % TP OINT,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HYDROCORTISONE 10 MG PO TABS,832.0,540.8,13270.0,14761.0,6
HCPCS,Z7610,HYDROCORTISONE 2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,HYDROCORTISONE 20 MG PO TABS,718.4,466.96,13270.0,14761.0,2
HCPCS,Z7610,HYDROCORTISONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,HYDROCORTISONE ACETATE 25 MG PR SUPP,465.64,302.66499999999996,13270.0,14761.0,4
HCPCS,Z7610,HYDROCORTISONE ORAL SUSPENSION 2 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,HYDROCORTISONE-PRAMOXINE 1-1 % PR FOAM,2759.68,1793.79,13270.0,14761.0,2
HCPCS,Z7610,HYDROMORPHONE 1 MG/ML PO LIQD,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HYDROMORPHONE 1 MG/ML PO LIQUID (DOSE >= 4 MG),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,HYDROMORPHONE 1MG/ML PED 20-50KG CONTIN PCA,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,HYDROMORPHONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,HYDROMORPHONE 4 MG PO TABS,350.4,227.76,13270.0,14761.0,6
HCPCS,Z7610,HYDROMORPHONE 8 MG PO TABS,931.2,605.28,13270.0,14761.0,4
HCPCS,Z7610,HYDROXYCHLOROQUINE 200 HALF-TAB = 100 MG,,,13270.0,14761.0,2
HCPCS,Z7610,HYDROXYCHLOROQUINE 200 MG/8 ML ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,HYDROXYUREA 500 MG PO CAPS,562.6,365.69,13270.0,14761.0,4
HCPCS,Z7610,HYDROXYUREA ORAL SUSPENSION 100 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,IBUPROFEN 100 MG/5 ML PO SUSP,,,13270.0,14761.0,6
HCPCS,Z7610,IMATINIB 100 MG PO TABS,125629.92,81659.45,13270.0,14761.0,2
HCPCS,Z7610,IMATINIB 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,2
HCPCS,Z7610,INHALATIONAL SPACING DEVICE MISC SPCR,542.24,352.46,,,0
HCPCS,Z7610,IODINE STRONG (LUGOLS) 5 % PO SOLN,504.9,328.19,,,0
HCPCS,Z7610,IPRATROPIUM BROMIDE 17 MCG/ACTUATION IN HFAA,2287.02,1486.56,13270.0,14761.0,2
HCPCS,Z7610,IRBESARTAN 150 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,IRBESARTAN 300 MG PO TABS,486.72,316.37,13270.0,14761.0,4
HCPCS,Z7610,IRBESARTAN 75 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,ISAVUCONAZONIUM SULFATE 186 MG PO CAPS,12455.595000000001,8096.135,13270.0,14761.0,4
HCPCS,Z7610,ITRACONAZOLE 10 MG/ML PO SOLN,5212.8,3388.32,13270.0,14761.0,2
HCPCS,Z7610,ITRACONAZOLE 100 MG PO CAPS,2243.04,1457.975,13270.0,14761.0,4
HCPCS,Z7610,IVABRADINE 5 MG PO TABS,8885.76,5775.74,13270.0,14761.0,2
HCPCS,Z7610,IVERMECTIN 3 MG PO TABS,1307.52,849.89,13270.0,14761.0,4
HCPCS,Z7610,IVOSIDENIB 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,KETOROLAC 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,LABETALOL ORAL SUSPENSION 10 MG/ML,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,LACOSAMIDE 10 MG/ML PO SOLN,443.92,288.55,13270.0,14761.0,4
HCPCS,Z7610,LACOSAMIDE 200 MG PO TABS,1833.42,1191.72,13270.0,14761.0,8
HCPCS,Z7610,LACOSAMIDE 50 MG PO TABS,1100.16,715.1,13270.0,14761.0,6
HCPCS,Z7610,LACTULOSE ENEMA,,,13270.0,14761.0,4
HCPCS,Z7610,LAMIVUDINE 10 MG/ML PO SOLN,1651.2,1073.28,13270.0,14761.0,2
HCPCS,Z7610,LAMIVUDINE 150 MG PO TABS,2019.36,1312.58,13270.0,14761.0,4
HCPCS,Z7610,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,10
HCPCS,Z7610,LAMOTRIGINE 200 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,LAMOTRIGINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,LATANOPROST 0.005 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,LETROZOLE 2.5 MG PO TABS,6068.68,3944.64,13270.0,14761.0,8
HCPCS,Z7610,LEVALBUTEROL HCL 0.31 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,LEVALBUTEROL HCL 1.25 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,LEVOCARNITINE 330 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,LEVOFLOXACIN 250 MG PO TABS,308.2,200.32999999999998,13270.0,14761.0,4
HCPCS,Z7610,LEVOFLOXACIN 250 MG/10 ML PO SOLN,7188.48,4672.51,13270.0,14761.0,2
HCPCS,Z7610,LEVOFLOXACIN 500 MG PO TABS,325.0,211.25,13270.0,14761.0,4
HCPCS,Z7610,LEVOFLOXACIN 750 MG PO TABS,472.2,306.93,13270.0,14761.0,4
HCPCS,Z7610,LIDOCAINE 4 % TP CREA,343.48,223.26,13270.0,14761.0,4
HCPCS,Z7610,LIDOCAINE 4 % TP CREA CC,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,LIDOCAINE 4 % TP PTMD,486.72,316.37,13270.0,14761.0,8
HCPCS,Z7610,LIDOCAINE 5 % TP OINT,323.78,210.46,13270.0,14761.0,6
HCPCS,Z7610,LIDOCAINE HCL 2 % MM JELL,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,Z7610,LIDOCAINE HCL 4 % LATR SOLN,1465.56,952.61,13270.0,14761.0,4
HCPCS,Z7610,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,LINACLOTIDE 145 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,2
HCPCS,Z7610,LINACLOTIDE 290 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,2
HCPCS,Z7610,LINACLOTIDE 72 MCG PO CAPS,10974.18,7133.215,13270.0,14761.0,4
HCPCS,Z7610,LINAGLIPTIN 5 MG PO TABS,20352.0,13228.8,13270.0,14761.0,2
HCPCS,Z7610,LINEZOLID 600 MG PO TABS,927.64,602.9649999999999,13270.0,14761.0,4
HCPCS,Z7610,"LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT PO CPDR",,,13270.0,14761.0,2
HCPCS,Z7610,"LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT PO CPDR",,,13270.0,14761.0,2
HCPCS,Z7610,"LIPASE-PROTEASE-AMYLASE 36,000-114,000- 180,000 UNIT PO CPDR",19249.6,12512.24,13270.0,14761.0,2
HCPCS,Z7610,"LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT PO CPDR",,,13270.0,14761.0,4
HCPCS,Z7610,LORATADINE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,LORAZEPAM 0.5 HALF-TAB = 0.25 MG,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,LORAZEPAM 0.5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,LORAZEPAM 1 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,LORAZEPAM 1 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,LORAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,LOSARTAN 25 MG HALF-TAB = 12.5 MG,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,LOSARTAN 25 MG PO TABS,731.2,475.28,13270.0,14761.0,12
HCPCS,Z7610,LOSARTAN 50 MG PO TABS,1123.98,730.585,13270.0,14761.0,14
HCPCS,Z7610,LUBIPROSTONE 24 MCG PO CAPS,842.88,547.87,13270.0,14761.0,2
HCPCS,Z7610,LURASIDONE 120 MG PO TABS,30622.08,19904.35,13270.0,14761.0,2
HCPCS,Z7610,LURASIDONE 40 MG PO TABS,20514.24,13334.26,13270.0,14761.0,2
HCPCS,Z7610,MAGIC MOUTHWASH (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MARIBAVIR 200 MG PO TABS,149399.04,97109.375,13270.0,14761.0,4
HCPCS,Z7610,MEDICINAL LEECH,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MELATONIN 1 MG PO TABS,,,13270.0,14761.0,6
HCPCS,Z7610,MELATONIN 3 MG PO TABS,,,13270.0,14761.0,4
HCPCS,Z7610,MEMANTINE 10 MG PO TABS,598.4,388.96,13270.0,14761.0,6
HCPCS,Z7610,MEMANTINE 5 MG PO TABS,600.0,390.0,13270.0,14761.0,8
HCPCS,Z7610,MESALAMINE 1.2 GRAM PO TBEC,,,13270.0,14761.0,2
HCPCS,Z7610,MESALAMINE 1000 MG PR SUPP,9439.24,6135.505,13270.0,14761.0,4
HCPCS,Z7610,MESALAMINE 4 GRAM/60 ML PR ENEM,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,METHADONE 1 MG/ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,METHADONE 10 MG PO TABS,334.6,217.49,13270.0,14761.0,4
HCPCS,Z7610,METHADONE 10 MG/ML PO CONC,294.24,191.26,13270.0,14761.0,2
HCPCS,Z7610,METHADONE 5 MG PO TABS,310.4,201.76,13270.0,14761.0,8
HCPCS,Z7610,METHADONE 5 MG/5 ML PO SOLN (2.5MG<DOSE<=10MG),290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,METHOCARBAMOL 500 MG PO HALF-TAB = 250 MG,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,METHOCARBAMOL 500 MG PO TABS,327.4,212.81,13270.0,14761.0,8
HCPCS,Z7610,METHOCARBAMOL 750 MG PO TABS,413.6,268.84000000000003,13270.0,14761.0,10
HCPCS,Z7610,METHOTREXATE SODIUM 2.5 MG PO TABS,4542.4,2952.56,13270.0,14761.0,2
HCPCS,Z7610,METHYL SALICYLATE-MENTHOL 15-10 % TP CREA,,,13270.0,14761.0,2
HCPCS,Z7610,METHYLERGONOVINE 0.2 MG PO TABS,4919.360000000001,3197.585,13270.0,14761.0,4
HCPCS,Z7610,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,2
HCPCS,Z7610,METHYLNALTREXONE 8 MG/0.4 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,2
HCPCS,Z7610,METHYLPHENIDATE 5 MG HALF-TAB = 2.5 MG,294.4,191.36,13270.0,14761.0,2
HCPCS,Z7610,METHYLPHENIDATE HCL 5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,METHYLPHENIDATE HCL 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,METRONIDAZOLE 250 MG PO TABS,525.6,341.64,13270.0,14761.0,8
HCPCS,Z7610,METRONIDAZOLE 500 MG PO TABS,920.0,598.0,13270.0,14761.0,6
HCPCS,Z7610,METRONIDAZOLE ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,MICONAZOLE NITRATE 2 % VA CREA,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,MIDAZOLAM 2 MG/ML PO SYRP,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,MIDOSTAURIN 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,MINOCYCLINE 100 MG PO CAPS,410.4,266.76,13270.0,14761.0,6
HCPCS,Z7610,MIRABEGRON 50 MG PO TB24,6861.6,4460.04,,,0
HCPCS,Z7610,MIRTAZAPINE 30 MG PO TBDL,,,13270.0,14761.0,2
HCPCS,Z7610,MMX ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MONTELUKAST 10 MG PO TABS,377.0,245.05,13270.0,14761.0,10
HCPCS,Z7610,MONTELUKAST 5 MG PO CHEW,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MORPHINE (PF) 1 MG/ML IJ SOLN,360.68,234.44,13270.0,14761.0,4
HCPCS,Z7610,MORPHINE 10 MG/5 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,Z7610,MORPHINE 100 MG PO TBSR,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MORPHINE 15 MG PO TABS,1124.8,731.12,13270.0,14761.0,2
HCPCS,Z7610,MORPHINE 15 MG PO TBSR,752.0,488.8,13270.0,14761.0,6
HCPCS,Z7610,MORPHINE 30 MG PO TBSR,1667.2,1083.68,13270.0,14761.0,6
HCPCS,Z7610,MORPHINE 60 MG PO TBSR,3123.2,2030.08,13270.0,14761.0,6
HCPCS,Z7610,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) PO SOLN,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,MORPHINE ORAL SOLUTION 1 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,MOXIFLOXACIN 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,2
HCPCS,Z7610,MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML PO LIQD,,,13270.0,14761.0,2
HCPCS,Z7610,MUPIROCIN 2 % TP OINT,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,11400.96,7410.625,13270.0,14761.0,4
HCPCS,Z7610,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,610.4,396.76,13270.0,14761.0,12
HCPCS,Z7610,MYCOPHENOLATE MOFETIL 500 MG PO TABS,1485.8,965.77,13270.0,14761.0,6
HCPCS,Z7610,MYCOPHENOLATE SODIUM 180 MG PO TBEC,6215.08,4039.8,13270.0,14761.0,4
HCPCS,Z7610,MYCOPHENOLATE SODIUM 360 MG PO TBEC,8009.58,5206.225,13270.0,14761.0,8
HCPCS,Z7610,NALOXEGOL 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,NEBIVOLOL 10 MG PO TABS,881.8199999999999,573.1800000000001,13270.0,14761.0,4
HCPCS,Z7610,NEBIVOLOL 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,NEBIVOLOL 5 MG PO TABS,8583.84,5579.5,13270.0,14761.0,2
HCPCS,Z7610,NEOMYCIN 500 MG PO TABS,1451.2,943.28,13270.0,14761.0,2
HCPCS,Z7610,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OP DRPS",877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT DRPS",1187.36,771.78,13270.0,14761.0,2
HCPCS,Z7610,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT SOLN",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,NIFEDIPINE 60 MG PO TR24,,,13270.0,14761.0,6
HCPCS,Z7610,NIFEDIPINE ORAL SUSPENSION 4 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,NIMODIPINE 30 MG PO CAPS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,NIMODIPINE 30 MG/5 ML PO SYRG,854.64,555.52,13270.0,14761.0,4
HCPCS,Z7610,NITAZOXANIDE 500 MG PO TABS,23294.4,15141.36,13270.0,14761.0,2
HCPCS,Z7610,NITROFURANTOIN 100 MG PO CAPS,1687.98,1097.185,13270.0,14761.0,6
HCPCS,Z7610,NITROGLYCERIN 2 % TD OINT,,,13270.0,14761.0,4
HCPCS,Z7610,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,3046.9449999999997,1980.5149999999999,13270.0,14761.0,2
HCPCS,Z7610,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG PO TABS,,,13270.0,14761.0,4
HCPCS,Z7610,NORFLURANE-PENTAFLUOROPROPANE TP SPRA,468.65,304.62,,,0
HCPCS,Z7610,NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,NYSTATIN 100000 UNIT/GRAM TP CREA,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,NYSTATIN 100000 UNIT/GRAM TP OINT,301.48,195.95999999999998,13270.0,14761.0,4
HCPCS,Z7610,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,8
HCPCS,Z7610,NYSTATIN 100000 UNITS/ML PO SUSP,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TP CREA",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TP OINT",290.0,188.5,,,0
HCPCS,Z7610,OFLOXACIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,OFLOXACIN 0.3 % OP DROP FOR EAR,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,OLANZAPINE 10 MG PO TABS,,,13270.0,14761.0,6
HCPCS,Z7610,OLANZAPINE 10 MG PO TBDL,5670.28,3685.68,13270.0,14761.0,4
HCPCS,Z7610,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,12
HCPCS,Z7610,OLANZAPINE 5 MG PO TABS,,,13270.0,14761.0,6
HCPCS,Z7610,OLANZAPINE 5 MG PO TBDL,1442.38,937.5450000000001,13270.0,14761.0,12
HCPCS,Z7610,OLANZAPINE 7.5 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,OLOPATADINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ONDANSETRON 4 MG PO TBDL,1465.56,952.61,13270.0,14761.0,8
HCPCS,Z7610,ONDANSETRON HCL 4 MG PO TABS,514.6,334.49,13270.0,14761.0,6
HCPCS,Z7610,ONDANSETRON HCL 4 MG/5 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,ONDANSETRON HCL 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,OPIUM TINCTURE 10 MG/ML (MORPHINE) PO TINC,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,OSELTAMIVIR 30 MG PO CAPS,891.36,579.385,13270.0,14761.0,8
HCPCS,Z7610,OSELTAMIVIR 6 MG/ML PO SUSR,2264.64,1472.02,13270.0,14761.0,2
HCPCS,Z7610,OSELTAMIVIR 75 MG PO CAPS,1277.08,830.1,13270.0,14761.0,4
HCPCS,Z7610,OXYBUTYNIN CHLORIDE 10 MG PO TR24,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,OXYBUTYNIN CHLORIDE 5 MG PO TR24,1174.4,763.36,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE 10 MG PO TR12,1338.56,870.06,13270.0,14761.0,2
HCPCS,Z7610,OXYCODONE 15 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,OXYCODONE 20 MG PO TR12,7325.12,4761.33,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE 20 MG/ML PO CONC,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE 30 MG PO TABS,421.8,274.16999999999996,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE 40 MG PO TR12,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,OXYCODONE 5 MG PO TABS,539.2,350.48,13270.0,14761.0,10
HCPCS,Z7610,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,8
HCPCS,Z7610,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1625.58,1056.625,13270.0,14761.0,12
HCPCS,Z7610,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,2430.4,1579.76,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,446.6,290.28999999999996,13270.0,14761.0,4
HCPCS,Z7610,OXYCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,Other Outpatient Services,767.28,498.72999999999996,,,0
HCPCS,Z7610,PANTOPRAZOLE 20 MG PO TBEC,877.78,570.5550000000001,13270.0,14761.0,10
HCPCS,Z7610,PANTOPRAZOLE 40 MG PO TBEC,364.8,237.12,13270.0,14761.0,12
HCPCS,Z7610,PARICALCITOL 1 MCG PO CAPS,555.12,360.82500000000005,13270.0,14761.0,4
HCPCS,Z7610,PAROMOMYCIN 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,352.0,228.8,13270.0,14761.0,4
HCPCS,Z7610,PENICILLIN V POTASSIUM 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PENTAMIDINE 300 MG IN SOLR,2013.6,1308.84,13270.0,14761.0,2
HCPCS,Z7610,PENTOXIFYLLINE 20 MG/ML ORAL SOLUTION,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PERAMPANEL 2 MG PO TABS,9257.28,6017.23,13270.0,14761.0,2
HCPCS,Z7610,PERMETHRIN 5 % TP CREA,421.44,273.93499999999995,13270.0,14761.0,4
HCPCS,Z7610,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML PO ELIX,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PHENOBARBITAL 32.4 MG PO TABS,536.0,348.4,13270.0,14761.0,2
HCPCS,Z7610,PHENOBARBITAL ORAL SOLUTION 8 MG/2 ML FOR NICU,1465.56,952.61,,,0
HCPCS,Z7610,PHENYLEPHRINE HCL 0.25 % NA SPRY,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PHENYLEPHRINE HCL 0.5 % NA SPRY,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PHENYLEPHRINE HCL 10 % OP DROP,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PHENYLEPHRINE HCL 2.5 % OP DROP,1341.6,872.04,13270.0,14761.0,4
HCPCS,Z7610,PHENYTOIN 50 MG PO CHEW,,,,,0
HCPCS,Z7610,PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IR SOLN,,,13270.0,14761.0,4
HCPCS,Z7610,PHYTONADIONE (VITAMIN K1) 5 MG PO TABS,11485.869999999999,7465.8150000000005,13270.0,14761.0,4
HCPCS,Z7610,PHYTONADIONE 5 MG HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PILOCARPINE HCL 2 % OP DROP,1465.56,952.61,,,0
HCPCS,Z7610,PIOGLITAZONE 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,PIOGLITAZONE 45 MG PO TABS,290.0,188.5,,,0
HCPCS,Z7610,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PORACTANT ALFA 240 MG/3 ML ITL SUSP,12262.08,7970.35,13270.0,14761.0,4
HCPCS,Z7610,POSACONAZOLE 100 MG PO TBEC,6639.07,4315.395,13270.0,14761.0,4
HCPCS,Z7610,POTASSIUM BICARB-CITRIC ACID 10 MEQ PO TBEF,,,13270.0,14761.0,4
HCPCS,Z7610,POTASSIUM BICARB-CITRIC ACID 20 MEQ PO TBEF,,,13270.0,14761.0,6
HCPCS,Z7610,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,314.44,204.385,13270.0,14761.0,6
HCPCS,Z7610,POTASSIUM IODIDE 1 G/ML PO SOLN,,,13270.0,14761.0,2
HCPCS,Z7610,POVIDONE-IODINE 5 % OP SOLN,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PRAMIPEXOLE 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,PRAMOXINE 1 % TP FOAM,611.28,397.33,13270.0,14761.0,2
HCPCS,Z7610,PRASUGREL 10 MG PO TABS,381.6,248.04,13270.0,14761.0,2
HCPCS,Z7610,PRAVASTATIN 10 MG PO TABS,355.68,231.19,13270.0,14761.0,6
HCPCS,Z7610,PRAVASTATIN 20 MG PO TABS,308.16,200.3,13270.0,14761.0,8
HCPCS,Z7610,PRAVASTATIN 40 MG PO TABS,1222.4,794.56,13270.0,14761.0,6
HCPCS,Z7610,PRAVASTATIN 80 MG PO TABS,2856.0,1856.4,13270.0,14761.0,2
HCPCS,Z7610,PREDNISOLONE ACETATE 1 % OP DRPS,657.76,427.545,13270.0,14761.0,4
HCPCS,Z7610,PREGABALIN 100 MG PO CAPS,771.4,501.41,13270.0,14761.0,4
HCPCS,Z7610,PREGABALIN 25 MG PO CAPS,722.6,469.69,13270.0,14761.0,4
HCPCS,Z7610,PREGABALIN 50 MG PO CAPS,1124.8,731.12,13270.0,14761.0,6
HCPCS,Z7610,PREGABALIN 75 MG PO CAPS,1145.6,744.64,13270.0,14761.0,6
HCPCS,Z7610,PROGESTERONE MICRONIZED 100 MG PO CAPS,,,13270.0,14761.0,2
HCPCS,Z7610,PROPARACAINE 0.5 % OP DROP,523.2,340.08,13270.0,14761.0,6
HCPCS,Z7610,PRUCALOPRIDE 1 MG PO TABS,8306.4,5399.16,13270.0,14761.0,2
HCPCS,Z7610,PRUCALOPRIDE 2 MG PO TABS,8306.4,5399.16,13270.0,14761.0,2
HCPCS,Z7610,QUETIAPINE 100 MG PO TABS,1022.4,664.56,13270.0,14761.0,10
HCPCS,Z7610,QUETIAPINE 200 MG PO TABS,963.2,626.08,13270.0,14761.0,8
HCPCS,Z7610,QUETIAPINE 25 MG PO TABS,350.6,227.89,13270.0,14761.0,8
HCPCS,Z7610,QUETIAPINE 25MG HALF-TAB = 12.5MG,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,QUETIAPINE 300 MG PO TABS,376.0,244.4,13270.0,14761.0,6
HCPCS,Z7610,QUETIAPINE 50 MG PO TABS,797.6,518.44,13270.0,14761.0,10
HCPCS,Z7610,RACEPINEPHRINE 2.25 % IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RANOLAZINE 500 MG PO TB12,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,REPAGLINIDE 0.5 MG PO TABS,363.2,236.08,13270.0,14761.0,2
HCPCS,Z7610,REPAGLINIDE 1 MG PO TABS,377519.4,245387.61,13270.0,14761.0,4
HCPCS,Z7610,REPAGLINIDE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RIBAVIRIN 200 MG PO CAPS,1670.59,1085.88,13270.0,14761.0,2
HCPCS,Z7610,RIBOCICLIB 600 MG/DAY (200 MG X 3) PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,RIFABUTIN 150 MG PO CAPS,19820.8,12883.52,13270.0,14761.0,4
HCPCS,Z7610,RIFAMPIN 150 MG PO CAPS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,RIFAMPIN 300 MG PO CAPS,753.5999999999999,489.84000000000003,13270.0,14761.0,10
HCPCS,Z7610,RIFAXIMIN 200 MG PO TABS,4736.16,3078.5,13270.0,14761.0,2
HCPCS,Z7610,RIFAXIMIN 550 MG PO TABS,48705.6,31658.64,13270.0,14761.0,4
HCPCS,Z7610,RILPIVIRINE HCL 25 MG PO TABS,22112.64,14373.22,13270.0,14761.0,2
HCPCS,Z7610,RILUZOLE 50 MG PO TABS,595.2,386.88,13270.0,14761.0,2
HCPCS,Z7610,RISPERIDONE 0.5 MG PO TABS,294.4,191.36,13270.0,14761.0,2
HCPCS,Z7610,RISPERIDONE 0.5 MG PO TBDL,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RISPERIDONE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RISPERIDONE 1 MG PO TBDL,394.53499999999997,256.45,13270.0,14761.0,4
HCPCS,Z7610,RISPERIDONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RISPERIDONE 2 MG PO TBDL,474.88,308.67,13270.0,14761.0,6
HCPCS,Z7610,RISPERIDONE 3 MG PO TABS,305.6,198.64,13270.0,14761.0,2
HCPCS,Z7610,RITONAVIR 100 MG PO TABS,3833.76,2491.94,13270.0,14761.0,2
HCPCS,Z7610,RIVAROXABAN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RIVAROXABAN 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,RIVAROXABAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,RIZATRIPTAN 10 MG PO TBDL,,,13270.0,14761.0,2
HCPCS,Z7610,RIZATRIPTAN 5 MG PO TBDL,,,13270.0,14761.0,2
HCPCS,Z7610,ROSUVASTATIN 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,8
HCPCS,Z7610,ROSUVASTATIN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
HCPCS,Z7610,ROSUVASTATIN 40 MG PO TABS,1036.2,673.53,13270.0,14761.0,12
HCPCS,Z7610,ROSUVASTATIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
HCPCS,Z7610,RUXOLITINIB 5 MG PO TABS,274399.68,178359.79,13270.0,14761.0,2
HCPCS,Z7610,SACUBITRIL-VALSARTAN 24-26 MG PO TABS,10153.92,6600.05,13270.0,14761.0,2
HCPCS,Z7610,SACUBITRIL-VALSARTAN 49-51 MG PO TABS,10153.92,6600.05,13270.0,14761.0,2
HCPCS,Z7610,SACUBITRIL-VALSARTAN 97-103 MG PO TABS,10153.92,6600.05,13270.0,14761.0,2
HCPCS,Z7610,SALMETEROL 50 MCG/DOSE IN DSDV,3156.48,2051.71,13270.0,14761.0,2
HCPCS,Z7610,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,626.855,407.455,13270.0,14761.0,8
HCPCS,Z7610,SELENIUM 200 MCG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,SELEXIPAG 200 MCG PO TABS,259342.08,168572.35,13270.0,14761.0,2
HCPCS,Z7610,SELEXIPAG 800 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
HCPCS,Z7610,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,6
HCPCS,Z7610,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,8
HCPCS,Z7610,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,12117.88,7876.62,13270.0,14761.0,8
HCPCS,Z7610,SEVELAMER CARBONATE 800 MG PO TABS,1449.3600000000001,942.085,13270.0,14761.0,16
HCPCS,Z7610,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,340.8,221.52,13270.0,14761.0,10
HCPCS,Z7610,SILDENAFIL 2.5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,SILODOSIN 4 MG PO CAPS,956.46,621.6949999999999,13270.0,14761.0,10
HCPCS,Z7610,SILODOSIN 8 MG PO CAPS,397.44,258.34000000000003,13270.0,14761.0,4
HCPCS,Z7610,SILVER SULFADIAZINE 1 % TP CREA,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,SIROLIMUS 0.5 MG PO TABS,25622.4,16654.56,13270.0,14761.0,2
HCPCS,Z7610,SIROLIMUS 1 MG PO TABS,25765.8,16747.77,13270.0,14761.0,4
HCPCS,Z7610,SIROLIMUS 2 MG PO TABS,15702.4,10206.56,13270.0,14761.0,2
HCPCS,Z7610,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,7523.56,4890.315,13270.0,14761.0,4
HCPCS,Z7610,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,7523.56,4890.315,13270.0,14761.0,4
HCPCS,Z7610,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,14757.12,9592.13,13270.0,14761.0,6
HCPCS,Z7610,"SOD,POT CHLOR-MAG-SOD,POT PHOS 800-40-20-8.75- 6.25 MG/100 ML IR IRSL",1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,SODIUM BICARBONATE 325 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,SODIUM BICARBONATE 650 MG PO TABS,696.0,452.4,13270.0,14761.0,10
HCPCS,Z7610,SODIUM CHLORIDE 0.65 % NA SPRA,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,SODIUM CHLORIDE 0.9 % IN NEBU,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,SODIUM CHLORIDE 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,SODIUM CHLORIDE 3 % IN NEBU,1465.56,952.61,13270.0,14761.0,4
HCPCS,Z7610,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,,,0
HCPCS,Z7610,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,921.95,599.27,13270.0,14761.0,4
HCPCS,Z7610,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM PO PWPK,921.95,599.27,13270.0,14761.0,4
HCPCS,Z7610,SOFOSBUVIR-VELPATASVIR 400-100 MG PO TABS,119257.6,77517.44,13270.0,14761.0,2
HCPCS,Z7610,SPIRONOLACTONE 5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,STERILE TALC 4 GRAM PL SUSR,2092.7799999999997,1360.305,13270.0,14761.0,4
HCPCS,Z7610,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,13270.0,14761.0,4
HCPCS,Z7610,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,635.71,413.21,13270.0,14761.0,14
HCPCS,Z7610,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,SULFASALAZINE 500 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,SUMATRIPTAN SUCCINATE 100 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,SUMATRIPTAN SUCCINATE 25 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,SUMATRIPTAN SUCCINATE 50 MG PO TABS,,,13270.0,14761.0,2
HCPCS,Z7610,TACROLIMUS 0.5 MG PO CAPS,1772.8000000000002,1152.32,13270.0,14761.0,4
HCPCS,Z7610,TACROLIMUS 1 MG PO CAPS,1465.56,952.61,13270.0,14761.0,10
HCPCS,Z7610,TACROLIMUS 1 MG PO TB24,2669.76,1735.34,13270.0,14761.0,2
HCPCS,Z7610,TACROLIMUS 5 MG PO CAPS,14574.4,9473.36,13270.0,14761.0,8
HCPCS,Z7610,TACROLIMUS ORAL SUSPENSION 1 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,745.44,484.54,13270.0,14761.0,2
HCPCS,Z7610,TAMOXIFEN 10 MG PO TABS,702.4,456.56,13270.0,14761.0,2
HCPCS,Z7610,TAMSULOSIN 0.4 MG PO CAPS,419.2,272.48,13270.0,14761.0,14
HCPCS,Z7610,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,,,0
HCPCS,Z7610,TELMISARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TELMISARTAN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,TEMAZEPAM 7.5 MG PO CAPS,1566.72,1018.37,13270.0,14761.0,2
HCPCS,Z7610,TEMOZOLOMIDE 140 MG PO CAPS,536.94,349.01,13270.0,14761.0,2
HCPCS,Z7610,TEMOZOLOMIDE 20 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TEMOZOLOMIDE 5 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TENOFOVIR ALAFENAMIDE 25 MG PO TABS,22758.24,14792.86,13270.0,14761.0,2
HCPCS,Z7610,TENOFOVIR DISOPROXIL FUMARATE 300 MG PO TABS,1779.36,1156.58,13270.0,14761.0,2
HCPCS,Z7610,TESTOSTERONE 1 % (50 MG/5 GRAM) TD GLPK,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TETRACAINE HCL (PF) 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TETRAHYDROZOLINE 0.05 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,13270.0,14761.0,4
HCPCS,Z7610,TICAGRELOR 60 MG PO TABS,6928.32,4503.41,13270.0,14761.0,2
HCPCS,Z7610,TICAGRELOR 90 MG PO TABS,11547.2,7505.68,13270.0,14761.0,2
HCPCS,Z7610,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TINIDAZOLE 500 MG PO TABS,735.04,477.78,13270.0,14761.0,2
HCPCS,Z7610,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TOBRAMYCIN 0.3 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,2
HCPCS,Z7610,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,565.44,367.54,13270.0,14761.0,6
HCPCS,Z7610,TOLTERODINE 4 MG PO CP24,2223.3599999999997,1445.185,13270.0,14761.0,4
HCPCS,Z7610,TOLVAPTAN 15 MG PO TABS,41854.89,27205.675000000003,13270.0,14761.0,4
HCPCS,Z7610,TOPIRAMATE (TOPAMAX) ORAL SUSPENSION PEDIATRIC 6 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,TOPIRAMATE 100 MG PO TABS,641.6,417.04,13270.0,14761.0,2
HCPCS,Z7610,TOPIRAMATE 25 MG PO TABS,386.4,251.16,13270.0,14761.0,4
HCPCS,Z7610,TRAMETINIB 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,TRANEXAMIC ACID 650 MG PO TABS,1121.28,728.83,13270.0,14761.0,2
HCPCS,Z7610,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,4
HCPCS,Z7610,TRETINOIN 0.025 % TP CREA,1465.56,952.61,,,0
HCPCS,Z7610,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,TRIAMCINOLONE ACETONIDE 0.1 % TP LOTN,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,6
HCPCS,Z7610,TROPICAMIDE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,TROPICAMIDE 1 % OP DROP,385.0,250.25,13270.0,14761.0,6
HCPCS,Z7610,UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION IN DSDV,498.29,323.89,13270.0,14761.0,2
HCPCS,Z7610,UREA 15 GRAM PO PWPK,,,13270.0,14761.0,4
HCPCS,Z7610,UREA 20 % TP CREA,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,URSODIOL 250 MG PO TABS,1329.6,864.24,13270.0,14761.0,6
HCPCS,Z7610,URSODIOL ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,VALACYCLOVIR 1 GRAM PO TABS,890.6999999999999,578.955,13270.0,14761.0,4
HCPCS,Z7610,VALACYCLOVIR 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
HCPCS,Z7610,VALGANCICLOVIR 450 MG PO TABS,8899.74,5784.83,13270.0,14761.0,12
HCPCS,Z7610,VALGANCICLOVIR 50 MG/ML PO SOLR,11929.98,7754.49,13270.0,14761.0,4
HCPCS,Z7610,VALSARTAN 160 MG PO TABS,596.16,387.5,13270.0,14761.0,4
HCPCS,Z7610,VALSARTAN 40 MG HALF-TAB = 20 MG,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,VALSARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,VALSARTAN 80 MG PO TABS,417.6,271.44,13270.0,14761.0,4
HCPCS,Z7610,VANCOMYCIN 125 MG PO CAPS,890.44,578.7850000000001,13270.0,14761.0,4
HCPCS,Z7610,VANCOMYCIN 25 MG/ML PO SOLR,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,VANCOMYCIN ORAL SOLUTION 25 MG/ML,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7610,VANILLA TPN WITH HEPARIN NICU,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,VENETOCLAX 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,VENLAFAXINE 150 MG PO CP24,493.92,321.05,13270.0,14761.0,6
HCPCS,Z7610,VENLAFAXINE 37.5 MG PO CP24,945.18,614.365,13270.0,14761.0,4
HCPCS,Z7610,VENLAFAXINE 37.5 MG PO TABS,303.4,197.20999999999998,13270.0,14761.0,4
HCPCS,Z7610,VENLAFAXINE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
HCPCS,Z7610,VENLAFAXINE 75 MG PO CP24,437.04,284.08,13270.0,14761.0,10
HCPCS,Z7610,VENLAFAXINE 75 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,6
HCPCS,Z7610,VERICIGUAT 10 MG PO TABS,10034.88,6522.67,13270.0,14761.0,2
HCPCS,Z7610,VILAZODONE 20 MG PO TABS,5177.28,3365.23,13270.0,14761.0,2
HCPCS,Z7610,VORICONAZOLE 200 MG PO TABS,5755.68,3741.195,13270.0,14761.0,4
HCPCS,Z7610,VORICONAZOLE 200 MG/5 ML (40 MG/ML) PO SUSR,6932.4,4506.06,13270.0,14761.0,2
HCPCS,Z7610,VORICONAZOLE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,2
HCPCS,Z7610,ZIPRASIDONE HCL 20 MG PO CAPS,2698.88,1754.27,13270.0,14761.0,2
HCPCS,Z7610,ZIPRASIDONE HCL 40 MG PO CAPS,3289.6,2138.24,13270.0,14761.0,2
HCPCS,Z7610,ZIPRASIDONE HCL 60 MG PO CAPS,2595.84,1687.3,13270.0,14761.0,2
HCPCS,Z7610,ZOLPIDEM 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
HCPCS,Z7610,ZOLPIDEM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
HCPCS,Z7612,HB REMOVAL SUTURES OR STAPLES,8738.51,5680.03,,,0
HCPCS,c9293,GLUCARPIDASE 1000 UNITS IV SOLR,1465.56,952.61,13270.0,14761.0,2
HCPCS,j9021,ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN,1465.56,952.61,65.73,14761.0,3
HCPCS,z7610,ESCITALOPRAM OXALATE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,2
ICD,001607A,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,001607B,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J0,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J1,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J2,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J3,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J4,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J7,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160J8,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160JA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160JB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K0,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K1,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K2,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K3,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K4,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K7,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160K8,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160KA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160KB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00160ZB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,001637A,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,001637B,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J0,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J1,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J2,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J3,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J4,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J7,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163J8,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163JA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163JB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K0,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K1,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K2,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K3,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K4,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K7,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163K8,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163KA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163KB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00163ZB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,001647A,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,001647B,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164J5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164J6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164JA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164JB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164K5,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164K6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164KA,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00164KB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00500ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00503ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00504ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00510ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00513ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00514ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00520ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00523ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00524ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00570ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00573ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00574ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00580ZZ,Pallidotomy,,,18000.0,18000.0,1
ICD,00583ZZ,Pallidotomy,,,18000.0,18000.0,1
ICD,00584ZZ,Pallidotomy,,,18000.0,18000.0,1
ICD,005B0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005B3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005B4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005C0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005C3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005C4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005D0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005D3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,005D4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009000Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00900ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00900ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009030Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00903ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009040Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00904ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009100Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00910ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009200Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00920ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009300Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00930ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009330Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00933ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009340Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00934ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009400Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00940ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009500Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00950ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009600Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00960ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00960ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009630Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009640Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009700Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00970ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00970ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009730Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00973ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009740Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00974ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00980ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00990ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009A0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B00Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B30Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B40Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009B4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C00Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C30Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C40Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009C4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D00Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D30Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D40Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,009D4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B00ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B23ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B60ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B63ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B70ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B80ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00B90ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BA0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BB0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BB3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BC0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BC3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BD0ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BD3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00BN0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C23ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C33ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C43ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C53ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C63ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00C74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CB3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CC3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CD3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00CD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D23ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00D74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00F3XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,00F4XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,00F5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,00F6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,00H002Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H003Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H00MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H00YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H032Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H033Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H03MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H03YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H042Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H043Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H04MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H04YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H602Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H603Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H60MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H60YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H632Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H633Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H63MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H63YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H642Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H643Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H64MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00H64YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HE0MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HE3MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HE4MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HU0MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HU3MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HU4MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HV0MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HV3MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00HV4MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00J00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00J03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00J04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K83ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K90ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K93ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00K94ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KA0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KA3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KA4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KB3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KC3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KD3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00KD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00NK0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00NK3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00NK4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P000Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P002Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P003Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P007Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P00JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P00KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P00MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P00YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P030Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P032Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P033Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P037Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P03JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P03KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P03MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P03YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P040Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P042Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P043Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P047Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P04JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P04KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P04M,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P04YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P600Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P602Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P603Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P60JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P60MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P60YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P630Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P632Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P633Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P63JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P63MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P63YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P640Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P642Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P643Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P64JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P64MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P64YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00P6X2Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PE0MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PE3MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PE4MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PEXMZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PV0MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PV3MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00PV4MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00Q10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00Q13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00Q14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R107Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R10JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R10KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R147Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R14JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R14KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R207Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R20JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R20KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R247Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R24JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00R24KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00T70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00T73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00T74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U107Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U10JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U10KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U137Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U13JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U13KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U147Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U14JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U14KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U207Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U20JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U20KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U237Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U23JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U23KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U247Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U24JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00U24KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W000Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W002Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W003Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W007Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W00JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W00KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W00MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W00YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W030Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W032Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W033Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W037Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W03JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W03KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W03MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W03YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W040Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W042Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W043Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W047Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W04JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W04KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W04MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W04YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W600Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W602Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W603Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W60JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W60MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W60YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W630Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W632Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W633Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W63JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W63MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W63YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W640Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W642Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W643Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W64JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W64MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,00W64YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,021008C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021008F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021008W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021009C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021009F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021009W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02100ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02103D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021048C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021048F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021048W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021049C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021049F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021049W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02104ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021108C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021108F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021108W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021109C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021109F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021109W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02110ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02113D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021148C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021148F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021148W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021149C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021149F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021149W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02114ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021208C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021208F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021208W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021209C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021209F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021209W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02120ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02123D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021248C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021248F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021248W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021249C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021249F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021249W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02124ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021308C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021308F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021308W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021309C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021309F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021309W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02130ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02133D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021348C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021348F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021348W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021349C,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021349F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021349W,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134A3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134A8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134A9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134AC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134AF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134AW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134D4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134J3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134J8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134J9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134JC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134JF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134JW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134K3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134K8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134K9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134KC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134KF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134KW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134Z3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02134ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021608P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021608Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021608R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021609P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021609Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021609R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02160ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02163Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021648P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021648Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021648R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021649P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021649Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021649R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02164ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021708U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021709U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170AU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170JU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170KU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02170ZU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02173J6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021748U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021749U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174AU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174JU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174KU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02174ZU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K08P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K08Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K08R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K09P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K09Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K09R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0Z5,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K0ZW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K48P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K48Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K48R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K49P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K49Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K49R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4Z5,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021K4ZW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L08P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L08Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L08R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L09P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L09Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L09R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0Z5,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L0ZW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L48P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L48Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L48R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L49P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L49Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L49R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4Z5,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4Z8,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4Z9,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021L4ZW,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P08A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P08B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P08D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P09A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P09B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P09D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P0ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P48A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P48B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P48D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P49A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P49B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P49D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021P4ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q08A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q08B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q08D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q09A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q09B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q09D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q0ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q48A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q48B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q48D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q49A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q49B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q49D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021Q4ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R08A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R08B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R08D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R09A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R09B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R09D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R0ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R48A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R48B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R48D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R49A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R49B,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R49D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4AB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4AD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4JB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4JD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4KB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4KD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4ZB,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021R4ZD,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V08U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V09U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0AU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0JU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0KU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V0ZU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V48U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49S,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V49U,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4AU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4JU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4KU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021V4ZU,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W08A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W08P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W08Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W08R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W09A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W09P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W09Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W09R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W0ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W48A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W48P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W48Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W48R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W49A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W49P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W49Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W49R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021W4ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X08A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X08P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X08Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X08R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X09A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X09P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X09Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X09R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0Aq,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X0ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X48A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X48P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X48Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X48R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X49A,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X49P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X49Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X49R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4AA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4JA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4KA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4ZA,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,021X4ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024F07J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024F08J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024F0JJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024F0KJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024G072,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024G082,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024G0J2,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024G0K2,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024J072,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024J082,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024J0J2,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,024J0K2,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02540ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02543ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02544ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02550ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02550ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02553ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02553ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02553ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02554ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02560ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02560ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02563ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02563ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02563ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02564ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02570ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02570ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02570ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02573ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02573ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02573ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02573ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02574ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02574ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02580ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02580ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02583ZF,Intracardiac Ablation (EPS performed separately),,,41999.85,65796.36,5
ICD,02583ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02583ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02583ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02584ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02590ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02590ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02593ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02593ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02593ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02594ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025D0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025D3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025D4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025F0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025F0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025F3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025F3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025F3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025F4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025G0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025G0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025G3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025G3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025G3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025G4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025H0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025H0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025H3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025H3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025H3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025H4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025J0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025J0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025J3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025J3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025J3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025J4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025K0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025K0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025K3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025K3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025K3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025K4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025L0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025L0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025L3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025L3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025L3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025L4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025M0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025M0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025M3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025M3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,025M3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,025M4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,025N0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025N3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,025N4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027004Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027004Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027005Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027005Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027006Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027006Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027007Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027007Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700D6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700F6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700G6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700GZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700T6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700TZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02700Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02700ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027034Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027035Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027036Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027037Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02703ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027044Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027045Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027046Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027047Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02704ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027104Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027104Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027105Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027105Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027106Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027106Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027107Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027107Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710D6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710F6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710G6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710GZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710T6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710TZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02710Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02710ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027134Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027135Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027136Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027137Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02713ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027144Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027145Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027146Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027147Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02714ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027204Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027204Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027205Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027205Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027206Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027206Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027207Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027207Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720D6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720F6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720G6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720GZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720T6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720TZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02720Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02720ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027234Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027235Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027236Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027237Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02723ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027244Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027245Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027246Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027247Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02724ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027304Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027304Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027305Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027305Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027306Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027306Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027307Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027307Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730D6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730F6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730G6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730GZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730T6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730TZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02730Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02730ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027334Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027335Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027336Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027337Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02733ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027344Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027345Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027346Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027347Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734D6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734EZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734F6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734FZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734G6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734GZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734T6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734TZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02734ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027F0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027F0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027F34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F34Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027F3DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F3DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027F3ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F3ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027F44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F44Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027F4DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F4DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027F4ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027F4ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027G0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027G0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027G34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G34Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G3DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G3DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G3ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G3ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G44Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G4DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G4DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027G4ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027G4ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027H0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027H0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027H34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H34Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H3DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H3DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H3ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H3ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H44Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H4DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H4DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027H4ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027H4ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027J0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027J0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027J34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J34Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J3DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J3DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J3ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J3ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J44Z,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J4DZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J4DZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027J4ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027J4ZZ,Percutaneous Valvuloplasty,,,33284.26,33284.26,2
ICD,027K04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K34Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K44Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027K4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L04Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L34Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L44Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027L4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027P04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027P34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027P44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027Q04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027Q34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027Q44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027R04T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027R0DT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R0ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R34T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027R3DT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R3ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R44T,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027R4DT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027R4ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,027S04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027S34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027S44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027T04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027T34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027T44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027V04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027V34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027V44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027W04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027W34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027W44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027X04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027X34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,027X44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02880ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02883ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02884ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02890ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02893ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02894ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,028D0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,028D3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,028D4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B44ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B50ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B50ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B53ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B53ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02B53ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02B54ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B54ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B60ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B60ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,54839.0,1
ICD,02B63ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B63ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02B63ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02B64ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B64ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B70ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B70ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B70ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B73ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B73ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B73ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02B73ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02B74ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B74ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B74ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B80ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B80ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B83ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B83ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02B83ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02B84ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B90ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02B90ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B93ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02B93ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02B93ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02B94ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BF0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BF0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BF3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BF3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BF3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BF4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BG0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BG0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BG3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BG3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BG3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BG4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BH0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BH3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BH3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BH3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BH4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BJ0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BJ0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BJ3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BJ3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BJ3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BJ4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BK0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BK0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BK3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BK3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BK3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BK4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BK4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BL0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BL0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BL3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BL3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BL3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BL4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BL4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BM0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BM0ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BM3ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BM3ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02BM3ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02BM4ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02BN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02BN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C00Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C00ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C03Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C03Z6,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C03Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C03Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C03Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C03ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C03ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C03ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C04Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C04ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C10Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C10ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C13Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C13Z6,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C13Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C13Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C13Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C13ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C13ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C13ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C14Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C14ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C20Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C20ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C23Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C23Z6,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C23Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C23Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C23Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C23ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C23ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C23ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C24Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C24ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C30Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C30ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C33Z6,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C33Z6,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C33Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C33Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C33Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C33ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C33ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02C33ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C34Z6,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C34ZZ,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,02C40ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C44ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C50ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C54ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C60ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C64ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C70ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C73ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C74ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C80ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C83ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C84ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C90ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02C94ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CF0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CG0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CJ0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CK0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CK3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CK4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CL0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CL4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CM0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CM4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CP3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CP3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CQ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CQ3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CR3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CR3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CS3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CS3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CT3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CT3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CV3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CV3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CW3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CW3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02CX3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02CX3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02FN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02FN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02FN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02FNXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,02H00YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H03YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H04YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H10YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H13YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H14YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H20YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H23YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H24YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H30YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H33YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H34YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H400Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H400Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H402Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H403Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H40DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H40KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H40YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H430Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H430Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H432Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H433Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H43DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H43YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H440Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H440Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H442Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H443Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H44DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H44KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H44YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H600Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H600Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H602Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H603Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H60DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H60KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H60YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H630Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H630Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H632Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H63DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H63KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H63YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H640Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H640Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H642Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H643Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H64DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H64KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H64YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H700Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H700Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H702Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H703Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H70DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H70KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H70YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H730Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H730Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H732Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H733Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H73DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H73KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H73YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H740Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H740Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02H742Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H743Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H74DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H74KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02H74YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA0QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA0RJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA0RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA0RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA3QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA3RJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA3RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA3RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA4QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA4RJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA4RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA4RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HA4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK0MZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK3MZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK4MZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HK4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL00Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HL02Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL30Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HL32Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL40Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HL42Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HL4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN02Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN32Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN42Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HN4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HS00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HS00Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HS30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HS30Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HS40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HS40Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HT00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HT00Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HT30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HT30Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HT40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HT40Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HV00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HV00Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HV30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HV30Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HV40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HV40Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02HW00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HW30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02HW40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02JA3ZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,02JA3ZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,02JY3ZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,02JY3ZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,37966.58,5
ICD,02K80ZZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,02K80ZZ,Electro Physiology Services,,,24237.78,37966.58,5
ICD,02K80ZZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,02K80ZZ,Electrophysiology Diagnostic Studies,,,25837.82,25837.82,2
ICD,02K83ZZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,02K83ZZ,Electro Physiology Services,,,24237.78,37966.58,5
ICD,02K83ZZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,02K83ZZ,Electrophysiology Diagnostic Studies,,,25837.82,25837.82,2
ICD,02K83ZZ,Intracardiac Ablation (EPS performed separately),,,41999.85,65796.36,5
ICD,02K84ZZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,02K84ZZ,Electro Physiology Services,,,24237.78,37966.58,5
ICD,02K84ZZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,02K84ZZ,Electrophysiology Diagnostic Studies,,,25837.82,25837.82,2
ICD,02L70ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02L73ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02L74ZK,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH0CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH3CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH4CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LH4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LR0ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LS0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02LT0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N00ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N03ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N04ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N10ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N13ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N14ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N20ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N23ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N24ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N30ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N33ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N34ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N40ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N44ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N50ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N54ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N60ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N64ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N70ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N73ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N74ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N80ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N83ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N84ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N90ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02N94ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02ND0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02ND3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02ND4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NF0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NG0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NJ0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NK0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NK3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NK4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NL0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NL4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NM0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NM4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02NN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA02Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA32Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA3RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA42Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02PA4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q00ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q03ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q04ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q10ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q13ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q14ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q20ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q23ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q24ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q30ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q33ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q34ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q40ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q44ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q50ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q54ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q60ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q64ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q70ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q73ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q74ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q80ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q83ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q84ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q90ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02Q94ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QA0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QA3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QA4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QB0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QB3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QB4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QC0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QC3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QC4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF0ZJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF3ZJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF4ZJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QF4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG0ZE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG3ZE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG4ZE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QG4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QH3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QH4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ0ZG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ3ZG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ4ZG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QJ4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QK0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QK3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QK4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QL0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QL4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QM0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QM4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02QN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R507Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R508Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R50JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R50KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R547Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R548Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R54JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R54KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R607Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R608Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R60JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R60KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R647Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R648Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R64JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R64KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R707Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R708Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R70JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R70KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R747Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R748Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R74JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R74KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R907Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R908Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R90JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R90KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R947Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R948Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R94JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02R94KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RA0LZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RA0MZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RD4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF37H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF37H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF37Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF38H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF38H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF38Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF3JH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF3JH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF3JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF3KH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF3KH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF3KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RF47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RF4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG37H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG37H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG37Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG38H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG38H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG38Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG3JH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG3JH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG3JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG3KH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG3KH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG3KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RG47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RG4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH37H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH37H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH37Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH38H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH38H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH38L,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH38M,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH38Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH3JH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH3JH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH3JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH3KH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH3KH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH3KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RH47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RH4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ37H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ37H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ37Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ38H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ38H,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ38Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ3JH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ3JH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ3JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ3KH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ3KH,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ3KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02RJ47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RJ4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RK4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RL4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RM4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RN4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RP0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RQ07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RQ0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RR07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02RR0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02S00ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02S10ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02SP0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02SW0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02SX0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T50ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T54ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T80ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T80ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02T83ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02T83ZZ,RADIOFREQUECY ABLATION,,,47620.0,52829.0,2
ICD,02T83ZZ,Radio Frequency Ablation,,,43061.99,43061.99,2
ICD,02T84ZZ,Cardiac Ablation,,,81017.27,109776.63,2
ICD,02T90ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02T94ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TH0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TH3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TH4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TM0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TM4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TN0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02TN4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U007Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U008Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U00JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U00KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U037Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U038Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U03JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U03KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U047Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U048Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U04JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U04KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U107Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U108Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U10JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U10KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U137Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U138Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U13JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U13KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U147Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U148Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U14JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U14KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U207Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U208Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U20JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U20KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U237Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U238Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U23JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U23KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U247Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U248Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U24JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U24KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U307Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U308Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U30JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U30KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U337Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U338Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U33JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U33KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U347Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U348Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U34JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U34KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U507Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U508Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U50JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U50KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U537Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U538Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U53JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U53KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U547Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U548Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U54JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U54KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U607Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U608Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U60JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U60KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U637Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U638Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U63JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U63KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U647Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U648Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U64JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U64KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U707Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U708Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U70JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U70KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U737Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U738Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U73KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U747Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U748Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U74KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U907Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U908Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U90JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U90KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U937Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U938Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U93JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U93KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U947Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U948Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U94JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02U94KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UA4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UD4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF07J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF08J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF0JJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF0KJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF37J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF38J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF3JJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF3KJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF47J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF48J,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF4JJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF4KJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UF4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG07E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG08E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG0JE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG0KE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG37E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG38E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG3JE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG3JH,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG3KE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG47E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG48E,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG4JE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG4KE,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UG4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UH4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ07G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ08G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ0JG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ0KG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ37G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ38G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ3JG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ3KG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ47G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ48G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ4JG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ4KG,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UJ4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UK4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UL4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UM7KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UN4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UW3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UW4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UX3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02UX4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA0CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA3CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA4CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VA4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VG0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VG3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VG4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL0CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL3CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL4CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VL4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VP0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VP4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VQ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0CT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0DT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0ZT,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VR0ZT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR3CT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4CT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4DT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4ZT,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VR4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VS4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VT4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW0EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW0EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW0FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW0FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW3EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW3EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW3FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW3FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VW4EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW4EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW4FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VW4FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VW4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VX0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VX0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX0EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX0EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX0FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX0FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VX3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VX3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX3EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX3EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX3FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX3FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02VX4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX4EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX4EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX4FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02VX4FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,02VX4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,02W50JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02W54JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA02Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA32Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA42Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4CZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4QZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4RS,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4RZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WA4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WF4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WG4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WH4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ07Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ08Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ0KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ37Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ38Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ3JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ3KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ47Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ48Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WJ4KZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WM0JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02WM4JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02YA0Z0,Adult Heart - Transplant Event: Combined Hospital and Professional Services,,,67600.0,67600.0,2
ICD,02YA0Z0,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02YA0Z0,General Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z0,Heart Transplant,,,216949.8,621838.12,5
ICD,02YA0Z0,Heart Transplants Hospital Services,,,80000.0,80000.0,1
ICD,02YA0Z0,"Heart/Kidney, Transplant",,,340920.66,340920.66,12
ICD,02YA0Z0,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,02YA0Z0,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,02YA0Z0,Organ Transplants,,,,,0
ICD,02YA0Z0,Organ Transplants - Heart - Adult,,,77825.12,77825.12,1
ICD,02YA0Z0,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,02YA0Z0,Other Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,02YA0Z0,Transplant: Heart,,,143000.0,143000.0,1
ICD,02YA0Z0,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,02YA0Z1,Adult Heart - Transplant Event: Combined Hospital and Professional Services,,,67600.0,67600.0,2
ICD,02YA0Z1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02YA0Z1,General Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z1,Heart Transplant,,,216949.8,621838.12,5
ICD,02YA0Z1,Heart Transplants Hospital Services,,,80000.0,80000.0,1
ICD,02YA0Z1,"Heart/Kidney, Transplant",,,340920.66,340920.66,12
ICD,02YA0Z1,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,02YA0Z1,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,02YA0Z1,Organ Transplants,,,,,0
ICD,02YA0Z1,Organ Transplants - Heart - Adult,,,77825.12,77825.12,1
ICD,02YA0Z1,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,02YA0Z1,Other Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,02YA0Z1,Transplant: Heart,,,143000.0,143000.0,1
ICD,02YA0Z1,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,02YA0Z2,Adult Heart - Transplant Event: Combined Hospital and Professional Services,,,67600.0,67600.0,2
ICD,02YA0Z2,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,02YA0Z2,General Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z2,Heart Transplant,,,216949.8,621838.12,5
ICD,02YA0Z2,Heart Transplants Hospital Services,,,80000.0,80000.0,1
ICD,02YA0Z2,"Heart/Kidney, Transplant",,,340920.66,340920.66,12
ICD,02YA0Z2,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,02YA0Z2,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,02YA0Z2,Organ Transplants,,,,,0
ICD,02YA0Z2,Organ Transplants - Heart - Adult,,,77825.12,77825.12,1
ICD,02YA0Z2,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,02YA0Z2,Other Transplant Services,,,51195.06,51195.06,10
ICD,02YA0Z2,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,02YA0Z2,Transplant: Heart,,,143000.0,143000.0,1
ICD,02YA0Z2,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,031309M,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,031309N,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130AM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130AN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130JM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130JN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130KM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130KN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130ZM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03130ZN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,031409M,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,031409N,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140AM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140AN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140JM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140JN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140KM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140KN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140ZM,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03140ZN,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,031H09G,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031H0AG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031H0JG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031H0KG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031H0ZG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031J09G,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031J0AG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031J0JG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031J0KG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031J0ZG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031S09G,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031S0AG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031S0JG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031S0KG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031S0ZG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031T09G,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031T0AG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031T0JG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031T0KG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,031T0ZG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0345T,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,037004Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037005Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037006Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037007Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037034Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037035Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037036Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037037Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037044Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037045Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037046Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037047Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037104Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037105Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037106Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037107Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037134Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037135Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037136Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037137Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037144Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037145Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037146Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037147Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037204Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037205Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037206Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037207Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037234Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037235Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037236Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037237Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037244Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037245Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037246Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037247Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037304Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037305Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037306Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037307Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037334Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037335Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037336Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037337Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037344Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037345Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037346Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037347Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037404Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037405Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037406Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037407Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037434Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037435Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037436Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037437Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037444Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037445Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037446Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037447Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037504Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037505Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037506Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037507Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037534Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037535Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037536Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037537Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037544Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037545Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037546Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037547Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037604Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037605Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037606Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037607Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037634Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037635Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037636Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037637Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037644Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037645Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037646Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037647Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037704Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037705Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037706Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037707Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037734Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037735Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037736Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037737Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037744Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037745Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037746Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037747Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037804Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037805Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037806Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037807Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037834Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037835Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037836Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037837Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037844Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037845Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037846Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037847Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037904Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037905Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037906Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037907Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037934Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037935Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037936Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037937Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037944Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037945Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037946Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037947Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037A47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037B47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037C47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037D47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037F47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037G04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037G05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037G06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037G07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037H47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037J47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037K47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037L47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037M47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037N47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037P47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Q47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037R47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037S47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037T47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037U47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037V47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,037Y47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,03C03ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C03ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C13ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C13ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C23ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C23ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C33ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C33ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C43ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C53ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C63ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C73ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C73ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C83ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C83ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03C93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03C93ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CA3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CA3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CB3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CB3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CC3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CC3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CD3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CF3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CF3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CG3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CG3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CG3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CG3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CH3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CH3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CH3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CH3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CJ3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CJ3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CJ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CJ3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CK3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CK3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CK3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CK3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CL3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CL3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CL3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CM3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CM3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CM3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CN3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CN3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CN3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CP3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CP3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CP3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CP3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CQ3Z7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CQ3Z7,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CQ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CQ3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CR3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CR3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CS3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CS3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CT3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CT3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CU3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CU3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CV3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CV3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03CY3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,03CY3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,03FG3Z0,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03FG3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LG4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LK4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03LL4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V00CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V03CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V04CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V10CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V13CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V14CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V20CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V23CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V24CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V30CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V33CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V34CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V40CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V43CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V44CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V50CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V53CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V54CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V60CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V63CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V64CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V70CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V73CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V74CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V80CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V83CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V84CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V90CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V90ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V93CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V94CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03V94ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VA0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VA0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VA3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VA4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VA4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VB0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VB3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VB4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VC0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VC3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VC4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VD0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VD3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VD4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VF0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VF0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VF3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VF4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VF4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VG0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VG0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VG3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VG4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VG4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VH0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VH0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VH3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VH4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VH4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VJ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VJ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VJ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VJ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VJ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VK0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VK0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VK3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VK4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VK4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VL0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VL0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VL3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VL4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VL4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VM0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VM0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VM3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VM4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VM4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VN0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VN0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VN3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VN4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VN4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VP0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VP0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VP3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VP4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VP4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VQ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VQ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VQ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VQ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VQ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VR0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VR0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VR3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VR4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VR4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VS0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VS0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VS3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VS4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VS4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VT0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VT0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VT3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VT4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VT4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VU0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VU0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VU3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VU4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VU4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VV0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VV0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VV3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VV4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VV4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VY0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VY0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VY3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VY4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,03VY4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,047004Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047005Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047006Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047007Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047034Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047035Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047036Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047037Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047044Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047045Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047046Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047047Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047104Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047105Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047106Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047107Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047134Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047135Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047136Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047137Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047144Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047145Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047146Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047147Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047204Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047205Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047206Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047207Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047234Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047235Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047236Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047237Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047244Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047245Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047246Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047247Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047304Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047305Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047306Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047307Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047334Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047335Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047336Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047337Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047344Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047345Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047346Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047347Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047404Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047405Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047406Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047407Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047434Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047435Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047436Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047437Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047444Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047445Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047446Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047447Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047504Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047505Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047506Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047507Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047534Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047535Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047536Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047537Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047544Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047545Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047546Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047547Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047604Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047605Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047606Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047607Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047634Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047635Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047636Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047637Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047644Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047645Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047646Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047647Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047704Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047705Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047706Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047707Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047734Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047735Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047736Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047737Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047744Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047745Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047746Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047747Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047804Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047805Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047806Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047807Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047834Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047835Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047836Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047837Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047844Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047845Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047846Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047847Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047904Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047905Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047906Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047907Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047934Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047935Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047936Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047937Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047944Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047945Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047946Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047947Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047A47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047B47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047C47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047D47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047E47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047F47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047H47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047J47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047K47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047L4D1,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047M47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047N47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047P47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Q47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047R47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047S47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047T47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047U47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047V47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047W47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y04Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y05Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y06Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y07Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y34Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y35Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y36Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y37Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y44Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y45Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y46Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,047Y47Z,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,04C03ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C03ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C13ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C13ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C23ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C23ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C33ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C33ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C43ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C43ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C53ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C53ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C63ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C63ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C73ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C73ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C83ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C83ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04C93ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04C93ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CA3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CA3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CB3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CB3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CC3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CC3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CD3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CE3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CE3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CF3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CF3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CH3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CH3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CJ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CJ3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CK3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CK3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CL3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CL3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CM3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CM3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CN3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CN3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CP3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CP3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CQ3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CQ3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CR3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CR3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CS3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CS3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CT3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CT3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CU3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CU3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CV3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CV3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CW3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CW3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04CY3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04CY3ZZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04H002Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04H032Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04H042Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04R007Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04R00JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04R00KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04R047Z,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04R04JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04R04KZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04U03JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04U03JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04U04JZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04U04JZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V00C6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V00CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V00DJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V00DJ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V00DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V00EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V00EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V00FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V00FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V00Z6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V03C6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V03CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V03DJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V03DJ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V03DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V03DZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V03EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V03EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V03FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V03FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V04C6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V04CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V04DJ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V04DJ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V04DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V04DZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V04EZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V04EZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V04FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,04V04FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,04V04Z6,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V10CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V13CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V14CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V20CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V23CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V24CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V30CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V33CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V34CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V40CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V43CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V44CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V50CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V53CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V54CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V60CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V63CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V64CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V70CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V73CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V74CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V80CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V83CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V84CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V90CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V90ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V93CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V94CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04V94ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VA0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VA0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VA3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VA4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VA4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VB0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VB3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VB4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VC0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VC3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VC4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VD0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VD3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VD4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VE0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VE0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VE3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VE4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VE4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VF0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VF0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VF3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VF4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VF4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VH0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VH0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VH3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VH4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VH4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VJ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VJ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VJ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VJ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VJ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VK0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VK0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VK3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VK4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VK4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VL0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VL0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VL3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VL4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VL4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VM0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VM0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VM3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VM4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VM4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VN0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VN0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VN3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VN4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VN4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VP0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VP0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VP3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VP4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VP4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VQ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VQ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VQ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VQ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VQ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VR0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VR0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VR3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VR4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VR4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VS0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VS0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VS3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VS4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VS4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VT0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VT0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VT3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VT4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VT4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VU0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VU0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VU3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VU4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VU4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VV0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VV0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VV3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VV4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VV4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VW0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VW0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VW3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VW4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VW4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VY0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VY0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VY3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VY4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,04VY4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL0DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL3DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL3ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL4DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05LL4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V00CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V03CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V04CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V04DZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V10CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V13CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V14CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V30CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V33CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V34CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V40CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V43CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V44CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V50CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V53CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V54CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V60CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V63CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V64CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V70CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V73CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V74CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V80CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V83CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V84CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V90CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V90ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V93CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V94CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05V94ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VA0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VA0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VA3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VA4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VA4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VB0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VB3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VB4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VC0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VC3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VC4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VD0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VD3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VD4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VF0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VF0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VF3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VF4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VF4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VG0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VG0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VG3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VG4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VG4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VH0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VH0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VH3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VH4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VH4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VL0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VL0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VL3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VL4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VL4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VM0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VM0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VM3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VM4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VM4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VN0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VN0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VN3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VN4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VN4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VP0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VP0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VP3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VP4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VP4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VQ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VQ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VQ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VQ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VQ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VR0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VR0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VR3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VR4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VR4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VS0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VS0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VS3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VS4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VS4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VT0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VT0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VT3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VT4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VT4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VV0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VV0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VV3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VV4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VV4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VY3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,05VY4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,061007P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061007Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061007R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061009P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061009Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061009R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06100ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061047P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061047Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061047R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061049P,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061049Q,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,061049R,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104AP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104AQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104AR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104JP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104JQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104JR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104KP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104KQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104KR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104ZP,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104ZQ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06104ZR,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0614T,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,06183J4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06183JY,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06184J4,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,06V10CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V13CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V14CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V20CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V23CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V24CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V30CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V33CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V34CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V40CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V43CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V44CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V50CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V53CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V54CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V60CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V63CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V64CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V70CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V73CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V74CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V80CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V83CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V84CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V90CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V90ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V93CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V94CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06V94ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VB0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VB0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VB3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VB4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VB4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VC0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VC0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VC3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VC4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VC4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VD0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VD0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VD3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VD4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VD4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VF0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VF0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VF3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VF4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VF4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VG0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VG0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VG3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VG4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VG4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VH0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VH0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VH3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VH4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VH4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VJ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VJ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VJ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VJ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VJ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VM0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VM0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VM3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VM4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VM4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VN0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VN0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VN3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VN4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VN4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VP0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VP0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VP3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VP4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VP4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VQ0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VQ0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VQ3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VQ4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VQ4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VR0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VR0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VR3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VR4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VR4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VS0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VS0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VS3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VS4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VS4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VT0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VT0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VT3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VT4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VT4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VV0CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VV0ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VV3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VV4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VV4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VY3CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VY4CZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,06VY4ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,08F4XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,08F5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF1XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF2XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF3XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF4XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF7XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF8XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BF9XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BFBXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0BYK0Z0,General Transplant Services,,,51195.06,51195.06,8
ICD,0BYK0Z0,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYK0Z0,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYK0Z0,"Lung Transplant Services: Incomplete transplant, Single Lung",,,148434.5,148434.5,2
ICD,0BYK0Z0,"Lung Transplant Services: Transplant Case Rate, Double Lung",,,77825.12,148434.5,3
ICD,0BYK0Z0,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,148434.5,148434.5,2
ICD,0BYK0Z0,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYK0Z0,"Lung ù Single, Transplant",,,223148.18,223148.18,2
ICD,0BYK0Z0,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0BYK0Z0,Organ Transplants,,,,,0
ICD,0BYK0Z0,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYK0Z0,Other Transplant Services,,,51195.06,51195.06,8
ICD,0BYK0Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0BYK0Z0,"Transplant: Lung, Single",,,160000.0,160000.0,1
ICD,0BYK0Z1,General Transplant Services,,,51195.06,51195.06,8
ICD,0BYK0Z1,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYK0Z1,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYK0Z1,"Lung Transplant Services: Incomplete transplant, Single Lung",,,148434.5,148434.5,2
ICD,0BYK0Z1,"Lung Transplant Services: Transplant Case Rate, Double Lung",,,77825.12,148434.5,3
ICD,0BYK0Z1,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,148434.5,148434.5,2
ICD,0BYK0Z1,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYK0Z1,"Lung ù Single, Transplant",,,223148.18,223148.18,2
ICD,0BYK0Z1,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0BYK0Z1,Organ Transplants,,,,,0
ICD,0BYK0Z1,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYK0Z1,Other Transplant Services,,,51195.06,51195.06,8
ICD,0BYK0Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0BYK0Z1,"Transplant: Lung, Single",,,160000.0,160000.0,1
ICD,0BYL0Z0,General Transplant Services,,,51195.06,51195.06,7
ICD,0BYL0Z0,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYL0Z0,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYL0Z0,"Lung Transplant Services: Incomplete transplant, Single Lung",,,148434.5,148434.5,2
ICD,0BYL0Z0,"Lung Transplant Services: Transplant Case Rate, Double Lung",,,77825.12,148434.5,3
ICD,0BYL0Z0,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,148434.5,148434.5,2
ICD,0BYL0Z0,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYL0Z0,"Lung ù Single, Transplant",,,223148.18,223148.18,2
ICD,0BYL0Z0,"Lung/Kidney, Transplant",,,340920.66,340920.66,10
ICD,0BYL0Z0,Organ Transplants,,,,,0
ICD,0BYL0Z0,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYL0Z0,Other Transplant Services,,,51195.06,51195.06,7
ICD,0BYL0Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,5
ICD,0BYL0Z0,"Transplant: Lung, Single",,,160000.0,160000.0,1
ICD,0BYL0Z1,General Transplant Services,,,51195.06,51195.06,8
ICD,0BYL0Z1,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYL0Z1,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYL0Z1,"Lung Transplant Services: Incomplete transplant, Single Lung",,,148434.5,148434.5,2
ICD,0BYL0Z1,"Lung Transplant Services: Transplant Case Rate, Double Lung",,,77825.12,148434.5,3
ICD,0BYL0Z1,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,148434.5,148434.5,2
ICD,0BYL0Z1,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYL0Z1,"Lung ù Single, Transplant",,,223148.18,223148.18,2
ICD,0BYL0Z1,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0BYL0Z1,Organ Transplants,,,,,0
ICD,0BYL0Z1,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYL0Z1,Other Transplant Services,,,51195.06,51195.06,8
ICD,0BYL0Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0BYL0Z1,"Transplant: Lung, Single",,,160000.0,160000.0,1
ICD,0BYM0Z0,General Transplant Services,,,51195.06,51195.06,11
ICD,0BYM0Z0,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,0BYM0Z0,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,0BYM0Z0,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYM0Z0,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYM0Z0,"Lung Transplant Services: Incomplete transplant, Double Lung",,,148434.5,148434.5,2
ICD,0BYM0Z0,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,77825.12,77825.12,1
ICD,0BYM0Z0,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYM0Z0,"Lung ù Double, Transplant",,,247942.77,247942.77,2
ICD,0BYM0Z0,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0BYM0Z0,Organ Transplants,,,,,0
ICD,0BYM0Z0,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,0BYM0Z0,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYM0Z0,Other Transplant Services,,,51195.06,51195.06,11
ICD,0BYM0Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0BYM0Z0,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,0BYM0Z0,"Transplant: Lung, Bilateral",,,160000.0,160000.0,1
ICD,0BYM0Z1,General Transplant Services,,,51195.06,51195.06,11
ICD,0BYM0Z1,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,0BYM0Z1,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,0BYM0Z1,Lung (Single/Bilateral) Transplant,,,534391.87,534391.87,3
ICD,0BYM0Z1,Lung Living Related Donor Surgery,,,56109.0,56109.0,1
ICD,0BYM0Z1,"Lung Transplant Services: Incomplete transplant, Double Lung",,,148434.5,148434.5,2
ICD,0BYM0Z1,"Lung Transplant Services: Transplant Case Rate, Single Lung",,,77825.12,77825.12,1
ICD,0BYM0Z1,Lung Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0BYM0Z1,"Lung ù Double, Transplant",,,247942.77,247942.77,2
ICD,0BYM0Z1,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0BYM0Z1,Organ Transplants,,,,,0
ICD,0BYM0Z1,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,0BYM0Z1,Organ Transplants - Lung - Adult,,,77825.12,77825.12,1
ICD,0BYM0Z1,Other Transplant Services,,,51195.06,51195.06,11
ICD,0BYM0Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0BYM0Z1,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,0BYM0Z1,"Transplant: Lung, Bilateral",,,160000.0,160000.0,1
ICD,0BYM0Z2,General Transplant Services,,,51195.06,51195.06,3
ICD,0BYM0Z2,Heart/Lung Transplant,,,700644.02,700644.02,9
ICD,0BYM0Z2,"Heart/Lung, Transplant",,,340920.66,340920.66,6
ICD,0BYM0Z2,Organ Transplants,,,,,0
ICD,0BYM0Z2,Organ Transplants - Heart/Lung - Adult,,,77825.12,77825.12,1
ICD,0BYM0Z2,Other Transplant Services,,,51195.06,51195.06,3
ICD,0BYM0Z2,Transplant: Heart/Lung,,,192000.0,192000.0,3
ICD,0CFBXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0CFCXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0D16079,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D16079,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1607A,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1607A,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1607B,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1607B,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1607L,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1607L,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160J9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160J9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160JA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160JA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160JB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160JB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160JL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160JL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160K9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160K9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160KA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160KA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160KB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160KB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160KL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160KL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160Z9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160Z9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160ZA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160ZA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160ZB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160ZB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D160ZL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D160ZL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D16479,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D16479,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1647A,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1647A,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1647B,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1647B,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1647L,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1647L,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164J9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164JA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164JA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164JB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164JB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164JL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164JL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164K9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164K9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164KA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164KB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164KL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164Z9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164Z9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164ZA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164ZA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164ZB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164ZB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D164ZL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D164ZL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D16879,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D16879,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1687A,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1687A,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1687B,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1687B,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D1687L,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D1687L,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168J9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168J9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168JA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168JA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168JB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168JB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168JL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168JL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168K9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168K9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168KA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168KA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168KB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168KB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168KL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168KL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168Z9,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168Z9,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168ZA,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168ZA,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168ZB,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168ZB,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0D168ZL,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0D168ZL,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DB64Z3,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DB64Z3,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DF5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DF6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DF8XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DF9XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFAXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFBXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFEXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFFXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFGXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFHXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFJXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFKXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFLXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFMXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFNXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFPXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DFQXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0DQ60ZZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DQ60ZZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DQ63ZZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DQ63ZZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DQ64ZZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DQ64ZZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DQ67ZZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DQ67ZZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DQ68ZZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DQ68ZZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DQP0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQP3ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQP4ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQP7ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQP8ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQR0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQR3ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DQR4ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0DV64CZ,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,0DV64CZ,Bariatric Surgery,,,32398.14,50753.04,5
ICD,0DY80Z0,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,4
ICD,0DY80Z0,General Transplant Services,,,51195.06,51195.06,3
ICD,0DY80Z0,Organ Transplants,,,,,0
ICD,0DY80Z0,Other Transplant Services,,,51195.06,51195.06,3
ICD,0DY80Z1,General Transplant Services,,,51195.06,51195.06,1
ICD,0DY80Z1,Organ Transplants,,,,,0
ICD,0DY80Z1,Other Transplant Services,,,51195.06,51195.06,1
ICD,0DY90Z1,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,4
ICD,0DY90Z1,General Transplant Services,,,51195.06,51195.06,2
ICD,0DY90Z1,Organ Transplants,,,,,0
ICD,0DY90Z1,Other Transplant Services,,,51195.06,51195.06,2
ICD,0FF4XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FF5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FF6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FF8XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FF9XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FFCXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FFDXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FFFXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0FY00Z0,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,6
ICD,0FY00Z0,General Transplant Services,,,51195.06,51195.06,9
ICD,0FY00Z0,Liver Transplant,,,485809.05,485809.05,3
ICD,0FY00Z0,Liver Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0FY00Z0,"Liver ù Deceased and Living, Transplant",,,247942.77,247942.77,2
ICD,0FY00Z0,"Liver/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0FY00Z0,Organ Transplants,,,,,0
ICD,0FY00Z0,Organ Transplants - Liver - Adult,,,50490.44,50490.44,1
ICD,0FY00Z0,Other Transplant Services,,,51195.06,51195.06,9
ICD,0FY00Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0FY00Z0,"Transplant: Liver, Cadaveric Donor",,,182000.0,182000.0,1
ICD,0FY00Z0,Transplant: Pancreas,,,107000.0,107000.0,1
ICD,0FY00Z1,Adult Liver - Transplant Event: Combined Hospital and Professional Services,,,95680.0,95680.0,6
ICD,0FY00Z1,General Transplant Services,,,51195.06,51195.06,9
ICD,0FY00Z1,Liver Transplant,,,485809.05,485809.05,3
ICD,0FY00Z1,Liver Transplants Hospital Services,,,115000.0,115000.0,1
ICD,0FY00Z1,"Liver ù Deceased and Living, Transplant",,,247942.77,247942.77,2
ICD,0FY00Z1,"Liver/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0FY00Z1,Organ Transplants,,,,,0
ICD,0FY00Z1,Organ Transplants - Liver - Adult,,,50490.44,50490.44,1
ICD,0FY00Z1,Other Transplant Services,,,51195.06,51195.06,9
ICD,0FY00Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,0FY00Z1,"Transplant: Liver, Cadaveric Donor",,,182000.0,182000.0,1
ICD,0FY00Z1,Transplant: Pancreas,,,107000.0,107000.0,1
ICD,0FYG0Z,Organ Transplants - Pancreas - Adult,,,54005.73,54005.73,1
ICD,0FYG0Z0,General Transplant Services,,,51195.06,51195.06,5
ICD,0FYG0Z0,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,4
ICD,0FYG0Z0,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,8
ICD,0FYG0Z0,Organ Transplants,,,,,0
ICD,0FYG0Z0,Organ Transplants - Pancreas - Adult,,,54005.73,54005.73,1
ICD,0FYG0Z0,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0FYG0Z0,Other Transplant Services,,,51195.06,51195.06,5
ICD,0FYG0Z0,Pancreas Transplant,,,291486.71,291486.71,3
ICD,0FYG0Z0,"Pancreas, Transplant",,,123970.87,123970.87,2
ICD,0FYG0Z0,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,12
ICD,0FYG0Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,4
ICD,0FYG0Z0,Transplant: Kidney/Pancreas,,,130000.0,130000.0,4
ICD,0FYG0Z1,General Transplant Services,,,51195.06,51195.06,5
ICD,0FYG0Z1,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,4
ICD,0FYG0Z1,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,8
ICD,0FYG0Z1,Organ Transplants,,,,,0
ICD,0FYG0Z1,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0FYG0Z1,Other Transplant Services,,,51195.06,51195.06,5
ICD,0FYG0Z1,Pancreas Transplant,,,291486.71,291486.71,3
ICD,0FYG0Z1,"Pancreas, Transplant",,,123970.87,123970.87,2
ICD,0FYG0Z1,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,12
ICD,0FYG0Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,4
ICD,0FYG0Z1,Transplant: Kidney/Pancreas,,,130000.0,130000.0,4
ICD,0G500ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0G503ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0G504ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0G800ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0G803ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0G804ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0GB00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0GB03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0GB04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0GT00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0JH608Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH609Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH60AZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH60FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH638Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH639Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH63AZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH63FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH808Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH809Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH80AZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH838Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH839Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JH83AZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JPT0FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JPT0PZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JPT3FZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JPT3FZ,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,0JPT3PZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JWT0PZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0JWT3PZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0N500ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N503ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N504ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N510ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N513ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N514ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N520ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N523ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N524ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N530ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N533ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N534ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N540ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N543ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N544ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N550ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N553ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N554ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N560ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N563ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N564ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N570ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N573ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N574ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N580ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N583ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N584ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N800ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N803ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N804ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N810ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N813ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N814ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N820ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N823ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N824ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N830ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N833ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N834ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N840ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N843ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N844ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N850ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N853ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N854ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N860ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N863ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N864ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N870ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N873ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N874ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N880ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N883ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0N884ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB00ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB03ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB04ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB23ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB33ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB43ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB53ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB63ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB83ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NB84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC23ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC24ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC33ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC34ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC43ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC44ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC53ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC54ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC63ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC64ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC73ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC74ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC83ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NC84ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH003Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH00MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH033Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH03MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH043Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NH04MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP000Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP004Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP005Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP007Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP00KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP00SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP030Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP034Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP037Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP03KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP03SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP040Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP044Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP047Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP04KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP04SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP0X4Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NP0XSZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT20ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT30ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT40ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT50ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT60ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT70ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NT80ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW000Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW004Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW005Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW007Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW00JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW00KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW00MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW00NZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW00SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW030Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW034Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW035Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW037Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW03JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW03KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW03MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW03SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW040Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW044Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW045Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW047Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW04JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW04KZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW04MZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0NW04SZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0Q820ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0Q823ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0Q824ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0Q833ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0Q834ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TF3XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TF4XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TF6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TF7XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TFBXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TFCXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TFDXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0TQB0ZZ,MATERNITY PER DIEM,,,11956.0,11956.0,1
ICD,0TQB3ZZ,MATERNITY PER DIEM,,,11956.0,11956.0,1
ICD,0TQB4ZZ,MATERNITY PER DIEM,,,11956.0,11956.0,1
ICD,0TQB7ZZ,MATERNITY PER DIEM,,,11956.0,11956.0,1
ICD,0TQB8ZZ,MATERNITY PER DIEM,,,11956.0,11956.0,1
ICD,0TQD0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TQD3ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TQD4ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TQD7ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TQD8ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TQDXZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0TY00Z0,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY00Z0,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY00Z0,General Transplant Services,,,51195.06,51195.06,15
ICD,0TY00Z0,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY00Z0,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY00Z0,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY00Z0,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z0,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z0,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z0,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY00Z0,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY00Z0,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,2
ICD,0TY00Z0,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,4
ICD,0TY00Z0,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY00Z0,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY00Z0,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0TY00Z0,Organ Transplants,,,,,0
ICD,0TY00Z0,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0TY00Z0,Other Transplant Services,,,51195.06,51195.06,15
ICD,0TY00Z0,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,6
ICD,0TY00Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,15
ICD,0TY00Z0,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY00Z0,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0TY00Z0,Transplant: Kidney/Pancreas,,,130000.0,130000.0,2
ICD,0TY00Z1,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY00Z1,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY00Z1,General Transplant Services,,,51195.06,51195.06,15
ICD,0TY00Z1,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY00Z1,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY00Z1,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY00Z1,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z1,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z1,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z1,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY00Z1,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY00Z1,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,2
ICD,0TY00Z1,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,4
ICD,0TY00Z1,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY00Z1,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY00Z1,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0TY00Z1,Organ Transplants,,,,,0
ICD,0TY00Z1,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0TY00Z1,Other Transplant Services,,,51195.06,51195.06,15
ICD,0TY00Z1,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,6
ICD,0TY00Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,15
ICD,0TY00Z1,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY00Z1,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0TY00Z1,Transplant: Kidney/Pancreas,,,130000.0,130000.0,2
ICD,0TY00Z2,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY00Z2,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY00Z2,General Transplant Services,,,51195.06,51195.06,13
ICD,0TY00Z2,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY00Z2,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY00Z2,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY00Z2,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z2,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY00Z2,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY00Z2,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY00Z2,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY00Z2,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY00Z2,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY00Z2,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0TY00Z2,Organ Transplants,,,,,0
ICD,0TY00Z2,Other Transplant Services,,,51195.06,51195.06,13
ICD,0TY00Z2,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,13
ICD,0TY00Z2,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY00Z2,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0TY10Z0,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY10Z0,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY10Z0,General Transplant Services,,,51195.06,51195.06,15
ICD,0TY10Z0,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY10Z0,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY10Z0,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY10Z0,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z0,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z0,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z0,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY10Z0,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY10Z0,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,2
ICD,0TY10Z0,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,4
ICD,0TY10Z0,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY10Z0,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY10Z0,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0TY10Z0,Organ Transplants,,,,,0
ICD,0TY10Z0,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0TY10Z0,Other Transplant Services,,,51195.06,51195.06,15
ICD,0TY10Z0,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,6
ICD,0TY10Z0,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,15
ICD,0TY10Z0,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY10Z0,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0TY10Z0,Transplant: Kidney/Pancreas,,,130000.0,130000.0,2
ICD,0TY10Z1,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY10Z1,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY10Z1,General Transplant Services,,,51195.06,51195.06,15
ICD,0TY10Z1,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY10Z1,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY10Z1,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY10Z1,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z1,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z1,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z1,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY10Z1,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY10Z1,Kidney/Pancreas Transplants Hospital Services,,,95000.0,95000.0,2
ICD,0TY10Z1,"Kidney/Pancreas, Transplant",,,161162.23,161162.23,4
ICD,0TY10Z1,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY10Z1,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY10Z1,"Lung/Kidney, Transplant",,,340920.66,340920.66,12
ICD,0TY10Z1,Organ Transplants,,,,,0
ICD,0TY10Z1,Organ Transplants - Simultaneous Kidney/Pancreas - Adult,,,40365.43,40365.43,1
ICD,0TY10Z1,Other Transplant Services,,,51195.06,51195.06,15
ICD,0TY10Z1,Simultaneous Pancreas/Kidney Transplant,,,361443.2,361443.2,6
ICD,0TY10Z1,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,15
ICD,0TY10Z1,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY10Z1,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0TY10Z1,Transplant: Kidney/Pancreas,,,130000.0,130000.0,2
ICD,0TY10Z2,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Cadaveric,,,32240.0,32240.0,2
ICD,0TY10Z2,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,2
ICD,0TY10Z2,General Transplant Services,,,51195.06,51195.06,12
ICD,0TY10Z2,"Heart/Kidney, Transplant",,,340920.66,340920.66,6
ICD,0TY10Z2,Kidney Living Related Donor Surgery,,,9243.0,9243.0,1
ICD,0TY10Z2,Kidney Transplant,,,156122.65,244575.91,8
ICD,0TY10Z2,"Kidney Transplant Services: Incomplete transplant, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z2,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate, Deceased Donor",,,37374.39,37374.39,2
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,2
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Deceased Donor",,,40365.43,40365.43,1
ICD,0TY10Z2,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,1
ICD,0TY10Z2,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,1
ICD,0TY10Z2,"Kidney ù Deceased and Living, Transplant",,,121491.72,121491.72,2
ICD,0TY10Z2,Liver/Kidney Transplant,,,631552.4,631552.4,3
ICD,0TY10Z2,"Liver/Kidney, Transplant",,,340920.66,340920.66,4
ICD,0TY10Z2,"Lung/Kidney, Transplant",,,340920.66,340920.66,10
ICD,0TY10Z2,Organ Transplants,,,,,0
ICD,0TY10Z2,Other Transplant Services,,,51195.06,51195.06,12
ICD,0TY10Z2,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,12
ICD,0TY10Z2,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,1
ICD,0TY10Z2,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,1
ICD,0UF5XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0UF6XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0UF7XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0UF9XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0UQ90ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQ93ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQ94ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQ97ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQ98ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQC0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQC3ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQC4ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQC7ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQC8ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQG0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQG3ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQG4ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQG7ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQG8ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQGXZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQM0ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0UQMXZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0W110J9,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W110JB,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W110JG,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W110JJ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W8NXZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0W9100Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W910ZX,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W910ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0W9D00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0W9D0ZX,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0W9D0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WC10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WC13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WC14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WCD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WCD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WCD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WF1XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WF3XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WF9XZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFBXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFCXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFD0ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WFD3ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WFD4ZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WFDXZZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WFGXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFJXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFPXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFQXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WFRXZZ,Lithotripsy,,,37156.17,37156.17,1
ICD,0WH103Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WH10YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WH133Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WH13YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WH143Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WH14YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WHD03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WHD0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WHD33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WHD3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WHD43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WHD4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WJ10ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WJ13ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WJ14ZZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WJD0ZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,0WJD0ZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,0WJD3ZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,0WJD3ZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,0WP100Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP101Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP10JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP10YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP130Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP131Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP13JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP13YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP140Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP141Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP14JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WP14YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WPD00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD01Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD31Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD41Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WPD4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WQNXZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,0WW100Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW101Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW103Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW10JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW10YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW130Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW131Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW133Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW13JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW13YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW140Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW141Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW143Z,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW14JZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WW14YZ,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,0WWD00Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD01Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD03Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD0YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD30Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD31Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD33Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD3YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD40Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD41Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD43Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,0WWD4YZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,10900ZC,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10903ZC,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10904ZC,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10907ZA,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10907ZC,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10908ZA,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10908ZC,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D00Z0,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D00Z0,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,36
ICD,10D00Z0,Maternity û C-Section,12964.0,8426.6,19659.11,30797.0,90
ICD,10D00Z0,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D00Z0,OB (mother only),,,1000.0,1000.0,1
ICD,10D00Z0,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,16
ICD,10D00Z1,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D00Z1,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,36
ICD,10D00Z1,Maternity û C-Section,12964.0,8426.6,19659.11,30797.0,90
ICD,10D00Z1,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D00Z1,OB (mother only),,,1000.0,1000.0,1
ICD,10D00Z1,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,16
ICD,10D00Z2,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D00Z2,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,36
ICD,10D00Z2,Maternity û C-Section,12964.0,8426.6,19659.11,30797.0,90
ICD,10D00Z2,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D00Z2,OB (mother only),,,1000.0,1000.0,1
ICD,10D00Z2,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z3,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z3,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z3,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z3,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D07Z3,OB (mother only),,,1000.0,1000.0,1
ICD,10D07Z3,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z4,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z4,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z4,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z4,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D07Z4,OB (mother only),,,1000.0,1000.0,1
ICD,10D07Z4,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z5,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z5,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z5,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z5,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D07Z5,OB (mother only),,,1000.0,1000.0,1
ICD,10D07Z5,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z6,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z6,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z6,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z6,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D07Z6,OB (mother only),,,1000.0,1000.0,1
ICD,10D07Z6,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z7,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z7,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z7,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z7,OB (mother and baby),,,1350.0,1350.0,1
ICD,10D07Z7,OB (mother only),,,1000.0,1000.0,1
ICD,10D07Z7,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,17
ICD,10D07Z8,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10D07Z8,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10D07Z8,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10D07Z8,OB (mother and baby),12964.0,8426.6,1350.0,1350.0,1
ICD,10D07Z8,OB (mother only),12964.0,8426.6,1000.0,1000.0,1
ICD,10D07Z8,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,16
ICD,10E0XZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10E0XZZ,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,38
ICD,10E0XZZ,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,90
ICD,10E0XZZ,OB (mother and baby),,,1350.0,1350.0,1
ICD,10E0XZZ,OB (mother only),,,1000.0,1000.0,1
ICD,10E0XZZ,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,16
ICD,10J07ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10S07ZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,10S0XZZ,MATERNITY PER DIEM,,,10775.0,11956.0,2
ICD,114,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,118,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,120,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,124,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,125,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,126,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,131,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,139,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,151,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,152,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,153,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,159,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16070,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16071,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16072,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16073,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16074,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16075,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16076,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16077,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16078,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16370,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16371,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16372,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16373,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16374,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16375,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16376,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16377,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16378,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16475,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,16476,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,1751,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1752,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1753,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1753,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,1754,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1754,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,1755,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1755,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,1756,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,1756,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,20932,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,20933,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,20934,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,210083,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210088,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210089,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210093,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210098,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210099,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210344,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210444,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210483,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210488,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210489,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210493,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210498,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,210499,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211083,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211088,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211089,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211093,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211098,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211099,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211344,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211444,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211483,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211488,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211489,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211493,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211498,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,211499,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,212083,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212088,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212089,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212093,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212098,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212099,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212344,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212444,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212483,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212488,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212489,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212493,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212498,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,212499,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213083,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213088,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213089,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213093,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213098,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213099,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213344,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213444,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213483,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213488,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213489,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213493,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213498,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,213499,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,220,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,221,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,222,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,22548,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22551,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22554,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22556,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22558,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22586,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22804,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,22812,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,234,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,242,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,243,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,270046,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,270046,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270056,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,270056,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270066,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,270066,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270076,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,270076,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270346,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270356,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270366,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270376,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270446,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270456,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270466,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,270476,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271046,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,271046,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271056,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,271056,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271066,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,271066,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271076,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,271076,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271346,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271356,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271366,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271376,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271446,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271456,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271466,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,271476,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272046,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,272046,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272056,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,272056,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272066,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,272066,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272076,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,272076,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272346,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272356,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272366,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272376,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272446,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272456,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272466,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,272476,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273046,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,273046,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273056,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,273056,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273066,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,273066,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273076,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,273076,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273346,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273356,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273366,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273376,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273446,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273456,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273466,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,273476,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,29866,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,29867,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,30230AZ,General Transplant Services,,,51195.06,51195.06,1
ICD,30230AZ,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230AZ,Other Transplant Services,,,51195.06,51195.06,1
ICD,30230G0,Autologous BMT,,,154963.84,154963.84,2
ICD,30230G0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30230G0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230G0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30230G0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30230G0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30230G0,General Transplant Services,,,51195.06,51195.06,2
ICD,30230G0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230G0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30230G1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30230G1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30230G1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30230G1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30230G1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230G1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30230G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30230G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30230G1,General Transplant Services,,,51195.06,51195.06,2
ICD,30230G1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230G1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30230X0,Autologous BMT,,,154963.84,154963.84,2
ICD,30230X0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230X0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30230X0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30230X0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30230X0,General Transplant Services,,,51195.06,51195.06,2
ICD,30230X0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230X0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30230X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,,,352797.12,352797.12,3
ICD,30230X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,,,433374.24,433374.24,3
ICD,30230X1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30230X1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30230X1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230X1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30230X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30230X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30230X1,General Transplant Services,,,51195.06,51195.06,2
ICD,30230X1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230X1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30230Y0,Autologous BMT,,,154963.84,154963.84,2
ICD,30230Y0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30230Y0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230Y0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30230Y0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30230Y0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30230Y0,General Transplant Services,,,51195.06,51195.06,2
ICD,30230Y0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230Y0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30230Y1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30230Y1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30230Y1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30230Y1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30230Y1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30230Y1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30230Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30230Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30230Y1,General Transplant Services,,,51195.06,51195.06,2
ICD,30230Y1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30230Y1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233AZ,General Transplant Services,,,51195.06,51195.06,1
ICD,30233AZ,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233AZ,Other Transplant Services,,,51195.06,51195.06,1
ICD,30233G0,Autologous BMT,,,154963.84,154963.84,2
ICD,30233G0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30233G0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233G0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30233G0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30233G0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30233G0,General Transplant Services,,,51195.06,51195.06,2
ICD,30233G0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233G0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233G1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30233G1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30233G1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30233G1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30233G1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233G1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30233G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30233G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30233G1,General Transplant Services,,,51195.06,51195.06,2
ICD,30233G1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233G1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233X0,Autologous BMT,,,154963.84,154963.84,2
ICD,30233X0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233X0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30233X0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30233X0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30233X0,General Transplant Services,,,51195.06,51195.06,2
ICD,30233X0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233X0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,,,352797.12,352797.12,3
ICD,30233X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,,,433374.24,433374.24,3
ICD,30233X1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30233X1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30233X1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233X1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30233X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30233X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30233X1,General Transplant Services,,,51195.06,51195.06,2
ICD,30233X1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233X1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233Y0,Autologous BMT,,,154963.84,154963.84,2
ICD,30233Y0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30233Y0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233Y0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30233Y0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30233Y0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30233Y0,General Transplant Services,,,51195.06,51195.06,2
ICD,30233Y0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233Y0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30233Y1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30233Y1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30233Y1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30233Y1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30233Y1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30233Y1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30233Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30233Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30233Y1,General Transplant Services,,,51195.06,51195.06,2
ICD,30233Y1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30233Y1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240AZ,General Transplant Services,,,51195.06,51195.06,1
ICD,30240AZ,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240AZ,Other Transplant Services,,,51195.06,51195.06,1
ICD,30240G0,Autologous BMT,,,154963.84,154963.84,2
ICD,30240G0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30240G0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240G0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30240G0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30240G0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30240G0,General Transplant Services,,,51195.06,51195.06,2
ICD,30240G0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240G0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240G1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30240G1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30240G1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30240G1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30240G1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240G1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30240G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30240G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30240G1,General Transplant Services,,,51195.06,51195.06,2
ICD,30240G1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240G1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240X0,Autologous BMT,,,154963.84,154963.84,2
ICD,30240X0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240X0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30240X0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30240X0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30240X0,General Transplant Services,,,51195.06,51195.06,2
ICD,30240X0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240X0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,,,352797.12,352797.12,3
ICD,30240X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,,,433374.24,433374.24,3
ICD,30240X1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30240X1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30240X1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240X1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30240X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30240X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30240X1,General Transplant Services,,,51195.06,51195.06,2
ICD,30240X1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240X1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240Y0,Autologous BMT,,,154963.84,154963.84,2
ICD,30240Y0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30240Y0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240Y0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30240Y0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30240Y0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30240Y0,General Transplant Services,,,51195.06,51195.06,2
ICD,30240Y0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240Y0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30240Y1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30240Y1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30240Y1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30240Y1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30240Y1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30240Y1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30240Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30240Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30240Y1,General Transplant Services,,,51195.06,51195.06,2
ICD,30240Y1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30240Y1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243AZ,General Transplant Services,,,51195.06,51195.06,1
ICD,30243AZ,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243AZ,Other Transplant Services,,,51195.06,51195.06,1
ICD,30243G0,Autologous BMT,,,154963.84,154963.84,2
ICD,30243G0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30243G0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243G0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30243G0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30243G0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30243G0,General Transplant Services,,,51195.06,51195.06,2
ICD,30243G0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243G0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243G1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30243G1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30243G1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30243G1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30243G1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243G1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30243G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30243G1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30243G1,General Transplant Services,,,51195.06,51195.06,2
ICD,30243G1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243G1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243X0,Autologous BMT,,,154963.84,154963.84,2
ICD,30243X0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243X0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30243X0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30243X0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30243X0,General Transplant Services,,,51195.06,51195.06,2
ICD,30243X0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243X0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Related,,,352797.12,352797.12,3
ICD,30243X1,Allogeneic Bone Marrow/Stem Cell/Cord Blood-Unrelated,,,433374.24,433374.24,3
ICD,30243X1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30243X1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30243X1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243X1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30243X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30243X1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30243X1,General Transplant Services,,,51195.06,51195.06,2
ICD,30243X1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243X1,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243Y0,Autologous BMT,,,154963.84,154963.84,2
ICD,30243Y0,Autologous Bone Marrow/Stem Cell (Single),,,233190.89,233190.89,3
ICD,30243Y0,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243Y0,Autologous/Autologous BMT (tandems),,,223148.18,223148.18,2
ICD,30243Y0,Bone Marrow Transplants Autologous,,,105000.0,105000.0,1
ICD,30243Y0,Bone Marrow or Peripheral Stem Cell Transplant Services - Autologous,,,120000.0,120000.0,1
ICD,30243Y0,General Transplant Services,,,51195.06,51195.06,2
ICD,30243Y0,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243Y0,Other Transplant Services,,,51195.06,51195.06,2
ICD,30243Y1,Allogeneic Bone Marrow/Stem Cell- Related,,,352797.12,352797.12,3
ICD,30243Y1,Allogeneic Bone Marrow/Stem Cell-Unrelated,,,433374.24,433374.24,3
ICD,30243Y1,Allogeneic Related BMT,,,223148.18,223148.18,2
ICD,30243Y1,Allogeneic Unrelated BMT (including cord blood),,,272736.32,272736.32,2
ICD,30243Y1,Autologous/Allogeneic BMT (tandems),,,223148.18,223148.18,2
ICD,30243Y1,Bone Marrow Transplants Hospital Services-Allogeneic,,,115000.0,115000.0,1
ICD,30243Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Related Donor, Allogenic",,,140000.0,140000.0,1
ICD,30243Y1,"Bone Marrow or Peripheral Stem Cell Transplant Services - Unrelated Donor, Allogenic",,,160000.0,160000.0,1
ICD,30243Y1,General Transplant Services,,,51195.06,51195.06,2
ICD,30243Y1,Hematopoietic Cell Transplant - Adult,,,12954.42,12954.42,1
ICD,30243Y1,Other Transplant Services,,,51195.06,51195.06,2
ICD,31382,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3241,Lung Lobectomy,,,18000.0,18000.0,1
ICD,32480,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,32482,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3249,Lung Lobectomy,,,18000.0,18000.0,1
ICD,32491,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,32851,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,32852,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,32853,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,32854,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33289,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33362,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33363,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33364,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33365,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33390,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33391,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33406,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33410,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33411,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33412,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33413,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33414,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33415,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33416,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33417,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33418,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33419,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33425,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33426,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33427,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33430,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33440,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33460,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33465,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33468,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33474,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33475,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33478,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33496,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,335,Transplants Lung,,,148434.5,148434.5,1
ICD,33500,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33504,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33505,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33506,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3351,Transplants Lung,,,148434.5,148434.5,1
ICD,33511,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33512,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33513,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33514,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33516,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33518,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33519,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3352,Transplants Lung,,,148434.5,148434.5,1
ICD,33521,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33522,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33523,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33530,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33534,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33535,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33536,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,336,Transplants Heart & Lung,,,129944.1,129944.1,1
ICD,3360,Transplants Heart & Lung,,,129944.1,129944.1,1
ICD,33608,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33610,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33611,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33612,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33615,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33617,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33619,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33622,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33641,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33647,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33660,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33665,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33670,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33675,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33676,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33677,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33681,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33684,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33688,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33692,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33694,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33697,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33702,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33710,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33720,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33726,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33730,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33770,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33771,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33774,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33775,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33776,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33777,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33778,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33779,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33780,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33781,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33782,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33783,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33786,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33814,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33840,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33845,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33851,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33852,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33853,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33858,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33859,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33863,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33864,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33866,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33871,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33875,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33877,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33910,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33916,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33917,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33920,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33927,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33928,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,33929,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34841,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34842,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34843,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34844,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34845,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34846,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34847,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,34848,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3500,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3501,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3502,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3503,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3504,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3505,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3505,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3506,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3506,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3507,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3507,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3508,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3508,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3509,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3509,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3510,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3510,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3511,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3511,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3512,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3512,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3513,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3513,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3514,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3514,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3518,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3519,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3520,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3520,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3521,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3521,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,35211,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3522,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3522,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3523,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3523,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3524,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3524,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,35241,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3525,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3525,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3526,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3526,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3527,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3527,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,35271,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,3528,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3528,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3529,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3530,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3530,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3531,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3531,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3532,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3532,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3533,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3533,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3534,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3534,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3535,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3535,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3536,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3538,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3539,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3539,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3540,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3541,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3541,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3542,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3542,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3543,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3544,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3545,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3548,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3549,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3550,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3550,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3551,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3551,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3552,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3552,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3553,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3553,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3554,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3554,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3555,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3555,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3556,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3558,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3559,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3560,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3560,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3561,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3561,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3562,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3562,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3563,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3563,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3564,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3568,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3569,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3570,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3570,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3571,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3571,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3572,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3572,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3573,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3573,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3574,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3575,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3576,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3577,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3579,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3581,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3581,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3582,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3582,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3583,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3583,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3584,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3584,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3588,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3589,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3590,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3591,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3591,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3592,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3592,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3593,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3593,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3594,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3594,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3595,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3595,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3596,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,3596,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,3598,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3598,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3599,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3599,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3603,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3603,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3606,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,3606,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,3607,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,3607,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,3609,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,3609,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,3610,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3610,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3611,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3611,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3612,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3612,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3613,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3613,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3614,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3614,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3615,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3615,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3616,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3616,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3617,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3617,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3619,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3619,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3620,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3629,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3631,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3631,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3632,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3632,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3633,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3634,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3638,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3639,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3639,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3643,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3649,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3659,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3668,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3669,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3670,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3671,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3674,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3679,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3682,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3688,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3689,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3691,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3691,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3693,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3694,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3698,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3699,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3699,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,370376,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,3708,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3709,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3710,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3710,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3711,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3711,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3712,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3712,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3720,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3721,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,3722,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,3723,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,3724,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3731,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3731,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3732,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3732,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3733,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3733,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3735,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3735,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3736,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3736,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3737,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3738,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3739,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3741,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3741,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3749,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3749,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,375,Transplants Heart,,,129944.1,129944.1,1
ICD,3750,Transplants Heart,,,129944.1,129944.1,1
ICD,3751,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3751,Transplants Heart,,,129944.1,129944.1,1
ICD,3752,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3752,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3753,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3753,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3754,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3754,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3755,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3755,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3759,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3760,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3760,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3761,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3761,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3762,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3762,Ventricular Assist Device,,,129944.1,129944.1,1
ICD,3763,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3763,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3764,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3764,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3765,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3765,Ventricular Assist Device,,,129944.1,129944.1,1
ICD,3766,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3766,Ventricular Assist Device,,,129944.1,129944.1,1
ICD,3767,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3767,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3768,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3768,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3791,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3791,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3794,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3795,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3796,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3797,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3798,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3799,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3799,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3804,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3805,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3806,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3807,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3814,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3815,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3816,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3823,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3824,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3826,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3826,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3834,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3835,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3836,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3837,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3844,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3844,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3845,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3846,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3847,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3855,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3864,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3865,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3866,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3867,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3881,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,3884,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3885,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3886,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3887,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,390,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,390,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,391,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,392,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3921,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3922,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3923,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3924,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3925,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3926,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3928,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,393,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,3950,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,3951,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,3952,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,3952,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3953,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,3954,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3961,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3962,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3963,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3964,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3965,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3965,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3966,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3971,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3972,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3973,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3973,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3974,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3975,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3976,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3977,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3977,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3977,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3978,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3978,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3978,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,3979,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3999,Cardiac Open Heart Surgery,,,17000.0,17000.0,1
ICD,3E053KZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,3E063KZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,3E080GC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,3E083GC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,401,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,410,Transplants Bone Marrow Stem Cell,,,62541.63,62541.63,1
ICD,4100,Transplants Bone Marrow Stem Cell,,,62541.63,62541.63,1
ICD,4101,Transplants Bone Marrow Autologous,,,62541.63,62541.63,1
ICD,4102,Transplants Bone Marrow Allogeneic,,,137782.87,137782.87,1
ICD,4103,Transplants Bone Marrow Allogeneic,,,137782.87,137782.87,1
ICD,4104,Transplants Bone Marrow Autologous,,,62541.63,62541.63,1
ICD,4105,Transplants Bone Marrow Allogeneic,,,137782.87,137782.87,1
ICD,4106,Transplants Bone Marrow Stem Cell,,,62541.63,62541.63,1
ICD,4107,Transplants Bone Marrow Autologous,,,62541.63,62541.63,1
ICD,4108,Transplants Bone Marrow Allogeneic,,,137782.87,137782.87,1
ICD,4109,Transplants Bone Marrow Autologous,,,62541.63,62541.63,1
ICD,4382,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,4382,Bariatric Surgery,,,32398.14,50753.04,5
ICD,441,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,4431,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,4431,Bariatric Surgery,,,32398.14,50753.04,5
ICD,4438,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,4438,Bariatric Surgery,,,32398.14,50753.04,5
ICD,4439,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,4439,Bariatric Surgery,,,32398.14,50753.04,5
ICD,445,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,445,Bariatric Surgery,,,32398.14,50753.04,5
ICD,4468,BARIATRIC SURGERY (GASTRIC BYPASS),,,37520.0,41627.0,2
ICD,4468,Bariatric Surgery,,,32398.14,50753.04,5
ICD,470041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,470341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,470441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,471041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,471341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,47135,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,471441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,472041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,472341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,472441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,473041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,473341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,473441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,474041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,474341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,474441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,475041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,475341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,475441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,47562,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,47563,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,47564,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,47570,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,476041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,476341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,476441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,477041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,477341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,477441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,478041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,478341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,478441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,479041,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,479341,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,479441,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,4A0234Z,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A023FZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,4A023FZ,Electro Physiology Services,,,24237.78,37966.58,5
ICD,4A023FZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A023FZ,Electrophysiology Diagnostic Studies,,,25837.82,25837.82,2
ICD,4A023PZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A0274Z,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A0279Z,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027CZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027FZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,4A027FZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027HZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027N6,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,4A027N6,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027N7,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,4A027N8,CARDIAC CATHETERIZATION,,,31750.0,35222.0,2
ICD,4A027N8,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027NZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A027PZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A0284Z,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A0289Z,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028CZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028FZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,4A028FZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028HZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028N6,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028N7,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028N8,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A028PZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A02X4Z,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,4A02XFZ,ELECTROPHYSIOLOGIC STUDIES,,,29150.0,32339.0,2
ICD,4A02XFZ,Electrophysiological Studies,,,46267.76,62690.43,2
ICD,4A030B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A030BC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A030BF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A033B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A033BC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A033BF,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A040B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A040B3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A043B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A043B3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A130BC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A133BC,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A140B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A140B3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A143B1,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,4A143B3,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,505,Transplants Liver,,,53455.24,53455.24,1
ICD,5050,Transplants Liver,,,53455.24,53455.24,1
ICD,5051,Transplants Liver,,,53455.24,53455.24,1
ICD,5059,Transplants Liver,,,53455.24,53455.24,1
ICD,50590,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,51,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,51597,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,528,Transplants Pancreas,,,82460.18,82460.18,1
ICD,5280,Transplants Pancreas,,,82460.18,82460.18,1
ICD,5282,Transplants Pancreas,,,82460.18,82460.18,1
ICD,5283,Transplants Pancreas,,,82460.18,82460.18,1
ICD,54,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,55,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,556,Transplants Kidney,,,37374.39,37374.39,1
ICD,5560,Transplants Kidney,,,37374.39,37374.39,1
ICD,5569,Transplants Kidney,,,37374.39,37374.39,1
ICD,55875,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,58,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,58210,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,58240,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,59,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A02110,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A02116,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A0211D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A02210,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A02216,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A0221D,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1213Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1221Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1223Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1522F,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1522G,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,5A1522H,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,61,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,61615,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,61616,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,61796,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,61798,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,62,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,63,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,63620,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,64,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,65,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,66,Coronary Angioplasty,,,6000.0,6000.0,1
ICD,66,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
ICD,67,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,68,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,69,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,761,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,762,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,763,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,764,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,765,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
ICD,8E023DZ,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,92920,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92924,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92928,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92933,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92937,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92941,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92943,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92992,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,92993,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93454,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93455,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93456,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93457,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93458,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93459,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93460,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93461,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93462,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93531,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93532,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93533,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93650,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93653,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93654,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93655,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93656,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,93657,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,B221Z2Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,B223Z2Z,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,B244YZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B244YZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B244ZZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B244ZZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B245YZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B245YZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B245ZZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B245ZZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B246YZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B246YZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B246ZZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B246ZZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B24DYZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B24DYZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,B24DZZZ,Eps & Other Diagnostic Procedures,,,25837.82,25837.82,2
ICD,B24DZZZ,Intracardiac Echocardiography and Other Diagnostic Procedures on Heart and Pericardium,,,24237.78,62690.43,7
ICD,C9758,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,C9760,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,G0339,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,G0340,Outpatient Surgery Group 9 Global Rate,,,39072.0,39072.0,1
ICD,O47.00,False Labor,,,6066.88,6492.24,18
ICD,O47.01,False Labor,,,6066.88,6492.24,18
ICD,O47.02,False Labor,,,6066.88,6492.24,18
ICD,O47.03,False Labor,,,6066.88,6492.24,18
ICD,O47.1,False Labor,,,6066.88,6492.24,18
ICD,O47.9,False Labor,,,6066.88,6492.24,18
ICD,X2C0361,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2C0361,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,X2C1361,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2C1361,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,X2C2361,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2C2361,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,X2C3361,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2C3361,ENDOVASCULAR CVS,,,54839.0,60837.0,2
ICD,X2CP3T7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2CY3T7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2RF032,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2RF332,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2RF432,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2RX0N7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2V73Q7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,X2VW0N7,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
ICD,XW033A7,CAR-T Cell Therapy,,,,,0
ICD,XW033A7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033C7,CAR-T Cell Therapy,,,,,0
ICD,XW033C7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033G7,CAR-T Cell Therapy,,,,,0
ICD,XW033G7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033H7,CAR-T Cell Therapy,,,,,0
ICD,XW033H7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033J7,CAR-T Cell Therapy,,,,,0
ICD,XW033J7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033K7,CAR-T Cell Therapy,,,,,0
ICD,XW033K7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033M7,CAR-T Cell Therapy,,,,,0
ICD,XW033M7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW033N7,CAR-T Cell Therapy,,,,,0
ICD,XW033N7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043A7,CAR-T Cell Therapy,,,,,0
ICD,XW043A7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043C7,CAR-T Cell Therapy,,,,,0
ICD,XW043C7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043G7,CAR-T Cell Therapy,,,,,0
ICD,XW043G7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043H7,CAR-T Cell Therapy,,,,,0
ICD,XW043H7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043J7,CAR-T Cell Therapy,,,,,0
ICD,XW043J7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043K7,CAR-T Cell Therapy,,,,,0
ICD,XW043K7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043M7,CAR-T Cell Therapy,,,,,0
ICD,XW043M7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,XW043N7,CAR-T Cell Therapy,,,,,0
ICD,XW043N7,Cellular Immunotherapy Hospital Services,,,150960.0,185700.0,3
ICD,Z524,Adult Kidney - Transplant Event: Combined Hospital and Professional Services - Living,,,37440.0,37440.0,12
ICD,Z524,General Transplant Services,,,51195.06,51195.06,6
ICD,Z524,Kidney Living Related Donor Surgery,,,9243.0,9243.0,6
ICD,Z524,Kidney Transplant,,,228246.0,228246.0,18
ICD,Z524,"Kidney Transplant Services: Incomplete transplant, Living Donor",,,37374.39,37374.39,12
ICD,Z524,"Kidney Transplant Services: Transplant Case Rate for Single-Organ Kidney Transplants Only, Living Donor",,,40365.43,40365.43,6
ICD,Z524,"Kidney Transplant Services: Transplant Case Rate, Living Donor",,,37374.39,37374.39,12
ICD,Z524,"Kidney Transplant Services: Transplant Case Rate, excluding Single-Organ Kidney, Living Donor",,,40365.43,40365.43,6
ICD,Z524,Kidney Transplants Hospital Services û Recipient,,,34000.0,34000.0,6
ICD,Z524,Kidney Transplants Living donor,,,18000.0,18000.0,1
ICD,Z524,Liver Living Related Donor Surgery,,,54427.0,54427.0,2
ICD,Z524,Organ Transplants,,,,,0
ICD,Z524,Other Transplant Services,,,51195.06,51195.06,6
ICD,Z524,Single-Organ Kidney and Corneal Transplants,,,40365.43,40365.43,6
ICD,Z524,"Transplant: Kidney, Living Donor",,,103000.0,103000.0,6
ICD,Z525,Liver/Kidney Transplant,,,631552.4,631552.4,18
ICD,Z525,"Transplant: Kidney, Cadaveric Donor",,,103000.0,103000.0,6
ICD,Z528,General Transplant Services,,,51195.06,51195.06,6
ICD,Z528,Lung Living Related Donor Surgery,,,56109.0,56109.0,6
ICD,Z528,Other Transplant Services,,,51195.06,51195.06,6
LOCAL,PRC020,ENDOVASCULAR CVS,,,54839.0,60837.0,2
LOCAL,PRC030,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
LOCAL,PRCC01,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC02,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC05,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC06,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC08,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC12,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC16,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
LOCAL,PRCC33,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC34,CARDIO VASCULAR SURGERY,,,54839.0,60837.0,2
LOCAL,PRCC35,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
LOCAL,PRCC36,PTCA - PERCUTANEOUS TRANSLUMINALCORONARY ANGIO,,,41639.0,46195.0,2
LOCAL,PRCN06,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
LOCAL,PRCN09,CRANIOTOMY/NEUROSURGERY,,,51228.0,56834.0,2
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,320653.27,556778.85,9
MS-DRG,001,Heart Retransplant - up to one year from previous transplant,,,95710.0,95710.0,1
MS-DRG,001,Heart Transplant,,,191422.0,191422.0,1
MS-DRG,001,Heart Transplant Or Implant Of Heart Assist System With Mcc,,,314240.2,320653.27,5
MS-DRG,001,Heart-Lung,,,274368.0,274368.0,1
MS-DRG,001,Heart-Lung Retransplant - up to one year from previous transplant,,,136635.0,136635.0,1
MS-DRG,001,Pediatric and Neonatal Services: VENTRICULAR ASSIST DEVICE (VAD),3217.9,2091.63,,,0
MS-DRG,001,Surgical,,,22870.31,24470.51,3
MS-DRG,001,VENTRICULAR ASSIST DEVICE (VAD),999.0,649.35,,,0
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,129944.1,225140.2,9
MS-DRG,002,Heart Retransplant - up to one year from previous transplant,,,95710.0,95710.0,1
MS-DRG,002,Heart Transplant,,,191422.0,191422.0,1
MS-DRG,002,Heart Transplant Or Implant Of Heart Assist System Without Mcc,,,127345.22,129944.1,5
MS-DRG,002,Heart-Lung,,,274368.0,274368.0,1
MS-DRG,002,Heart-Lung Retransplant - up to one year from previous transplant,,,136635.0,136635.0,1
MS-DRG,002,Pediatric and Neonatal Services: VENTRICULAR ASSIST DEVICE (VAD),3217.9,2091.63,,,0
MS-DRG,002,Surgical,,,22870.31,24470.51,3
MS-DRG,002,VENTRICULAR ASSIST DEVICE (VAD),64536.75,41948.89,,,0
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE",,,242977.33,499280.38,10
MS-DRG,003,"Ecmo Or Tracheostomy With Mv >96 Hours Or Pdx Except Face, Mouth And Neck With Major O.R. Procedure",,,238117.79,242977.33,5
MS-DRG,003,Pediatric and Neonatal Services: Extracorporeal Membrane Oxygenation (ECMO),,,16700.0,16700.0,1
MS-DRG,003,Surgical,,,22870.31,24470.51,3
MS-DRG,004,Surgical,,,22870.31,24470.51,3
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE",,,158730.82,325826.48,10
MS-DRG,004,"Tracheostomy With Mv >96 Hours Or Pdx Except Face, Mouth And Neck Without Major O.R. Procedure",,,155556.2,158730.82,5
MS-DRG,005,Cadaveric Liver,,,204621.0,204621.0,1
MS-DRG,005,Cadaveric Liver/Kidney,,,257246.0,257246.0,1
MS-DRG,005,General Transplant Services,,,118275.63,118275.63,1
MS-DRG,005,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,118275.63,204849.01,9
MS-DRG,005,Liver Living Related Donor Surgery,,,54427.0,54427.0,1
MS-DRG,005,Liver Retransplant - up to one year from previous transplant,,,102306.0,102306.0,1
MS-DRG,005,Liver Transplant With Mcc Or Intestinal Transplant,,,115910.11,118275.63,5
MS-DRG,005,Liver/Kidney Retransplant - up to one year from previous transplant,,,128716.0,128716.0,1
MS-DRG,005,Other Transplant Services,,,118275.63,118275.63,1
MS-DRG,005,Surgical,,,22870.31,24470.51,3
MS-DRG,006,Cadaveric Liver,,,204621.0,204621.0,1
MS-DRG,006,Cadaveric Liver/Kidney,,,257246.0,257246.0,1
MS-DRG,006,General Transplant Services,,,53455.24,53455.24,1
MS-DRG,006,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,53455.24,92127.92,9
MS-DRG,006,Liver Living Related Donor Surgery,,,54427.0,54427.0,1
MS-DRG,006,Liver Retransplant - up to one year from previous transplant,,,102306.0,102306.0,1
MS-DRG,006,Liver Transplant Without Mcc,,,52386.13,53455.24,5
MS-DRG,006,Liver/Kidney Retransplant - up to one year from previous transplant,,,128716.0,128716.0,1
MS-DRG,006,Other Transplant Services,,,53455.24,53455.24,1
MS-DRG,006,Surgical,,,22870.31,24470.51,3
MS-DRG,007,Heart-Lung,,,274368.0,274368.0,1
MS-DRG,007,Heart-Lung Retransplant - up to one year from previous transplant,,,136635.0,136635.0,1
MS-DRG,007,LUNG TRANSPLANT,,,148434.5,257294.57,9
MS-DRG,007,Lung Retransplant - up to one year from previous transplant,,,105612.0,105612.0,1
MS-DRG,007,Lung Transplant,,,145465.81,148434.5,5
MS-DRG,007,"Lung: Single, Double Lobar, Double Lobar (Living Related)",,,211222.0,211222.0,1
MS-DRG,007,Surgical,,,22870.31,24470.51,3
MS-DRG,008,Cadaveric Kidney/Pancreas,,,233665.0,233665.0,1
MS-DRG,008,General Transplant Services,,,64510.18,64510.18,1
MS-DRG,008,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,008,Kidney/Pancreas Retransplant - up to one year from previous transplant,,,116833.0,116833.0,1
MS-DRG,008,Other Transplant Services,,,64510.18,64510.18,1
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,64510.18,111352.19,9
MS-DRG,008,Simultaneous Pancreas And Kidney Transplant,,,63219.97,64510.18,5
MS-DRG,008,Surgical,,,22870.31,24470.51,3
MS-DRG,010,PANCREAS TRANSPLANT,,,82460.18,168793.99,10
MS-DRG,010,Pancreas Transplant,,,80810.97,82460.18,5
MS-DRG,010,Surgical,,,22870.31,24470.51,3
MS-DRG,011,Surgical,,,22870.31,24470.51,3
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,62790.7,128296.79,10
MS-DRG,011,"Tracheostomy For Face, Mouth & Neck Diagnoses Or Laryngectomy With Mcc",,,61534.88,62790.7,5
MS-DRG,012,Surgical,,,22870.31,24470.51,3
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,48645.26,99172.97,10
MS-DRG,012,"Tracheostomy For Face, Mouth & Neck Diagnoses Or Laryngectomy With Cc",,,47672.36,48645.26,5
MS-DRG,013,Surgical,,,22870.31,24470.51,3
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,33401.87,67788.58,10
MS-DRG,013,"Tracheostomy For Face, Mouth & Neck Diagnoses Or Laryngectomy Without Cc/Mcc",,,32733.84,33401.87,5
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,137782.87,238771.64,9
MS-DRG,014,Allogeneic Bone Marrow Transplant,,,135027.21,137782.87,5
MS-DRG,014,Allogeneic Haploidentical Hematopoietic Stem Cell Transplantation (HSCT),,,249480.0,249480.0,1
MS-DRG,014,Bone Marrow Allogeneic Matched Related Donor,,,209819.0,209819.0,1
MS-DRG,014,Bone Marrow Allogeneic Matched Related Donor Retransplant - up toone year from previous transplant,,,104909.0,104909.0,1
MS-DRG,014,Bone Marrow Allogeneic Matched Unrelated Donor Retransplant - up to one year from previous transplant,,,127861.0,127861.0,1
MS-DRG,014,Bone Marrow Allogeneic MatchedUnrelated Donor,,,249480.0,249480.0,1
MS-DRG,014,General Transplant Services,,,137782.87,137782.87,1
MS-DRG,014,HSCT Retransplant - up to one year from previous transplant,,,127861.0,127861.0,1
MS-DRG,014,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,014,Medical,,,13041.13,13953.63,3
MS-DRG,014,Other Transplant Services,,,137782.87,137782.87,1
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC OR T-CELL IMMUNOTHERAPY,,,68224.48,117811.28,9
MS-DRG,016,Autologous Bone Marrow Transplant With Cc/Mcc Or T-Cell Immunotherapy,,,66859.99,68224.48,5
MS-DRG,016,Bone Marrow Autologous,,,157365.0,157365.0,1
MS-DRG,016,Bone Marrow Autologous Retransplant - up to one year from previous transplant,,,78682.0,78682.0,1
MS-DRG,016,General Transplant Services,,,68224.48,68224.48,1
MS-DRG,016,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,016,Medical,,,13041.13,13953.63,3
MS-DRG,016,Other Transplant Services,,,68224.48,68224.48,1
MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,62541.63,107928.94,9
MS-DRG,017,Autologous Bone Marrow Transplant Without Cc/Mcc,,,61290.8,62541.63,5
MS-DRG,017,Bone Marrow Autologous,,,157365.0,157365.0,1
MS-DRG,017,Bone Marrow Autologous Retransplant - up to one year from previous transplant,,,78682.0,78682.0,1
MS-DRG,017,General Transplant Services,,,62541.63,62541.63,1
MS-DRG,017,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,017,Medical,,,13041.13,13953.63,3
MS-DRG,017,Other Transplant Services,,,62541.63,62541.63,1
MS-DRG,018,"CAR-T - Pharmaceutical Carve Out YESCARTA and/or TECARTUS, and other cell therapies",1731275.0,1125328.75,,,0
MS-DRG,018,Medical,,,13041.13,13953.63,3
MS-DRG,019,Surgical,,,22870.31,24470.51,3
MS-DRG,020,INTRACRA VASC PROC W PDX HEMOR W MCC,,,103825.85,140683.62,2
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITH MCC,,,90378.92,156337.32,9
MS-DRG,020,Intracranial Vascular Procedures With Pdx Hemorrhage With Mcc,,,88571.34,90378.92,5
MS-DRG,020,Neurosurgery,,,105615.0,105615.0,1
MS-DRG,020,Surgical,,,22870.31,24470.51,3
MS-DRG,021,INTRACRA VASC PROC W PDX HEMOR W CC,,,103825.85,140683.62,2
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITH CC,,,60959.25,105177.22,9
MS-DRG,021,Intracranial Vascular Procedures With Pdx Hemorrhage With Cc,,,59740.07,60959.25,5
MS-DRG,021,Neurosurgery,,,105615.0,105615.0,1
MS-DRG,021,Surgical,,,22870.31,24470.51,3
MS-DRG,022,INTRACRA VASC PROC W PDX HEM WO CC/MCC,,,103825.85,140683.62,2
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITHOUT CC/MCC,,,36779.14,63128.58,9
MS-DRG,022,Intracranial Vascular Procedures With Pdx Hemorrhage Without Cc/Mcc,,,36043.55,36779.14,5
MS-DRG,022,Neurosurgery,,,105615.0,105615.0,1
MS-DRG,022,Surgical,,,22870.31,24470.51,3
MS-DRG,023,CRA W MAJ DEV IMPorACU COM CNS PDX wMCC,,,103825.85,140683.62,2
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,65946.31,113849.6,9
MS-DRG,023,Craniotomy With Major Device Implant Or Acute Complex Cns Pdx With Mcc Or Chemotherapy Implant Or Epilepsy With Neurostimulator,,,64627.39,65946.31,5
MS-DRG,023,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,023,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,023,Surgical,,,22870.31,24470.51,3
MS-DRG,024,CRA W MAJ DEV IMP/ACU COM CNSPDX woMCC,,,103825.85,140683.62,2
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX WITHOUT MCC,,,45170.88,77721.63,9
MS-DRG,024,Craniotomy With Major Device Implant Or Acute Complex Cns Pdx Without Mcc,,,44267.47,45170.88,5
MS-DRG,024,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,024,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,024,Surgical,,,22870.31,24470.51,3
MS-DRG,025,CRAN AND ENDOVASC INTRA PROC W MCC,,,103825.85,140683.62,2
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,52423.55,90333.84,9
MS-DRG,025,Craniotomy And Endovascular Intracranial Procedures With Mcc,,,51375.08,52423.55,5
MS-DRG,025,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,025,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,025,Surgical,,,22870.31,24470.51,3
MS-DRG,026,CRAN/ENDO/INTRACR PROC W CC,,,103825.85,140683.62,2
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,35999.94,61773.59,9
MS-DRG,026,Craniotomy And Endovascular Intracranial Procedures With Cc,,,35279.95,35999.94,5
MS-DRG,026,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,026,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,026,Surgical,,,22870.31,24470.51,3
MS-DRG,027,CRAN/ENDO/INTRACR PROC WO CC/MCC,,,103825.85,140683.62,2
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,29301.4,50124.98,9
MS-DRG,027,Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc,,,28715.37,29301.4,5
MS-DRG,027,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,027,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,027,Surgical,,,22870.31,24470.51,3
MS-DRG,028,Neurosurgery,,,105615.0,105615.0,1
MS-DRG,028,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,028,SPINAL PROCEDURES W MCC,,,88784.16,120304.46,2
MS-DRG,028,SPINAL PROCEDURES WITH MCC,,,69122.5,119372.9,9
MS-DRG,028,Spinal Procedures With Mcc,,,67740.05,69122.5,5
MS-DRG,028,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,028,Surgical,,,22870.31,24470.51,3
MS-DRG,029,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,029,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,029,SPINAL PROCEDURES W CC,,,88784.16,120304.46,2
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,39454.9,67781.67,9
MS-DRG,029,Spinal Procedures With Cc Or Spinal Neurostimulators,,,38665.8,39454.9,5
MS-DRG,029,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,029,Surgical,,,22870.31,24470.51,3
MS-DRG,030,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,030,SPINAL PROCEDURES W/O CC/MCC,,,88784.16,120304.46,2
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,25557.39,51637.69,10
MS-DRG,030,Spinal Procedures Without Cc/Mcc,,,25046.24,25557.39,5
MS-DRG,030,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,030,Surgical,,,22870.31,24470.51,3
MS-DRG,031,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,031,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,031,Surgical,,,22870.31,24470.51,3
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES W MCC,,,103825.85,140683.62,2
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,51667.21,89018.57,9
MS-DRG,031,Ventricular Shunt Procedures With Mcc,,,50633.86,51667.21,5
MS-DRG,032,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,032,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,032,Surgical,,,22870.31,24470.51,3
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES W CC,,,103825.85,140683.62,2
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,24823.9,42338.71,9
MS-DRG,032,Ventricular Shunt Procedures With Cc,,,24327.42,24823.9,5
MS-DRG,033,Neurosurgery,,,54913.12,105615.0,8
MS-DRG,033,Pediatric and Neonatal Services: Neurosurgical Services,,,8620.0,8620.0,1
MS-DRG,033,Surgical,,,22870.31,24470.51,3
MS-DRG,033,VENTRICULAR SHUNT PROC W/O CC/MCC,,,103825.85,140683.62,2
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,19475.8,33038.5,9
MS-DRG,033,Ventricular Shunt Procedures Without Cc/Mcc,,,19086.28,19475.8,5
MS-DRG,034,CAROTID ARTERY STENT PROCEDURE WITH MCC,,,44700.17,91050.48,10
MS-DRG,034,Carotid Artery Stent Procedure With Mcc,,,43806.17,44700.17,5
MS-DRG,034,Surgical,,,22870.31,24470.51,3
MS-DRG,035,CAROTID ARTERY STENT PROCEDURE WITH CC,,,27788.71,56231.73,10
MS-DRG,035,Carotid Artery Stent Procedure With Cc,,,27232.94,27788.71,5
MS-DRG,035,Surgical,,,22870.31,24470.51,3
MS-DRG,036,CAROTID ARTERY STENT PROCEDURE WITHOUT CC/MCC,,,22673.69,45700.48,10
MS-DRG,036,Carotid Artery Stent Procedure Without Cc/Mcc,,,22220.22,22673.69,5
MS-DRG,036,Surgical,,,22870.31,24470.51,3
MS-DRG,037,EXTRACRANIAL PROCEDURES W/MCC,,,103825.85,140683.62,2
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,38089.6,77440.07,10
MS-DRG,037,Extracranial Procedures With Mcc,,,37327.81,38089.6,5
MS-DRG,037,Surgical,,,22870.31,24470.51,3
MS-DRG,038,EXTRACRANIAL PROCEDURES W/CC,,,103825.85,140683.62,2
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,19015.37,38168.42,10
MS-DRG,038,Extracranial Procedures With Cc,,,18635.06,19015.37,5
MS-DRG,038,Surgical,,,22870.31,24470.51,3
MS-DRG,039,EXTRACRANIAL PROCEDURES W/O CC/MCC,,,103825.85,140683.62,2
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,13907.2,27651.29,10
MS-DRG,039,Extracranial Procedures Without Cc/Mcc,,,13629.05,13907.2,5
MS-DRG,039,Surgical,,,22870.31,24470.51,3
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,44591.63,90827.01,10
MS-DRG,040,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc",,,43699.8,44591.63,5
MS-DRG,040,Surgical,,,22870.31,24470.51,3
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,25597.38,51720.02,10
MS-DRG,041,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator",,,25085.43,25597.38,5
MS-DRG,041,Surgical,,,22870.31,24470.51,3
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,20216.15,40640.69,10
MS-DRG,042,"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc",,,19811.82,20216.15,5
MS-DRG,042,Surgical,,,22870.31,24470.51,3
MS-DRG,052,Medical,,,13041.13,13953.63,3
MS-DRG,052,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,052,SPINAL DISORDERS AND INJURIES W CC/MCC,,,88784.16,120304.46,2
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,21171.29,35986.91,9
MS-DRG,052,Spinal Disorders And Injuries With Cc/Mcc,,,20747.86,21171.29,5
MS-DRG,053,Medical,,,13041.13,13953.63,3
MS-DRG,053,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,053,SPINAL DISORDER AND INJURY W/O CC/MCC,,,88784.16,120304.46,2
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,11664.45,19454.75,9
MS-DRG,053,Spinal Disorders And Injuries Without Cc/Mcc,,,11431.16,11664.45,5
MS-DRG,054,Medical,,,13041.13,13953.63,3
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,17921.98,30336.45,9
MS-DRG,054,Nervous System Neoplasms With Mcc,,,17563.54,17921.98,5
MS-DRG,054,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,055,Medical,,,13041.13,13953.63,3
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,12126.02,20257.41,9
MS-DRG,055,Nervous System Neoplasms Without Mcc,,,11883.5,12126.02,5
MS-DRG,055,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,27018.66,54646.28,10
MS-DRG,056,Degenerative Nervous System Disorders With Mcc,,,26478.29,27018.66,5
MS-DRG,056,Medical,,,13041.13,13953.63,3
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,15279.36,30476.4,10
MS-DRG,057,Degenerative Nervous System Disorders Without Mcc,,,14973.77,15279.36,5
MS-DRG,057,Medical,,,13041.13,13953.63,3
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,20008.21,40212.57,10
MS-DRG,058,Medical,,,13041.13,13953.63,3
MS-DRG,058,Multiple Sclerosis And Cerebellar Ataxia With Mcc,,,19608.05,20008.21,5
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,14654.4,29189.69,10
MS-DRG,059,Medical,,,13041.13,13953.63,3
MS-DRG,059,Multiple Sclerosis And Cerebellar Ataxia With Cc,,,14361.31,14654.4,5
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,10985.8,21636.46,10
MS-DRG,060,Medical,,,13041.13,13953.63,3
MS-DRG,060,Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc,,,10766.08,10985.8,5
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,31977.16,54778.06,9
MS-DRG,061,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc",,,31337.62,31977.16,5
MS-DRG,061,Medical,,,13041.13,13953.63,3
MS-DRG,061,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,20553.19,34912.05,9
MS-DRG,062,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc",,,20142.12,20553.19,5
MS-DRG,062,Medical,,,13041.13,13953.63,3
MS-DRG,062,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,16515.55,27890.7,9
MS-DRG,063,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc",,,16185.24,16515.55,5
MS-DRG,063,Medical,,,13041.13,13953.63,3
MS-DRG,063,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,23452.88,39954.55,9
MS-DRG,064,Intracranial Hemorrhage Or Cerebral Infarction With Mcc,,,22983.83,23452.88,5
MS-DRG,064,Medical,,,13041.13,13953.63,3
MS-DRG,064,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,12019.77,20072.64,9
MS-DRG,065,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,,,11779.37,12019.77,5
MS-DRG,065,Medical,,,13041.13,13953.63,3
MS-DRG,065,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,8296.32,13597.66,9
MS-DRG,066,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,,,8130.4,8296.32,5
MS-DRG,066,Medical,,,13041.13,13953.63,3
MS-DRG,066,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,067,Medical,,,13041.13,13953.63,3
MS-DRG,067,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,17257.04,34548.23,10
MS-DRG,067,Nonspecific Cva And Precerebral Occlusion Without Infarction With Mcc,,,16911.9,17257.04,5
MS-DRG,068,Medical,,,13041.13,13953.63,3
MS-DRG,068,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,10352.85,20333.28,10
MS-DRG,068,Nonspecific Cva And Precerebral Occlusion Without Infarction Without Mcc,,,10145.79,10352.85,5
MS-DRG,069,Medical,,,13041.13,13953.63,3
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,9603.36,18790.17,10
MS-DRG,069,Transient Ischemia Without Thrombolytic,,,9411.29,9603.36,5
MS-DRG,070,Medical,,,13041.13,13953.63,3
MS-DRG,070,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,,19497.51,39161.09,10
MS-DRG,070,Nonspecific Cerebrovascular Disorders With Mcc,,,19107.56,19497.51,5
MS-DRG,071,Medical,,,13041.13,13953.63,3
MS-DRG,071,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,,12199.14,24134.6,10
MS-DRG,071,Nonspecific Cerebrovascular Disorders With Cc,,,11955.16,12199.14,5
MS-DRG,072,Medical,,,13041.13,13953.63,3
MS-DRG,072,NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,9116.65,17788.09,10
MS-DRG,072,Nonspecific Cerebrovascular Disorders Without Cc/Mcc,,,8934.32,9116.65,5
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,18806.29,37737.95,10
MS-DRG,073,Cranial And Peripheral Nerve Disorders With Mcc,,,18430.16,18806.29,5
MS-DRG,073,Medical,,,13041.13,13953.63,3
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,12253.98,24247.51,10
MS-DRG,074,Cranial And Peripheral Nerve Disorders Without Mcc,,,12008.9,12253.98,5
MS-DRG,074,Medical,,,13041.13,13953.63,3
MS-DRG,075,Medical,,,13041.13,13953.63,3
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,22384.63,45105.35,10
MS-DRG,075,Viral Meningitis With Cc/Mcc,,,21936.94,22384.63,5
MS-DRG,076,Medical,,,13041.13,13953.63,3
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,9904.98,19411.18,10
MS-DRG,076,Viral Meningitis Without Cc/Mcc,,,9706.88,9904.98,5
MS-DRG,077,Medical,,,13041.13,13953.63,3
MS-DRG,078,Medical,,,13041.13,13953.63,3
MS-DRG,079,Medical,,,13041.13,13953.63,3
MS-DRG,080,Medical,,,13041.13,13953.63,3
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,21156.43,42576.63,10
MS-DRG,080,Nontraumatic Stupor And Coma With Mcc,,,20733.31,21156.43,5
MS-DRG,081,Medical,,,13041.13,13953.63,3
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,10709.31,21067.2,10
MS-DRG,081,Nontraumatic Stupor And Coma Without Mcc,,,10495.12,10709.31,5
MS-DRG,082,Medical,,,13041.13,13953.63,3
MS-DRG,082,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,082,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITH MCC",,,26590.22,45410.3,9
MS-DRG,082,"Traumatic Stupor And Coma, Coma >1 Hour With Mcc",,,26058.42,26590.22,5
MS-DRG,083,Medical,,,13041.13,13953.63,3
MS-DRG,083,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,083,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITH CC",,,16424.15,27731.75,9
MS-DRG,083,"Traumatic Stupor And Coma, Coma >1 Hour With Cc",,,16095.67,16424.15,5
MS-DRG,084,Medical,,,13041.13,13953.63,3
MS-DRG,084,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,084,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITHOUT CC/MCC",,,11397.1,18989.83,9
MS-DRG,084,"Traumatic Stupor And Coma, Coma >1 Hour Without Cc/Mcc",,,11169.16,11397.1,5
MS-DRG,085,Medical,,,13041.13,13953.63,3
MS-DRG,085,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,085,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITH MCC",,,26433.7,45138.11,9
MS-DRG,085,"Traumatic Stupor And Coma, Coma <1 Hour With Mcc",,,25905.02,26433.7,5
MS-DRG,086,Medical,,,13041.13,13953.63,3
MS-DRG,086,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,086,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITH CC",,,15360.47,25882.04,9
MS-DRG,086,"Traumatic Stupor And Coma, Coma <1 Hour With Cc",,,15053.26,15360.47,5
MS-DRG,087,Medical,,,13041.13,13953.63,3
MS-DRG,087,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,087,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITHOUT CC/MCC",,,10927.53,18173.26,9
MS-DRG,087,"Traumatic Stupor And Coma, Coma <1 Hour Without Cc/Mcc",,,10708.98,10927.53,5
MS-DRG,088,CONCUSSION WITH MCC,,,15921.45,31798.39,10
MS-DRG,088,Concussion With Mcc,,,15603.02,15921.45,5
MS-DRG,088,Medical,,,13041.13,13953.63,3
MS-DRG,089,CONCUSSION WITH CC,,,13028.61,25842.37,10
MS-DRG,089,Concussion With Cc,,,12768.04,13028.61,5
MS-DRG,089,Medical,,,13041.13,13953.63,3
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,,,9882.13,19364.13,10
MS-DRG,090,Concussion Without Cc/Mcc,,,9684.49,9882.13,5
MS-DRG,090,Medical,,,13041.13,13953.63,3
MS-DRG,091,Medical,,,13041.13,13953.63,3
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,20541.76,41311.09,10
MS-DRG,091,Other Disorders Of Nervous System With Mcc,,,20130.93,20541.76,5
MS-DRG,092,Medical,,,13041.13,13953.63,3
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,12164.87,24064.03,10
MS-DRG,092,Other Disorders Of Nervous System With Cc,,,11921.57,12164.87,5
MS-DRG,093,Medical,,,13041.13,13953.63,3
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,9574.8,18731.36,10
MS-DRG,093,Other Disorders Of Nervous System Without Cc/Mcc,,,9383.3,9574.8,5
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,40686.53,69923.44,9
MS-DRG,094,Bacterial And Tuberculous Infections Of Nervous System With Mcc,,,39872.8,40686.53,5
MS-DRG,094,Medical,,,13041.13,13953.63,3
MS-DRG,094,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,29944.63,51243.55,9
MS-DRG,095,Bacterial And Tuberculous Infections Of Nervous System With Cc,,,29345.74,29944.63,5
MS-DRG,095,Medical,,,13041.13,13953.63,3
MS-DRG,095,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,29944.63,51243.55,9
MS-DRG,096,Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc,,,29345.74,29944.63,5
MS-DRG,096,Medical,,,13041.13,13953.63,3
MS-DRG,096,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,097,Medical,,,13041.13,13953.63,3
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,41742.21,71759.24,9
MS-DRG,097,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc,,,40907.36,41742.21,5
MS-DRG,097,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,098,Medical,,,13041.13,13953.63,3
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,26696.47,45595.07,9
MS-DRG,098,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc,,,26162.54,26696.47,5
MS-DRG,098,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,099,Medical,,,13041.13,13953.63,3
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,16042.55,27068.16,9
MS-DRG,099,Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc,,,15721.7,16042.55,5
MS-DRG,099,Other Neurological Procedures,,,39600.0,39600.0,1
MS-DRG,100,Medical,,,13041.13,13953.63,3
MS-DRG,100,SEIZURES WITH MCC,,,22605.14,45559.35,10
MS-DRG,100,Seizures With Mcc,,,22153.04,22605.14,5
MS-DRG,101,Medical,,,13041.13,13953.63,3
MS-DRG,101,SEIZURES WITHOUT MCC,,,10789.28,21231.86,10
MS-DRG,101,Seizures Without Mcc,,,10573.5,10789.28,5
MS-DRG,102,HEADACHES WITH MCC,,,13283.39,26366.93,10
MS-DRG,102,Headaches With Mcc,,,13017.72,13283.39,5
MS-DRG,102,Medical,,,13041.13,13953.63,3
MS-DRG,103,HEADACHES WITHOUT MCC,,,10031.8,19672.28,10
MS-DRG,103,Headaches Without Mcc,,,9831.16,10031.8,5
MS-DRG,103,Medical,,,13041.13,13953.63,3
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,27338.56,55304.93,10
MS-DRG,113,Orbital Procedures With Cc/Mcc,,,26791.79,27338.56,5
MS-DRG,113,Surgical,,,22870.31,24470.51,3
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,15935.16,31826.62,10
MS-DRG,114,Orbital Procedures Without Cc/Mcc,,,15616.45,15935.16,5
MS-DRG,114,Surgical,,,22870.31,24470.51,3
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,18013.39,36105.45,10
MS-DRG,115,Extraocular Procedures Except Orbit,,,17653.12,18013.39,5
MS-DRG,115,Surgical,,,22870.31,24470.51,3
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,21134.73,42531.94,10
MS-DRG,116,Intraocular Procedures With Cc/Mcc,,,20712.03,21134.73,5
MS-DRG,116,Surgical,,,22870.31,24470.51,3
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,12872.08,25520.1,10
MS-DRG,117,Intraocular Procedures Without Cc/Mcc,,,12614.64,12872.08,5
MS-DRG,117,Surgical,,,22870.31,24470.51,3
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,13767.81,27364.31,10
MS-DRG,121,Acute Major Eye Infections With Cc/Mcc,,,13492.46,13767.81,5
MS-DRG,121,Medical,,,13041.13,13953.63,3
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,9454.83,18484.37,10
MS-DRG,122,Acute Major Eye Infections Without Cc/Mcc,,,9265.73,9454.83,5
MS-DRG,122,Medical,,,13041.13,13953.63,3
MS-DRG,123,Medical,,,13041.13,13953.63,3
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,9601.07,18785.47,10
MS-DRG,123,Neurological Eye Disorders,,,9409.05,9601.07,5
MS-DRG,124,Medical,,,13041.13,13953.63,3
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC,,,15593.55,31123.28,10
MS-DRG,124,Other Disorders Of The Eye With Mcc,,,15281.67,15593.55,5
MS-DRG,125,Medical,,,13041.13,13953.63,3
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,9249.18,18060.96,10
MS-DRG,125,Other Disorders Of The Eye Without Mcc,,,9064.2,9249.18,5
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,25269.48,51044.91,10
MS-DRG,135,Sinus And Mastoid Procedures With Cc/Mcc,,,24764.09,25269.48,5
MS-DRG,135,Surgical,,,22870.31,24470.51,3
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,12076.9,23882.9,10
MS-DRG,136,Sinus And Mastoid Procedures Without Cc/Mcc,,,11835.36,12076.9,5
MS-DRG,136,Surgical,,,22870.31,24470.51,3
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,17536.96,35124.54,10
MS-DRG,137,Mouth Procedures With Cc/Mcc,,,17186.22,17536.96,5
MS-DRG,137,Surgical,,,22870.31,24470.51,3
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,10601.91,20846.08,10
MS-DRG,138,Mouth Procedures Without Cc/Mcc,,,10389.87,10601.91,5
MS-DRG,138,Surgical,,,22870.31,24470.51,3
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,14594.99,29067.37,10
MS-DRG,139,Salivary Gland Procedures,,,14303.09,14594.99,5
MS-DRG,139,Surgical,,,22870.31,24470.51,3
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH CC/MCC OR MAJOR DEVICE,,,49208.52,100332.65,10
MS-DRG,140,Major Head And Neck Procedures With Cc/Mcc Or Major Device,,,48224.35,49208.52,5
MS-DRG,140,Surgical,,,22870.31,24470.51,3
MS-DRG,141,Surgical,,,22870.31,24470.51,3
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,18716.03,37552.12,10
MS-DRG,142,Major Head And Neck Procedures Without Cc/Mcc,,,18341.71,18716.03,5
MS-DRG,142,Surgical,,,22870.31,24470.51,3
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC/MCC",,,43282.31,88131.27,10
MS-DRG,143,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc/Mcc",,,42416.67,43282.31,5
MS-DRG,143,Surgical,,,22870.31,24470.51,3
MS-DRG,144,Surgical,,,22870.31,24470.51,3
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,14213.39,28281.7,10
MS-DRG,145,"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc",,,13929.12,14213.39,5
MS-DRG,145,Surgical,,,22870.31,24470.51,3
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,24668.51,49807.6,10
MS-DRG,146,"Ear, Nose, Mouth And Throat Malignancy With Mcc",,,24175.14,24668.51,5
MS-DRG,146,Medical,,,13041.13,13953.63,3
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,15004.01,29909.49,10
MS-DRG,147,"Ear, Nose, Mouth And Throat Malignancy With Cc",,,14703.93,15004.01,5
MS-DRG,147,Medical,,,13041.13,13953.63,3
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,9583.94,18750.18,10
MS-DRG,148,"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc",,,9392.26,9583.94,5
MS-DRG,148,Medical,,,13041.13,13953.63,3
MS-DRG,149,DYSEQUILIBRIUM,,,9064.09,17679.89,10
MS-DRG,149,Dysequilibrium,,,8882.81,9064.09,5
MS-DRG,149,Medical,,,13041.13,13953.63,3
MS-DRG,150,EPISTAXIS WITH MCC,,,15689.52,31320.87,10
MS-DRG,150,Epistaxis With Mcc,,,15375.73,15689.52,5
MS-DRG,150,Medical,,,13041.13,13953.63,3
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,8863.01,17265.88,10
MS-DRG,151,Epistaxis Without Mcc,,,8685.75,8863.01,5
MS-DRG,151,Medical,,,13041.13,13953.63,3
MS-DRG,152,Medical,,,13041.13,13953.63,3
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,13983.75,27808.89,10
MS-DRG,152,Otitis Media And Uri With Mcc,,,13704.07,13983.75,5
MS-DRG,153,Medical,,,13041.13,13953.63,3
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,8911.0,17364.68,10
MS-DRG,153,Otitis Media And Uri Without Mcc,,,8732.78,8911.0,5
MS-DRG,154,Medical,,,13041.13,13953.63,3
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,18340.14,36778.21,10
MS-DRG,154,"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc",,,17973.34,18340.14,5
MS-DRG,155,Medical,,,13041.13,13953.63,3
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,10948.09,21558.83,10
MS-DRG,155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",,,10729.13,10948.09,5
MS-DRG,156,Medical,,,13041.13,13953.63,3
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,8372.87,16256.75,10
MS-DRG,156,"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc",,,8205.42,8372.87,5
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,20091.61,40384.29,10
MS-DRG,157,Dental And Oral Diseases With Mcc,,,19689.78,20091.61,5
MS-DRG,157,Medical,,,13041.13,13953.63,3
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,10871.55,21401.23,10
MS-DRG,158,Dental And Oral Diseases With Cc,,,10654.11,10871.55,5
MS-DRG,158,Medical,,,13041.13,13953.63,3
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,8571.67,16666.05,10
MS-DRG,159,Dental And Oral Diseases Without Cc/Mcc,,,8400.24,8571.67,5
MS-DRG,159,Medical,,,13041.13,13953.63,3
MS-DRG,163,ACT ISC SK W THRM AGT WO CCMCC,,,111128.61,150579.49,2
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,51682.06,105425.38,10
MS-DRG,163,Major Chest Procedures With Mcc,,,50648.42,51682.06,5
MS-DRG,163,Surgical,,,22870.31,24470.51,3
MS-DRG,164,INTRCRAN HEM OR CER INFA W MCC,,,111128.61,150579.49,2
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,29313.97,59372.05,10
MS-DRG,164,Major Chest Procedures With Cc,,,28727.69,29313.97,5
MS-DRG,164,Surgical,,,22870.31,24470.51,3
MS-DRG,165,INTRACRAN HEM OR CER INF W CC,,,111128.61,150579.49,2
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,22346.93,45027.73,10
MS-DRG,165,Major Chest Procedures Without Cc/Mcc,,,21899.99,22346.93,5
MS-DRG,165,Surgical,,,22870.31,24470.51,3
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,43180.63,87921.92,10
MS-DRG,166,Other Respiratory System O.R. Procedures With Mcc,,,42317.02,43180.63,5
MS-DRG,166,Surgical,,,22870.31,24470.51,3
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,21081.03,42421.38,10
MS-DRG,167,Other Respiratory System O.R. Procedures With Cc,,,20659.41,21081.03,5
MS-DRG,167,Surgical,,,22870.31,24470.51,3
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,16088.25,32141.83,10
MS-DRG,168,Other Respiratory System O.R. Procedures Without Cc/Mcc,,,15766.49,16088.25,5
MS-DRG,168,Surgical,,,22870.31,24470.51,3
MS-DRG,173,Surgical,,,22870.31,24470.51,3
MS-DRG,175,Medical,,,13041.13,13953.63,3
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,16170.51,32311.19,10
MS-DRG,175,Pulmonary Embolism With Mcc Or Acute Cor Pulmonale,,,15847.1,16170.51,5
MS-DRG,176,Medical,,,13041.13,13953.63,3
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,9674.19,18936.02,10
MS-DRG,176,Pulmonary Embolism Without Mcc,,,9480.71,9674.19,5
MS-DRG,177,Medical,,,13041.13,13953.63,3
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,18331.0,36759.39,10
MS-DRG,177,Respiratory Infections And Inflammations With Mcc,,,17964.38,18331.0,5
MS-DRG,178,Medical,,,13041.13,13953.63,3
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,11627.89,22958.45,10
MS-DRG,178,Respiratory Infections And Inflammations With Cc,,,11395.33,11627.89,5
MS-DRG,179,Medical,,,13041.13,13953.63,3
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,9102.94,17759.87,10
MS-DRG,179,Respiratory Infections And Inflammations Without Cc/Mcc,,,8920.88,9102.94,5
MS-DRG,180,Medical,,,13041.13,13953.63,3
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,20653.73,41541.62,10
MS-DRG,180,Respiratory Neoplasms With Mcc,,,20240.65,20653.73,5
MS-DRG,181,Medical,,,13041.13,13953.63,3
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,12713.27,25193.13,10
MS-DRG,181,Respiratory Neoplasms With Cc,,,12459.01,12713.27,5
MS-DRG,182,Medical,,,13041.13,13953.63,3
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,9089.23,17731.64,10
MS-DRG,182,Respiratory Neoplasms Without Cc/Mcc,,,8907.44,9089.23,5
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,17956.26,35987.84,10
MS-DRG,183,Major Chest Trauma With Mcc,,,17597.13,17956.26,5
MS-DRG,183,Medical,,,13041.13,13953.63,3
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,12634.44,25030.82,10
MS-DRG,184,Major Chest Trauma With Cc,,,12381.75,12634.44,5
MS-DRG,184,Medical,,,13041.13,13953.63,3
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,9462.83,18500.84,10
MS-DRG,185,Major Chest Trauma Without Cc/Mcc,,,9273.57,9462.83,5
MS-DRG,185,Medical,,,13041.13,13953.63,3
MS-DRG,186,Medical,,,13041.13,13953.63,3
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,18283.02,36660.6,10
MS-DRG,186,Pleural Effusion With Mcc,,,17917.36,18283.02,5
MS-DRG,187,Medical,,,13041.13,13953.63,3
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,11777.56,23266.6,10
MS-DRG,187,Pleural Effusion With Cc,,,11542.01,11777.56,5
MS-DRG,188,Medical,,,13041.13,13953.63,3
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,8671.07,16870.7,10
MS-DRG,188,Pleural Effusion Without Cc/Mcc,,,8497.65,8671.07,5
MS-DRG,189,Medical,,,13041.13,13953.63,3
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,14591.56,29060.31,10
MS-DRG,189,Pulmonary Edema And Respiratory Failure,,,14299.73,14591.56,5
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,13132.58,26056.43,10
MS-DRG,190,Chronic Obstructive Pulmonary Disease With Mcc,,,12869.92,13132.58,5
MS-DRG,190,Medical,,,13041.13,13953.63,3
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,10108.35,19829.89,10
MS-DRG,191,Chronic Obstructive Pulmonary Disease With Cc,,,9906.18,10108.35,5
MS-DRG,191,Medical,,,13041.13,13953.63,3
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,7811.9,15101.77,10
MS-DRG,192,Chronic Obstructive Pulmonary Disease Without Cc/Mcc,,,7655.66,7811.9,5
MS-DRG,192,Medical,,,13041.13,13953.63,3
MS-DRG,193,Medical,,,13041.13,13953.63,3
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,15494.15,30918.63,10
MS-DRG,193,Simple Pneumonia And Pleurisy With Mcc,,,15184.26,15494.15,5
MS-DRG,194,Medical,,,13041.13,13953.63,3
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,9684.48,18957.19,10
MS-DRG,194,Simple Pneumonia And Pleurisy With Cc,,,9490.79,9684.48,5
MS-DRG,195,Medical,,,13041.13,13953.63,3
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,7657.66,14784.21,10
MS-DRG,195,Simple Pneumonia And Pleurisy Without Cc/Mcc,,,7504.51,7657.66,5
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,22038.45,44392.61,10
MS-DRG,196,Interstitial Lung Disease With Mcc,,,21597.68,22038.45,5
MS-DRG,196,Medical,,,13041.13,13953.63,3
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,11320.55,22325.68,10
MS-DRG,197,Interstitial Lung Disease With Cc,,,11094.14,11320.55,5
MS-DRG,197,Medical,,,13041.13,13953.63,3
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,8659.64,16847.17,10
MS-DRG,198,Interstitial Lung Disease Without Cc/Mcc,,,8486.45,8659.64,5
MS-DRG,198,Medical,,,13041.13,13953.63,3
MS-DRG,199,Medical,,,13041.13,13953.63,3
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,20632.02,41496.92,10
MS-DRG,199,Pneumothorax With Mcc,,,20219.38,20632.02,5
MS-DRG,200,Medical,,,13041.13,13953.63,3
MS-DRG,200,PNEUMOTHORAX WITH CC,,,13036.61,25858.83,10
MS-DRG,200,Pneumothorax With Cc,,,12775.87,13036.61,5
MS-DRG,201,Medical,,,13041.13,13953.63,3
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,8647.08,16821.3,10
MS-DRG,201,Pneumothorax Without Cc/Mcc,,,8474.13,8647.08,5
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,11573.05,22845.54,10
MS-DRG,202,Bronchitis And Asthma With Cc/Mcc,,,11341.59,11573.05,5
MS-DRG,202,Medical,,,13041.13,13953.63,3
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,8131.8,15760.41,10
MS-DRG,203,Bronchitis And Asthma Without Cc/Mcc,,,7969.17,8131.8,5
MS-DRG,203,Medical,,,13041.13,13953.63,3
MS-DRG,204,Medical,,,13041.13,13953.63,3
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,9701.61,18992.47,10
MS-DRG,204,Respiratory Signs And Symptoms,,,9507.58,9701.61,5
MS-DRG,205,Medical,,,13041.13,13953.63,3
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,21396.36,43070.61,10
MS-DRG,205,Other Respiratory System Diagnoses With Mcc,,,20968.43,21396.36,5
MS-DRG,206,Medical,,,13041.13,13953.63,3
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,11229.15,22137.5,10
MS-DRG,206,Other Respiratory System Diagnoses Without Mcc,,,11004.57,11229.15,5
MS-DRG,207,Medical,,,13041.13,13953.63,3
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,73994.17,151363.45,10
MS-DRG,207,Respiratory System Diagnosis With Ventilator Support >96 Hours,,,72514.28,73994.17,5
MS-DRG,208,Medical,,,13041.13,13953.63,3
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,31881.19,64657.67,10
MS-DRG,208,Respiratory System Diagnosis With Ventilator Support <=96 Hours,,,31243.57,31881.19,5
MS-DRG,212,Surgical,,,22870.31,24470.51,3
MS-DRG,215,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,215,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,215,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,215,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,215,Heart Retransplant - up to one year from previous transplant,,,95710.0,95710.0,1
MS-DRG,215,Heart Transplant,,,191422.0,191422.0,1
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,114236.85,197825.68,9
MS-DRG,215,Other Heart Assist System Implant,,,111952.11,114236.85,5
MS-DRG,215,Pediatric and Neonatal Services: VENTRICULAR ASSIST DEVICE (VAD),3217.9,2091.63,,,0
MS-DRG,215,Surgical,,,22870.31,24470.51,3
MS-DRG,215,VENTRICULAR ASSIST DEVICE (VAD),19799.1,12869.41,,,0
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,112246.59,194364.67,9
MS-DRG,216,CARDIAC VALVE W CARD CAT W MCC,,,111128.61,150579.49,2
MS-DRG,216,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc,,,110001.66,112246.59,5
MS-DRG,216,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,216,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,216,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,216,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,216,Surgical,,,22870.31,24470.51,3
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,75600.54,130638.06,9
MS-DRG,217,CARDIAC VALVE W CARD CAT W CC,,,111128.61,150579.49,2
MS-DRG,217,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc,,,74088.53,75600.54,5
MS-DRG,217,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,217,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,217,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,217,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,217,Surgical,,,22870.31,24470.51,3
MS-DRG,218,CARD VALVE W CAR CTH WO CC/MCC,,,111128.61,150579.49,2
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,75600.54,130638.06,9
MS-DRG,218,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc,,,74088.53,75600.54,5
MS-DRG,218,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,218,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,218,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,218,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,218,Surgical,,,22870.31,24470.51,3
MS-DRG,219,CARD VALVE W CAR CTH W CC/MCC,,,111128.61,150579.49,2
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,88202.44,152552.46,9
MS-DRG,219,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc,,,86438.39,88202.44,5
MS-DRG,219,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,219,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,219,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,219,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,219,Surgical,,,22870.31,24470.51,3
MS-DRG,220,CARD VALVE W CAR CTH WO CC/CC,,,111128.61,150579.49,2
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,61404.83,105952.07,9
MS-DRG,220,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc,,,60176.73,61404.83,5
MS-DRG,220,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,220,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,220,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,220,Surgical,,,22870.31,24470.51,3
MS-DRG,221,CARD VALVE W CAR CTH WO CC/MCC,,,111128.61,150579.49,2
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,58061.84,100138.69,9
MS-DRG,221,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/Mcc,,,56900.61,58061.84,5
MS-DRG,221,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,221,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,221,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,221,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,221,Surgical,,,22870.31,24470.51,3
MS-DRG,222,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,222,CRD DEF IMP W AMI/HF/SK W MCC,,,111128.61,150579.49,2
MS-DRG,222,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,223,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,223,CRD DEF IMP W AMI/HF/SK WO MCC,,,111128.61,150579.49,2
MS-DRG,223,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,227,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,227,CAR DEF IMPL WO CAR CAT WO MCC,,,111128.61,150579.49,2
MS-DRG,227,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,228,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,228,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,228,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,228,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,228,OTH CARDIOTHORACIC PROCS W MCC,,,111128.61,150579.49,2
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,57001.59,98294.94,9
MS-DRG,228,Other Cardiothoracic Procedures With Mcc,,,55861.56,57001.59,5
MS-DRG,228,Surgical,,,22870.31,24470.51,3
MS-DRG,229,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,229,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,229,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,229,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,229,OTH CARDIOTHORACIC PROCS W CC,,,111128.61,150579.49,2
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,36460.38,62574.27,9
MS-DRG,229,Other Cardiothoracic Procedures Without Mcc,,,35731.17,36460.38,5
MS-DRG,229,Surgical,,,22870.31,24470.51,3
MS-DRG,230,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,230,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,230,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,230,OTH CARDIOTHORAC PX WO CC/MCC,,,111128.61,150579.49,2
MS-DRG,231,CORONARY BYPASS W PTCA W MCC,,,111128.61,150579.49,2
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,96789.56,167485.25,9
MS-DRG,231,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,231,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,231,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,231,Coronary Bypass With Ptca With Mcc,,,94853.76,96789.56,5
MS-DRG,231,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,231,Surgical,,,22870.31,24470.51,3
MS-DRG,232,CORONARY BYPASS W PTCA W/O MCC,,,111128.61,150579.49,2
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,69742.88,120451.74,9
MS-DRG,232,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,232,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,232,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,232,Coronary Bypass With Ptca Without Mcc,,,68348.02,69742.88,5
MS-DRG,232,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,232,Surgical,,,22870.31,24470.51,3
MS-DRG,233,CORONARY BYP W CARD CATH W MCC,,,111128.61,150579.49,2
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,,,87824.27,151894.83,9
MS-DRG,233,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,233,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,233,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,233,Coronary Bypass With Cardiac Catheterization With Mcc,,,86067.78,87824.27,5
MS-DRG,233,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,233,Surgical,,,22870.31,24470.51,3
MS-DRG,234,COR BYPASS W CARD CATH WO MCC,,,111128.61,150579.49,2
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,62888.95,108532.92,9
MS-DRG,234,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,234,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,234,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,234,Coronary Bypass With Cardiac Catheterization Without Mcc,,,61631.17,62888.95,5
MS-DRG,234,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,234,Surgical,,,22870.31,24470.51,3
MS-DRG,235,COR BYPASS WO CARD CATH W MCC,,,111128.61,150579.49,2
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,67526.41,116597.34,9
MS-DRG,235,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,235,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,235,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,235,Coronary Bypass Without Cardiac Catheterization With Mcc,,,66175.88,67526.41,5
MS-DRG,235,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,235,Surgical,,,22870.31,24470.51,3
MS-DRG,236,COR BYPASS WO CARD CATH WO MCC,,,111128.61,150579.49,2
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,48334.5,83223.08,9
MS-DRG,236,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,236,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,236,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,236,Coronary Bypass Without Cardiac Catheterization Without Mcc,,,47367.81,48334.5,5
MS-DRG,236,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,236,Surgical,,,22870.31,24470.51,3
MS-DRG,237,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,238,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,56707.97,115773.15,10
MS-DRG,239,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc,,,55573.81,56707.97,5
MS-DRG,239,Surgical,,,22870.31,24470.51,3
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,33044.27,67052.31,10
MS-DRG,240,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc,,,32383.38,33044.27,5
MS-DRG,240,Surgical,,,22870.31,24470.51,3
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,16293.91,32565.24,10
MS-DRG,241,Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc,,,15968.03,16293.91,5
MS-DRG,241,Surgical,,,22870.31,24470.51,3
MS-DRG,242,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,242,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,36955.08,63434.55,9
MS-DRG,242,Permanent Cardiac Pacemaker Implant With Mcc,,,36215.98,36955.08,5
MS-DRG,242,Surgical,,,22870.31,24470.51,3
MS-DRG,243,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,243,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,24822.75,42336.72,9
MS-DRG,243,Permanent Cardiac Pacemaker Implant With Cc,,,24326.3,24822.75,5
MS-DRG,243,Surgical,,,22870.31,24470.51,3
MS-DRG,244,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,244,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,21127.87,35911.41,9
MS-DRG,244,Permanent Cardiac Pacemaker Implant Without Cc/Mcc,,,20705.31,21127.87,5
MS-DRG,244,Surgical,,,22870.31,24470.51,3
MS-DRG,245,AICD GENERATOR PROCEDURES,,,52602.92,90645.76,9
MS-DRG,245,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,245,Aicd Generator Procedures,,,51550.86,52602.92,5
MS-DRG,245,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,245,Surgical,,,22870.31,24470.51,3
MS-DRG,246,Angioplasty,,,3780.0,3780.0,1
MS-DRG,246,Angioplasty (PTCA),,,2295.0,2295.0,1
MS-DRG,246,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,246,PERC CARD PX W DG ELST W MCC,,,65184.08,88324.18,2
MS-DRG,246,Percutaneous Cardiovascular (PTCA),,,29653.62,46451.71,5
MS-DRG,247,Angioplasty,,,3780.0,3780.0,1
MS-DRG,247,Angioplasty (PTCA),,,2295.0,2295.0,1
MS-DRG,247,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,247,PERC CARD PX W DG ELST WO MCC,,,65184.08,88324.18,2
MS-DRG,247,Percutaneous Cardiovascular (PTCA),,,29653.62,46451.71,5
MS-DRG,248,Angioplasty,,,3780.0,3780.0,1
MS-DRG,248,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,248,PERC CAR PX W N-DG ELST W MCC,,,65184.08,88324.18,2
MS-DRG,249,Angioplasty,,,3780.0,3780.0,1
MS-DRG,249,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,249,PER CAR PX W N-DG ELST WO MCC,,,65184.08,88324.18,2
MS-DRG,250,Angioplasty,,,3780.0,3780.0,1
MS-DRG,250,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,250,PER CAR PX WO ST OR AMI W MCC,,,65184.08,88324.18,2
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC,,,25412.29,51338.95,10
MS-DRG,250,Percutaneous Cardiovascular Procedures Without Coronary Artery Stent With Mcc,,,24904.04,25412.29,5
MS-DRG,250,Surgical,,,22870.31,24470.51,3
MS-DRG,251,Angioplasty,,,3780.0,3780.0,1
MS-DRG,251,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,251,PER CAR PX WO ST OR AMI WO MCC,,,65184.08,88324.18,2
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC,,,17551.81,35155.12,10
MS-DRG,251,Percutaneous Cardiovascular Procedures Without Coronary Artery Stent Without Mcc,,,17200.77,17551.81,5
MS-DRG,251,Surgical,,,22870.31,24470.51,3
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,40331.21,82055.28,10
MS-DRG,252,Other Vascular Procedures With Mcc,,,39524.58,40331.21,5
MS-DRG,252,Surgical,,,22870.31,24470.51,3
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,30132.01,61056.3,10
MS-DRG,253,Other Vascular Procedures With Cc,,,29529.37,30132.01,5
MS-DRG,253,Surgical,,,22870.31,24470.51,3
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,20833.1,41910.93,10
MS-DRG,254,Other Vascular Procedures Without Cc/Mcc,,,20416.44,20833.1,5
MS-DRG,254,Surgical,,,22870.31,24470.51,3
MS-DRG,255,Surgical,,,22870.31,24470.51,3
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,31295.08,63450.94,10
MS-DRG,255,Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc,,,30669.18,31295.08,5
MS-DRG,256,Surgical,,,22870.31,24470.51,3
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,19875.68,39939.7,10
MS-DRG,256,Upper Limb And Toe Amputation For Circulatory System Disorders With Cc,,,19478.17,19875.68,5
MS-DRG,257,Surgical,,,22870.31,24470.51,3
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,12955.49,25691.82,10
MS-DRG,257,Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc,,,12696.38,12955.49,5
MS-DRG,258,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,36375.83,62427.24,9
MS-DRG,258,Cardiac Pacemaker Device Replacement With Mcc,,,35648.31,36375.83,5
MS-DRG,258,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,258,Surgical,,,22870.31,24470.51,3
MS-DRG,259,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,23579.7,40175.08,9
MS-DRG,259,Cardiac Pacemaker Device Replacement Without Mcc,,,23108.11,23579.7,5
MS-DRG,259,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,259,Surgical,,,22870.31,24470.51,3
MS-DRG,260,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,37640.59,64626.63,9
MS-DRG,260,Cardiac Pacemaker Revision Except Device Replacement With Mcc,,,36887.78,37640.59,5
MS-DRG,260,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,260,Surgical,,,22870.31,24470.51,3
MS-DRG,261,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,22076.16,37560.45,9
MS-DRG,261,Cardiac Pacemaker Revision Except Device Replacement With Cc,,,21634.63,22076.16,5
MS-DRG,261,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,261,Surgical,,,22870.31,24470.51,3
MS-DRG,262,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,19098.77,32382.85,9
MS-DRG,262,Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc,,,18716.8,19098.77,5
MS-DRG,262,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,262,Surgical,,,22870.31,24470.51,3
MS-DRG,263,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,263,Surgical,,,22870.31,24470.51,3
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,35408.12,60744.42,9
MS-DRG,263,Vein Ligation And Stripping,,,34699.96,35408.12,5
MS-DRG,264,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,264,OTHER CIRCULATORY SYST O.R. PX,,,111128.61,150579.49,2
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,38643.72,66371.04,9
MS-DRG,264,Other Circulatory System O.R. Procedures,,,37870.84,38643.72,5
MS-DRG,264,Surgical,,,22870.31,24470.51,3
MS-DRG,265,AICD LEAD PROCEDURES,,,41815.33,71886.4,9
MS-DRG,265,Aicd & Pacemaker Implant Revision And Replacement,,,57790.67,57790.67,2
MS-DRG,265,Aicd Lead Procedures,,,40979.02,41815.33,5
MS-DRG,265,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,265,Surgical,,,22870.31,24470.51,3
MS-DRG,266,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,70494.65,121759.05,9
MS-DRG,266,Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc,,,69084.76,70494.65,5
MS-DRG,266,Surgical,,,22870.31,24470.51,3
MS-DRG,267,Cardiovascular Surgical Procedures,,,171620.0,171620.0,1
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,54869.66,94587.57,9
MS-DRG,267,Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc,,,53772.27,54869.66,5
MS-DRG,267,Surgical,,,22870.31,24470.51,3
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,79057.78,161788.84,10
MS-DRG,268,Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc,,,77476.62,79057.78,5
MS-DRG,268,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,268,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,268,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,268,Surgical,,,22870.31,24470.51,3
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,48727.52,99342.33,10
MS-DRG,269,Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc,,,47752.97,48727.52,5
MS-DRG,269,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,269,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,269,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,269,Surgical,,,22870.31,24470.51,3
MS-DRG,270,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,270,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,270,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,60759.31,124114.4,10
MS-DRG,270,Other Major Cardiovascular Procedures With Mcc,,,59544.13,60759.31,5
MS-DRG,270,Surgical,,,22870.31,24470.51,3
MS-DRG,271,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,271,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,271,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,41108.11,83654.84,10
MS-DRG,271,Other Major Cardiovascular Procedures With Cc,,,40285.95,41108.11,5
MS-DRG,271,Surgical,,,22870.31,24470.51,3
MS-DRG,272,Cardiovascular Surgery,,,80913.04,80913.04,2
MS-DRG,272,Cardiovascular surgery,,,2295.0,2295.0,1
MS-DRG,272,Coronary Surgery,,,61503.27,96346.95,5
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,29645.3,60054.22,10
MS-DRG,272,Other Major Cardiovascular Procedures Without Cc/Mcc,,,29052.39,29645.3,5
MS-DRG,272,Surgical,,,22870.31,24470.51,3
MS-DRG,273,Angioplasty,,,3780.0,3780.0,1
MS-DRG,273,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,273,PERCUTANEOUS INTRACARDIAC PROCEDURES WITH MCC,,,47611.29,97044.14,10
MS-DRG,273,Percutaneous Intracardiac Procedures With Mcc,,,46659.06,47611.29,5
MS-DRG,273,Surgical,,,22870.31,24470.51,3
MS-DRG,274,Angioplasty,,,3780.0,3780.0,1
MS-DRG,274,"Angioplasty, Valvuloplasty, Coronary Artherectomy",,,33284.26,33284.26,2
MS-DRG,274,PERCUTANEOUS INTRACARDIAC PROCEDURES WITHOUT MCC,,,38085.03,77430.66,10
MS-DRG,274,Percutaneous Intracardiac Procedures Without Mcc,,,37323.33,38085.03,5
MS-DRG,274,Surgical,,,22870.31,24470.51,3
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,57790.67,171620.0,19
MS-DRG,275,Surgical,,,22870.31,24470.51,3
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,57790.67,171620.0,19
MS-DRG,276,Surgical,,,22870.31,24470.51,3
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,52178.99,171620.0,19
MS-DRG,277,Surgical,,,22870.31,24470.51,3
MS-DRG,278,Surgical,,,22870.31,24470.51,3
MS-DRG,279,Surgical,,,22870.31,24470.51,3
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,18804.0,37733.24,10
MS-DRG,280,"Acute Myocardial Infarction, Discharged Alive With Mcc",,,18427.92,18804.0,5
MS-DRG,280,Medical,,,13041.13,13953.63,3
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,10977.8,21619.99,10
MS-DRG,281,"Acute Myocardial Infarction, Discharged Alive With Cc",,,10758.24,10977.8,5
MS-DRG,281,Inpatient STEMI Services,,,,,0
MS-DRG,281,Medical,,,13041.13,13953.63,3
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,8738.48,17009.48,10
MS-DRG,282,"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc",,,8563.71,8738.48,5
MS-DRG,282,Medical,,,13041.13,13953.63,3
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,23107.84,46594.36,10
MS-DRG,283,"Acute Myocardial Infarction, Expired With Mcc",,,22645.69,23107.84,5
MS-DRG,283,Medical,,,13041.13,13953.63,3
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,8385.44,16282.62,10
MS-DRG,284,"Acute Myocardial Infarction, Expired With Cc",,,8217.73,8385.44,5
MS-DRG,284,Medical,,,13041.13,13953.63,3
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,7319.48,14087.92,10
MS-DRG,285,"Acute Myocardial Infarction, Expired Without Cc/Mcc",,,7173.09,7319.48,5
MS-DRG,285,Medical,,,13041.13,13953.63,3
MS-DRG,286,"CIRC DSRD EX AMI, W CA CA W MCC",,,61103.28,82792.98,2
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MCC",,,25758.47,52051.69,10
MS-DRG,286,Cardiac Catheterization,,,2295.0,49711.73,9
MS-DRG,286,"Circulatory Disorders Except Ami, With Cardiac Cateterization With Mcc",,,25243.3,25758.47,5
MS-DRG,286,Medical,,,13041.13,13953.63,3
MS-DRG,287,"CIRCULAT DIS, W CAR CAT WO MCC",,,61103.28,82792.98,2
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MCC",,,12702.99,25171.96,10
MS-DRG,287,Cardiac Catheterization,,,2295.0,49711.73,9
MS-DRG,287,"Circulatory Disorders Except Ami, With Cardiac Cateterization Without Mcc",,,12448.93,12702.99,5
MS-DRG,287,Medical,,,13041.13,13953.63,3
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,31395.62,63657.94,10
MS-DRG,288,Acute And Subacute Endocarditis With Mcc,,,30767.71,31395.62,5
MS-DRG,288,Medical,,,13041.13,13953.63,3
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,19978.51,40151.41,10
MS-DRG,289,Acute And Subacute Endocarditis With Cc,,,19578.94,19978.51,5
MS-DRG,289,Medical,,,13041.13,13953.63,3
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,11098.91,21869.33,10
MS-DRG,290,Acute And Subacute Endocarditis Without Cc/Mcc,,,10876.93,11098.91,5
MS-DRG,290,Medical,,,13041.13,13953.63,3
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,15144.54,30198.83,10
MS-DRG,291,Heart Failure And Shock With Mcc,,,14841.65,15144.54,5
MS-DRG,291,Medical,,,13041.13,13953.63,3
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,10176.9,19971.03,10
MS-DRG,292,Heart Failure And Shock With Cc,,,9973.36,10176.9,5
MS-DRG,292,Medical,,,13041.13,13953.63,3
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,6943.59,13314.02,10
MS-DRG,293,Heart Failure And Shock Without Cc/Mcc,,,6804.72,6943.59,5
MS-DRG,293,Medical,,,13041.13,13953.63,3
MS-DRG,294,Medical,,,13041.13,13953.63,3
MS-DRG,295,Medical,,,13041.13,13953.63,3
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,18321.86,36740.57,10
MS-DRG,296,"Cardiac Arrest, Unexplained With Mcc",,,17955.43,18321.86,5
MS-DRG,296,Medical,,,13041.13,13953.63,3
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,7720.5,14913.58,10
MS-DRG,297,"Cardiac Arrest, Unexplained With Cc",,,7566.09,7720.5,5
MS-DRG,297,Medical,,,13041.13,13953.63,3
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,5676.55,10705.32,10
MS-DRG,298,"Cardiac Arrest, Unexplained Without Cc/Mcc",,,5563.01,5676.55,5
MS-DRG,298,Medical,,,13041.13,13953.63,3
MS-DRG,299,Medical,,,13041.13,13953.63,3
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,19130.76,38406.0,10
MS-DRG,299,Peripheral Vascular Disorders With Mcc,,,18748.15,19130.76,5
MS-DRG,300,Medical,,,13041.13,13953.63,3
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,12673.29,25110.8,10
MS-DRG,300,Peripheral Vascular Disorders With Cc,,,12419.82,12673.29,5
MS-DRG,301,Medical,,,13041.13,13953.63,3
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,8699.63,16929.5,10
MS-DRG,301,Peripheral Vascular Disorders Without Cc/Mcc,,,8525.64,8699.63,5
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,14148.27,28147.62,10
MS-DRG,302,Atherosclerosis With Mcc,,,13865.3,14148.27,5
MS-DRG,302,Medical,,,13041.13,13953.63,3
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,8168.36,15835.68,10
MS-DRG,303,Atherosclerosis Without Mcc,,,8005.0,8168.36,5
MS-DRG,303,Medical,,,13041.13,13953.63,3
MS-DRG,304,HYPERTENSION WITH MCC,,,14072.86,27992.37,10
MS-DRG,304,Hypertension With Mcc,,,13791.41,14072.86,5
MS-DRG,304,Medical,,,13041.13,13953.63,3
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,9104.08,17762.22,10
MS-DRG,305,Hypertension Without Mcc,,,8922.0,9104.08,5
MS-DRG,305,Medical,,,13041.13,13953.63,3
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,18480.67,37067.54,10
MS-DRG,306,Cardiac Congenital And Valvular Disorders With Mcc,,,18111.06,18480.67,5
MS-DRG,306,Medical,,,13041.13,13953.63,3
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,10910.39,21481.2,10
MS-DRG,307,Cardiac Congenital And Valvular Disorders Without Mcc,,,10692.18,10910.39,5
MS-DRG,307,Medical,,,13041.13,13953.63,3
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,14232.81,28321.69,10
MS-DRG,308,Cardiac Arrhythmia And Conduction Disorders With Mcc,,,13948.16,14232.81,5
MS-DRG,308,Medical,,,13041.13,13953.63,3
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,8882.43,17305.87,10
MS-DRG,309,Cardiac Arrhythmia And Conduction Disorders With Cc,,,8704.78,8882.43,5
MS-DRG,309,Medical,,,13041.13,13953.63,3
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,6944.73,13316.37,10
MS-DRG,310,Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc,,,6805.84,6944.73,5
MS-DRG,310,Medical,,,13041.13,13953.63,3
MS-DRG,311,ANGINA PECTORIS,,,8496.26,16510.79,10
MS-DRG,311,Angina Pectoris,,,8326.34,8496.26,5
MS-DRG,311,Medical,,,13041.13,13953.63,3
MS-DRG,312,Medical,,,13041.13,13953.63,3
MS-DRG,312,SYNCOPE AND COLLAPSE,,,10435.11,20502.65,10
MS-DRG,312,Syncope And Collapse,,,10226.4,10435.11,5
MS-DRG,313,CHEST PAIN,,,8703.06,16936.56,10
MS-DRG,313,Chest Pain,,,8529.0,8703.06,5
MS-DRG,313,Medical,,,13041.13,13953.63,3
MS-DRG,314,Medical,,,13041.13,13953.63,3
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,24300.63,49050.16,10
MS-DRG,314,Other Circulatory System Diagnoses With Mcc,,,23814.61,24300.63,5
MS-DRG,315,Medical,,,13041.13,13953.63,3
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,11482.79,22659.71,10
MS-DRG,315,Other Circulatory System Diagnoses With Cc,,,11253.13,11482.79,5
MS-DRG,316,Medical,,,13041.13,13953.63,3
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,8270.05,16045.04,10
MS-DRG,316,Other Circulatory System Diagnoses Without Cc/Mcc,,,8104.65,8270.05,5
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,51466.12,104980.8,10
MS-DRG,319,Other Endovascular Cardiac Valve Procedures With Mcc,,,50436.8,51466.12,5
MS-DRG,319,Surgical,,,22870.31,24470.51,3
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,27957.81,56579.87,10
MS-DRG,320,Other Endovascular Cardiac Valve Procedures Without Mcc,,,27398.65,27957.81,5
MS-DRG,320,Surgical,,,22870.31,24470.51,3
MS-DRG,321,Surgical,,,22870.31,24470.51,3
MS-DRG,322,Surgical,,,22870.31,24470.51,3
MS-DRG,323,Surgical,,,22870.31,24470.51,3
MS-DRG,324,Surgical,,,22870.31,24470.51,3
MS-DRG,325,Surgical,,,22870.31,24470.51,3
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,57458.6,117318.61,10
MS-DRG,326,"Stomach, Esophageal And Duodenal Procedures With Mcc",,,56309.42,57458.6,5
MS-DRG,326,Surgical,,,22870.31,24470.51,3
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,28402.24,57494.92,10
MS-DRG,327,"Stomach, Esophageal And Duodenal Procedures With Cc",,,27834.2,28402.24,5
MS-DRG,327,Surgical,,,22870.31,24470.51,3
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,18783.44,37690.9,10
MS-DRG,328,"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc",,,18407.77,18783.44,5
MS-DRG,328,Surgical,,,22870.31,24470.51,3
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,52992.52,108123.47,10
MS-DRG,329,Major Small And Large Bowel Procedures With Mcc,,,51932.67,52992.52,5
MS-DRG,329,Surgical,,,22870.31,24470.51,3
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,27865.26,56389.34,10
MS-DRG,330,Major Small And Large Bowel Procedures With Cc,,,27307.96,27865.26,5
MS-DRG,330,Surgical,,,22870.31,24470.51,3
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,19704.3,39586.86,10
MS-DRG,331,Major Small And Large Bowel Procedures Without Cc/Mcc,,,19310.22,19704.3,5
MS-DRG,331,Surgical,,,22870.31,24470.51,3
MS-DRG,332,RECTAL RESECTION WITH MCC,,,41843.89,85169.73,10
MS-DRG,332,Rectal Resection With Mcc,,,41007.01,41843.89,5
MS-DRG,332,Surgical,,,22870.31,24470.51,3
MS-DRG,333,RECTAL RESECTION WITH CC,,,27236.88,55095.57,10
MS-DRG,333,Rectal Resection With Cc,,,26692.14,27236.88,5
MS-DRG,333,Surgical,,,22870.31,24470.51,3
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,19190.17,38528.32,10
MS-DRG,334,Rectal Resection Without Cc/Mcc,,,18806.37,19190.17,5
MS-DRG,334,Surgical,,,22870.31,24470.51,3
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,41274.92,83998.28,10
MS-DRG,335,Peritoneal Adhesiolysis With Mcc,,,40449.42,41274.92,5
MS-DRG,335,Surgical,,,22870.31,24470.51,3
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,24569.12,49602.95,10
MS-DRG,336,Peritoneal Adhesiolysis With Cc,,,24077.73,24569.12,5
MS-DRG,336,Surgical,,,22870.31,24470.51,3
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,18014.53,36107.81,10
MS-DRG,337,Peritoneal Adhesiolysis Without Cc/Mcc,,,17654.24,18014.53,5
MS-DRG,337,Surgical,,,22870.31,24470.51,3
MS-DRG,341,Appendectomy Without Complicated Principal Diagnosis With Mcc,,,,,0
MS-DRG,343,Appendectomy Without Complicated Principal Diagnosis Without Cc/Mcc,,,,,0
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,29985.76,60755.2,10
MS-DRG,344,Minor Small And Large Bowel Procedures With Mcc,,,29386.05,29985.76,5
MS-DRG,344,Surgical,,,22870.31,24470.51,3
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,17668.35,35395.06,10
MS-DRG,345,Minor Small And Large Bowel Procedures With Cc,,,17314.98,17668.35,5
MS-DRG,345,Surgical,,,22870.31,24470.51,3
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,14029.45,27902.98,10
MS-DRG,346,Minor Small And Large Bowel Procedures Without Cc/Mcc,,,13748.86,14029.45,5
MS-DRG,346,Surgical,,,22870.31,24470.51,3
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,26704.47,53999.4,10
MS-DRG,347,Anal And Stomal Procedures With Mcc,,,26170.38,26704.47,5
MS-DRG,347,Surgical,,,22870.31,24470.51,3
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,15430.17,30786.9,10
MS-DRG,348,Anal And Stomal Procedures With Cc,,,15121.56,15430.17,5
MS-DRG,348,Surgical,,,22870.31,24470.51,3
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,10423.68,20479.12,10
MS-DRG,349,Anal And Stomal Procedures Without Cc/Mcc,,,10215.21,10423.68,5
MS-DRG,349,Surgical,,,22870.31,24470.51,3
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,28947.22,58616.96,10
MS-DRG,350,Inguinal And Femoral Hernia Procedures With Mcc,,,28368.28,28947.22,5
MS-DRG,350,Surgical,,,22870.31,24470.51,3
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,17894.56,35860.81,10
MS-DRG,351,Inguinal And Femoral Hernia Procedures With Cc,,,17536.67,17894.56,5
MS-DRG,351,Surgical,,,22870.31,24470.51,3
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,13819.23,27470.16,10
MS-DRG,352,Inguinal And Femoral Hernia Procedures Without Cc/Mcc,,,13542.84,13819.23,5
MS-DRG,352,Surgical,,,22870.31,24470.51,3
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,33632.66,68263.75,10
MS-DRG,353,Hernia Procedures Except Inguinal And Femoral With Mcc,,,32960.01,33632.66,5
MS-DRG,353,Surgical,,,22870.31,24470.51,3
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,19698.59,39575.1,10
MS-DRG,354,Hernia Procedures Except Inguinal And Femoral With Cc,,,19304.62,19698.59,5
MS-DRG,354,Surgical,,,22870.31,24470.51,3
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,15843.76,31638.44,10
MS-DRG,355,Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc,,,15526.88,15843.76,5
MS-DRG,355,Surgical,,,22870.31,24470.51,3
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,50665.22,103331.83,10
MS-DRG,356,Other Digestive System O.R. Procedures With Mcc,,,49651.92,50665.22,5
MS-DRG,356,Surgical,,,22870.31,24470.51,3
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,27046.08,54702.74,10
MS-DRG,357,Other Digestive System O.R. Procedures With Cc,,,26505.16,27046.08,5
MS-DRG,357,Surgical,,,22870.31,24470.51,3
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,16448.14,32882.8,10
MS-DRG,358,Other Digestive System O.R. Procedures Without Cc/Mcc,,,16119.18,16448.14,5
MS-DRG,358,Surgical,,,22870.31,24470.51,3
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,18664.62,37446.26,10
MS-DRG,368,Major Esophageal Disorders With Mcc,,,18291.32,18664.62,5
MS-DRG,368,Medical,,,13041.13,13953.63,3
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,11904.38,23527.7,10
MS-DRG,369,Major Esophageal Disorders With Cc,,,11666.29,11904.38,5
MS-DRG,369,Medical,,,13041.13,13953.63,3
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,8483.7,16484.92,10
MS-DRG,370,Major Esophageal Disorders Without Cc/Mcc,,,8314.02,8483.7,5
MS-DRG,370,Medical,,,13041.13,13953.63,3
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,20734.85,41708.63,10
MS-DRG,371,Major Gastrointestinal Disorders And Peritoneal Infections With Mcc,,,20320.15,20734.85,5
MS-DRG,371,Medical,,,13041.13,13953.63,3
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,12142.02,24016.98,10
MS-DRG,372,Major Gastrointestinal Disorders And Peritoneal Infections With Cc,,,11899.18,12142.02,5
MS-DRG,372,Medical,,,13041.13,13953.63,3
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,8787.6,17110.63,10
MS-DRG,373,Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc,,,8611.85,8787.6,5
MS-DRG,373,Medical,,,13041.13,13953.63,3
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,24911.87,42491.69,9
MS-DRG,374,Digestive Malignancy With Mcc,,,24413.63,24911.87,5
MS-DRG,374,Medical,,,13041.13,13953.63,3
MS-DRG,374,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,14296.8,24032.33,9
MS-DRG,375,Digestive Malignancy With Cc,,,14010.86,14296.8,5
MS-DRG,375,Medical,,,13041.13,13953.63,3
MS-DRG,375,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,11037.21,18363.99,9
MS-DRG,376,Digestive Malignancy Without Cc/Mcc,,,10816.47,11037.21,5
MS-DRG,376,Medical,,,13041.13,13953.63,3
MS-DRG,376,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,377,G.I. HEMORRHAGE WITH MCC,,,21362.09,43000.04,10
MS-DRG,377,G.I. Hemorrhage With Mcc,,,20934.84,21362.09,5
MS-DRG,377,Medical,,,13041.13,13953.63,3
MS-DRG,378,G.I. HEMORRHAGE WITH CC,,,11681.59,23069.01,10
MS-DRG,378,G.I. Hemorrhage With Cc,,,11447.95,11681.59,5
MS-DRG,378,Medical,,,13041.13,13953.63,3
MS-DRG,379,G.I. HEMORRHAGE WITHOUT CC/MCC,,,7679.37,14828.9,10
MS-DRG,379,G.I. Hemorrhage Without Cc/Mcc,,,7525.78,7679.37,5
MS-DRG,379,Medical,,,13041.13,13953.63,3
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,22895.34,46156.83,10
MS-DRG,380,Complicated Peptic Ulcer With Mcc,,,22437.43,22895.34,5
MS-DRG,380,Medical,,,13041.13,13953.63,3
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,12856.09,25487.17,10
MS-DRG,381,Complicated Peptic Ulcer With Cc,,,12598.97,12856.09,5
MS-DRG,381,Medical,,,13041.13,13953.63,3
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,9623.92,18832.51,10
MS-DRG,382,Complicated Peptic Ulcer Without Cc/Mcc,,,9431.44,9623.92,5
MS-DRG,382,Medical,,,13041.13,13953.63,3
MS-DRG,383,Medical,,,13041.13,13953.63,3
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,16251.63,32478.21,10
MS-DRG,383,Uncomplicated Peptic Ulcer With Mcc,,,15926.6,16251.63,5
MS-DRG,384,Medical,,,13041.13,13953.63,3
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,10243.16,20107.46,10
MS-DRG,384,Uncomplicated Peptic Ulcer Without Mcc,,,10038.3,10243.16,5
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,18554.94,37220.44,10
MS-DRG,385,Inflammatory Bowel Disease With Mcc,,,18183.84,18554.94,5
MS-DRG,385,Medical,,,13041.13,13953.63,3
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,11631.32,22965.5,10
MS-DRG,386,Inflammatory Bowel Disease With Cc,,,11398.69,11631.32,5
MS-DRG,386,Medical,,,13041.13,13953.63,3
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,8260.91,16026.22,10
MS-DRG,387,Inflammatory Bowel Disease Without Cc/Mcc,,,8095.69,8260.91,5
MS-DRG,387,Medical,,,13041.13,13953.63,3
MS-DRG,388,G.I. OBSTRUCTION WITH MCC,,,17349.59,34738.77,10
MS-DRG,388,G.I. Obstruction With Mcc,,,17002.59,17349.59,5
MS-DRG,388,Medical,,,13041.13,13953.63,3
MS-DRG,389,G.I. OBSTRUCTION WITH CC,,,9500.53,18578.47,10
MS-DRG,389,G.I. Obstruction With Cc,,,9310.52,9500.53,5
MS-DRG,389,Medical,,,13041.13,13953.63,3
MS-DRG,390,G.I. OBSTRUCTION WITHOUT CC/MCC,,,6692.24,12796.51,10
MS-DRG,390,G.I. Obstruction Without Cc/Mcc,,,6558.39,6692.24,5
MS-DRG,390,Medical,,,13041.13,13953.63,3
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,14967.45,29834.22,10
MS-DRG,391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc",,,14668.1,14967.45,5
MS-DRG,391,Medical,,,13041.13,13953.63,3
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,9384.0,18338.53,10
MS-DRG,392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc",,,9196.32,9384.0,5
MS-DRG,392,Medical,,,13041.13,13953.63,3
MS-DRG,393,Medical,,,13041.13,13953.63,3
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,18749.16,37620.33,10
MS-DRG,393,Other Digestive System Diagnoses With Mcc,,,18374.18,18749.16,5
MS-DRG,394,Medical,,,13041.13,13953.63,3
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,11167.46,22010.47,10
MS-DRG,394,Other Digestive System Diagnoses With Cc,,,10944.11,11167.46,5
MS-DRG,395,Medical,,,13041.13,13953.63,3
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,7891.88,15266.43,10
MS-DRG,395,Other Digestive System Diagnoses Without Cc/Mcc,,,7734.04,7891.88,5
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,27282.2,56335.23,15
MS-DRG,397,Surgical,,,22870.31,24470.51,3
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,17414.63,35604.41,15
MS-DRG,398,Surgical,,,22870.31,24470.51,3
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,13284.2,26926.78,15
MS-DRG,399,Surgical,,,22870.31,24470.51,3
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,62978.07,128682.57,10
MS-DRG,405,"Pancreas, Liver And Shunt Procedures With Mcc",,,61718.51,62978.07,5
MS-DRG,405,Surgical,,,22870.31,24470.51,3
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,33612.1,68221.4,10
MS-DRG,406,"Pancreas, Liver And Shunt Procedures With Cc",,,32939.85,33612.1,5
MS-DRG,406,Surgical,,,22870.31,24470.51,3
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,25836.16,52211.65,10
MS-DRG,407,"Pancreas, Liver And Shunt Procedures Without Cc/Mcc",,,25319.44,25836.16,5
MS-DRG,407,Surgical,,,22870.31,24470.51,3
MS-DRG,408,BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,41214.37,83873.61,10
MS-DRG,408,Biliary Tract Procedure Except Only Cholecystectomy With Or Without C.D.E. With Mcc,,,40390.08,41214.37,5
MS-DRG,408,Surgical,,,22870.31,24470.51,3
MS-DRG,409,BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,25352.88,51216.63,10
MS-DRG,409,Biliary Tract Procedure Except Only Cholecystectomy With Or Without C.D.E. With Cc,,,24845.82,25352.88,5
MS-DRG,409,Surgical,,,22870.31,24470.51,3
MS-DRG,410,BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,18616.63,37347.47,10
MS-DRG,410,Biliary Tract Procedure Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc,,,18244.3,18616.63,5
MS-DRG,410,Surgical,,,22870.31,24470.51,3
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,38217.56,77703.53,10
MS-DRG,411,Cholecystectomy With C.D.E. With Mcc,,,37453.21,38217.56,5
MS-DRG,411,Surgical,,,22870.31,24470.51,3
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,24498.28,49457.11,10
MS-DRG,412,Cholecystectomy With C.D.E. With Cc,,,24008.32,24498.28,5
MS-DRG,412,Surgical,,,22870.31,24470.51,3
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,19448.38,39059.94,10
MS-DRG,413,Cholecystectomy With C.D.E. Without Cc/Mcc,,,19059.41,19448.38,5
MS-DRG,413,Surgical,,,22870.31,24470.51,3
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,41180.09,83803.04,10
MS-DRG,414,Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc,,,40356.49,41180.09,5
MS-DRG,414,Surgical,,,22870.31,24470.51,3
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,24089.26,48614.98,10
MS-DRG,415,Cholecystectomy Except By Laparoscope Without C.D.E. With Cc,,,23607.48,24089.26,5
MS-DRG,415,Surgical,,,22870.31,24470.51,3
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,16052.84,32068.91,10
MS-DRG,416,Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc,,,15731.78,16052.84,5
MS-DRG,416,Surgical,,,22870.31,24470.51,3
MS-DRG,417,LAPAR CHOLECYS WO C.D.E. W MCC,,,43740.96,60558.34,2
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,27741.87,56135.29,10
MS-DRG,417,Laparoscopic Cholecystectomy,,,22982.02,36003.55,5
MS-DRG,417,Laparoscopic Cholecystectomy Without C.D.E. With Mcc,,,27187.03,27741.87,5
MS-DRG,417,Surgical,,,22870.31,24470.51,3
MS-DRG,418,LAPARO CHOLECYS WO C.D.E. W CC,,,43740.96,60558.34,2
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,19803.7,39791.51,10
MS-DRG,418,Laparoscopic Cholecystectomy,,,22982.02,36003.55,5
MS-DRG,418,Laparoscopic Cholecystectomy Without C.D.E. With Cc,,,19407.63,19803.7,5
MS-DRG,418,Surgical,,,22870.31,24470.51,3
MS-DRG,419,LAP CHOLE WO C.D.E. WO CC/MCC,,,43740.96,60558.34,2
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,16081.4,32127.71,10
MS-DRG,419,Laparoscopic Cholecystectomy,,,22982.02,36003.55,5
MS-DRG,419,Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc,,,15759.77,16081.4,5
MS-DRG,419,Surgical,,,22870.31,24470.51,3
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,39403.49,80145.21,10
MS-DRG,420,Hepatobiliary Diagnostic Procedures With Mcc,,,38615.42,39403.49,5
MS-DRG,420,Surgical,,,22870.31,24470.51,3
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,20328.11,40871.21,10
MS-DRG,421,Hepatobiliary Diagnostic Procedures With Cc,,,19921.55,20328.11,5
MS-DRG,421,Surgical,,,22870.31,24470.51,3
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,16466.42,32920.44,10
MS-DRG,422,Hepatobiliary Diagnostic Procedures Without Cc/Mcc,,,16137.1,16466.42,5
MS-DRG,422,Surgical,,,22870.31,24470.51,3
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,47925.48,97691.02,10
MS-DRG,423,Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc,,,46966.97,47925.48,5
MS-DRG,423,Surgical,,,22870.31,24470.51,3
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,25473.99,51465.97,10
MS-DRG,424,Other Hepatobiliary Or Pancreas O.R. Procedures With Cc,,,24964.51,25473.99,5
MS-DRG,424,Surgical,,,22870.31,24470.51,3
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,17618.08,35291.56,10
MS-DRG,425,Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc,,,17265.71,17618.08,5
MS-DRG,425,Surgical,,,22870.31,24470.51,3
MS-DRG,429,COMB ANTE/POST SPNL FSN W CC,,,88784.16,120304.46,2
MS-DRG,429,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH CC,,,103412.69,179002.73,9
MS-DRG,429,Combined Anterior/Posterior Spinal Fusion With Cc,,,101344.44,103412.69,5
MS-DRG,429,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,429,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,429,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,429,Surgical,,,22870.31,24470.51,3
MS-DRG,430,COM ANTE/POST SPL FS WO CC/MCC,,,88784.16,120304.46,2
MS-DRG,430,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITHOUT CC/MCC,,,66366.76,114580.74,9
MS-DRG,430,Combined Anterior/Posterior Spinal Fusion Without Cc/Mcc,,,65039.42,66366.76,5
MS-DRG,430,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,430,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,430,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,430,Surgical,,,22870.31,24470.51,3
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,22963.89,46297.97,10
MS-DRG,432,Cirrhosis And Alcoholic Hepatitis With Mcc,,,22504.61,22963.89,5
MS-DRG,432,Medical,,,13041.13,13953.63,3
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,12544.18,24844.99,10
MS-DRG,433,Cirrhosis And Alcoholic Hepatitis With Cc,,,12293.3,12544.18,5
MS-DRG,433,Medical,,,13041.13,13953.63,3
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,8617.37,16760.14,10
MS-DRG,434,Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc,,,8445.02,8617.37,5
MS-DRG,434,Medical,,,13041.13,13953.63,3
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,21461.49,36491.56,9
MS-DRG,435,Malignancy Of Hepatobiliary System Or Pancreas With Mcc,,,21032.26,21461.49,5
MS-DRG,435,Medical,,,13041.13,13953.63,3
MS-DRG,435,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,13399.92,22472.69,9
MS-DRG,436,Malignancy Of Hepatobiliary System Or Pancreas With Cc,,,13131.93,13399.92,5
MS-DRG,436,Medical,,,13041.13,13953.63,3
MS-DRG,436,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,10226.03,16953.36,9
MS-DRG,437,Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc,,,10021.51,10226.03,5
MS-DRG,437,Medical,,,13041.13,13953.63,3
MS-DRG,437,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,19102.2,38347.19,10
MS-DRG,438,Disorders Of Pancreas Except Malignancy With Mcc,,,18720.15,19102.2,5
MS-DRG,438,Medical,,,13041.13,13953.63,3
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,10087.78,19787.55,10
MS-DRG,439,Disorders Of Pancreas Except Malignancy With Cc,,,9886.03,10087.78,5
MS-DRG,439,Medical,,,13041.13,13953.63,3
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,7576.54,14617.19,10
MS-DRG,440,Disorders Of Pancreas Except Malignancy Without Cc/Mcc,,,7425.01,7576.54,5
MS-DRG,440,Medical,,,13041.13,13953.63,3
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,20981.63,42216.73,10
MS-DRG,441,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc",,,20562.0,20981.63,5
MS-DRG,441,Medical,,,13041.13,13953.63,3
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,11505.64,22706.75,10
MS-DRG,442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",,,11275.53,11505.64,5
MS-DRG,442,Medical,,,13041.13,13953.63,3
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,8471.13,16459.04,10
MS-DRG,443,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc",,,8301.71,8471.13,5
MS-DRG,443,Medical,,,13041.13,13953.63,3
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,19567.2,39304.58,10
MS-DRG,444,Disorders Of The Biliary Tract With Mcc,,,19175.86,19567.2,5
MS-DRG,444,Medical,,,13041.13,13953.63,3
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,12980.62,25743.57,10
MS-DRG,445,Disorders Of The Biliary Tract With Cc,,,12721.01,12980.62,5
MS-DRG,445,Medical,,,13041.13,13953.63,3
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,9928.97,19460.58,10
MS-DRG,446,Disorders Of The Biliary Tract Without Cc/Mcc,,,9730.39,9928.97,5
MS-DRG,446,Medical,,,13041.13,13953.63,3
MS-DRG,453,COMB ANTE/POST SPNL FUS W MCC,,,88784.16,120304.46,2
MS-DRG,453,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,453,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,453,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,453,Surgical,,,22870.31,24470.51,3
MS-DRG,456,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,456,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,456,SPINAL FUS MALIG 9 FUS W MCC,,,88784.16,120304.46,2
MS-DRG,456,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH MCC,,,96486.79,166958.75,9
MS-DRG,456,Spinal Fusion Except Cervical With Spinal Curvature Or Malignancy Or Infection Or Extensive Fusions With Mcc,,,94557.05,96486.79,5
MS-DRG,456,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,456,Surgical,,,22870.31,24470.51,3
MS-DRG,457,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,457,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,457,SPINAL FUS MALIG 9 FUS W CC,,,88784.16,120304.46,2
MS-DRG,457,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH CC,,,68606.08,118474.87,9
MS-DRG,457,Spinal Fusion Except Cervical With Spinal Curvature Or Malignancy Or Infection Or Extensive Fusions With Cc,,,67233.96,68606.08,5
MS-DRG,457,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,457,Surgical,,,22870.31,24470.51,3
MS-DRG,458,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,458,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,458,SPINAL FUS MAL 9 FUS WO CCMCC,,,88784.16,120304.46,2
MS-DRG,458,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC,,,48149.41,82901.22,9
MS-DRG,458,Spinal Fusion Except Cervical With Spinal Curvature Or Malignancy Or Infection Or Extensive Fusions Without Cc/Mcc,,,47186.42,48149.41,5
MS-DRG,458,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,458,Surgical,,,22870.31,24470.51,3
MS-DRG,459,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,459,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,459,SPINAL FUS EXCEPT CERV W MCC,,,88784.16,120304.46,2
MS-DRG,459,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,459,Surgical,,,22870.31,24470.51,3
MS-DRG,460,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,460,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,,,0
MS-DRG,460,SPNL FUSION EXCPT CERV WO MCC,,,88784.16,120304.46,2
MS-DRG,460,Spinal Fusion Except Cervical Without Mcc,,,,,0
MS-DRG,460,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,460,Surgical,,,22870.31,24470.51,3
MS-DRG,461,BILAT MULT MAJ JT LW EXT W MCC,,,57081.53,77346.72,2
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,63577.89,109730.96,9
MS-DRG,461,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc,,,62306.33,63577.89,5
MS-DRG,461,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,461,Surgical,,,22870.31,24470.51,3
MS-DRG,462,BILAT MT MAJ JT LW EXT WO MCC,,,57081.53,77346.72,2
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,30867.78,52848.88,9
MS-DRG,462,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc,,,30250.43,30867.78,5
MS-DRG,462,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,462,Surgical,,,22870.31,24470.51,3
MS-DRG,463,Surgical,,,22870.31,24470.51,3
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,65594.42,134069.34,10
MS-DRG,463,Wound Debridement And Skin Graft Except Hand For Musculoskeletal System And Connective Tissue Disorders With Mcc,,,64282.53,65594.42,5
MS-DRG,464,Surgical,,,22870.31,24470.51,3
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,36062.78,73267.09,10
MS-DRG,464,Wound Debridement And Skin Graft Except Hand For Musculoskeletal System And Connective Tissue Disorders With Cc,,,35341.53,36062.78,5
MS-DRG,465,Surgical,,,22870.31,24470.51,3
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,21312.96,42898.9,10
MS-DRG,465,Wound Debridement And Skin Graft Except Hand For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,20886.7,21312.96,5
MS-DRG,466,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,59949.27,103420.89,9
MS-DRG,466,Revision Of Hip Or Knee Replacement With Mcc,,,58750.29,59949.27,5
MS-DRG,466,Surgical,,,22870.31,24470.51,3
MS-DRG,467,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,40768.79,70066.49,9
MS-DRG,467,Revision Of Hip Or Knee Replacement With Cc,,,39953.41,40768.79,5
MS-DRG,467,Surgical,,,22870.31,24470.51,3
MS-DRG,468,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,31873.19,54597.26,9
MS-DRG,468,Revision Of Hip Or Knee Replacement Without Cc/Mcc,,,31235.73,31873.19,5
MS-DRG,468,Surgical,,,22870.31,24470.51,3
MS-DRG,469,Joint Replacement,,,41982.12,41982.12,2
MS-DRG,469,Joint Surgery,,,30161.91,47249.7,5
MS-DRG,469,MAJ JT REP/REATT LW EXT W MCC,,,57081.53,77346.72,2
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,35131.64,60263.62,9
MS-DRG,469,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Replacement,,,34429.0,35131.64,5
MS-DRG,469,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,469,Surgical,,,22870.31,24470.51,3
MS-DRG,470,Joint Replacement,,,41982.12,41982.12,2
MS-DRG,470,Joint Surgery,,,30161.91,47249.7,5
MS-DRG,470,MAJ JT REP/REATT LW EXT WO MCC,,,57081.53,77346.72,2
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,22514.88,38323.39,9
MS-DRG,470,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc,,,22064.58,22514.88,5
MS-DRG,470,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,470,Surgical,,,22870.31,24470.51,3
MS-DRG,471,CERVICAL SPINAL FUSION W MCC,,,88784.16,120304.46,2
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,55645.43,95936.61,9
MS-DRG,471,Cervical Spinal Fusion With Mcc,,,54532.52,55645.43,5
MS-DRG,471,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,471,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,471,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,471,Surgical,,,22870.31,24470.51,3
MS-DRG,472,CERVICAL SPINAL FUSION W CC,,,88784.16,120304.46,2
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,34136.51,58533.11,9
MS-DRG,472,Cervical Spinal Fusion With Cc,,,33453.78,34136.51,5
MS-DRG,472,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,472,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,472,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,472,Surgical,,,22870.31,24470.51,3
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,28369.11,48503.75,9
MS-DRG,473,CRVCL SPINAL FUSION W/O CC/MCC,,,88784.16,120304.46,2
MS-DRG,473,Cervical Spinal Fusion Without Cc/Mcc,,,27801.73,28369.11,5
MS-DRG,473,Orthopedic Surgery - Spine/Spine Fusion,,,155120.0,155120.0,1
MS-DRG,473,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,473,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,473,Surgical,,,22870.31,24470.51,3
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,49523.85,85291.34,9
MS-DRG,474,Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc,,,48533.38,49523.85,5
MS-DRG,474,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,474,Surgical,,,22870.31,24470.51,3
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,26477.11,45213.61,9
MS-DRG,475,Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc,,,25947.57,26477.11,5
MS-DRG,475,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,475,Surgical,,,22870.31,24470.51,3
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,13960.9,23448.21,9
MS-DRG,476,Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,13681.68,13960.9,5
MS-DRG,476,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,476,Surgical,,,22870.31,24470.51,3
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,39946.18,68635.99,9
MS-DRG,477,Biopsies Of Musculoskeletal System And Connective Tissue With Mcc,,,39147.26,39946.18,5
MS-DRG,477,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,477,Surgical,,,22870.31,24470.51,3
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,28573.62,48859.39,9
MS-DRG,478,Biopsies Of Musculoskeletal System And Connective Tissue With Cc,,,28002.15,28573.62,5
MS-DRG,478,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,478,Surgical,,,22870.31,24470.51,3
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,21715.12,36932.63,9
MS-DRG,479,Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc,,,21280.82,21715.12,5
MS-DRG,479,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,479,Surgical,,,22870.31,24470.51,3
MS-DRG,480,HIP AND FEM PX EXCP MAJ JT W MCC,,,57081.53,77346.72,2
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,33750.34,57861.58,9
MS-DRG,480,Hip And Femur Procedures Except Major Joint With Mcc,,,33075.33,33750.34,5
MS-DRG,480,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,480,Surgical,,,22870.31,24470.51,3
MS-DRG,481,HIP AND FEM PX EXCPT MAJ JT W CC,,,57081.53,78557.81,2
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,24406.88,41613.53,9
MS-DRG,481,Hip And Femur Procedures Except Major Joint With Cc,,,23918.74,24406.88,5
MS-DRG,481,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,481,Surgical,,,22870.31,24470.51,3
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,19111.34,32404.71,9
MS-DRG,482,HPANDFM PXS EX MAJ JNT WO CC/MCC,,,57081.53,77346.72,2
MS-DRG,482,Hip And Femur Procedures Except Major Joint Without Cc/Mcc,,,18729.11,19111.34,5
MS-DRG,482,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,482,Surgical,,,22870.31,24470.51,3
MS-DRG,483,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,32146.25,55072.11,9
MS-DRG,483,Major Joint/Limb Reattachment Procedure Of Upper Extremities,,,31503.33,32146.25,5
MS-DRG,483,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,483,Surgical,,,22870.31,24470.51,3
MS-DRG,484,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,485,KNEE PROCEDURES WITH PDX OF INFECTION WITH MCC,,,37346.97,64116.02,9
MS-DRG,485,Knee Procedures With Pdx Of Infection With Mcc,,,36600.03,37346.97,5
MS-DRG,485,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,485,Surgical,,,22870.31,24470.51,3
MS-DRG,486,KNEE PROCEDURES WITH PDX OF INFECTION WITH CC,,,24368.03,41545.97,9
MS-DRG,486,Knee Procedures With Pdx Of Infection With Cc,,,23880.67,24368.03,5
MS-DRG,486,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,486,Surgical,,,22870.31,24470.51,3
MS-DRG,487,KNEE PROCEDURES WITH PDX OF INFECTION WITHOUT CC/MCC,,,18370.99,31117.26,9
MS-DRG,487,Knee Procedures With Pdx Of Infection Without Cc/Mcc,,,18003.57,18370.99,5
MS-DRG,487,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,487,Surgical,,,22870.31,24470.51,3
MS-DRG,488,KNEE PROCEDURES WITHOUT PDX OF INFECTION WITH CC/MCC,,,20686.86,35144.51,9
MS-DRG,488,Knee Procedures Without Pdx Of Infection With Cc/Mcc,,,20273.13,20686.86,5
MS-DRG,488,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,488,Surgical,,,22870.31,24470.51,3
MS-DRG,489,KNEE PROCEDURES WITHOUT PDX OF INFECTION WITHOUT CC/MCC,,,13236.54,22188.58,9
MS-DRG,489,Knee Procedures Without Pdx Of Infection Without Cc/Mcc,,,12971.81,13236.54,5
MS-DRG,489,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,489,Surgical,,,22870.31,24470.51,3
MS-DRG,490,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,491,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,42425.43,72947.35,9
MS-DRG,492,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc",,,41576.92,42425.43,5
MS-DRG,492,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,492,Surgical,,,22870.31,24470.51,3
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,29452.21,50387.23,9
MS-DRG,493,"LR EXANDHUM PX EX HP, FT, FEM W CC",,,57081.53,77346.72,2
MS-DRG,493,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc",,,28863.17,29452.21,5
MS-DRG,493,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,493,Surgical,,,22870.31,24470.51,3
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,23401.47,39865.14,9
MS-DRG,494,"LR EXANDHU EX HP, FT, FEM WO CCMCC",,,57081.53,77346.72,2
MS-DRG,494,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc",,,22933.44,23401.47,5
MS-DRG,494,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,494,Surgical,,,22870.31,24470.51,3
MS-DRG,495,EXC AND REM FIX DVC EX HANDF W MCC,,,57081.53,77346.72,2
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,41901.02,72035.41,9
MS-DRG,495,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc,,,41063.0,41901.02,5
MS-DRG,495,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,495,Surgical,,,22870.31,24470.51,3
MS-DRG,496,EXC AND REM FIX DVC EX HANDF W CC,,,57081.53,77346.72,2
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,21086.74,35839.89,9
MS-DRG,496,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc,,,20665.01,21086.74,5
MS-DRG,496,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,496,Surgical,,,22870.31,24470.51,3
MS-DRG,497,EXCANDREM FIX DV EX HANDF WO CCMCC,,,57081.53,77346.72,2
MS-DRG,497,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,14281.94,24006.5,9
MS-DRG,497,Local Excision And Removal Internal Fixation Devices Except Hip And Femur Without Cc/Mcc,,,13996.3,14281.94,5
MS-DRG,497,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,497,Surgical,,,22870.31,24470.51,3
MS-DRG,498,EXCANDREM INT FIX DV HANDF W CCMCC,,,57081.53,77346.72,2
MS-DRG,498,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,34944.26,59937.78,9
MS-DRG,498,Local Excision And Removal Internal Fixation Devices Of Hip And Femur With Cc/Mcc,,,34245.38,34944.26,5
MS-DRG,498,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,498,Surgical,,,22870.31,24470.51,3
MS-DRG,499,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,23496.3,40030.05,9
MS-DRG,499,Local Excision And Removal Internal Fixation Devices Of Hip And Femur Without Cc/Mcc,,,23026.37,23496.3,5
MS-DRG,499,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,499,Surgical,,,22870.31,24470.51,3
MS-DRG,500,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,36635.18,62878.25,9
MS-DRG,500,Soft Tissue Procedures With Mcc,,,35902.48,36635.18,5
MS-DRG,500,Surgical,,,22870.31,24470.51,3
MS-DRG,501,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,20449.22,34731.25,9
MS-DRG,501,Soft Tissue Procedures With Cc,,,20040.24,20449.22,5
MS-DRG,501,Surgical,,,22870.31,24470.51,3
MS-DRG,502,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,15854.04,26740.34,9
MS-DRG,502,Soft Tissue Procedures Without Cc/Mcc,,,15536.96,15854.04,5
MS-DRG,502,Surgical,,,22870.31,24470.51,3
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,32365.62,55453.57,9
MS-DRG,503,Foot Procedures With Mcc,,,31718.3,32365.62,5
MS-DRG,503,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,503,Surgical,,,22870.31,24470.51,3
MS-DRG,504,FOOT PROCEDURES WITH CC,,,21832.8,37137.27,9
MS-DRG,504,Foot Procedures With Cc,,,21396.15,21832.8,5
MS-DRG,504,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,504,Surgical,,,22870.31,24470.51,3
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,20959.92,35619.35,9
MS-DRG,505,Foot Procedures Without Cc/Mcc,,,20540.72,20959.92,5
MS-DRG,505,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,505,Surgical,,,22870.31,24470.51,3
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,15891.74,26805.91,9
MS-DRG,506,MAJOR THUMB OR JOINT PROCS,,,57081.53,77346.72,2
MS-DRG,506,Major Thumb Or Joint Procedures,,,15573.91,15891.74,5
MS-DRG,506,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,506,Surgical,,,22870.31,24470.51,3
MS-DRG,507,MAJ SHLD OR ELB JT PX W CC/MCC,,,57081.53,77346.72,2
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,21115.3,35889.56,9
MS-DRG,507,Major Shoulder Or Elbow Joint Procedures With Cc/Mcc,,,20693.0,21115.3,5
MS-DRG,507,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,507,Surgical,,,22870.31,24470.51,3
MS-DRG,508,MAJ SHD ELBW JNT PXS WO CC/MCC,,,57081.53,77346.72,2
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,17779.17,30088.1,9
MS-DRG,508,Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc,,,17423.59,17779.17,5
MS-DRG,508,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,508,Surgical,,,22870.31,24470.51,3
MS-DRG,509,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,509,Surgical,,,22870.31,24470.51,3
MS-DRG,510,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,510,"SHD, ELB, FOREARM PX W MCC",,,57081.53,77346.72,2
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,34986.54,60011.29,9
MS-DRG,510,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc",,,34286.81,34986.54,5
MS-DRG,510,Surgical,,,22870.31,24470.51,3
MS-DRG,511,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,511,"SHD, ELB, FOREARM PX W CC",,,57081.53,77346.72,2
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,24234.36,41313.52,9
MS-DRG,511,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc",,,23749.67,24234.36,5
MS-DRG,511,Surgical,,,22870.31,24470.51,3
MS-DRG,512,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,512,"SHD, ELB, FOREARM PX WO CC/MCC",,,57081.53,77346.72,2
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,19390.11,32889.49,9
MS-DRG,512,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc",,,19002.31,19390.11,5
MS-DRG,512,Surgical,,,22870.31,24470.51,3
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,18463.53,31278.19,9
MS-DRG,513,HND/WRST EX MAJ TH/JT W CCMCC,,,57081.53,77346.72,2
MS-DRG,513,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc",,,18094.26,18463.53,5
MS-DRG,513,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,513,Surgical,,,22870.31,24470.51,3
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,12156.87,20311.06,9
MS-DRG,514,HND/WRST EX MAJ TH/JT WO CCMCC,,,57081.53,77346.72,2
MS-DRG,514,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc",,,11913.73,12156.87,5
MS-DRG,514,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,514,Surgical,,,22870.31,24470.51,3
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,36887.68,63317.33,9
MS-DRG,515,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,515,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc,,,36149.92,36887.68,5
MS-DRG,515,Surgical,,,22870.31,24470.51,3
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,24219.51,41287.69,9
MS-DRG,516,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,516,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc,,,23735.12,24219.51,5
MS-DRG,516,Surgical,,,22870.31,24470.51,3
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,18033.95,30531.16,9
MS-DRG,517,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,517,Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc,,,17673.27,18033.95,5
MS-DRG,517,Surgical,,,22870.31,24470.51,3
MS-DRG,518,BACK AND NECK PROC EXC SPIN FUSI W MCC,,,88784.16,120304.46,2
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,43176.06,87912.51,10
MS-DRG,518,Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator,,,42312.54,43176.06,5
MS-DRG,518,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,518,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,518,Surgical,,,22870.31,24470.51,3
MS-DRG,519,BACK AND NECK PROC EXC SPINAL FUSI WCC,,,88784.16,120304.46,2
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,23329.49,47050.7,10
MS-DRG,519,Back And Neck Procedures Except Spinal Fusion With Cc,,,22862.9,23329.49,5
MS-DRG,519,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,519,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,519,Surgical,,,22870.31,24470.51,3
MS-DRG,520,BACK AND NECK PROC EXC SPINAL FUSIO W/O,,,88784.16,120304.46,2
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,17544.96,35141.01,10
MS-DRG,520,Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc,,,17194.06,17544.96,5
MS-DRG,520,Pediatric and Neonatal Services: Orthopedic Spine Procedures,,,9160.0,9160.0,1
MS-DRG,520,Spine Surgery,,,46127.97,70651.17,3
MS-DRG,520,Surgical,,,22870.31,24470.51,3
MS-DRG,521,Joint Replacement,,,41982.12,41982.12,2
MS-DRG,521,Joint Surgery,,,30161.91,47249.7,5
MS-DRG,521,Surgical,,,22870.31,24470.51,3
MS-DRG,522,Joint Replacement,,,41982.12,41982.12,2
MS-DRG,522,Joint Surgery,,,30161.91,47249.7,5
MS-DRG,522,Surgical,,,22870.31,24470.51,3
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,18388.13,36877.01,10
MS-DRG,533,Fractures Of Femur With Mcc,,,18020.37,18388.13,5
MS-DRG,533,Medical,,,13041.13,13953.63,3
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,9686.76,18961.89,10
MS-DRG,534,Fractures Of Femur Without Mcc,,,9493.03,9686.76,5
MS-DRG,534,Medical,,,13041.13,13953.63,3
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,15123.97,30156.49,10
MS-DRG,535,Fractures Of Hip And Pelvis With Mcc,,,14821.49,15123.97,5
MS-DRG,535,Inpatient Acetabular Surgeries,,,,,0
MS-DRG,535,Medical,,,13041.13,13953.63,3
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,9703.9,18997.17,10
MS-DRG,536,Fractures Of Hip And Pelvis Without Mcc,,,9509.82,9703.9,5
MS-DRG,536,Inpatient Acetabular Surgeries,,,,,0
MS-DRG,536,Medical,,,13041.13,13953.63,3
MS-DRG,537,Medical,,,13041.13,13953.63,3
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,11379.96,22448.0,10
MS-DRG,537,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc",,,11152.36,11379.96,5
MS-DRG,538,Medical,,,13041.13,13953.63,3
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,8706.49,16943.62,10
MS-DRG,538,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc",,,8532.36,8706.49,5
MS-DRG,539,Medical,,,13041.13,13953.63,3
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,22981.03,46333.25,10
MS-DRG,539,Osteomyelitis With Mcc,,,22521.4,22981.03,5
MS-DRG,540,Medical,,,13041.13,13953.63,3
MS-DRG,540,OSTEOMYELITIS WITH CC,,,15287.35,30492.86,10
MS-DRG,540,Osteomyelitis With Cc,,,14981.61,15287.35,5
MS-DRG,541,Medical,,,13041.13,13953.63,3
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,9473.11,18522.01,10
MS-DRG,541,Osteomyelitis Without Cc/Mcc,,,9283.65,9473.11,5
MS-DRG,542,Medical,,,13041.13,13953.63,3
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,20659.44,41553.38,10
MS-DRG,542,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc,,,20246.25,20659.44,5
MS-DRG,543,Medical,,,13041.13,13953.63,3
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,12221.99,24181.64,10
MS-DRG,543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,,,11977.55,12221.99,5
MS-DRG,544,Medical,,,13041.13,13953.63,3
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,9098.37,17750.46,10
MS-DRG,544,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc,,,8916.4,9098.37,5
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,28830.68,58377.03,10
MS-DRG,545,Connective Tissue Disorders With Mcc,,,28254.07,28830.68,5
MS-DRG,545,Medical,,,13041.13,13953.63,3
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,13654.7,27131.43,10
MS-DRG,546,Connective Tissue Disorders With Cc,,,13381.61,13654.7,5
MS-DRG,546,Medical,,,13041.13,13953.63,3
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,10030.66,19669.93,10
MS-DRG,547,Connective Tissue Disorders Without Cc/Mcc,,,9830.04,10030.66,5
MS-DRG,547,Medical,,,13041.13,13953.63,3
MS-DRG,548,Medical,,,13041.13,13953.63,3
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,22537.73,45420.56,10
MS-DRG,548,Septic Arthritis With Mcc,,,22086.98,22537.73,5
MS-DRG,549,Medical,,,13041.13,13953.63,3
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,14269.38,28396.97,10
MS-DRG,549,Septic Arthritis With Cc,,,13983.99,14269.38,5
MS-DRG,550,Medical,,,13041.13,13953.63,3
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,10463.67,20561.45,10
MS-DRG,550,Septic Arthritis Without Cc/Mcc,,,10254.4,10463.67,5
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,19626.61,39426.9,10
MS-DRG,551,Medical,,,13041.13,13953.63,3
MS-DRG,551,Medical Back Problems With Mcc,,,19234.08,19626.61,5
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,11459.94,22612.66,10
MS-DRG,552,Medical,,,13041.13,13953.63,3
MS-DRG,552,Medical Back Problems Without Mcc,,,11230.74,11459.94,5
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,15287.35,30492.86,10
MS-DRG,553,Bone Diseases And Arthropathies With Mcc,,,14981.61,15287.35,5
MS-DRG,553,Medical,,,13041.13,13953.63,3
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,9960.96,19526.44,10
MS-DRG,554,Bone Diseases And Arthropathies Without Mcc,,,9761.74,9960.96,5
MS-DRG,554,Medical,,,13041.13,13953.63,3
MS-DRG,555,Medical,,,13041.13,13953.63,3
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,15578.69,31092.7,10
MS-DRG,555,Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,,,15267.12,15578.69,5
MS-DRG,556,Medical,,,13041.13,13953.63,3
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,9966.68,19538.2,10
MS-DRG,556,Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,,,9767.34,9966.68,5
MS-DRG,557,Medical,,,13041.13,13953.63,3
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,17464.98,34976.35,10
MS-DRG,557,"Tendonitis, Myositis And Bursitis With Mcc",,,17115.68,17464.98,5
MS-DRG,558,Medical,,,13041.13,13953.63,3
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,10681.89,21010.74,10
MS-DRG,558,"Tendonitis, Myositis And Bursitis Without Mcc",,,10468.25,10681.89,5
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,21783.67,43868.04,10
MS-DRG,559,"Aftercare, Musculoskeletal System And Connective Tissue With Mcc",,,21348.0,21783.67,5
MS-DRG,559,Medical,,,13041.13,13953.63,3
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,13342.8,26489.25,10
MS-DRG,560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",,,13075.94,13342.8,5
MS-DRG,560,Medical,,,13041.13,13953.63,3
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,9661.63,18910.14,10
MS-DRG,561,"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc",,,9468.39,9661.63,5
MS-DRG,561,Medical,,,13041.13,13953.63,3
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,16755.48,33515.57,10
MS-DRG,562,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc",,,16420.37,16755.48,5
MS-DRG,562,Medical,,,13041.13,13953.63,3
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,10708.17,21064.85,10
MS-DRG,563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc",,,10494.0,10708.17,5
MS-DRG,563,Medical,,,13041.13,13953.63,3
MS-DRG,564,Medical,,,13041.13,13953.63,3
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,18112.78,36310.1,10
MS-DRG,564,Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc,,,17750.53,18112.78,5
MS-DRG,565,Medical,,,13041.13,13953.63,3
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,11609.61,22920.81,10
MS-DRG,565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,,,11377.42,11609.61,5
MS-DRG,566,Medical,,,13041.13,13953.63,3
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,9037.81,17625.78,10
MS-DRG,566,Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc,,,8857.06,9037.81,5
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,34079.38,69183.5,10
MS-DRG,570,Skin Debridement With Mcc,,,33397.79,34079.38,5
MS-DRG,570,Surgical,,,22870.31,24470.51,3
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,19779.71,39742.11,10
MS-DRG,571,Skin Debridement With Cc,,,19384.11,19779.71,5
MS-DRG,571,Surgical,,,22870.31,24470.51,3
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,13573.59,26964.41,10
MS-DRG,572,Skin Debridement Without Cc/Mcc,,,13302.11,13573.59,5
MS-DRG,572,Surgical,,,22870.31,24470.51,3
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,75327.48,154108.58,10
MS-DRG,573,Skin Graft For Skin Ulcer Or Cellulitis With Mcc,,,73820.93,75327.48,5
MS-DRG,573,Surgical,,,22870.31,24470.51,3
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,40138.12,81657.74,10
MS-DRG,574,Skin Graft For Skin Ulcer Or Cellulitis With Cc,,,39335.36,40138.12,5
MS-DRG,574,Surgical,,,22870.31,24470.51,3
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,21007.91,42270.83,10
MS-DRG,575,Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,20587.75,21007.91,5
MS-DRG,575,Surgical,,,22870.31,24470.51,3
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,56473.75,115290.93,10
MS-DRG,576,Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc,,,55344.28,56473.75,5
MS-DRG,576,Surgical,,,22870.31,24470.51,3
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,30761.53,62352.42,10
MS-DRG,577,Skin Graft Except For Skin Ulcer Or Cellulitis With Cc,,,30146.3,30761.53,5
MS-DRG,577,Surgical,,,22870.31,24470.51,3
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,18830.28,37787.35,10
MS-DRG,578,Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,18453.68,18830.28,5
MS-DRG,578,Surgical,,,22870.31,24470.51,3
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,37477.21,76179.24,10
MS-DRG,579,"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc",,,36727.67,37477.21,5
MS-DRG,579,Surgical,,,22870.31,24470.51,3
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,20219.58,40647.74,10
MS-DRG,580,"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc",,,19815.18,20219.58,5
MS-DRG,580,Surgical,,,22870.31,24470.51,3
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,16964.56,33946.04,10
MS-DRG,581,"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc",,,16625.27,16964.56,5
MS-DRG,581,Surgical,,,22870.31,24470.51,3
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,22488.6,45319.41,10
MS-DRG,582,Mastectomy For Malignancy With Cc/Mcc,,,22038.83,22488.6,5
MS-DRG,582,Surgical,,,22870.31,24470.51,3
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,20178.44,40563.06,10
MS-DRG,583,Mastectomy For Malignancy Without Cc/Mcc,,,19774.88,20178.44,5
MS-DRG,583,Surgical,,,22870.31,24470.51,3
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,24934.72,50355.69,10
MS-DRG,584,"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc",,,24436.03,24934.72,5
MS-DRG,584,Surgical,,,22870.31,24470.51,3
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,22517.17,45378.22,10
MS-DRG,585,"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc",,,22066.82,22517.17,5
MS-DRG,585,Surgical,,,22870.31,24470.51,3
MS-DRG,592,Medical,,,13041.13,13953.63,3
MS-DRG,592,SKIN ULCERS WITH MCC,,,22588.0,45524.06,10
MS-DRG,592,Skin Ulcers With Mcc,,,22136.24,22588.0,5
MS-DRG,593,Medical,,,13041.13,13953.63,3
MS-DRG,593,SKIN ULCERS WITH CC,,,14030.59,27905.33,10
MS-DRG,593,Skin Ulcers With Cc,,,13749.98,14030.59,5
MS-DRG,594,Medical,,,13041.13,13953.63,3
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,10380.27,20389.74,10
MS-DRG,594,Skin Ulcers Without Cc/Mcc,,,10172.66,10380.27,5
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,24706.22,49885.23,10
MS-DRG,595,Major Skin Disorders With Mcc,,,24212.09,24706.22,5
MS-DRG,595,Medical,,,13041.13,13953.63,3
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,12844.66,25463.65,10
MS-DRG,596,Major Skin Disorders Without Mcc,,,12587.77,12844.66,5
MS-DRG,596,Medical,,,13041.13,13953.63,3
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,19523.79,39215.19,10
MS-DRG,597,Malignant Breast Disorders With Mcc,,,19133.31,19523.79,5
MS-DRG,597,Medical,,,13041.13,13953.63,3
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,13402.21,26611.57,10
MS-DRG,598,Malignant Breast Disorders With Cc,,,13134.16,13402.21,5
MS-DRG,598,Medical,,,13041.13,13953.63,3
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,9267.46,18098.6,10
MS-DRG,599,Malignant Breast Disorders Without Cc/Mcc,,,9082.11,9267.46,5
MS-DRG,599,Medical,,,13041.13,13953.63,3
MS-DRG,600,Medical,,,13041.13,13953.63,3
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,12377.38,24501.56,10
MS-DRG,600,Non-Malignant Breast Disorders With Cc/Mcc,,,12129.83,12377.38,5
MS-DRG,601,Medical,,,13041.13,13953.63,3
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,7389.17,14231.42,10
MS-DRG,601,Non-Malignant Breast Disorders Without Cc/Mcc,,,7241.39,7389.17,5
MS-DRG,602,CELLULITIS WITH MCC,,,16715.49,33433.24,10
MS-DRG,602,Cellulitis With Mcc,,,16381.18,16715.49,5
MS-DRG,602,Medical,,,13041.13,13953.63,3
MS-DRG,603,CELLULITIS WITHOUT MCC,,,10427.11,20486.18,10
MS-DRG,603,Cellulitis Without Mcc,,,10218.57,10427.11,5
MS-DRG,603,Medical,,,13041.13,13953.63,3
MS-DRG,604,Medical,,,13041.13,13953.63,3
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,17295.89,34628.21,10
MS-DRG,604,"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc",,,16949.97,17295.89,5
MS-DRG,605,Medical,,,13041.13,13953.63,3
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,10942.38,21547.07,10
MS-DRG,605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc",,,10723.53,10942.38,5
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,17765.46,35595.0,10
MS-DRG,606,Medical,,,13041.13,13953.63,3
MS-DRG,606,Minor Skin Disorders With Mcc,,,17410.15,17765.46,5
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,10832.7,21321.25,10
MS-DRG,607,Medical,,,13041.13,13953.63,3
MS-DRG,607,Minor Skin Disorders Without Mcc,,,10616.05,10832.7,5
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,25518.54,51557.71,10
MS-DRG,614,Adrenal And Pituitary Procedures With Cc/Mcc,,,25008.17,25518.54,5
MS-DRG,614,Surgical,,,22870.31,24470.51,3
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,16464.14,32915.73,10
MS-DRG,615,Adrenal And Pituitary Procedures Without Cc/Mcc,,,16134.86,16464.14,5
MS-DRG,615,Surgical,,,22870.31,24470.51,3
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,40320.92,69287.66,9
MS-DRG,616,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,39514.5,40320.92,5
MS-DRG,616,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,616,Surgical,,,22870.31,24470.51,3
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,21845.37,37159.12,9
MS-DRG,617,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc",,,21408.46,21845.37,5
MS-DRG,617,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,617,Surgical,,,22870.31,24470.51,3
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,16681.22,28178.78,9
MS-DRG,618,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,16347.59,16681.22,5
MS-DRG,618,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,618,Surgical,,,22870.31,24470.51,3
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,33465.85,67920.31,10
MS-DRG,619,O.R. Procedures For Obesity With Mcc,,,32796.54,33465.85,5
MS-DRG,619,OR PROCS FOR OBESITYW MCC,,,54649.0,78557.81,2
MS-DRG,619,Surgical,,,22870.31,24470.51,3
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,18760.59,37643.86,10
MS-DRG,620,O.R. Procedures For Obesity With Cc,,,18385.38,18760.59,5
MS-DRG,620,OR PROCS FOR OBESITY W CC,,,54649.0,78557.81,2
MS-DRG,620,Surgical,,,22870.31,24470.51,3
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,17710.62,35482.09,10
MS-DRG,621,O.R. Procedures For Obesity Without Cc/Mcc,,,17356.41,17710.62,5
MS-DRG,621,OR PROCS FOR OBESITY WO CC/MCC,,,54649.0,78557.81,2
MS-DRG,621,Surgical,,,22870.31,24470.51,3
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,41141.25,83723.06,10
MS-DRG,622,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,40318.42,41141.25,5
MS-DRG,622,Surgical,,,22870.31,24470.51,3
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,20972.49,42197.91,10
MS-DRG,623,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc",,,20553.04,20972.49,5
MS-DRG,623,Surgical,,,22870.31,24470.51,3
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,14780.08,29448.44,10
MS-DRG,624,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,14484.48,14780.08,5
MS-DRG,624,Surgical,,,22870.31,24470.51,3
MS-DRG,625,Surgical,,,22870.31,24470.51,3
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,34981.97,71041.81,10
MS-DRG,625,"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc",,,34282.33,34981.97,5
MS-DRG,626,Surgical,,,22870.31,24470.51,3
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,17607.79,35270.39,10
MS-DRG,626,"Thyroid, Parathyroid And Thyroglossal Procedures With Cc",,,17255.64,17607.79,5
MS-DRG,627,Surgical,,,22870.31,24470.51,3
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,15652.96,31245.6,10
MS-DRG,627,"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc",,,15339.9,15652.96,5
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,43056.1,87665.52,10
MS-DRG,628,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc",,,42194.97,43056.1,5
MS-DRG,628,Surgical,,,22870.31,24470.51,3
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,25370.02,51251.91,10
MS-DRG,629,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc",,,24862.62,25370.02,5
MS-DRG,629,Surgical,,,22870.31,24470.51,3
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,17151.93,34331.82,10
MS-DRG,630,"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc",,,16808.89,17151.93,5
MS-DRG,630,Surgical,,,22870.31,24470.51,3
MS-DRG,637,DIABETES WITH MCC,,,16891.44,33795.49,10
MS-DRG,637,Diabetes With Mcc,,,16553.61,16891.44,5
MS-DRG,637,Medical,,,13041.13,13953.63,3
MS-DRG,638,DIABETES WITH CC,,,10716.16,21081.31,10
MS-DRG,638,Diabetes With Cc,,,10501.84,10716.16,5
MS-DRG,638,Medical,,,13041.13,13953.63,3
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,7574.26,14612.49,10
MS-DRG,639,Diabetes Without Cc/Mcc,,,7422.77,7574.26,5
MS-DRG,639,Medical,,,13041.13,13953.63,3
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,15736.36,31417.32,10
MS-DRG,640,Medical,,,13041.13,13953.63,3
MS-DRG,640,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc",,,15421.63,15736.36,5
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,9368.0,18305.6,10
MS-DRG,641,Medical,,,13041.13,13953.63,3
MS-DRG,641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc",,,9180.64,9368.0,5
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,16724.63,33452.06,10
MS-DRG,642,Inborn And Other Disorders Of Metabolism,,,16390.14,16724.63,5
MS-DRG,642,Medical,,,13041.13,13953.63,3
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,19283.86,38721.21,10
MS-DRG,643,Endocrine Disorders With Mcc,,,18898.18,19283.86,5
MS-DRG,643,Medical,,,13041.13,13953.63,3
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,12187.72,24111.08,10
MS-DRG,644,Endocrine Disorders With Cc,,,11943.96,12187.72,5
MS-DRG,644,Medical,,,13041.13,13953.63,3
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,9254.89,18072.72,10
MS-DRG,645,Endocrine Disorders Without Cc/Mcc,,,9069.79,9254.89,5
MS-DRG,645,Medical,,,13041.13,13953.63,3
MS-DRG,650,Surgical,,,22870.31,24470.51,3
MS-DRG,651,Surgical,,,22870.31,24470.51,3
MS-DRG,652,Cadaveric Kidney/ Matched Living/Related,,,105612.0,105612.0,1
MS-DRG,652,Cadaveric Liver/Kidney,,,257246.0,257246.0,1
MS-DRG,652,General Transplant Services,,,37374.39,37374.39,1
MS-DRG,652,"Inpatient Care Hospital, Mechanical Circulatory Support",12964.0,8426.6,,,0
MS-DRG,652,KIDNEY TRANSPLANT,,,37374.39,64163.71,9
MS-DRG,652,Kidney Retransplant - up to one year from previous transplant,,,52806.0,52806.0,1
MS-DRG,652,Kidney Transplant,,,36626.9,37374.39,5
MS-DRG,652,Liver/Kidney Retransplant - up to one year from previous transplant,,,128716.0,128716.0,1
MS-DRG,652,Other Transplant Services,,,37374.39,37374.39,1
MS-DRG,652,Surgical,,,22870.31,24470.51,3
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,59846.45,122234.92,10
MS-DRG,653,Major Bladder Procedures With Mcc,,,58649.52,59846.45,5
MS-DRG,653,Surgical,,,22870.31,24470.51,3
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,32459.3,65847.93,10
MS-DRG,654,Major Bladder Procedures With Cc,,,31810.12,32459.3,5
MS-DRG,654,Surgical,,,22870.31,24470.51,3
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,24659.37,49788.78,10
MS-DRG,655,Major Bladder Procedures Without Cc/Mcc,,,24166.19,24659.37,5
MS-DRG,655,Surgical,,,22870.31,24470.51,3
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,36852.26,74892.53,10
MS-DRG,656,Kidney And Ureter Procedures For Neoplasm With Mcc,,,36115.21,36852.26,5
MS-DRG,656,Surgical,,,22870.31,24470.51,3
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,21384.94,43047.09,10
MS-DRG,657,Kidney And Ureter Procedures For Neoplasm With Cc,,,20957.24,21384.94,5
MS-DRG,657,Surgical,,,22870.31,24470.51,3
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,18206.47,36502.99,10
MS-DRG,658,Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc,,,17842.34,18206.47,5
MS-DRG,658,Surgical,,,22870.31,24470.51,3
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,29507.05,59769.59,10
MS-DRG,659,Kidney And Ureter Procedures For Non-Neoplasm With Mcc,,,28916.91,29507.05,5
MS-DRG,659,Surgical,,,22870.31,24470.51,3
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,15577.55,31090.35,10
MS-DRG,660,Kidney And Ureter Procedures For Non-Neoplasm With Cc,,,15266.0,15577.55,5
MS-DRG,660,Surgical,,,22870.31,24470.51,3
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,12306.54,24355.71,10
MS-DRG,661,Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc,,,12060.41,12306.54,5
MS-DRG,661,Surgical,,,22870.31,24470.51,3
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,35454.97,72015.66,10
MS-DRG,662,Minor Bladder Procedures With Mcc,,,34745.87,35454.97,5
MS-DRG,662,Surgical,,,22870.31,24470.51,3
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,17845.44,35759.66,10
MS-DRG,663,Minor Bladder Procedures With Cc,,,17488.53,17845.44,5
MS-DRG,663,Surgical,,,22870.31,24470.51,3
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,12437.93,24626.23,10
MS-DRG,664,Minor Bladder Procedures Without Cc/Mcc,,,12189.17,12437.93,5
MS-DRG,664,Surgical,,,22870.31,24470.51,3
MS-DRG,665,PROSTATECTOMY WITH MCC,,,36137.05,73419.99,10
MS-DRG,665,Prostatectomy With Mcc,,,35414.3,36137.05,5
MS-DRG,665,Surgical,,,22870.31,24470.51,3
MS-DRG,666,PROSTATECTOMY WITH CC,,,20462.93,41148.78,10
MS-DRG,666,Prostatectomy With Cc,,,20053.67,20462.93,5
MS-DRG,666,Surgical,,,22870.31,24470.51,3
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,13115.44,26021.14,10
MS-DRG,667,Prostatectomy Without Cc/Mcc,,,12853.13,13115.44,5
MS-DRG,667,Surgical,,,22870.31,24470.51,3
MS-DRG,668,Surgical,,,22870.31,24470.51,3
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,33838.31,68687.16,10
MS-DRG,668,Transurethral Procedures With Mcc,,,33161.55,33838.31,5
MS-DRG,669,Surgical,,,22870.31,24470.51,3
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,18208.75,36507.7,10
MS-DRG,669,Transurethral Procedures With Cc,,,17844.58,18208.75,5
MS-DRG,670,Surgical,,,22870.31,24470.51,3
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,11642.74,22989.03,10
MS-DRG,670,Transurethral Procedures Without Cc/Mcc,,,11409.89,11642.74,5
MS-DRG,671,Surgical,,,22870.31,24470.51,3
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,20985.06,42223.79,10
MS-DRG,671,Urethral Procedures With Cc/Mcc,,,20565.36,20985.06,5
MS-DRG,672,Surgical,,,22870.31,24470.51,3
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,12810.39,25393.08,10
MS-DRG,672,Urethral Procedures Without Cc/Mcc,,,12554.18,12810.39,5
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,48480.74,98834.24,10
MS-DRG,673,Other Kidney And Urinary Tract Procedures With Mcc,,,47511.13,48480.74,5
MS-DRG,673,Surgical,,,22870.31,24470.51,3
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,27195.75,55010.89,10
MS-DRG,674,Other Kidney And Urinary Tract Procedures With Cc,,,26651.84,27195.75,5
MS-DRG,674,Surgical,,,22870.31,24470.51,3
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,19230.16,38610.65,10
MS-DRG,675,Other Kidney And Urinary Tract Procedures Without Cc/Mcc,,,18845.56,19230.16,5
MS-DRG,675,Surgical,,,22870.31,24470.51,3
MS-DRG,682,Medical,,,13041.13,13953.63,3
MS-DRG,682,RENAL FAILURE WITH MCC,,,17397.57,34837.56,10
MS-DRG,682,Renal Failure With Mcc,,,17049.62,17397.57,5
MS-DRG,683,Medical,,,13041.13,13953.63,3
MS-DRG,683,RENAL FAILURE WITH CC,,,10483.09,20601.44,10
MS-DRG,683,Renal Failure With Cc,,,10273.43,10483.09,5
MS-DRG,684,Medical,,,13041.13,13953.63,3
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,7335.47,14120.86,10
MS-DRG,684,Renal Failure Without Cc/Mcc,,,7188.76,7335.47,5
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,21084.46,42428.44,10
MS-DRG,686,Kidney And Urinary Tract Neoplasms With Mcc,,,20662.77,21084.46,5
MS-DRG,686,Medical,,,13041.13,13953.63,3
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,12448.21,24647.4,10
MS-DRG,687,Kidney And Urinary Tract Neoplasms With Cc,,,12199.25,12448.21,5
MS-DRG,687,Medical,,,13041.13,13953.63,3
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,9506.24,18590.23,10
MS-DRG,688,Kidney And Urinary Tract Neoplasms Without Cc/Mcc,,,9316.12,9506.24,5
MS-DRG,688,Medical,,,13041.13,13953.63,3
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,13733.54,27293.74,10
MS-DRG,689,Kidney And Urinary Tract Infections With Mcc,,,13458.87,13733.54,5
MS-DRG,689,Medical,,,13041.13,13953.63,3
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,9725.61,19041.87,10
MS-DRG,690,Kidney And Urinary Tract Infections Without Mcc,,,9531.09,9725.61,5
MS-DRG,690,Medical,,,13041.13,13953.63,3
MS-DRG,693,Medical,,,13041.13,13953.63,3
MS-DRG,693,URINARY STONES WITH MCC,,,15838.04,31626.67,10
MS-DRG,693,Urinary Stones With Mcc,,,15521.28,15838.04,5
MS-DRG,694,Medical,,,13041.13,13953.63,3
MS-DRG,694,URINARY STONES WITHOUT MCC,,,9407.99,18387.93,10
MS-DRG,694,Urinary Stones Without Mcc,,,9219.83,9407.99,5
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,13545.02,26905.61,10
MS-DRG,695,Kidney And Urinary Tract Signs And Symptoms With Mcc,,,13274.12,13545.02,5
MS-DRG,695,Medical,,,13041.13,13953.63,3
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,8348.88,16207.35,10
MS-DRG,696,Kidney And Urinary Tract Signs And Symptoms Without Mcc,,,8181.9,8348.88,5
MS-DRG,696,Medical,,,13041.13,13953.63,3
MS-DRG,697,Medical,,,13041.13,13953.63,3
MS-DRG,697,URETHRAL STRICTURE,,,12790.97,25353.09,10
MS-DRG,697,Urethral Stricture,,,12535.15,12790.97,5
MS-DRG,698,Medical,,,13041.13,13953.63,3
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,19378.69,38916.45,10
MS-DRG,698,Other Kidney And Urinary Tract Diagnoses With Mcc,,,18991.11,19378.69,5
MS-DRG,699,Medical,,,13041.13,13953.63,3
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,12073.47,23875.85,10
MS-DRG,699,Other Kidney And Urinary Tract Diagnoses With Cc,,,11832.0,12073.47,5
MS-DRG,700,Medical,,,13041.13,13953.63,3
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,8359.16,16228.52,10
MS-DRG,700,Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc,,,8191.98,8359.16,5
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,23330.63,47053.06,10
MS-DRG,707,Major Male Pelvic Procedures With Cc/Mcc,,,22864.02,23330.63,5
MS-DRG,707,Surgical,,,22870.31,24470.51,3
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,18005.39,36088.99,10
MS-DRG,708,Major Male Pelvic Procedures Without Cc/Mcc,,,17645.28,18005.39,5
MS-DRG,708,Surgical,,,22870.31,24470.51,3
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,27064.36,54740.37,10
MS-DRG,709,Penis Procedures With Cc/Mcc,,,26523.07,27064.36,5
MS-DRG,709,Surgical,,,22870.31,24470.51,3
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,16485.85,32960.43,10
MS-DRG,710,Penis Procedures Without Cc/Mcc,,,16156.13,16485.85,5
MS-DRG,710,Surgical,,,22870.31,24470.51,3
MS-DRG,711,Surgical,,,22870.31,24470.51,3
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,24284.63,49017.23,10
MS-DRG,711,Testes Procedures With Cc/Mcc,,,23798.94,24284.63,5
MS-DRG,712,Surgical,,,22870.31,24470.51,3
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,13041.18,25868.24,10
MS-DRG,712,Testes Procedures Without Cc/Mcc,,,12780.35,13041.18,5
MS-DRG,713,Surgical,,,22870.31,24470.51,3
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,17653.49,35364.48,10
MS-DRG,713,Transurethral Prostatectomy With Cc/Mcc,,,17300.42,17653.49,5
MS-DRG,714,Surgical,,,22870.31,24470.51,3
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,12557.89,24873.22,10
MS-DRG,714,Transurethral Prostatectomy Without Cc/Mcc,,,12306.73,12557.89,5
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,26038.39,52628.01,10
MS-DRG,715,Other Male Reproductive System O.R. Procedures For Malignancy With Cc/Mcc,,,25517.62,26038.39,5
MS-DRG,715,Surgical,,,22870.31,24470.51,3
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,17283.32,34602.33,10
MS-DRG,716,Other Male Reproductive System O.R. Procedures For Malignancy Without Cc/Mcc,,,16937.65,17283.32,5
MS-DRG,716,Surgical,,,22870.31,24470.51,3
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,22076.16,44470.23,10
MS-DRG,717,Other Male Reproductive System O.R. Procedures Except Malignancy With Cc/Mcc,,,21634.63,22076.16,5
MS-DRG,717,Surgical,,,22870.31,24470.51,3
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT MALIGNANCY WITHOUT CC/MCC,,,15822.05,31593.74,10
MS-DRG,718,Other Male Reproductive System O.R. Proc Except Malignancy Without Cc/Mcc,,,15505.61,15822.05,5
MS-DRG,718,Surgical,,,22870.31,24470.51,3
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,21153.01,42569.57,10
MS-DRG,722,"Malignancy, Male Reproductive System With Mcc",,,20729.95,21153.01,5
MS-DRG,722,Medical,,,13041.13,13953.63,3
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,13532.46,26879.73,10
MS-DRG,723,"Malignancy, Male Reproductive System With Cc",,,13261.81,13532.46,5
MS-DRG,723,Medical,,,13041.13,13953.63,3
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,7968.42,15424.03,10
MS-DRG,724,"Malignancy, Male Reproductive System Without Cc/Mcc",,,7809.06,7968.42,5
MS-DRG,724,Medical,,,13041.13,13953.63,3
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,13846.65,27526.61,10
MS-DRG,725,Benign Prostatic Hypertrophy With Mcc,,,13569.71,13846.65,5
MS-DRG,725,Medical,,,13041.13,13953.63,3
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,8725.91,16983.61,10
MS-DRG,726,Benign Prostatic Hypertrophy Without Mcc,,,8551.39,8725.91,5
MS-DRG,726,Medical,,,13041.13,13953.63,3
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,17419.28,34882.26,10
MS-DRG,727,Inflammation Of The Male Reproductive System With Mcc,,,17070.89,17419.28,5
MS-DRG,727,Medical,,,13041.13,13953.63,3
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,9745.03,19081.86,10
MS-DRG,728,Inflammation Of The Male Reproductive System Without Mcc,,,9550.13,9745.03,5
MS-DRG,728,Medical,,,13041.13,13953.63,3
MS-DRG,729,Medical,,,13041.13,13953.63,3
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,12572.75,24903.8,10
MS-DRG,729,Other Male Reproductive System Diagnoses With Cc/Mcc,,,12321.29,12572.75,5
MS-DRG,730,Medical,,,13041.13,13953.63,3
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,8154.65,15807.46,10
MS-DRG,730,Other Male Reproductive System Diagnoses Without Cc/Mcc,,,7991.56,8154.65,5
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,24812.47,50103.99,10
MS-DRG,734,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc",,,24316.22,24812.47,5
MS-DRG,734,Surgical,,,22870.31,24470.51,3
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,15849.47,31650.2,10
MS-DRG,735,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc",,,15532.48,15849.47,5
MS-DRG,735,Surgical,,,22870.31,24470.51,3
MS-DRG,736,Surgical,,,22870.31,24470.51,3
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,41316.05,84082.96,10
MS-DRG,736,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc,,,40489.73,41316.05,5
MS-DRG,737,Surgical,,,22870.31,24470.51,3
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,24019.57,48471.49,10
MS-DRG,737,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc,,,23539.18,24019.57,5
MS-DRG,738,Surgical,,,22870.31,24470.51,3
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,17254.76,34543.53,10
MS-DRG,738,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc,,,16909.66,17254.76,5
MS-DRG,739,Surgical,,,22870.31,24470.51,3
MS-DRG,739,"UTERINE, ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC",,,41410.88,84278.2,10
MS-DRG,739,"Uterine, Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc",,,40582.66,41410.88,5
MS-DRG,740,Surgical,,,22870.31,24470.51,3
MS-DRG,740,"UTERINE, ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC",,,21151.86,42567.22,10
MS-DRG,740,"Uterine, Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc",,,20728.83,21151.86,5
MS-DRG,741,Surgical,,,22870.31,24470.51,3
MS-DRG,741,"UTERINE, ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC",,,16770.33,33546.15,10
MS-DRG,741,"Uterine, Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc",,,16434.93,16770.33,5
MS-DRG,742,Surgical,,,22870.31,24470.51,3
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,21439.78,43160.0,10
MS-DRG,742,Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc,,,21010.98,21439.78,5
MS-DRG,743,Surgical,,,22870.31,24470.51,3
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,14652.12,29184.99,10
MS-DRG,743,Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc,,,14359.07,14652.12,5
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,23888.18,48200.98,10
MS-DRG,744,"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc",,,23410.42,23888.18,5
MS-DRG,744,Surgical,,,22870.31,24470.51,3
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,13473.04,26757.41,10
MS-DRG,745,"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc",,,13203.58,13473.04,5
MS-DRG,745,Surgical,,,22870.31,24470.51,3
MS-DRG,746,Surgical,,,22870.31,24470.51,3
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,20323.54,40861.8,10
MS-DRG,746,"Vagina, Cervix And Vulva Procedures With Cc/Mcc",,,19917.07,20323.54,5
MS-DRG,747,Surgical,,,22870.31,24470.51,3
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,10299.15,20222.72,10
MS-DRG,747,"Vagina, Cervix And Vulva Procedures Without Cc/Mcc",,,10093.16,10299.15,5
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,16327.04,32633.46,10
MS-DRG,748,Female Reproductive System Reconstructive Procedures,,,16000.5,16327.04,5
MS-DRG,748,Surgical,,,22870.31,24470.51,3
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,29812.1,60397.65,10
MS-DRG,749,Other Female Reproductive System O.R. Procedures With Cc/Mcc,,,29215.86,29812.1,5
MS-DRG,749,Surgical,,,22870.31,24470.51,3
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,17338.16,34715.24,10
MS-DRG,750,Other Female Reproductive System O.R. Procedures Without Cc/Mcc,,,16991.4,17338.16,5
MS-DRG,750,Surgical,,,22870.31,24470.51,3
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,21518.61,43322.31,10
MS-DRG,754,"Malignancy, Female Reproductive System With Mcc",,,21088.24,21518.61,5
MS-DRG,754,Medical,,,13041.13,13953.63,3
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,12905.22,25588.32,10
MS-DRG,755,"Malignancy, Female Reproductive System With Cc",,,12647.11,12905.22,5
MS-DRG,755,Medical,,,13041.13,13953.63,3
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,11450.8,22593.84,10
MS-DRG,756,"Malignancy, Female Reproductive System Without Cc/Mcc",,,11221.78,11450.8,5
MS-DRG,756,Medical,,,13041.13,13953.63,3
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,16836.6,33682.58,10
MS-DRG,757,"Infections, Female Reproductive System With Mcc",,,16499.87,16836.6,5
MS-DRG,757,Medical,,,13041.13,13953.63,3
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,11662.16,23029.02,10
MS-DRG,758,"Infections, Female Reproductive System With Cc",,,11428.92,11662.16,5
MS-DRG,758,Medical,,,13041.13,13953.63,3
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,8058.68,15609.86,10
MS-DRG,759,"Infections, Female Reproductive System Without Cc/Mcc",,,7897.51,8058.68,5
MS-DRG,759,Medical,,,13041.13,13953.63,3
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,11987.78,23699.42,10
MS-DRG,760,Medical,,,13041.13,13953.63,3
MS-DRG,760,Menstrual And Other Female Reproductive System Disorders With Cc/Mcc,,,11748.02,11987.78,5
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,6995.0,13419.87,10
MS-DRG,761,Medical,,,13041.13,13953.63,3
MS-DRG,761,Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc,,,6855.1,6995.0,5
MS-DRG,765,C Section Delivery (mom/baby),,,6800.0,6800.0,1
MS-DRG,765,C-Section Delivery û Mom Only Case Rate û Days 1 through 3,,,35820.74,51436.36,2
MS-DRG,765,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,766,C Section Delivery (mom/baby),,,6800.0,6800.0,1
MS-DRG,766,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,766,C-Section Delivery û Mom Only Case Rate û Days 1 through 3,,,35820.74,51436.36,2
MS-DRG,767,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,767,Vaginal Delivery (mom/baby),,,4250.0,4250.0,1
MS-DRG,767,Vaginal Delivery û Mom Only Case Rate Days 1 through 2,,,22938.08,32926.15,2
MS-DRG,768,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,768,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROC EXCEPT STERIL &/OR D&C,,,12720.13,25207.25,8
MS-DRG,768,Vaginal Delivery (mom/baby),,,4250.0,4250.0,1
MS-DRG,768,Vaginal Delivery With O.R. Proc Except Steril &/Or D&C,,,12465.73,12720.13,5
MS-DRG,768,Vaginal Delivery û Mom Only Case Rate Days 1 through 2,,,22938.08,32926.15,2
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURE,,,19783.14,39749.17,10
MS-DRG,769,Postpartum And Post Abortion Diagnoses With O.R. Procedure,,,19387.47,19783.14,5
MS-DRG,769,Surgical,,,22870.31,24470.51,3
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,11932.94,23586.51,10
MS-DRG,770,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,11694.28,11932.94,5
MS-DRG,770,Surgical,,,22870.31,24470.51,3
MS-DRG,774,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,774,Vaginal Delivery (mom/baby),,,4250.0,4250.0,1
MS-DRG,774,Vaginal Delivery û Mom Only Case Rate Days 1 through 2,,,22938.08,32926.15,2
MS-DRG,775,NORMAL VAGINAL DELIVERY,,,10456.0,11775.0,2
MS-DRG,775,Vaginal Delivery (mom/baby),,,4250.0,4250.0,1
MS-DRG,775,Vaginal Delivery û Mom Only Case Rate Days 1 through 2,,,22938.08,32926.15,2
MS-DRG,776,Medical,,,13041.13,13953.63,3
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURE,,,7957.0,15400.51,10
MS-DRG,776,Postpartum And Post Abortion Diagnoses Without O.R. Procedure,,,7797.86,7957.0,5
MS-DRG,777,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,779,ABORTION WITHOUT D&C,,,10088.93,19789.9,10
MS-DRG,779,Abortion Without D&C,,,9887.15,10088.93,5
MS-DRG,779,Medical,,,13041.13,13953.63,3
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,28526.78,57751.32,8
MS-DRG,783,Cesarean Section With Sterilization With Mcc,,,27956.24,28526.78,5
MS-DRG,783,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,783,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,12588.74,24936.73,8
MS-DRG,784,Cesarean Section With Sterilization With Cc,,,12336.97,12588.74,5
MS-DRG,784,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,784,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,785,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,11419.95,22530.33,8
MS-DRG,785,Cesarean Section With Sterilization Without Cc/Mcc,,,11191.55,11419.95,5
MS-DRG,785,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,19322.7,38801.19,8
MS-DRG,786,Cesarean Section Without Sterilization With Mcc,,,18936.25,19322.7,5
MS-DRG,786,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,786,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,13236.54,26270.49,8
MS-DRG,787,Cesarean Section Without Sterilization With Cc,,,12971.81,13236.54,5
MS-DRG,787,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,787,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,788,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,11431.38,22553.85,8
MS-DRG,788,Cesarean Section Without Sterilization Without Cc/Mcc,,,11202.75,11431.38,5
MS-DRG,788,Obstetrics (Mother Only) Cesarean Section,,,33509.13,35855.36,3
MS-DRG,789,Medical,,,13041.13,13953.63,3
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,21067.32,42393.15,10
MS-DRG,789,"Neonates, Died Or Transferred To Another Acute Care Facility",,,20645.97,21067.32,5
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,68382.15,139808.95,10
MS-DRG,790,"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate",,,67014.51,68382.15,5
MS-DRG,790,Medical,,,13041.13,13953.63,3
MS-DRG,791,Medical,,,13041.13,13953.63,3
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,46851.52,95479.86,10
MS-DRG,791,Prematurity With Major Problems,,,45914.49,46851.52,5
MS-DRG,792,Medical,,,13041.13,13953.63,3
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,28459.37,57612.53,10
MS-DRG,792,Prematurity Without Major Problems,,,27890.18,28459.37,5
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,48115.14,98081.5,10
MS-DRG,793,Full Term Neonate With Major Problems,,,47152.83,48115.14,5
MS-DRG,793,Medical,,,13041.13,13953.63,3
MS-DRG,794,Medical,,,13041.13,13953.63,3
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,17339.3,34717.6,10
MS-DRG,794,Neonate With Other Significant Problems,,,16992.52,17339.3,5
MS-DRG,795,Medical,,,13041.13,13953.63,3
MS-DRG,795,NORMAL NEWBORN,,,2759.71,4699.9,10
MS-DRG,795,Normal Newborn,,,2704.52,2759.71,5
MS-DRG,796,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,796,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION/D&C WITH MCC,,,13810.09,27451.34,8
MS-DRG,796,Vaginal Delivery With Sterilization/D&C With Mcc,,,13533.88,13810.09,5
MS-DRG,797,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,797,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION/D&C WITH CC,,,11906.66,23532.41,8
MS-DRG,797,Vaginal Delivery With Sterilization/D&C With Cc,,,11668.53,11906.66,5
MS-DRG,798,OTHER COMPLICATED DELIVERY,,,4362.0,4915.0,2
MS-DRG,798,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION/D&C WITHOUT CC/MCC,,,11411.95,22513.86,8
MS-DRG,798,Vaginal Delivery With Sterilization/D&C Without Cc/Mcc,,,11183.71,11411.95,5
MS-DRG,799,SPLENECTOMY WITH MCC,,,52220.18,106533.31,10
MS-DRG,799,Splenectomy With Mcc,,,51175.78,52220.18,5
MS-DRG,799,Surgical,,,22870.31,24470.51,3
MS-DRG,800,SPLENECTOMY WITH CC,,,32574.69,66085.52,10
MS-DRG,800,Splenectomy With Cc,,,31923.2,32574.69,5
MS-DRG,800,Surgical,,,22870.31,24470.51,3
MS-DRG,801,SPLENECTOMY WITHOUT CC/MCC,,,22286.38,44903.05,10
MS-DRG,801,Splenectomy Without Cc/Mcc,,,21840.65,22286.38,5
MS-DRG,801,Surgical,,,22870.31,24470.51,3
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,45995.78,93717.98,10
MS-DRG,802,Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc,,,45075.86,45995.78,5
MS-DRG,802,Surgical,,,22870.31,24470.51,3
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,21715.12,43726.9,10
MS-DRG,803,Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc,,,21280.82,21715.12,5
MS-DRG,803,Surgical,,,22870.31,24470.51,3
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,15969.43,31897.19,10
MS-DRG,804,Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc,,,15650.04,15969.43,5
MS-DRG,804,Surgical,,,22870.31,24470.51,3
MS-DRG,805,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,805,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH MCC,,,12806.96,25386.02,8
MS-DRG,805,Vaginal Delivery Without Sterilization/D&C With Mcc,,,12550.82,12806.96,5
MS-DRG,806,C-SECTION W/O COMP & VAGINAL W/COMP,,,10456.0,11775.0,2
MS-DRG,806,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC,,,9091.51,17736.34,8
MS-DRG,806,Vaginal Delivery Without Sterilization/D&C With Cc,,,8909.68,9091.51,5
MS-DRG,807,NORMAL VAGINAL DELIVERY,,,10456.0,11775.0,2
MS-DRG,807,Obstetrics (Mother Only) Vaginal Delivery,,,23236.88,24863.49,3
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC,,,8179.79,15859.21,8
MS-DRG,807,Vaginal Delivery Without Sterilization/D&C Without Cc/Mcc,,,8016.19,8179.79,5
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,25702.49,51936.43,10
MS-DRG,808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders With Mcc,,,25188.44,25702.49,5
MS-DRG,808,Medical,,,13041.13,13953.63,3
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,14940.03,29777.77,10
MS-DRG,809,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders With Cc,,,14641.23,14940.03,5
MS-DRG,809,Medical,,,13041.13,13953.63,3
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,12434.5,24619.17,10
MS-DRG,810,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders Without Cc/Mcc,,,12185.81,12434.5,5
MS-DRG,810,Medical,,,13041.13,13953.63,3
MS-DRG,811,Medical,,,13041.13,13953.63,3
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,16521.27,33033.35,10
MS-DRG,811,Red Blood Cell Disorders With Mcc,,,16190.84,16521.27,5
MS-DRG,812,Medical,,,13041.13,13953.63,3
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,10967.52,21598.82,10
MS-DRG,812,Red Blood Cell Disorders Without Mcc,,,10748.17,10967.52,5
MS-DRG,813,COAGULATION DISORDERS,,,17903.7,35879.63,10
MS-DRG,813,Coagulation Disorders,,,17545.63,17903.7,5
MS-DRG,813,Medical,,,13041.13,13953.63,3
MS-DRG,814,Medical,,,13041.13,13953.63,3
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,24774.77,50026.36,10
MS-DRG,814,Reticuloendothelial And Immunity Disorders With Mcc,,,24279.27,24774.77,5
MS-DRG,815,Medical,,,13041.13,13953.63,3
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,12062.04,23852.32,10
MS-DRG,815,Reticuloendothelial And Immunity Disorders With Cc,,,11820.8,12062.04,5
MS-DRG,816,Medical,,,13041.13,13953.63,3
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,7697.65,14866.54,10
MS-DRG,816,Reticuloendothelial And Immunity Disorders Without Cc/Mcc,,,7543.7,7697.65,5
MS-DRG,817,False Labor,,,6066.88,6492.24,18
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH MCC,,,26544.52,53670.08,10
MS-DRG,817,Other Antepartum Diagnoses With O.R. Procedure With Mcc,,,26013.63,26544.52,5
MS-DRG,818,False Labor,,,6066.88,6492.24,18
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH CC,,,13720.97,27267.86,10
MS-DRG,818,Other Antepartum Diagnoses With O.R. Procedure With Cc,,,13446.55,13720.97,5
MS-DRG,819,False Labor,,,6066.88,6492.24,18
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITHOUT CC/MCC,,,10301.43,20227.43,10
MS-DRG,819,Other Antepartum Diagnoses With O.R. Procedure Without Cc/Mcc,,,10095.4,10301.43,5
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH MCC,,,67482.99,116521.85,9
MS-DRG,820,Lymphoma And Leukemia With Major O.R. Procedure With Mcc,,,66133.33,67482.99,5
MS-DRG,820,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,820,Surgical,,,22870.31,24470.51,3
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH CC,,,26053.24,44476.5,9
MS-DRG,821,Lymphoma And Leukemia With Major O.R. Procedure With Cc,,,25532.17,26053.24,5
MS-DRG,821,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,821,Surgical,,,22870.31,24470.51,3
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC,,,14232.81,23921.07,9
MS-DRG,822,Lymphoma And Leukemia With Major O.R. Procedure Without Cc/Mcc,,,13948.16,14232.81,5
MS-DRG,822,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,822,Surgical,,,22870.31,24470.51,3
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH MCC,,,52858.84,107848.25,10
MS-DRG,823,Lymphoma And Non-Acute Leukemia With Other Procedure With Mcc,,,51801.67,52858.84,5
MS-DRG,823,Surgical,,,22870.31,24470.51,3
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH CC,,,26361.72,53293.71,10
MS-DRG,824,Lymphoma And Non-Acute Leukemia With Other Procedure With Cc,,,25834.48,26361.72,5
MS-DRG,824,Surgical,,,22870.31,24470.51,3
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITHOUT CC/MCC,,,15894.03,31741.94,10
MS-DRG,825,Lymphoma And Non-Acute Leukemia With Other Procedure Without Cc/Mcc,,,15576.15,15894.03,5
MS-DRG,825,Surgical,,,22870.31,24470.51,3
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH MCC,,,53921.38,110035.89,10
MS-DRG,826,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedure With Mcc,,,52842.95,53921.38,5
MS-DRG,826,Surgical,,,22870.31,24470.51,3
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH CC,,,26882.7,54366.36,10
MS-DRG,827,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedure With Cc,,,26345.05,26882.7,5
MS-DRG,827,Surgical,,,22870.31,24470.51,3
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC,,,19943.09,40078.49,10
MS-DRG,828,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedure Without Cc/Mcc,,,19544.23,19943.09,5
MS-DRG,828,Surgical,,,22870.31,24470.51,3
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITH CC/MCC,,,36580.34,74332.68,10
MS-DRG,829,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedure With Cc/Mcc,,,35848.73,36580.34,5
MS-DRG,829,Surgical,,,22870.31,24470.51,3
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITHOUT CC/MCC,,,17671.77,35402.12,10
MS-DRG,830,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedure Without Cc/Mcc,,,17318.34,17671.77,5
MS-DRG,830,Surgical,,,22870.31,24470.51,3
MS-DRG,831,False Labor,,,6066.88,6492.24,18
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH MCC,,,14215.68,28286.41,10
MS-DRG,831,Other Antepartum Diagnoses Without O.R. Procedure With Mcc,,,13931.36,14215.68,5
MS-DRG,832,False Labor,,,6066.88,6492.24,18
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH CC,,,8721.34,16974.2,10
MS-DRG,832,Other Antepartum Diagnoses Without O.R. Procedure With Cc,,,8546.91,8721.34,5
MS-DRG,833,False Labor,,,6066.88,6492.24,18
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITHOUT CC/MCC,,,6451.17,12300.18,10
MS-DRG,833,Other Antepartum Diagnoses Without O.R. Procedure Without Cc/Mcc,,,6322.15,6451.17,5
MS-DRG,834,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH MCC,,,63199.72,129138.92,10
MS-DRG,834,Acute Leukemia Without Major O.R. Procedure With Mcc,,,61935.72,63199.72,5
MS-DRG,834,Medical,,,13041.13,13953.63,3
MS-DRG,835,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH CC,,,24307.48,49064.27,10
MS-DRG,835,Acute Leukemia Without Major O.R. Procedure With Cc,,,23821.33,24307.48,5
MS-DRG,835,Medical,,,13041.13,13953.63,3
MS-DRG,836,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITHOUT CC/MCC,,,14409.9,28686.3,10
MS-DRG,836,Acute Leukemia Without Major O.R. Procedure Without Cc/Mcc,,,14121.71,14409.9,5
MS-DRG,836,Medical,,,13041.13,13953.63,3
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,55366.66,95451.83,9
MS-DRG,837,Chemotherapy With Acute Leukemia As Sdx Or With High Dose Chemotherapy Agent With Mcc,,,54259.32,55366.66,5
MS-DRG,837,Medical,,,13041.13,13953.63,3
MS-DRG,837,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,24325.76,41472.46,9
MS-DRG,838,Chemotherapy With Acute Leukemia As Sdx With Cc Or High Dose Chemotherapy Agent,,,23839.25,24325.76,5
MS-DRG,838,Medical,,,13041.13,13953.63,3
MS-DRG,838,Oncology Procedures,,,54455.0,54455.0,1
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX WITHOUT CC/MCC,,,16973.7,33964.86,10
MS-DRG,839,Chemotherapy With Acute Leukemia As Sdx Without Cc/Mcc,,,16634.23,16973.7,5
MS-DRG,839,Medical,,,13041.13,13953.63,3
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,37436.08,76094.55,10
MS-DRG,840,Lymphoma And Non-Acute Leukemia With Mcc,,,36687.36,37436.08,5
MS-DRG,840,Medical,,,13041.13,13953.63,3
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,19115.91,38375.42,10
MS-DRG,841,Lymphoma And Non-Acute Leukemia With Cc,,,18733.59,19115.91,5
MS-DRG,841,Medical,,,13041.13,13953.63,3
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,12020.91,23767.64,10
MS-DRG,842,Lymphoma And Non-Acute Leukemia Without Cc/Mcc,,,11780.49,12020.91,5
MS-DRG,842,Medical,,,13041.13,13953.63,3
MS-DRG,843,Medical,,,13041.13,13953.63,3
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,23267.8,46923.68,10
MS-DRG,843,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc,,,22802.44,23267.8,5
MS-DRG,844,Medical,,,13041.13,13953.63,3
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,14385.91,28636.9,10
MS-DRG,844,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc,,,14098.19,14385.91,5
MS-DRG,845,Medical,,,13041.13,13953.63,3
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,10206.6,20032.19,10
MS-DRG,845,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc,,,10002.47,10206.6,5
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,30096.59,60983.38,10
MS-DRG,846,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc,,,29494.66,30096.59,5
MS-DRG,846,Medical,,,13041.13,13953.63,3
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,15423.31,30772.79,10
MS-DRG,847,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc,,,15114.85,15423.31,5
MS-DRG,847,Medical,,,13041.13,13953.63,3
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,10181.47,19980.44,10
MS-DRG,848,Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,9977.84,10181.47,5
MS-DRG,848,Medical,,,13041.13,13953.63,3
MS-DRG,849,Medical,,,13041.13,13953.63,3
MS-DRG,849,RADIOTHERAPY,,,31433.33,63735.57,10
MS-DRG,849,Radiotherapy,,,30804.66,31433.33,5
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MCC,,,56901.05,116170.69,10
MS-DRG,853,Infectious And Parasitic Diseases With O.R. Procedure With Mcc,,,55763.03,56901.05,5
MS-DRG,853,Surgical,,,22870.31,24470.51,3
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH CC,,,23305.5,47001.31,10
MS-DRG,854,Infectious And Parasitic Diseases With O.R. Procedure With Cc,,,22839.39,23305.5,5
MS-DRG,854,Surgical,,,22870.31,24470.51,3
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITHOUT CC/MCC,,,17582.66,35218.64,10
MS-DRG,855,Infectious And Parasitic Diseases With O.R. Procedure Without Cc/Mcc,,,17231.01,17582.66,5
MS-DRG,855,Surgical,,,22870.31,24470.51,3
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITH MCC,,,52446.4,106999.07,10
MS-DRG,856,Postoperative Or Post-Traumatic Infections With O.R. Procedure With Mcc,,,51397.47,52446.4,5
MS-DRG,856,Surgical,,,22870.31,24470.51,3
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITH CC,,,24943.86,50374.5,10
MS-DRG,857,Postoperative Or Post-Traumatic Infections With O.R. Procedure With Cc,,,24444.98,24943.86,5
MS-DRG,857,Surgical,,,22870.31,24470.51,3
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITHOUT CC/MCC,,,16391.02,32765.19,10
MS-DRG,858,Postoperative Or Post-Traumatic Infections With O.R. Procedure Without Cc/Mcc,,,16063.2,16391.02,5
MS-DRG,858,Surgical,,,22870.31,24470.51,3
MS-DRG,862,Medical,,,13041.13,13953.63,3
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,21312.96,42898.9,10
MS-DRG,862,Postoperative And Post-Traumatic Infections With Mcc,,,20886.7,21312.96,5
MS-DRG,863,Medical,,,13041.13,13953.63,3
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,11878.1,23473.6,10
MS-DRG,863,Postoperative And Post-Traumatic Infections Without Mcc,,,11640.54,11878.1,5
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,10619.05,20881.37,10
MS-DRG,864,Fever And Inflammatory Conditions,,,10406.67,10619.05,5
MS-DRG,864,Medical,,,13041.13,13953.63,3
MS-DRG,865,Medical,,,13041.13,13953.63,3
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,17595.23,35244.51,10
MS-DRG,865,Viral Illness With Mcc,,,17243.32,17595.23,5
MS-DRG,866,Medical,,,13041.13,13953.63,3
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,10412.26,20455.6,10
MS-DRG,866,Viral Illness Without Mcc,,,10204.01,10412.26,5
MS-DRG,867,Medical,,,13041.13,13953.63,3
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,24392.03,49238.34,10
MS-DRG,867,Other Infectious And Parasitic Diseases Diagnoses With Mcc,,,23904.19,24392.03,5
MS-DRG,868,Medical,,,13041.13,13953.63,3
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,12257.41,24254.57,10
MS-DRG,868,Other Infectious And Parasitic Diseases Diagnoses With Cc,,,12012.26,12257.41,5
MS-DRG,869,Medical,,,13041.13,13953.63,3
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,8813.88,17164.73,10
MS-DRG,869,Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc,,,8637.6,8813.88,5
MS-DRG,870,Medical,,,13041.13,13953.63,3
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,79445.09,162586.27,10
MS-DRG,870,Septicemia Or Severe Sepsis With Mv >96 Hours,,,77856.19,79445.09,5
MS-DRG,871,Medical,,,13041.13,13953.63,3
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,22670.26,45693.43,10
MS-DRG,871,Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc,,,22216.86,22670.26,5
MS-DRG,872,Medical,,,13041.13,13953.63,3
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,12168.3,24071.09,10
MS-DRG,872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc,,,11924.93,12168.3,5
MS-DRG,876,O.R. PROCEDURE WITH PRINCIPAL DIAGNOSES OF MENTAL ILLNESS,,,44633.9,90914.04,10
MS-DRG,876,O.R. Procedure With Principal Diagnoses Of Mental Illness,,,43741.23,44633.9,5
MS-DRG,876,Surgical,,,22870.31,24470.51,3
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,11447.37,22586.78,10
MS-DRG,880,Acute Adjustment Reaction And Psychosocial Dysfunction,,,11218.42,11447.37,5
MS-DRG,880,Medical,,,13041.13,13953.63,3
MS-DRG,881,DEPRESSIVE NEUROSES,,,11226.87,22132.79,10
MS-DRG,881,Depressive Neuroses,,,11002.33,11226.87,5
MS-DRG,881,Medical,,,13041.13,13953.63,3
MS-DRG,882,Medical,,,13041.13,13953.63,3
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,12745.26,25259.0,10
MS-DRG,882,Neuroses Except Depressive,,,12490.36,12745.26,5
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,22942.18,46253.27,10
MS-DRG,883,Disorders Of Personality And Impulse Control,,,22483.34,22942.18,5
MS-DRG,883,Medical,,,13041.13,13953.63,3
MS-DRG,884,Medical,,,13041.13,13953.63,3
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,18858.84,37846.15,10
MS-DRG,884,Organic Disturbances And Intellectual Disability,,,18481.67,18858.84,5
MS-DRG,885,Medical,,,13041.13,13953.63,3
MS-DRG,885,PSYCHOSES,,,16435.58,32856.93,10
MS-DRG,885,Psychoses,,,16106.87,16435.58,5
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,24187.52,48817.28,10
MS-DRG,886,Behavioral And Developmental Disorders,,,23703.77,24187.52,5
MS-DRG,886,Medical,,,13041.13,13953.63,3
MS-DRG,887,Medical,,,13041.13,13953.63,3
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,12712.13,25190.78,10
MS-DRG,887,Other Mental Disorder Diagnoses,,,12457.89,12712.13,5
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,7525.13,14511.34,10
MS-DRG,894,"Alcohol, Drug Abuse Or Dependence, Left Ama",,,7374.63,7525.13,5
MS-DRG,894,Medical,,,13041.13,13953.63,3
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,16650.37,33299.16,10
MS-DRG,895,"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy",,,16317.36,16650.37,5
MS-DRG,895,Medical,,,13041.13,13953.63,3
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,20414.94,41049.99,10
MS-DRG,896,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc",,,20006.65,20414.94,5
MS-DRG,896,Medical,,,13041.13,13953.63,3
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,10563.07,20766.1,10
MS-DRG,897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc",,,10351.81,10563.07,5
MS-DRG,897,Medical,,,13041.13,13953.63,3
MS-DRG,901,Surgical,,,22870.31,24470.51,3
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,48423.61,98716.62,10
MS-DRG,901,Wound Debridements For Injuries With Mcc,,,47455.14,48423.61,5
MS-DRG,902,Surgical,,,22870.31,24470.51,3
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,22350.36,45034.78,10
MS-DRG,902,Wound Debridements For Injuries With Cc,,,21903.35,22350.36,5
MS-DRG,903,Surgical,,,22870.31,24470.51,3
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,13839.79,27512.5,10
MS-DRG,903,Wound Debridements For Injuries Without Cc/Mcc,,,13562.99,13839.79,5
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,42442.57,86402.33,10
MS-DRG,904,Skin Grafts For Injuries With Cc/Mcc,,,41593.72,42442.57,5
MS-DRG,904,Surgical,,,22870.31,24470.51,3
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,17424.99,34894.02,10
MS-DRG,905,Skin Grafts For Injuries Without Cc/Mcc,,,17076.49,17424.99,5
MS-DRG,905,Surgical,,,22870.31,24470.51,3
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,22919.33,39026.71,9
MS-DRG,906,Hand Procedures For Injuries,,,22460.94,22919.33,5
MS-DRG,906,"Orthopedic Surgery - Joints (Elbow, Hip, Knees, Lower Extremity, Shoulder, Wrists)",,,58080.0,58080.0,1
MS-DRG,906,Surgical,,,22870.31,24470.51,3
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,44341.42,90311.85,10
MS-DRG,907,Other O.R. Procedures For Injuries With Mcc,,,43454.59,44341.42,5
MS-DRG,907,Surgical,,,22870.31,24470.51,3
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,23272.37,46933.09,10
MS-DRG,908,Other O.R. Procedures For Injuries With Cc,,,22806.92,23272.37,5
MS-DRG,908,Surgical,,,22870.31,24470.51,3
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,15474.72,30878.64,10
MS-DRG,909,Other O.R. Procedures For Injuries Without Cc/Mcc,,,15165.23,15474.72,5
MS-DRG,909,Surgical,,,22870.31,24470.51,3
MS-DRG,913,Medical,,,13041.13,13953.63,3
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,19152.47,38450.7,10
MS-DRG,913,Traumatic Injury With Mcc,,,18769.42,19152.47,5
MS-DRG,914,Medical,,,13041.13,13953.63,3
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,10593.92,20829.62,10
MS-DRG,914,Traumatic Injury Without Mcc,,,10382.04,10593.92,5
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,19689.45,39556.28,10
MS-DRG,915,Allergic Reactions With Mcc,,,19295.66,19689.45,5
MS-DRG,915,Medical,,,13041.13,13953.63,3
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,8089.53,15673.37,10
MS-DRG,916,Allergic Reactions Without Mcc,,,7927.74,8089.53,5
MS-DRG,916,Medical,,,13041.13,13953.63,3
MS-DRG,917,Medical,,,13041.13,13953.63,3
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,18396.13,36893.47,10
MS-DRG,917,Poisoning And Toxic Effects Of Drugs With Mcc,,,18028.2,18396.13,5
MS-DRG,918,Medical,,,13041.13,13953.63,3
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,10269.44,20161.56,10
MS-DRG,918,Poisoning And Toxic Effects Of Drugs Without Mcc,,,10064.05,10269.44,5
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,21394.08,43065.91,10
MS-DRG,919,Complications Of Treatment With Mcc,,,20966.2,21394.08,5
MS-DRG,919,Medical,,,13041.13,13953.63,3
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,11928.37,23577.1,10
MS-DRG,920,Complications Of Treatment With Cc,,,11689.8,11928.37,5
MS-DRG,920,Medical,,,13041.13,13953.63,3
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,8342.03,16193.23,10
MS-DRG,921,Complications Of Treatment Without Cc/Mcc,,,8175.18,8342.03,5
MS-DRG,921,Medical,,,13041.13,13953.63,3
MS-DRG,922,Medical,,,13041.13,13953.63,3
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,20464.07,41151.14,10
MS-DRG,922,"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc",,,20054.79,20464.07,5
MS-DRG,923,Medical,,,13041.13,13953.63,3
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,12104.32,23939.36,10
MS-DRG,923,"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc",,,11862.23,12104.32,5
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,244408.9,502227.81,10
MS-DRG,927,Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft,,,239520.72,244408.9,5
MS-DRG,927,Surgical,,,22870.31,24470.51,3
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,82425.9,168723.42,10
MS-DRG,928,Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc,,,80777.38,82425.9,5
MS-DRG,928,Surgical,,,22870.31,24470.51,3
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,37274.99,75762.88,10
MS-DRG,929,Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc,,,36529.49,37274.99,5
MS-DRG,929,Surgical,,,22870.31,24470.51,3
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,44968.66,91603.27,10
MS-DRG,933,Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft,,,44069.29,44968.66,5
MS-DRG,933,Medical,,,13041.13,13953.63,3
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,25733.34,51999.94,10
MS-DRG,934,Full Thickness Burn Without Skin Graft Or Inhalation Injury,,,25218.67,25733.34,5
MS-DRG,934,Medical,,,13041.13,13953.63,3
MS-DRG,935,Medical,,,13041.13,13953.63,3
MS-DRG,935,NON-EXTENSIVE BURNS,,,24012.71,48457.38,10
MS-DRG,935,Non-Extensive Burns,,,23532.46,24012.71,5
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,41933.01,85353.21,10
MS-DRG,939,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Mcc,,,41094.35,41933.01,5
MS-DRG,939,Surgical,,,22870.31,24470.51,3
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,27176.33,54970.9,10
MS-DRG,940,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc,,,26632.8,27176.33,5
MS-DRG,940,Surgical,,,22870.31,24470.51,3
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,23643.68,47697.59,10
MS-DRG,941,O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc,,,23170.81,23643.68,5
MS-DRG,941,Surgical,,,22870.31,24470.51,3
MS-DRG,945,Medical,,,13041.13,13953.63,3
MS-DRG,945,REHABILITATION WITH CC/MCC,,,18169.91,36427.72,10
MS-DRG,945,Rehabilitation With Cc/Mcc,,,17806.51,18169.91,5
MS-DRG,946,Medical,,,13041.13,13953.63,3
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,13579.3,26976.18,10
MS-DRG,946,Rehabilitation Without Cc/Mcc,,,13307.71,13579.3,5
MS-DRG,947,Medical,,,13041.13,13953.63,3
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,14980.02,29860.1,10
MS-DRG,947,Signs And Symptoms With Mcc,,,14680.42,14980.02,5
MS-DRG,948,Medical,,,13041.13,13953.63,3
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,9622.78,18830.16,10
MS-DRG,948,Signs And Symptoms Without Mcc,,,9430.33,9622.78,5
MS-DRG,949,AFTERCARE WITH CC/MCC,,,14069.44,27985.31,10
MS-DRG,949,Aftercare With Cc/Mcc,,,13788.05,14069.44,5
MS-DRG,949,Medical,,,13041.13,13953.63,3
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,7648.52,14765.39,10
MS-DRG,950,Aftercare Without Cc/Mcc,,,7495.55,7648.52,5
MS-DRG,950,Medical,,,13041.13,13953.63,3
MS-DRG,951,Medical,,,13041.13,13953.63,3
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,6829.34,13078.79,10
MS-DRG,951,Other Factors Influencing Health Status,,,6692.75,6829.34,5
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,77380.57,158335.67,10
MS-DRG,955,Craniotomy For Multiple Significant Trauma,,,75832.96,77380.57,5
MS-DRG,955,Surgical,,,22870.31,24470.51,3
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,43469.68,88517.05,10
MS-DRG,956,"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma",,,42600.29,43469.68,5
MS-DRG,956,Surgical,,,22870.31,24470.51,3
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,87535.21,179242.91,10
MS-DRG,957,Other O.R. Procedures For Multiple Significant Trauma With Mcc,,,85784.51,87535.21,5
MS-DRG,957,Surgical,,,22870.31,24470.51,3
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,48621.27,99123.57,10
MS-DRG,958,Other O.R. Procedures For Multiple Significant Trauma With Cc,,,47648.84,48621.27,5
MS-DRG,958,Surgical,,,22870.31,24470.51,3
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,34113.66,69254.06,10
MS-DRG,959,Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc,,,33431.38,34113.66,5
MS-DRG,959,Surgical,,,22870.31,24470.51,3
MS-DRG,963,Medical,,,13041.13,13953.63,3
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,31710.96,64307.18,10
MS-DRG,963,Other Multiple Significant Trauma With Mcc,,,31076.74,31710.96,5
MS-DRG,964,Medical,,,13041.13,13953.63,3
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,17987.11,36051.35,10
MS-DRG,964,Other Multiple Significant Trauma With Cc,,,17627.37,17987.11,5
MS-DRG,965,Medical,,,13041.13,13953.63,3
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,11222.3,22123.38,10
MS-DRG,965,Other Multiple Significant Trauma Without Cc/Mcc,,,10997.85,11222.3,5
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURE WITH MCC,,,70413.53,143991.34,10
MS-DRG,969,Hiv With Extensive O.R. Procedure With Mcc,,,69005.26,70413.53,5
MS-DRG,969,Surgical,,,22870.31,24470.51,3
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURE WITHOUT MCC,,,30609.57,62039.56,10
MS-DRG,970,Hiv With Extensive O.R. Procedure Without Mcc,,,29997.38,30609.57,5
MS-DRG,970,Surgical,,,22870.31,24470.51,3
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,33449.86,67887.38,10
MS-DRG,974,Hiv With Major Related Condition With Mcc,,,32780.86,33449.86,5
MS-DRG,974,Medical,,,13041.13,13953.63,3
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,15272.5,30462.29,10
MS-DRG,975,Hiv With Major Related Condition With Cc,,,14967.05,15272.5,5
MS-DRG,975,Medical,,,13041.13,13953.63,3
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,10790.43,21234.21,10
MS-DRG,976,Hiv With Major Related Condition Without Cc/Mcc,,,10574.62,10790.43,5
MS-DRG,976,Medical,,,13041.13,13953.63,3
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,15303.35,30525.8,10
MS-DRG,977,Hiv With Or Without Other Related Condition,,,14997.28,15303.35,5
MS-DRG,977,Medical,,,13041.13,13953.63,3
MS-DRG,981,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,54081.33,110365.21,10
MS-DRG,981,Extensive O.R. Procedure Unrelated To Principal Diagnosis With Mcc,,,52999.71,54081.33,5
MS-DRG,981,Surgical,,,22870.31,24470.51,3
MS-DRG,982,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,28565.62,57831.3,10
MS-DRG,982,Extensive O.R. Procedure Unrelated To Principal Diagnosis With Cc,,,27994.31,28565.62,5
MS-DRG,982,Surgical,,,22870.31,24470.51,3
MS-DRG,983,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,20059.62,40318.42,10
MS-DRG,983,Extensive O.R. Procedure Unrelated To Principal Diagnosis Without Cc/Mcc,,,19658.43,20059.62,5
MS-DRG,983,Surgical,,,22870.31,24470.51,3
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,39646.84,80646.25,10
MS-DRG,987,Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis With Mcc,,,38853.9,39646.84,5
MS-DRG,987,Surgical,,,22870.31,24470.51,3
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,19255.3,38662.4,10
MS-DRG,988,Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis With Cc,,,18870.19,19255.3,5
MS-DRG,988,Surgical,,,22870.31,24470.51,3
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,14177.97,28208.78,10
MS-DRG,989,Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis Without Cc/Mcc,,,13894.41,14177.97,5
MS-DRG,989,Surgical,,,22870.31,24470.51,3
NDC,00002120001,FLORBETAPIR F-18 10 MCI (370 MBQ) IV SOLN,1.01,0.65,2732.71,3142.62,8
NDC,00002143301,DULAGLUTIDE 0.75 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002143380,DULAGLUTIDE 0.75 MG/0.5 ML SC PNIJ,1465.56,952.61,,,0
NDC,00002143401,DULAGLUTIDE 1.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002143480,DULAGLUTIDE 1.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002143611,GALCANEZUMAB-GNLM 120 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002148401,TIRZEPATIDE 7.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002149501,TIRZEPATIDE 5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002223601,DULAGLUTIDE 3 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002237701,GALCANEZUMAB-GNLM 120 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00002298026,SELPERCATINIB 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00002318201,DULAGLUTIDE 4.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002322730,ATOMOXETINE 10 MG PO CAPS,5894.4,3831.36,13270.0,14761.0,2
NDC,00002323560,DULOXETINE 20 MG PO CPDR,7459.2,4848.48,13270.0,14761.0,2
NDC,00002323930,ATOMOXETINE 60 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00002325030,ATOMOXETINE 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00002325130,ATOMOXETINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00002418230,BARICITINIB 2 MG PO TABS,43614.24,28349.26,13270.0,14761.0,6
NDC,00002445385,OLANZAPINE 5 MG PO TBDL,7481.76,4863.14,13270.0,14761.0,4
NDC,00002445485,OLANZAPINE 10 MG PO TBDL,11050.56,7182.86,13270.0,14761.0,4
NDC,00002446230,TADALAFIL 5 MG PO TABS,4296.48,2792.71,13270.0,14761.0,2
NDC,00002446534,TADALAFIL 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00002473230,BARICITINIB 1 MG PO TABS,43614.24,28349.26,13270.0,14761.0,2
NDC,00002481554,ABEMACICLIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00002533754,ABEMACICLIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00002751001,INSULIN LISPRO 100 UNITS/ML SC SOLN,767.84,499.1,13270.0,14761.0,6
NDC,00002751017,INSULIN LISPRO 100 UNITS/ML SC SOLN,296.98,193.04,13270.0,14761.0,4
NDC,00002751017,Other Outpatient Services,296.98,193.04,,,0
NDC,00002751101,INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) SC SUSP,767.84,499.1,13270.0,14761.0,2
NDC,00002751601,INSULIN LISPRO 100 UNITS/ML SC CRTG,1465.56,952.61,13270.0,14761.0,2
NDC,00002758901,BEBTELOVIMAB 175 MG/2 ML (87.5 MG/ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00002759701,OLANZAPINE 10 MG IM SOLR,749.28,487.03,13270.0,14761.0,2
NDC,00002762301,PEMETREXED DISODIUM 500 MG IV SOLR,60269.76,39175.34,5.21,14761.0,11
NDC,00002764001,PEMETREXED DISODIUM 100 MG IV SOLR,12053.92,7835.05,5.21,14761.0,11
NDC,00002766901,RAMUCIRUMAB 10 MG/ML IV SOLN,13242.24,8607.46,88.5,14761.0,11
NDC,00002767801,RAMUCIRUMAB 10 MG/ML IV SOLN,66211.2,43037.28,88.5,14761.0,11
NDC,00002771501,INSULIN GLARGINE 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00002771559,INSULIN GLARGINE 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00002772411,IXEKIZUMAB 80 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00002773701,INSULIN LISPRO 100 UNITS/ML SC SOLN,926.425,602.175,13270.0,14761.0,6
NDC,00002773701,INSULIN LISPRO 100 UNITS/ML SC SOLN (SLIDING SCALE),,,,,0
NDC,00002814801,SOMATROPIN 12 MG (36 UNIT) IJ CRTG,1465.56,952.61,13270.0,14761.0,2
NDC,00002821301,INSULIN LISPRO 100 UNITS/ML SC INPN,1465.56,952.61,,,0
NDC,00002821501,INSULIN OTHER PATIENT SUPPLIED PUMP BOLUS,290.0,188.5,13270.0,14761.0,2
NDC,00002821501,Other Outpatient Services,290.0,188.5,,,0
NDC,00002821517,INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN (PRL 1772 & 2600 ONLY),290.0,188.5,13270.0,14761.0,2
NDC,00002821517,INSULIN REGULAR HUMAN 100 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00002831501,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00002831517,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,00002840001,TERIPARATIDE 20 MCG/DOSE (600MCG/2.4ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,4
NDC,00002840001,TERIPARATIDE 20 MCG/DOSE (620MCG/2.48ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00002871501,INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SC SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00002871501,Other Outpatient Services,290.0,188.5,,,0
NDC,00002871517,INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SC SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00002879901,INSULIN LISPRO 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00002880501,INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00002882401,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,4
NDC,00003029305,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00003029320,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,708.32,460.41,13270.0,14761.0,2
NDC,00003029328,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,10974.18,7133.215,13270.0,14761.0,2
NDC,00003037113,BELATACEPT 250 MG IV SOLR,14744.0,9583.6,4.75,14761.0,11
NDC,00003049420,TRIAMCINOLONE ACETONIDE 10 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00003052711,DASATINIB 20 MG PO TABS,150916.8,98095.92,13270.0,14761.0,2
NDC,00003052811,DASATINIB 50 MG PO TABS,301833.6,196191.84,13270.0,14761.0,2
NDC,00003085222,DASATINIB 100 MG PO TABS,272001.6,176801.04,13270.0,14761.0,2
NDC,00003085722,DASATINIB 140 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00003089321,APIXABAN 2.5 MG PO TABS,1342.08,872.35,13270.0,14761.0,4
NDC,00003089331,APIXABAN 2.5 MG PO TABS,2236.8,1453.92,13270.0,14761.0,4
NDC,00003089421,APIXABAN 5 MG PO TABS,1342.08,872.35,13270.0,14761.0,4
NDC,00003089431,APIXABAN 5 MG PO TABS,2236.8,1453.92,13270.0,14761.0,4
NDC,00003161112,ENTECAVIR 0.5 MG PO TABS,20460.0,13299.0,13270.0,14761.0,4
NDC,00003161412,ENTECAVIR 0.05 MG/ML PO SOLN,14320.32,9308.21,13270.0,14761.0,4
NDC,00003218713,ABATACEPT (WITH MALTOSE) 250 MG IV SOLR,11987.465,7791.8550000000005,54.09,14761.0,11
NDC,00003229111,ELOTUZUMAB 300 MG IV SOLR,20480.94,13312.61,9.44,14761.0,11
NDC,00003232711,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,79894.8,51931.62,220.25,253.29,8
NDC,00003232822,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,319578.48,207726.01,220.25,14761.0,11
NDC,00003256016,AZTREONAM 1 GRAM IJ SOLR,443.12,288.03,13270.0,14761.0,6
NDC,00003257016,AZTREONAM 2 GRAM IJ SOLR,886.24,576.06,13270.0,14761.0,6
NDC,00003373413,NIVOLUMAB 240 MG/24 ML IV SOLN,70085.95,45555.87,39.53,14761.0,11
NDC,00003375614,NIVOLUMAB 120 MG/12 ML IV SOLN,35042.98,22777.94,39.53,45.46,8
NDC,00003377211,NIVOLUMAB 40 MG/4 ML IV SOLN,11681.03,7592.67,39.53,14761.0,11
NDC,00003377412,NIVOLUMAB 100 MG/10 ML IV SOLN,29202.39,18981.55,39.53,14761.0,11
NDC,00003452211,ELOTUZUMAB 400 MG IV SOLR,27307.62,17749.95,9.44,10.85,8
NDC,00003633617,HYDROXYUREA (SICKLE CELL) 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00003712511,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,20482.8,13313.82,237.16,272.73,8
NDC,00004003822,VALGANCICLOVIR 450 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00004025943,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,6704.0,4357.6,13270.0,14761.0,4
NDC,00004026001,MYCOPHENOLATE MOFETIL 500 MG PO TABS,2681.6,1743.04,13270.0,14761.0,4
NDC,00004026129,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,16056.32,10436.61,13270.0,14761.0,4
NDC,00004029809,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,4120.64,2678.42,13270.0,14761.0,4
NDC,00004035009,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00004080085,OSELTAMIVIR 75 MG PO CAPS,2264.16,1471.7,13270.0,14761.0,4
NDC,00004080285,OSELTAMIVIR 30 MG PO CAPS,2077.12,1350.13,13270.0,14761.0,4
NDC,00004082205,OSELTAMIVIR 6 MG/ML PO SUSR,2264.64,1472.02,13270.0,14761.0,4
NDC,00004110150,CAPECITABINE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00005010001,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",1465.56,952.61,,,0
NDC,00005197101,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3342.62,2172.7,13270.0,14761.0,2
NDC,00005197105,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,20482.8,13313.82,,,0
NDC,00005200001,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3861.76,2510.14,13270.0,14761.0,2
NDC,00005200002,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3861.76,2510.14,,,0
NDC,00005475652,MULTIVIT-MIN-IRON-FA-VIT K-LUT 8 MG IRON-400 MCG-50 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006003220,IVERMECTIN 3 MG PO TABS,1387.2,901.68,13270.0,14761.0,4
NDC,00006003310,SUVOREXANT 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006007131,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006007154,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006011201,Other Outpatient Services,290.0,188.5,,,0
NDC,00006011201,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00006011228,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,16396.8,10657.92,13270.0,14761.0,4
NDC,00006011231,Other Outpatient Services,1465.56,952.61,,,0
NDC,00006011254,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,14757.12,9592.13,13270.0,14761.0,4
NDC,00006022101,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00006022128,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,16396.8,10657.92,13270.0,14761.0,2
NDC,00006022131,Other Outpatient Services,1465.56,952.61,,,0
NDC,00006022154,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,14757.12,9592.13,13270.0,14761.0,4
NDC,00006022761,Other Outpatient Services,29766.72,19348.37,,,0
NDC,00006022761,RALTEGRAVIR 400 MG PO TABS,29766.72,19348.37,13270.0,14761.0,2
NDC,00006027701,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00006027728,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,16396.8,10657.92,13270.0,14761.0,2
NDC,00006027754,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,14757.12,9592.13,13270.0,14761.0,4
NDC,00006032510,SUVOREXANT 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006033510,SUVOREXANT 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006046106,APREPITANT 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00006071731,LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006302501,BEZLOTOXUMAB 25 MG/ML IV SOLN,20482.8,13313.82,49.64,57.08,8
NDC,00006302601,PEMBROLIZUMAB 25 MG/ML IV SOLN,10974.18,7133.215,72.49,14761.0,11
NDC,00006302602,PEMBROLIZUMAB 25 MG/ML IV SOLN,52038.72,33825.17,72.49,14761.0,11
NDC,00006302604,PEMBROLIZUMAB 25 MG/ML IV SOLN,20482.8,13313.82,72.49,83.36,8
NDC,00006306100,FOSAPREPITANT 150 MG IV SOLR,2493.84,1621.0,,,0
NDC,00006306101,FOSAPREPITANT 150 MG IV SOLR,20482.8,13313.82,,,0
NDC,00006306901,DORAVIRINE 100 MG PO TABS,1653.63,1074.86,13270.0,14761.0,2
NDC,00006307601,LETERMOVIR 480 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006307602,LETERMOVIR 480 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006307603,LETERMOVIR 480 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006307604,LETERMOVIR 480 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00006351659,IMIPENEM-CILASTATIN 500 MG IV SOLR,486.74,316.38,13270.0,14761.0,4
NDC,00006351936,DORZOLAMIDE 2 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00006384371,ERTAPENEM 1 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,00006412101,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",10974.18,7133.215,,,0
NDC,00006412102,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",4586.35,2981.13,,,0
NDC,00006430501,INFLIXIMAB-ABDA 100 MG IV SOLR,20482.8,13313.82,33.85,38.92,8
NDC,00006468100,"MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR",1352.35,879.03,13270.0,14761.0,2
NDC,00006468101,"MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR",1352.35,879.03,13270.0,14761.0,2
NDC,00006482701,VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SC SUSR,10974.18,7133.215,,,0
NDC,00006483701,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SYRG,1745.28,1134.43,,,0
NDC,00006483703,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SYRG,1745.28,1134.43,,,0
NDC,00006494300,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN,872.64,567.22,,,0
NDC,00006494301,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00006502801,VERICIGUAT 2.5 MG PO TABS,4682.5,3043.63,13270.0,14761.0,2
NDC,00006502802,VERICIGUAT 2.5 MG PO TABS,10034.88,6522.67,13270.0,14761.0,2
NDC,00006503001,VERICIGUAT 10 MG PO TABS,10034.88,6522.67,13270.0,14761.0,4
NDC,00006505506,MOLNUPIRAVIR 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00006542302,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,13270.0,14761.0,4
NDC,00006542312,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,13270.0,14761.0,4
NDC,00007337113,CARVEDILOL PHOSPHATE 20 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00007337213,CARVEDILOL PHOSPHATE 40 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00007338313,CARVEDILOL PHOSPHATE 10 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00007338513,CARVEDILOL PHOSPHATE 20 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00007488213,ROPINIROLE 12 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00007488713,ROPINIROLE 4 MG PO TB24,1465.56,952.61,,,0
NDC,00007488813,ROPINIROLE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00008010001,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,206172.0,134011.8,3260.96,14761.0,11
NDC,00008092351,PANTOPRAZOLE (PROTONIX) 40 MG/50 ML NS VIAL-TO-BAG IV INFUSION,290.0,188.5,13270.0,14761.0,2
NDC,00008092351,PANTOPRAZOLE 40 MG IV SOLR,290.0,188.5,13270.0,14761.0,6
NDC,00008092355,PANTOPRAZOLE 40 MG IV SOLR,290.0,188.5,13270.0,14761.0,6
NDC,00008103006,SIROLIMUS 1 MG/ML PO SOLN,29280.96,19032.62,13270.0,14761.0,2
NDC,00008104010,SIROLIMUS 0.5 MG PO TABS,25622.4,16654.56,13270.0,14761.0,4
NDC,00008104110,SIROLIMUS 1 MG PO TABS,51241.6,33307.04,13270.0,14761.0,4
NDC,00008121130,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00008200110,PANTOPRAZOLE 40 MG IV SOLR,20482.8,13313.82,,,0
NDC,00008451001,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,90405.0,58763.25,285.99,14761.0,3
NDC,00009000302,METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML IV SOLR,690.88,449.07,13270.0,14761.0,2
NDC,00009001103,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML IJ SOLR,337.92,219.65,13270.0,14761.0,4
NDC,00009001612,HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML IJ SOLR,1237.76,804.54,13270.0,14761.0,2
NDC,00009002901,ALPRAZOLAM 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00009003101,HYDROCORTISONE 10 MG PO TABS,2531.2,1645.28,13270.0,14761.0,4
NDC,00009003928,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00009003930,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00009004722,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00009004725,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00009005707,ALPRAZOLAM 0.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00009026001,COLESTIPOL 5 GRAM PO PACK,,,13270.0,14761.0,2
NDC,00009031508,"GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TP SPGE",1465.56,952.61,13270.0,14761.0,2
NDC,00009041701,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,13270.0,14761.0,2
NDC,00009043601,ARGININE HCL (L-ARGININE) 10 % IV SOLP,624.0,405.6,13270.0,14761.0,2
NDC,00009045003,COLESTIPOL 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00009069801,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,654.88,425.67,13270.0,14761.0,2
NDC,00009075801,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,360.0,234.0,13270.0,14761.0,2
NDC,00009076004,CLINDAMYCIN PALMITATE HCL 75 MG/5 ML PO SOLR,406.4,264.16,13270.0,14761.0,4
NDC,00009077520,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00009077526,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00009077526,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,00009085605,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,1982.29,1288.49,13270.0,14761.0,2
NDC,00009085608,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,1982.29,1288.49,13270.0,14761.0,2
NDC,00009087026,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00009090218,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00009307301,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,00009307303,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00009316901,ALPROSTADIL 500 MCG/ML IJ SOLN,1931.84,1255.7,13270.0,14761.0,6
NDC,00009316906,ALPROSTADIL 500 MCG/ML IJ SOLN,1931.84,1255.7,13270.0,14761.0,2
NDC,00009347501,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,00009347503,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00009379401,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1312.8,853.32,300.59,14761.0,11
NDC,00009454402,TOLTERODINE 2 MG PO TABS,7745.28,5034.43,13270.0,14761.0,2
NDC,00009514001,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,480.0,312.0,13270.0,14761.0,4
NDC,00009519002,TOLTERODINE 2 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00009519103,TOLTERODINE 4 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00009722401,"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN",40419.23,26272.5,4941.46,14761.0,3
NDC,00009722402,"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN",42440.18,27586.12,4941.46,14761.0,3
NDC,00009737611,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,819.2,532.48,,,0
NDC,00009766304,EXEMESTANE 25 MG PO TABS,17160.96,11154.62,13270.0,14761.0,2
NDC,0001.00E+12,All Other Outpatient Services,20482.8,13313.82,,,0
NDC,0001.00E+12,All Oupatient,20482.8,13313.82,,,0
NDC,0001.00E+12,All Outpatient Hospital Services,20482.8,13313.82,,,0
NDC,0001.00E+12,CSMC OPED,20482.8,13313.82,,,0
NDC,00013010201,SULFASALAZINE 500 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,00013111410,TRANEXAMIC ACID (CYCLOKAPRON) (100MG/ML) 5000MG IN 50ML (STRAIGHT DRU),1465.56,952.61,13270.0,14761.0,2
NDC,00013111415,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00013257691,IDARUBICIN 1 MG/ML IV SOLN,743.2,483.08,13270.0,14761.0,4
NDC,00013258691,IDARUBICIN 1 MG/ML IV SOLN,1486.56,966.26,13270.0,14761.0,2
NDC,00013530117,RIFABUTIN 150 MG PO CAPS,12171.2,7911.28,13270.0,14761.0,2
NDC,00013871762,DEXRAZOXANE HCL 250 MG IV SOLR,10974.18,7133.215,108.95,14761.0,13
NDC,00019481604,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),307.68,199.99,13270.0,14761.0,4
NDC,00019905040,INDIUM 111-PENTETREOTIDE 3-10 MCI/ML-MCG IV KIT,1.01,0.65,2384.05,2741.66,8
NDC,00019N068B0,LABELED RED BLOOD CELLS (TC-99M RBC) (ULTRATAG) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
NDC,00023024004,WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,00023040330,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DPET,290.0,188.5,13270.0,14761.0,4
NDC,00023079801,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023079815,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023114501,ONABOTULINUMTOXINA 100 UNITS IJ SOLR,8398.0,5458.7,7.98,14761.0,11
NDC,00023320502,BIMATOPROST 0.01 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023320503,BIMATOPROST 0.01 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023320505,BIMATOPROST 0.01 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023320508,BIMATOPROST 0.01 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023361525,GATIFLOXACIN 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023361605,BIMATOPROST 0.03 % LASH DRPA,1465.56,952.61,13270.0,14761.0,2
NDC,00023392102,ONABOTULINUMTOXINA 200 UNITS IJ SOLR,10336.0,6718.4,7.98,9.17,8
NDC,00023449130,CARBOXYMETHYL-GLY-POLY80-PF 0.5-1-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00023455430,CARBOXYMETHYLCELLULOSE SODIUM 1 % OP DPGE,,,13270.0,14761.0,2
NDC,00023585318,MESALAMINE 400 MG PO CDTI,10411.2,6767.28,13270.0,14761.0,2
NDC,00023585801,LEVONORGESTREL 20.4 MCG/24 HR (8 YRS) 52 MG IU IUD,14907.68,9689.99,13270.0,14761.0,2
NDC,00023588512,ESTRADIOL 0.025 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00023588811,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00023590118,MESALAMINE 800 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,00023599204,TESTOSTERONE 4 MG/24 HR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,00023601560,MORPHINE 50 MG PO CSRP,1465.56,952.61,13270.0,14761.0,2
NDC,00023603003,NORETH-ETHINYL ESTRADIOL-IRON 0.8MG-25MCG(24) AND 75 MG (4) PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00023608201,IRON DEXTRAN 50 MG/ML IJ SOLN,529.06,343.89,22.0,14761.0,11
NDC,00023608210,IRON DEXTRAN 50 MG/ML IJ SOLN,529.06,343.89,22.0,14761.0,11
NDC,00023611201,"LIPASE-PROTEASE-AMYLASE 20,000-63,000- 84,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,00023611301,"LIPASE-PROTEASE-AMYLASE 3,000-10,000 -14,000-UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,00023611401,"LIPASE-PROTEASE-AMYLASE 40,000-126,000- 168,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,00023614730,SILODOSIN 4 MG PO CAPS,3898.08,2533.75,13270.0,14761.0,4
NDC,00023649802,UBROGEPANT 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00023650102,UBROGEPANT 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00023650110,UBROGEPANT 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00023916330,CYCLOSPORINE 0.05 % OP DPET,4809.6,3126.24,13270.0,14761.0,2
NDC,00023916330,Other Outpatient Services,4809.6,3126.24,,,0
NDC,00023916360,CYCLOSPORINE 0.05 % OP DPET,9620.16,6253.1,13270.0,14761.0,2
NDC,00023917705,BRIMONIDINE 0.15 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023921105,BRIMONIDINE-TIMOLOL 0.2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023921110,BRIMONIDINE-TIMOLOL 0.2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023921115,BRIMONIDINE-TIMOLOL 0.2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023927705,KETOROLAC 0.4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023932105,BRIMONIDINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023932110,BRIMONIDINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00023932115,BRIMONIDINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00024065401,ISATUXIMAB-IRFC 20 MG/ML IV SOLN,20482.8,13313.82,97.19,111.76,8
NDC,00024065601,ISATUXIMAB-IRFC 20 MG/ML IV SOLN,20482.8,13313.82,97.19,111.76,8
NDC,00024159601,PRIMAQUINE 26.3 MG PO TABS,,,13270.0,14761.0,2
NDC,00024279201,SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN,20482.8,13313.82,,,0
NDC,00024279210,SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN,474.08,308.15,,,0
NDC,00024414210,DRONEDARONE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00024414260,DRONEDARONE 400 MG PO TABS,11658.24,7577.86,13270.0,14761.0,2
NDC,00024515010,RASBURICASE 1.5 MG IV SOLR,17450.13,11342.58,462.33,14761.0,3
NDC,00024515011,RASBURICASE 1.5 MG IV SOLR,17450.13,11342.58,462.33,14761.0,11
NDC,00024515411,RASBURICASE 1.5 MG IV SOLR,1465.56,952.61,462.33,14761.0,5
NDC,00024550131,ZOLPIDEM 6.25 MG PO TBMP,1465.56,952.61,13270.0,14761.0,2
NDC,00024552131,ZOLPIDEM 12.5 MG PO TBMP,1465.56,952.61,,,0
NDC,00024576105,INSULIN GLARGINE-LIXISENATIDE 100 UNIT-33 MCG/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00024582315,CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN,129228.48,83998.51,269.53,14761.0,3
NDC,00024582411,CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN,129228.48,83998.51,269.53,14761.0,11
NDC,00024585230,IRBESARTAN 300 MG PO TABS,4116.0,2675.4,13270.0,14761.0,2
NDC,00024585530,IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00024586201,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SC SOLN,20482.8,13313.82,62.85,72.27,8
NDC,00024586901,INSULIN GLARGINE U-300 CONC 300 UNIT/ML (1.5 ML) SC INPN,1465.56,952.61,,,0
NDC,00024587100,INSULIN GLARGINE U-300 CONC 300 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00024590200,ALIROCUMAB 150 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00024591400,DUPILUMAB 300 MG/2 ML SC SYRG,1465.56,952.61,,,0
NDC,00024591401,DUPILUMAB 300 MG/2 ML SC SYRG,16742.75,10882.79,13270.0,14761.0,2
NDC,00024591500,DUPILUMAB 300 MG/2 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00024591502,DUPILUMAB 300 MG/2 ML SC PNIJ,1465.56,952.61,,,0
NDC,00024591801,DUPILUMAB 200 MG/1.14 ML SC SYRG,16742.74,10882.78,,,0
NDC,00024592605,Other Outpatient Services,290.0,188.5,,,0
NDC,00025141160,DICLOFENAC-MISOPROSTOL 50-200 MG-MCG PO TBID,1465.56,952.61,,,0
NDC,00025141190,DICLOFENAC-MISOPROSTOL 50-200 MG-MCG PO TBID,1465.56,952.61,13270.0,14761.0,2
NDC,00025152534,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,00025191131,VERAPAMIL 180 MG PO TBSR,,,13270.0,14761.0,2
NDC,00026378555,"ANTIHEMOPHIL FVIII,FULL LENGTH 1,000 (+/-) UNIT IV SOLR",19040.0,12376.0,1.93,14761.0,12
NDC,00026378665,"ANTIHEMOPHIL FVIII,FULL LENGTH 2,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.93,2.22,8
NDC,00026478301,"ANTIHEMOPHIL FVIII,FULL LENGTH 500 (+/-) UNIT IV SOLR",9520.0,6188.0,13270.0,14761.0,2
NDC,00032120370,"LIPASE-PROTEASE-AMYLASE 3,000-9,500- 15,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,00032120601,"LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT PO CPDR",,,13270.0,14761.0,4
NDC,00032120607,"LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT PO CPDR",,,13270.0,14761.0,4
NDC,00032121201,"LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT PO CPDR",,,13270.0,14761.0,4
NDC,00032122401,"LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT PO CPDR",,,13270.0,14761.0,4
NDC,00032301613,"LIPASE-PROTEASE-AMYLASE 36,000-114,000- 180,000 UNIT PO CPDR",19249.6,12512.24,13270.0,14761.0,4
NDC,00037024523,AZELASTINE-FLUTICASONE 137-50 MCG/SPRAY NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00037043101,FELBAMATE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00037044267,FELBAMATE 600 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00037067808,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,00037067896,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,00037682210,HYDROCORTISONE-PRAMOXINE 1-1 % PR FOAM,2759.68,1793.79,13270.0,14761.0,4
NDC,00037682315,PRAMOXINE 1 % TP FOAM,1368.72,889.67,13270.0,14761.0,2
NDC,00039022310,GLIMEPIRIDE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00040050101,ALLOPURINOL 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
NDC,00040050301,ASPIRIN 81 MG HALF-TAB = 40.5 MG,,,13270.0,14761.0,2
NDC,00040050401,ATENOLOL 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
NDC,00040050701,BUPROPION 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
NDC,00040050801,BUSPIRONE 5 MG HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
NDC,00040051001,CAPTOPRIL 12.5 MG HALF-TAB = 6.25 MG,,,13270.0,14761.0,2
NDC,00040051201,CARBIDOPA-LEVODOPA 25-100 MG HALF-TAB = 12.5-50 MG,,,13270.0,14761.0,2
NDC,00040051801,FLUDROCORTISONE 0.1 MG HALF-TAB = 0.05 MG,,,13270.0,14761.0,2
NDC,00040051901,FUROSEMIDE 20 MG HALF-TAB = 10 MG,,,13270.0,14761.0,2
NDC,00040052001,GLIPIZIDE 5 MG HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
NDC,00040052101,HYDRALAZINE 10 MG HALF-TAB = 5 MG,,,13270.0,14761.0,2
NDC,00040052201,LEVOTHYROXINE 25 MCG HALF-TAB = 12.5 MCG,,,13270.0,14761.0,2
NDC,00040052301,LEVOTHYROXINE 75 MCG HALF-TAB = 37.5 MCG,,,13270.0,14761.0,2
NDC,00040052401,LEVOTHYROXINE 88 MCG HALF-TAB = 44 MCG,,,13270.0,14761.0,2
NDC,00040052501,LEVOTHYROXINE 125 MCG HALF-TAB = 62.5 MCG,,,13270.0,14761.0,2
NDC,00040052601,LIOTHYRONINE 25 MCG HALF-TAB = 12.5 MCG,,,13270.0,14761.0,2
NDC,00040053201,METOPROLOL TARTRATE 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
NDC,00040053801,SOTALOL 120 MG HALF-TAB = 60 MG,,,13270.0,14761.0,2
NDC,00040053901,SOTALOL 80 MG HALF-TAB = 40 MG,,,13270.0,14761.0,2
NDC,00040054001,SPIRONOLACTONE 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
NDC,00040054201,TRAZODONE 50 MG HALF-TAB = 25 MG,,,13270.0,14761.0,2
NDC,00040054401,WARFARIN 1 MG HALF-TAB = 0.5 MG,,,13270.0,14761.0,2
NDC,00040054502,METOPROLOL SUCCINATE 25 MG HALF-TAB = 12.5 MG PO TB24,,,13270.0,14761.0,2
NDC,00040054601,ASPIRIN 81 MG QUARTER-TAB = 20.25 MG,,,13270.0,14761.0,2
NDC,00045040920,IBUPROFEN 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00046074905,CONJUGATED ESTROGENS 25 MG IJ SOLR,5618.24,3651.86,476.64,14761.0,11
NDC,00046087221,CONJUGATED ESTROGENS 0.625 MG/GRAM VA CREA,6869.76,4465.34,13270.0,14761.0,4
NDC,00046110081,CONJUGATED ESTROGENS 0.3 MG PO TABS,,,13270.0,14761.0,2
NDC,00046110281,CONJUGATED ESTROGENS 0.625 MG PO TABS,,,13270.0,14761.0,2
NDC,00046110511,CONJ ESTROG-MEDROXYPROGEST ACE 0.3-1.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00046110611,CONJ ESTROG-MEDROXYPROGEST ACE 0.45-1.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00046110711,CONJ ESTROG-MEDROXYPROGEST ACE 0.625-2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00049001481,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,00049052083,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00049052084,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00049234045,ELETRIPTAN 40 MG PO TABS,7224.19,4695.72,13270.0,14761.0,2
NDC,00049316044,VORICONAZOLE 200 MG/5 ML (40 MG/ML) PO SUSR,6932.4,4506.06,13270.0,14761.0,4
NDC,00049317030,VORICONAZOLE 50 MG PO TABS,665.76,432.74,13270.0,14761.0,2
NDC,00049318030,VORICONAZOLE 200 MG PO TABS,1665.12,1082.33,13270.0,14761.0,4
NDC,00049319028,VORICONAZOLE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00049392020,ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR,960.45,624.29,13270.0,14761.0,2
NDC,00051845030,TESTOSTERONE 1 % (50 MG/5 GRAM) TD GLPK,1465.56,952.61,13270.0,14761.0,2
NDC,00051846233,TESTOSTERONE 20.25 MG/1.25 GRAM (1.62 %) TD GLPM,1465.56,952.61,13270.0,14761.0,2
NDC,00052060202,BCG LIVE 50 MG IS SUSR,2632.96,1711.42,,,0
NDC,00052433001,ETONOGESTREL 68 MG SD IMPL,10974.18,7133.215,13270.0,14761.0,2
NDC,00053720102,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG IV SOLR,5000.0,3250.0,6.15,7.07,8
NDC,00054000725,CALCITRIOL 0.25 MCG PO CAPS,,,13270.0,14761.0,2
NDC,00054001020,FLECAINIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00054001025,FLECAINIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00054001720,PREDNISONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00054001820,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00054001920,PREDNISONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00054001925,PREDNISONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00054002125,LITHIUM CARBONATE 300 MG PO TBSR,,,13270.0,14761.0,2
NDC,00054004544,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00054004641,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00054006258,CITALOPRAM 10 MG/5 ML PO SOLN,994.56,646.46,13270.0,14761.0,2
NDC,00054007928,BALSALAZIDE 750 MG PO CAPS,,,13270.0,14761.0,2
NDC,00054008425,ZALEPLON 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00054008525,ZALEPLON 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00054017613,BUPRENORPHINE HCL 2 MG SL SUBL,290.0,188.5,13270.0,14761.0,4
NDC,00054017713,BUPRENORPHINE HCL 8 MG SL SUBL,693.12,450.53,13270.0,14761.0,4
NDC,00054021125,PROTRIPTYLINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00054023025,QUETIAPINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00054023524,MORPHINE 15 MG PO TABS,1124.8,731.12,13270.0,14761.0,4
NDC,00054023755,MORPHINE 10 MG/5 ML PO SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00054024324,CODEINE SULFATE 15 MG PO TABS,1072.0,696.8,13270.0,14761.0,2
NDC,00054024424,CODEINE SULFATE 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00054032756,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00054033425,CEVIMELINE 30 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00054038225,CYCLOPHOSPHAMIDE 25 MG PO CAPS,11164.8,7257.12,,,0
NDC,00054038325,CYCLOPHOSPHAMIDE 50 MG PO CAPS,20489.6,13318.24,13270.0,14761.0,4
NDC,00054038925,METHAMPHETAMINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00054040013,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,460.8,299.52,13270.0,14761.0,4
NDC,00054040113,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00054047921,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,00054050823,ICOSAPENT ETHYL 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00054051744,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00054053222,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00054053322,DROXIDOPA 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00054053422,DROXIDOPA 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00054060313,DESVENLAFAXINE SUCCINATE 25 MG PO TB24,436.32,283.61,13270.0,14761.0,2
NDC,00054065025,BUTALBITAL-ACETAMINOP-CAF-COD 50-300-40-30 MG PO CAPS,8540.8,5551.52,13270.0,14761.0,2
NDC,00054070920,METHADONE 5 MG PO TABS,310.4,201.76,13270.0,14761.0,4
NDC,00054075664,MULTIVIT-MIN-IRON-FA-VIT K-LUT 8 MG IRON-400 MCG-50 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00054309036,BUTORPHANOL 10 MG/ML NA SPRY,20482.8,13313.82,,,0
NDC,00054311705,"CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) PO SUSP",,,13270.0,14761.0,2
NDC,00054312047,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,4
NDC,00054317644,DEXAMETHASONE 1 MG/ML PO DROP,354.72,230.57,13270.0,14761.0,2
NDC,00054317644,Other Outpatient Services,354.72,230.57,,,0
NDC,00054317763,DEXAMETHASONE 0.5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00054319446,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,00054327099,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,290.0,188.5,13270.0,14761.0,4
NDC,00054350547,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,596.0,387.4,13270.0,14761.0,4
NDC,00054355344,METHADONE 10 MG/ML PO CONC,294.24,191.26,13270.0,14761.0,4
NDC,00054355563,METHADONE 1 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00054356699,MIDAZOLAM 2 MG/ML PO SYRP,1465.56,952.61,,,0
NDC,00054372144,PREDNISONE 5 MG/ML PO CONC,,,13270.0,14761.0,2
NDC,00054372250,PREDNISONE 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00054372763,PROPRANOLOL 20 MG/5 ML (4 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,00054408425,AZATHIOPRINE ORAL SUSPENSION 50 MG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,00054414623,CLOTRIMAZOLE 10 MG MM TROC,3626.56,2357.26,13270.0,14761.0,4
NDC,00054418125,DEXAMETHASONE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00054418225,DEXAMETHASONE 1.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00054418325,DEXAMETHASONE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00054418425,DEXAMETHASONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00054449625,LEUCOVORIN CALCIUM 5 MG PO TABS,1622.4,1054.56,,,0
NDC,00054458111,MERCAPTOPURINE 50 MG PO TABS,1181.6,768.04,13270.0,14761.0,4
NDC,00054474225,PREDNISONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00054485825,TRIAZOLAM 0.125 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00054814622,CLOTRIMAZOLE 10 MG MM TROC,3077.76,2000.54,13270.0,14761.0,4
NDC,00054817425,DEXAMETHASONE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00054817525,DEXAMETHASONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00054817625,DEXAMETHASONE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00054817925,DEXAMETHASONE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00054818125,DEXAMETHASONE 1.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00054829725,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00054829925,FUROSEMIDE 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00054849619,LEUCOVORIN CALCIUM 5 MG PO TABS,1173.6,762.84,13270.0,14761.0,2
NDC,00054852625,LITHIUM CARBONATE 150 MG PO CAPS,,,13270.0,14761.0,2
NDC,00054852725,LITHIUM CARBONATE 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,00054855025,METHOTREXATE SODIUM 2.5 MG PO TABS,4542.4,2952.56,13270.0,14761.0,4
NDC,00054855324,METHADONE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00054872425,PREDNISONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00054873925,PREDNISONE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00054874025,PREDNISONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00056016975,WARFARIN 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00056018901,WARFARIN 6 MG PO TABS,,,13270.0,14761.0,2
NDC,00065000203,NEPAFENAC 0.1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00065008515,NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,00065009265,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,777.44,505.34,13270.0,14761.0,4
NDC,00065027105,OLOPATADINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065027510,BRINZOLAMIDE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00065027515,BRINZOLAMIDE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00065030355,Other Outpatient Services,760.64,494.42,,,0
NDC,00065033230,OLOPATADINE 0.6 % NA SPRY,1465.56,952.61,,,0
NDC,00065035902,CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OP DROP,476.0,309.4,13270.0,14761.0,4
NDC,00065040872,ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OP DROP,416.88,270.97,13270.0,14761.0,4
NDC,00065041130,POVIDONE-IODINE 5 % OP SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00065042636,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065042915,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065043133,PEG 400-PROPYLENE GLYCOL (PF) 0.4-0.3 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00065045407,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
NDC,00065047401,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OP GEL,,,13270.0,14761.0,2
NDC,00065048101,PROPYLENE GLYCOL 0.6 % OP DROP,1465.56,952.61,,,0
NDC,00065048110,PROPYLENE GLYCOL 0.6 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065051801,WHITE PETROLATUM-MINERAL OIL 94-3 % OP OINT,,,13270.0,14761.0,2
NDC,00065064435,TOBRAMYCIN 0.3 % OP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,00065064515,NATAMYCIN 5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00065064725,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,1239.36,805.58,13270.0,14761.0,2
NDC,00065064835,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,00065066010,APRACLONIDINE 1 % OP DPET,1465.56,952.61,,,0
NDC,00065074114,TETRACAINE HCL (PF) 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,00065079515,BALANCED SALT SOLN NO.2 IRRIG. IO SOLN,,,13270.0,14761.0,4
NDC,00065081701,ATROPINE 1 % OP DROP,858.08,557.75,13270.0,14761.0,2
NDC,00065143105,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065143302,PROPYLENE GLYCOL 0.6 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065401303,MOXIFLOXACIN 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00065414727,BRINZOLAMIDE-BRIMONIDINE 1-0.2 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00065804603,Other Outpatient Services,1465.56,952.61,,,0
NDC,00065924007,DIFLUPREDNATE 0.05 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00067204524,ACETAMINOPHEN-CAFFEINE 500-65 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00068042017,METHYLCELLULOSE (LAXATIVE) PO POWD,,,13270.0,14761.0,2
NDC,00068059701,RIFAMPIN 600 MG IV SOLR,1103.2,717.08,13270.0,14761.0,2
NDC,00069005904,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,20482.8,13313.82,,,0
NDC,00069018821,PALBOCICLIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00069018921,PALBOCICLIB 125 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00069021701,"DALTEPARIN (PORCINE) 10,000 ANTI-XA UNIT/ML SC SYRG",20482.8,13313.82,,,0
NDC,00069022701,LORLATINIB 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069023101,LORLATINIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069023401,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,4
NDC,00069023801,RITUXIMAB-PVVR 10 MG/ML IV SOLN,8120.96,5278.62,27.94,14761.0,11
NDC,00069024230,FESOTERODINE 4 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00069024430,FESOTERODINE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00069024801,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,6
NDC,00069024901,RITUXIMAB-PVVR 10 MG/ML IV SOLN,40604.8,26393.12,27.94,14761.0,11
NDC,00069030501,TRASTUZUMAB-QYYP 420 MG IV SOLR,17962.56,11675.66,23.87,14761.0,11
NDC,00069030601,TRASTUZUMAB-QYYP 420 MG IV SOLR,17962.56,11675.66,23.87,14761.0,11
NDC,00069030801,TRASTUZUMAB-QYYP 420 MG IV SOLR,20482.8,13313.82,23.87,27.45,8
NDC,00069031501,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,7570.43,4920.78,29.37,14761.0,11
NDC,00069034201,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,30281.73,19683.12,29.37,14761.0,11
NDC,00069034506,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG PO DSPK,,,13270.0,14761.0,2
NDC,00069034530,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG PO DSPK,,,13270.0,14761.0,2
NDC,00069046856,VARENICLINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069046956,VARENICLINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00069048603,PALBOCICLIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069050130,TOFACITINIB 11 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00069068803,PALBOCICLIB 125 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069068807,PALBOCICLIB 125 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069080901,INFLIXIMAB-DYYB 100 MG IV SOLR,6708.32,4360.41,16.96,14761.0,11
NDC,00069097065,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,4
NDC,00069100201,TOFACITINIB 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00069108506,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG PO DSPK,,,13270.0,14761.0,2
NDC,00069110104,NIRMATRELVIR-RITONAVIR 150-100 MG PO DSPK,1465.56,952.61,13270.0,14761.0,4
NDC,00069110120,NIRMATRELVIR-RITONAVIR 150-100 MG PO DSPK,1465.56,952.61,13270.0,14761.0,2
NDC,00069130501,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,0.95,14761.0,22
NDC,00069130510,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,0.95,14761.0,6
NDC,00069130601,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,344.775,224.105,0.95,14761.0,22
NDC,00069130610,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,344.775,224.105,0.95,14761.0,6
NDC,00069130701,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,432.85,281.34999999999997,0.95,14761.0,22
NDC,00069130710,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,432.85,281.34999999999997,0.95,14761.0,6
NDC,00069130801,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,1082.135,703.3900000000001,0.95,14761.0,22
NDC,00069130810,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,1082.135,703.3900000000001,0.95,14761.0,14
NDC,00069130901,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,4328.545,2813.5550000000003,0.95,14761.0,22
NDC,00069130904,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,3329.65,2164.27,9.49,10.91,8
NDC,00069197512,TAFAMIDIS MEGLUMINE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00069197540,TAFAMIDIS MEGLUMINE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00069303120,DOXORUBICIN 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00069303220,DOXORUBICIN 2 MG/ML IV SOLN,338.8,220.22,13270.0,14761.0,2
NDC,00069303320,DOXORUBICIN 2 MG/ML IV SOLN,20482.8,13313.82,,,0
NDC,00069303420,DOXORUBICIN 2 MG/ML IV SOLN,932.8,606.32,,,0
NDC,00069314019,AZITHROMYCIN 200 MG/5 ML PO SUSR,1465.56,952.61,,,0
NDC,00069315084,AZITHROMYCIN 500 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,00069581060,DOFETILIDE 250 MCG PO CAPS,10010.88,6507.07,13270.0,14761.0,2
NDC,00069582043,DOFETILIDE 500 MCG PO CAPS,7091.84,4609.7,13270.0,14761.0,2
NDC,00069600102,FOSPHENYTOIN 100 MG PE/2 ML IJ SOLN,361.63,235.06,13270.0,14761.0,4
NDC,00069600110,FOSPHENYTOIN 500 MG PE/10 ML IJ SOLN,1808.16,1175.3,13270.0,14761.0,2
NDC,00069600121,FOSPHENYTOIN 500 MG PE/10 ML IJ SOLN,1808.16,1175.3,13270.0,14761.0,4
NDC,00069873001,TAFAMIDIS 61 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00069873030,TAFAMIDIS 61 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00071000740,PHENYTOIN 50 MG PO CHEW,,,13270.0,14761.0,2
NDC,00071015523,ATORVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00071015623,ATORVASTATIN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00071015640,ATORVASTATIN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00071015723,ATORVASTATIN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00071015823,ATORVASTATIN 80 MG PO TABS,24795.36,16116.98,13270.0,14761.0,4
NDC,00071036940,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00071041813,NITROGLYCERIN 0.4 MG SL SUBL,,,13270.0,14761.0,2
NDC,00071041824,NITROGLYCERIN 0.4 MG SL SUBL,,,13270.0,14761.0,2
NDC,00071080524,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,00071101268,PREGABALIN 25 MG PO CAPS,13577.76,8825.54,13270.0,14761.0,2
NDC,00071101341,PREGABALIN 50 MG PO CAPS,16592.0,10784.8,13270.0,14761.0,4
NDC,00071101441,PREGABALIN 75 MG PO CAPS,16592.0,10784.8,13270.0,14761.0,4
NDC,00071102001,PREGABALIN 20 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00071201223,GABAPENTIN 250 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00071201223,GABAPENTIN 300 MG/6 ML (6 ML) PO SOLN,,,13270.0,14761.0,2
NDC,00071374066,PHENYTOIN SODIUM EXTENDED 30 MG PO CAPS,,,13270.0,14761.0,2
NDC,00074003801,ELAGOLIX 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074012402,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
NDC,00074012403,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
NDC,00074012404,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
NDC,00074012474,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
NDC,00074024302,ADALIMUMAB 40 MG/0.4 ML SC SYKT,1465.56,952.61,,,0
NDC,00074055402,ADALIMUMAB 40 MG/0.4 ML SC PNKT,10974.18,7133.215,13270.0,14761.0,2
NDC,00074056111,VENETOCLAX 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074056114,VENETOCLAX 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074056607,VENETOCLAX 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074056611,VENETOCLAX 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074057611,VENETOCLAX 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00074057622,VENETOCLAX 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074106901,RISANKIZUMAB-RZAA 360 MG/2.4 ML (150 MG/ML) SC INJT,1465.56,952.61,,,0
NDC,00074107001,RISANKIZUMAB-RZAA 360 MG/2.4 ML (150 MG/ML) SC INJT,1465.56,952.61,,,0
NDC,00074194063,RITONAVIR 80 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00074230630,Other Outpatient Services,1465.56,952.61,,,0
NDC,00074230630,UPADACITINIB 15 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00074231030,UPADACITINIB 30 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00074254003,ADALIMUMAB 80 MG/0.8 ML SC SYKT,1465.56,952.61,,,0
NDC,00074262501,GLECAPREVIR-PIBRENTASVIR 100-40 MG PO TABS,7027.68,4567.99,13270.0,14761.0,2
NDC,00074262528,GLECAPREVIR-PIBRENTASVIR 100-40 MG PO TABS,196775.04,127903.78,13270.0,14761.0,2
NDC,00074310832,CYCLOSPORINE MODIFIED 25 MG PO CAPS,419.52,272.69,13270.0,14761.0,4
NDC,00074310932,CYCLOSPORINE MODIFIED 100 MG PO CAPS,1675.2,1088.88,13270.0,14761.0,2
NDC,00074327813,POTASSIUM CHLORIDE 10 MEQ PO TBSR,,,13270.0,14761.0,2
NDC,00074333330,RITONAVIR 100 MG PO TABS,3833.76,2491.94,13270.0,14761.0,4
NDC,00074334603,LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT,53991.9,35094.74,219.79,14761.0,11
NDC,00074364103,LEUPROLIDE 3.75 MG IM SYKT,15102.81,9816.83,2014.27,14761.0,11
NDC,00074364203,LEUPROLIDE 7.5 MG IM SYKT,17997.48,11698.36,219.79,252.76,8
NDC,00074366303,LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT,45308.88,29450.77,2014.27,2316.42,8
NDC,00074368303,LEUPROLIDE (4 MONTH) 30 MG IM SYKT,71989.47,46793.16,219.79,252.76,8
NDC,00074377903,LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT,98955.63,64321.16,2014.27,2316.42,8
NDC,00074379902,ADALIMUMAB 40 MG/0.8 ML SC SYKT,58048.29,37731.39,13270.0,14761.0,2
NDC,00074382611,DIVALPROEX 250 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00074433902,ADALIMUMAB 40 MG/0.8 ML SC PNKT,58048.29,37731.39,,,0
NDC,00074438010,CISATRACURIUM 2 MG/ML IV SOLN,410.08,266.55,13270.0,14761.0,4
NDC,00074455290,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,00074463701,PARICALCITOL 2 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00074501501,RISANKIZUMAB-RZAA 60 MG/ML IV SOLN,86978.16,56535.8,18.22,20.95,8
NDC,00074659490,LEVOTHYROXINE 88 MCG PO TABS,,,13270.0,14761.0,2
NDC,00074662411,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,00074662490,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,00074679922,LOPINAVIR-RITONAVIR 200-50 MG PO TABS,15267.84,9924.1,13270.0,14761.0,2
NDC,00074709404,ATOGEPANT 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074709430,ATOGEPANT 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00074712611,DIVALPROEX 500 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00074712613,DIVALPROEX 500 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00074929619,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,2
NDC,00074969403,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,108989.73,70843.32,2014.27,2316.42,8
NDC,00075062001,ENOXAPARIN 40 MG/0.4 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00075062040,ENOXAPARIN 40 MG/0.4 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00075062160,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00075062201,ENOXAPARIN 80 MG/0.8 ML SC SYRG,20482.8,13313.82,,,0
NDC,00075062300,ENOXAPARIN 100 MG/ML SC SYRG,370.24,240.66,13270.0,14761.0,2
NDC,00075062303,ENOXAPARIN 100 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00075062430,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00075800404,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,00078010901,CYCLOSPORINE 250 MG/5 ML IV SOLN,1019.84,662.9,13270.0,14761.0,4
NDC,00078010961,CYCLOSPORINE 250 MG/5 ML IV SOLN,1019.84,662.9,13270.0,14761.0,2
NDC,00078018161,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00078024015,CYCLOSPORINE 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078024061,CYCLOSPORINE 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078024115,CYCLOSPORINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078024161,CYCLOSPORINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078024661,CYCLOSPORINE MODIFIED 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078024915,LETROZOLE 2.5 MG PO TABS,11847.36,7700.78,13270.0,14761.0,4
NDC,00078027422,CYCLOSPORINE MODIFIED 100 MG/ML PO SOLN,8693.6,5650.84,13270.0,14761.0,4
NDC,00078033184,BASILIXIMAB 20 MG IV SOLR,38230.02,24849.51,5713.88,14761.0,11
NDC,00078035752,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) PO SUSP,,,13270.0,14761.0,2
NDC,00078036405,AMLODIPINE-BENAZEPRIL 10-20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078036542,ESTRADIOL 0.025 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00078038566,MYCOPHENOLATE SODIUM 180 MG PO TBEC,12140.16,7891.1,13270.0,14761.0,4
NDC,00078038666,MYCOPHENOLATE SODIUM 360 MG PO TBEC,24278.4,15780.96,13270.0,14761.0,4
NDC,00078040134,IMATINIB 100 MG PO TABS,125629.92,81659.45,13270.0,14761.0,4
NDC,00078040905,CARBIDOPA-LEVODOPA-ENTACAPONE 37.5-150-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078041420,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,18853.44,12254.74,13270.0,14761.0,4
NDC,00078041461,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,314.22,204.24,13270.0,14761.0,4
NDC,00078041720,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,9427.2,6127.68,13270.0,14761.0,4
NDC,00078041761,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00078042220,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,37707.84,24510.1,13270.0,14761.0,4
NDC,00078042261,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,628.46,408.5,13270.0,14761.0,4
NDC,00078043561,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,20482.8,13313.82,,,0
NDC,00078044105,METHYLPHENIDATE HCL 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078049471,TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00078049491,TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML IN NEBU,1941.36,1261.88,13270.0,14761.0,2
NDC,00078050115,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,10226.4,6647.16,13270.0,14761.0,2
NDC,00078050261,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,340.88,221.57,13270.0,14761.0,2
NDC,00078051005,CARBAMAZEPINE 100 MG PO TB12,,,13270.0,14761.0,2
NDC,00078051105,CARBAMAZEPINE 200 MG PO TB12,,,13270.0,14761.0,2
NDC,00078051205,CARBAMAZEPINE 400 MG PO TB12,,,13270.0,14761.0,2
NDC,00078052651,NILOTINIB 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078054505,CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG PO TABS,1465.56,952.61,,,0
NDC,00078056845,ARTEMETHER-LUMEFANTRINE 20-120 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078056999,Other Outpatient Services,1465.56,952.61,,,0
NDC,00078065415,DEFERASIROX 90 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078065615,DEFERASIROX 360 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078065920,SACUBITRIL-VALSARTAN 24-26 MG PO TABS,10153.92,6600.05,13270.0,14761.0,6
NDC,00078066815,Other Outpatient Services,1465.56,952.61,,,0
NDC,00078066815,TRAMETINIB 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00078068166,DABRAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00078068361,NELARABINE 250 MG/50 ML IVPB,10626.4,6907.16,90.31,14761.0,11
NDC,00078068515,ELTROMBOPAG OLAMINE 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078068615,ELTROMBOPAG OLAMINE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078068715,ELTROMBOPAG OLAMINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078069620,SACUBITRIL-VALSARTAN 97-103 MG PO TABS,10153.92,6600.05,13270.0,14761.0,4
NDC,00078069667,SACUBITRIL-VALSARTAN 97-103 MG PO TABS,30461.76,19800.14,13270.0,14761.0,2
NDC,00078069802,MIDOSTAURIN 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078070802,ALPELISIB 300 MG/DAY (150 MG X 2) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078070956,CAPMATINIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078071656,CAPMATINIB 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00078072210,BRINZOLAMIDE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078072215,BRINZOLAMIDE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078073461,CANAKINUMAB (PF) 150 MG/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00078077720,Other Outpatient Services,10153.92,6600.05,,,0
NDC,00078077720,SACUBITRIL-VALSARTAN 49-51 MG PO TABS,10153.92,6600.05,13270.0,14761.0,4
NDC,00078077803,NEPAFENAC 0.1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078079761,"OCTREOTIDE,MICROSPHERES 20 MG IM SSRR",1465.56,952.61,267.57,14761.0,3
NDC,00078080461,"OCTREOTIDE,MICROSPHERES 30 MG IM SSRR",20482.8,13313.82,267.57,307.71,8
NDC,00078081181,"OCTREOTIDE,MICROSPHERES 10 MG IM SSRR",25999.68,16899.79,267.57,307.71,8
NDC,00078081301,Other Outpatient Services,3798.09,2468.76,,,0
NDC,00078081881,"OCTREOTIDE,MICROSPHERES 20 MG IM SSRR",36193.0,23525.449999999997,267.57,14761.0,11
NDC,00078082581,"OCTREOTIDE,MICROSPHERES 30 MG IM SSRR",54196.17,35227.51,267.57,14761.0,11
NDC,00078084101,CIPROFLOXACIN HCL 0.3 % OP OINT,4052.5,2634.13,13270.0,14761.0,2
NDC,00078087421,RIBOCICLIB 600 MG/DAY (200 MG X 3) PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00078088361,CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN,10974.18,7133.215,160.05,184.06,16
NDC,00078090438,BRINZOLAMIDE-BRIMONIDINE 1-0.2 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078091105,LIFITEGRAST 5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00078091112,LIFITEGRAST 5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00078094625,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00078094640,Other Outpatient Services,3336.8,2168.92,,,0
NDC,00078095340,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00078100060,INCLISIRAN 284 MG/1.5 ML SC SYRG,30426.75,19777.39,15.17,17.45,16
NDC,00078100768,OFATUMUMAB 20 MG/0.4 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00078109820,ASCIMINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00081079888,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",1465.56,952.61,13270.0,14761.0,4
NDC,00085132801,POSACONAZOLE 200 MG/5 ML (40 MG/ML) PO SUSP,21458.64,13948.12,13270.0,14761.0,2
NDC,00085432402,POSACONAZOLE 100 MG PO TBEC,61295.04,39841.78,13270.0,14761.0,2
NDC,00085433401,MOMETASONE 200 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00085461001,MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00085461005,MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00088210201,RIFAPENTINE 150 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00088221901,Other Outpatient Services,1465.56,952.61,,,0
NDC,00088221905,Other Outpatient Services,1465.56,952.61,,,0
NDC,00088222033,INSULIN GLARGINE 100 UNITS/ML SC SOLN,914.24,594.26,13270.0,14761.0,2
NDC,00088250033,INSULIN GLULISINE U-100 100 UNITS/ML SC SOLN,1257.28,817.23,13270.0,14761.0,2
NDC,00093001006,TOLTERODINE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093001198,PANTOPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,4
NDC,00093005101,CARVEDILOL 3.125 MG PO TABS,,,13270.0,14761.0,2
NDC,00093005301,BUSPIRONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00093005401,BUSPIRONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00093005801,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00093006456,RABEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,00093007401,ZOLPIDEM 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00093010901,CARBAMAZEPINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00093013501,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,2
NDC,00093031101,LOPERAMIDE 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093031401,KETOROLAC 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093031805,DILTIAZEM HCL 30 MG PO TABS,,,13270.0,14761.0,2
NDC,00093031901,DILTIAZEM HCL 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00093032001,DILTIAZEM HCL 90 MG PO TABS,,,13270.0,14761.0,2
NDC,00093035001,ACETAMINOPHEN-CODEINE 300-60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093046301,LAMOTRIGINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093075201,ATENOLOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00093075301,ATENOLOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00093077198,PRAVASTATIN 10 MG PO TABS,355.68,231.19,13270.0,14761.0,4
NDC,00093078701,ATENOLOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00093080701,FLUOXETINE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093081101,NORTRIPTYLINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093083201,CLONAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00093100301,BUSPIRONE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,00093101042,MUPIROCIN 2 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,00093106001,SOTALOL 120 MG PO TABS,,,13270.0,14761.0,2
NDC,00093106201,SOTALOL 160 MG PO TABS,,,13270.0,14761.0,2
NDC,00093112589,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093113556,ACITRETIN 10 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00093117701,NEOMYCIN 500 MG PO TABS,1451.2,943.28,13270.0,14761.0,4
NDC,00093206406,CILOSTAZOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00093214028,NORGESTIMATE-ETHINYL ESTRADIOL 0.18/0.215/0.25 MG-25 MCG PO TABS,,,13270.0,14761.0,2
NDC,00093217801,LIOTHYRONINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,00093220305,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00093220405,METOCLOPRAMIDE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00093221001,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,00093221005,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,00093226301,AMOXICILLIN 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093227434,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,420.48,273.31,13270.0,14761.0,2
NDC,00093227434,Other Outpatient Services,420.48,273.31,,,0
NDC,00093227534,Other Outpatient Services,1465.56,952.61,,,0
NDC,00093300919,LANSOPRAZOLE 30 MG PO TBLD,1465.56,952.61,13270.0,14761.0,2
NDC,00093312301,DICLOXACILLIN 250 MG PO CAPS,1017.6,661.44,13270.0,14761.0,2
NDC,00093312701,DISOPYRAMIDE PHOSPHATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093312901,DISOPYRAMIDE PHOSPHATE 150 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093314501,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,00093314705,CEPHALEXIN 500 MG PO CAPS,1536.0,998.4,13270.0,14761.0,4
NDC,00093317431,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,290.0,188.5,,,0
NDC,00093321301,CLONAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00093330416,DESOGESTREL-ETHINYL ESTRADIOL 0.15-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093342501,LORAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00093342601,LORAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00093342701,LORAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00093354143,ESTRADIOL 0.01 % (0.1 MG/GRAM) VA CREA,,,13270.0,14761.0,2
NDC,00093354856,ATOMOXETINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00093360982,FLUTICASONE PROPION-SALMETEROL 232-14 MCG/ACTUATION IN AEPB,1465.56,952.61,13270.0,14761.0,2
NDC,00093365621,BUPRENORPHINE 5 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00093365721,BUPRENORPHINE 10 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00093365821,BUPRENORPHINE 15 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00093365921,BUPRENORPHINE 20 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00093400028,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.02 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093406106,FORMOTEROL FUMARATE 20 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00093406119,FORMOTEROL FUMARATE 20 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00093412774,PENICILLIN V POTASSIUM 250 MG/5 ML PO SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00093415573,Other Outpatient Services,1465.56,952.61,,,0
NDC,00093417573,Other Outpatient Services,1465.56,952.61,,,0
NDC,00093417773,CEPHALEXIN 250 MG/5 ML PO SUSR,342.4,222.56,13270.0,14761.0,4
NDC,00093503056,TIAGABINE 2 MG PO TABS,1465.56,952.61,,,0
NDC,00093503156,TIAGABINE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093523456,EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG PO TABS,3577.92,2325.65,13270.0,14761.0,4
NDC,00093524519,OLANZAPINE 5 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,00093526356,SOLIFENACIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093532828,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093532862,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093540189,OMEGA-3 ACID ETHYL ESTERS 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00093542088,CABERGOLINE 0.5 MG PO TABS,580.99,377.64,13270.0,14761.0,4
NDC,00093545528,ESTRADIOL-NORETHINDRONE ACET 1-0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093553901,ESZOPICLONE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093557256,ERYTHROMYCIN 500 MG PO TABS,4459.2,2898.48,13270.0,14761.0,2
NDC,00093574065,CYCLOSPORINE MODIFIED 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00093590786,MESALAMINE 400 MG PO CDTI,8994.24,5846.26,13270.0,14761.0,2
NDC,00093593854,LANTHANUM 500 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00093593898,LANTHANUM 500 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00093595545,ARFORMOTEROL 15 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00093596301,GUANFACINE 3 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00093614882,L NORGEST/E.ESTRADIOL-E.ESTRAD 0.1 MG-20 MCG (84)/10 MCG (7) PO 3MPK,1465.56,952.61,13270.0,14761.0,2
NDC,00093614891,L NORGEST/E.ESTRADIOL-E.ESTRAD 0.1 MG-20 MCG (84)/10 MCG (7) PO 3MPK,1465.56,952.61,13270.0,14761.0,2
NDC,00093645056,ESOMEPRAZOLE MAGNESIUM 20 MG PO CPDR,,,13270.0,14761.0,2
NDC,00093645156,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,2
NDC,00093645198,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,2
NDC,00093681519,BUDESONIDE 0.25 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00093681545,BUDESONIDE 0.25 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00093681619,BUDESONIDE 0.5 MG IN NBSP,1465.56,952.61,13270.0,14761.0,4
NDC,00093681645,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00093703056,AMLODIPINE-OLMESARTAN 10-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093716501,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093716505,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093716601,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093720198,PRAVASTATIN 20 MG PO TABS,361.44,234.94,13270.0,14761.0,4
NDC,00093727298,PIOGLITAZONE 30 MG PO TABS,321.12,208.73,13270.0,14761.0,2
NDC,00093729505,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00093729605,CARVEDILOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00093736410,LOSARTAN 25 MG HALF-TAB = 12.5 MG,1465.56,952.61,,,0
NDC,00093738598,VENLAFAXINE 75 MG PO CP24,383.04,248.98,13270.0,14761.0,4
NDC,00093738698,VENLAFAXINE 150 MG PO CP24,493.92,321.05,13270.0,14761.0,4
NDC,00093751631,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00093751831,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00093761256,OLMESARTAN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093761756,OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093762056,LETROZOLE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00093762998,IMATINIB 100 MG PO TABS,1627.2,1057.68,13270.0,14761.0,4
NDC,00093770198,LEVOCETIRIZINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093811856,FAMCICLOVIR 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093816201,QUETIAPINE 100 MG PO TABS,1022.4,664.56,13270.0,14761.0,4
NDC,00093816301,QUETIAPINE 200 MG PO TABS,1928.0,1253.2,13270.0,14761.0,4
NDC,00093820401,CIMETIDINE 400 MG PO TABS,,,13270.0,14761.0,2
NDC,00093821028,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG(24) /75 MG (4) PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00093834201,GLYBURIDE 1.25 MG PO TABS,,,13270.0,14761.0,2
NDC,00093834498,GLYBURIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00093873901,MEXILETINE 150 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093874001,MEXILETINE 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,00093901819,CYCLOSPORINE MODIFIED 25 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,00093901865,CYCLOSPORINE MODIFIED 25 MG PO CAPS,480.96,312.62,13270.0,14761.0,2
NDC,00093902019,CYCLOSPORINE MODIFIED 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,00093914701,VENLAFAXINE 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00093921906,DIMETHYL FUMARATE 240 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,00093922489,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00093970101,CARBIDOPA-LEVODOPA 10-100 MG PO TABS,,,13270.0,14761.0,2
NDC,00093970201,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,00113034405,NICOTINE (POLACRILEX) 2 MG BU LOZG,1465.56,952.61,13270.0,14761.0,2
NDC,00113044164,DOXYLAMINE SUCCINATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00113046162,IBUPROFEN 100 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00113048672,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00113089801,ESOMEPRAZOLE MAGNESIUM 20 MG PO CPDR,,,13270.0,14761.0,2
NDC,00113091530,OMEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,00115051101,FENOFIBRATE MICRONIZED 67 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00115052201,FENOFIBRATE MICRONIZED 134 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00115053301,FENOFIBRATE MICRONIZED 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00115133101,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00115133301,DEXTROAMPHETAMINE-AMPHETAMINE 30 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00115136530,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,4
NDC,00115143808,DUTASTERIDE 0.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00115146853,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,00115148901,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00115149101,DEXTROAMPHETAMINE-AMPHETAMINE 30 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00115155701,OXYCODONE 15 MG PO TR12,1465.56,952.61,13270.0,14761.0,2
NDC,00115168776,BUDESONIDE 0.25 MG IN NBSP,1465.56,952.61,13270.0,14761.0,2
NDC,00115170210,DEXTROAMPHETAMINE SULFATE 5 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,00115170310,DEXTROAMPHETAMINE SULFATE 10 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,00115214216,COLESTIPOL 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00115261101,TERBUTALINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00115521116,COLESTIPOL 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00115552202,FENOFIBRATE 160 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00115703301,FLUDROCORTISONE 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,00115703302,FLUDROCORTISONE 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,00115992710,DEXTROAMPHETAMINE SULFATE 5 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,00115994108,Other Outpatient Services,1465.56,952.61,,,0
NDC,00116200116,CHLORHEXIDINE GLUCONATE 0.12 % MM MWSH,,,13270.0,14761.0,2
NDC,00121043130,MAGNESIUM HYDROXIDE 400 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00121050405,ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00121053005,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,00121054410,DOCUSATE SODIUM 50 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,00121058104,HALOPERIDOL LACTATE 2 MG/ML PO CONC,,,13270.0,14761.0,2
NDC,00121059515,SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML PO SOLN,,,13270.0,14761.0,4
NDC,00121059530,SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML PO SOLN,,,13270.0,14761.0,4
NDC,00121063805,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,13270.0,14761.0,4
NDC,00121064610,AMANTADINE HCL 50 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00121065705,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00121067016,ETHOSUXIMIDE 250 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121067816,NORTRIPTYLINE 10 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121074710,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,00121076605,"CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) PO SUSP",,,13270.0,14761.0,2
NDC,00121079905,BLENDED ACUTE CARE,,,13270.0,14761.0,2
NDC,00121079910,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,00121079965,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,00121079975,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,00121085320,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00121086720,Other Outpatient Services,391.68,254.59,,,0
NDC,00121086805,NYSTATIN 100000 UNITS/ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,00121089805,ATOVAQUONE 750 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,00121090315,LIDOCAINE HCL 2 % MM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00121090405,MORPHINE 10 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00121090505,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) PO SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00121091400,IBUPROFEN 100 MG/5 ML PO SUSP,,,13270.0,14761.0,4
NDC,00121091405,IBUPROFEN 100 MG/5 ML PO SUSP,,,13270.0,14761.0,4
NDC,00121094510,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,00121097410,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,00121100812,Other Outpatient Services,1465.56,952.61,,,0
NDC,00121115400,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121115430,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121119030,Other Outpatient Services,,,,,0
NDC,00121119030,SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML PO SOLN,,,13270.0,14761.0,4
NDC,00121127610,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,13270.0,14761.0,4
NDC,00121148810,GUAIFENESIN 100 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,00121154410,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00121154440,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00121155010,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,4
NDC,00121157610,METOCLOPRAMIDE HCL 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121168016,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,00121172410,CARBAMAZEPINE 200 MG/10 ML PO SUSP,,,13270.0,14761.0,2
NDC,00121174405,GUAIFENESIN 100 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,00121176230,ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00121177505,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,4
NDC,00121187010,DOCUSATE SODIUM 50 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,00121189410,CARBAMAZEPINE 200 MG/10 ML PO SUSP,,,13270.0,14761.0,2
NDC,00121197121,ACETAMINOPHEN 650 MG PO SOLN,,,13270.0,14761.0,2
NDC,00121198410,LACOSAMIDE 10 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00121457715,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,00121467505,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
NDC,00121472105,FLUOXETINE 20 MG/5 ML (4 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,00121476605,"CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) PO SUSP",,,13270.0,14761.0,2
NDC,00121477210,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00121482705,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00131181067,LACOSAMIDE 200 MG/20 ML IV SOLN,1477.12,960.13,13270.0,14761.0,2
NDC,00131247735,LACOSAMIDE 50 MG PO TABS,10797.12,7018.13,13270.0,14761.0,2
NDC,00131247760,LACOSAMIDE 50 MG PO TABS,11878.08,7720.75,13270.0,14761.0,4
NDC,00131248060,LACOSAMIDE 200 MG PO TABS,19673.28,12787.63,13270.0,14761.0,4
NDC,00132007912,GLYCERIN (ADULT) PR SUPP,,,13270.0,14761.0,4
NDC,00132008112,GLYCERIN (CHILD) PR SUPP,,,13270.0,14761.0,2
NDC,00132019012,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML PR SOLN,,,13270.0,14761.0,2
NDC,00132020220,SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML PR ENEM,,,13270.0,14761.0,2
NDC,00132030140,MINERAL OIL PR ENEM,,,13270.0,14761.0,2
NDC,00135007027,CALCIUM CARBONATE 200 MG CALCIUM (500 MG) PO CHEW,,,13270.0,14761.0,2
NDC,00135007407,CALCIUM CARBONATE 300 MG (750 MG) PO CHEW,,,13270.0,14761.0,2
NDC,00135015710,NICOTINE (POLACRILEX) 2 MG BU GUM,,,13270.0,14761.0,2
NDC,00135019901,METHYLCELLULOSE (LAXATIVE) 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00135048201,FAMOTIDINE-CA CARB-MAG HYDROX 10-800-165 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,00135061503,FLUTICASONE FUROATE 27.5 MCG/ACTUATION NA SPSN,1465.56,952.61,13270.0,14761.0,2
NDC,00143117201,CAPTOPRIL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00143117401,CAPTOPRIL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00143145501,PHENOBARBITAL 60 MG PO TABS,1465.56,952.61,,,0
NDC,00143177101,ISOSORBIDE DINITRATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00143177201,ISOSORBIDE DINITRATE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00143211250,Other Outpatient Services,1465.56,952.61,,,0
NDC,00143312601,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00143312610,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00143314250,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00143902201,FULVESTRANT 250 MG/5 ML IM SYRG,543.36,353.18,9.35,10.75,8
NDC,00143902202,FULVESTRANT 250 MG/5 ML IM SYRG,543.36,353.18,9.35,14761.0,11
NDC,00143908401,DOXORUBICIN 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143908501,DOXORUBICIN 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143908601,DOXORUBICIN 2 MG/ML IV SOLN,521.6,339.04,13270.0,14761.0,2
NDC,00143908701,DOXORUBICIN 2 MG/ML IV SOLN,2086.4,1356.16,,,0
NDC,00143909301,DOXORUBICIN 50 MG IV SOLR (FOR CHEMOEMBOLIZATION),3724.96,2421.22,,,0
NDC,00143909801,BORTEZOMIB 3.5 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143920401,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,894.4,581.36,13270.0,14761.0,2
NDC,00143921701,IDARUBICIN 1 MG/ML IV SOLN,417.28,271.23,13270.0,14761.0,2
NDC,00143923301,BENZTROPINE 1 MG/ML IJ SOLN,372.67,242.24,13270.0,14761.0,2
NDC,00143923401,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00143924001,BLEOMYCIN 15 UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143924501,DACARBAZINE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143924510,DACARBAZINE 200 MG IV SOLR,290.0,188.5,,,0
NDC,00143925001,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143925201,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143925401,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143927001,FLOXURIDINE 0.5 GRAM IJ SOLR,20482.8,13313.82,4803.97,5524.57,8
NDC,00143927301,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,1267.12,823.63,13270.0,14761.0,2
NDC,00143927901,MITOMYCIN 20 MG IV SOLR,803.52,522.29,52.93,14761.0,11
NDC,00143929701,DANTROLENE 20 MG IV SOLR,775.2,503.88,13270.0,14761.0,2
NDC,00143929901,GANCICLOVIR SODIUM 500 MG IV SOLR,499.39,324.6,13270.0,14761.0,4
NDC,00143931801,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143931810,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143933001,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143933401,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143935510,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143936201,MICAFUNGIN 100 MG IV SOLR,432.32,281.01,13270.0,14761.0,2
NDC,00143936701,METHOTREXATE SODIUM (PF) 1 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,00143937801,DAPTOMYCIN 500 MG IV SOLR,20482.8,13313.82,,,0
NDC,00143938101,DOXYCYCLINE (VIBRAMYCIN) 100 MG/100 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,00143938101,DOXYCYCLINE HYCLATE 100 MG IV SOLR,290.0,188.5,,,0
NDC,00143938401,FOSAPREPITANT 150 MG IV SOLR,316.44,205.685,13270.0,14761.0,2
NDC,00143938501,DECITABINE 50 MG IV SOLR,521.76,339.14,,,0
NDC,00143938601,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143939801,ERTAPENEM 1 GRAM IJ SOLR,365.23,237.4,13270.0,14761.0,4
NDC,00143950301,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,365.28,237.43,13270.0,14761.0,2
NDC,00143950401,CISPLATIN 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143950501,CISPLATIN 1 MG/ML IV SOLN,457.6,297.44,13270.0,14761.0,2
NDC,00143950601,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143950801,KETAMINE 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143950810,KETAMINE 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143950901,Other Outpatient Services,1465.56,952.61,,,0
NDC,00143951001,ETOPOSIDE 20 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143951901,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143951910,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143952501,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143952510,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143955201,LEUCOVORIN CALCIUM 350 MG IJ SOLR,361.44,234.94,,,0
NDC,00143955901,ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN,1426.4,927.16,13270.0,14761.0,2
NDC,00143955901,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1426.4,927.16,1.57,14761.0,5
NDC,00143956401,PHENTOLAMINE 5 MG IJ SOLR,6938.88,4510.27,457.13,14761.0,3
NDC,00143956501,THIOTEPA 15 MG IJ SOLR,2459.68,1598.79,260.26,14761.0,3
NDC,00143957001,SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN,290.0,188.5,,,0
NDC,00143957401,LEVETIRACETAM 500 MG/5 ML IV SOLN,20482.8,13313.82,,,0
NDC,00143957701,LIDOCAINE 10 MG/ML (1 %) IJ SOLN (CC),290.0,188.5,13270.0,14761.0,2
NDC,00143957701,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143959401,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
NDC,00143959501,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143959501,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,00143959525,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143959525,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,00143960601,AZACITIDINE 100 MG IJ SOLR,372.64,242.22,,,0
NDC,00143962101,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143962201,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143962301,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143963701,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143963801,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143965901,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,13270.0,14761.0,2
NDC,00143967301,LEVETIRACETAM 500 MG/5 ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00143968201,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143968901,NICARDIPINE 25 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143970101,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143970201,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,,,0
NDC,00143971001,MILRINONE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143971010,MILRINONE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143971901,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00143972001,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00143972024,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00143972101,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00143972124,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,,,0
NDC,00143972201,LEVOFLOXACIN 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,00143972201,LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK,290.0,188.5,,,0
NDC,00143972301,CLONIDINE (PF) 5000 MCG/10 ML EP SOLN,729.76,474.34,13270.0,14761.0,2
NDC,00143972401,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00143972901,BENZTROPINE 1 MG/ML IJ SOLN,372.67,242.24,13270.0,14761.0,2
NDC,00143974401,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143974601,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143974610,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143978401,FLUMAZENIL 0.1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143978501,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143978510,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143978601,ENALAPRILAT 1.25 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00143978701,ENALAPRILAT 1.25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00143983001,METHOTREXATE SODIUM (PF) 1 GRAM IJ SOLR,650.4,422.76,13270.0,14761.0,2
NDC,00143985001,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143985101,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143985601,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143985701,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143987101,CLADRIBINE 10 MG/10 ML IV SOLN,1073.28,697.63,17.74,14761.0,5
NDC,00143987201,PROPRANOLOL 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143987501,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00143988801,Other Outpatient Services,1465.56,952.61,,,0
NDC,00143992390,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,,,0
NDC,00143992390,CEFAZOLIN 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143992490,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143992801,Other Outpatient Services,313.6,203.84,,,0
NDC,00143997722,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00143997790,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00143997990,CEFUROXIME SODIUM 750 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00168000315,TRIAMCINOLONE ACETONIDE 0.025 % TP CREA,,,13270.0,14761.0,2
NDC,00168000415,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00168000615,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,00168001531,HYDROCORTISONE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00168001531,Other Outpatient Services,290.0,188.5,,,0
NDC,00168002031,HYDROCORTISONE 1 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,00168003315,BETAMETHASONE VALERATE 0.1 % TP OINT,,,13270.0,14761.0,2
NDC,00168004015,BETAMETHASONE VALERATE 0.1 % TP CREA,,,13270.0,14761.0,2
NDC,00168004160,BETAMETHASONE VALERATE 0.1 % TP LOTN,,,13270.0,14761.0,2
NDC,00168005615,BETAMETHASONE DIPROPIONATE 0.05 % TP OINT,,,13270.0,14761.0,2
NDC,00168005760,BETAMETHASONE DIPROPIONATE 0.05 % TP LOTN,,,13270.0,14761.0,2
NDC,00168008031,HYDROCORTISONE 2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00168009930,KETOCONAZOLE 2 % TP CREA,347.04,225.58,13270.0,14761.0,2
NDC,00168014630,HYDROCORTISONE 2.5 % TP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,00168016215,CLOBETASOL 0.05 % TP OINT,,,13270.0,14761.0,2
NDC,00168016315,CLOBETASOL 0.05 % TP CREA,,,13270.0,14761.0,2
NDC,00168020437,LIDOCAINE 5 % TP OINT,3378.43,2195.98,13270.0,14761.0,2
NDC,00168026515,"BETAMETHASONE, AUGMENTED 0.05 % TP CREA",1465.56,952.61,13270.0,14761.0,2
NDC,00168035222,MUPIROCIN 2 % TP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,00168035705,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00168035755,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,00168038360,METRONIDAZOLE 0.75 % TP LOTN,1465.56,952.61,13270.0,14761.0,2
NDC,00168043224,IMIQUIMOD 5 % TP CRPK,1465.56,952.61,13270.0,14761.0,2
NDC,00169183311,INSULIN REGULAR HUMAN 100 UNITS/ML IJ SOLN,521.76,339.14,13270.0,14761.0,2
NDC,00169210011,INSULIN OTHER PATIENT SUPPLIED PUMP BOLUS,1465.56,952.61,13270.0,14761.0,2
NDC,00169220125,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00169255013,INSULIN DEGLUDEC 200 UNIT/ML (3 ML) SC INPN,3031.68,1970.59,13270.0,14761.0,2
NDC,00169255013,Other Outpatient Services,3031.68,1970.59,,,0
NDC,00169266015,INSULIN DEGLUDEC 100 UNIT/ML (3 ML) SC INPN,1515.84,985.3,13270.0,14761.0,2
NDC,00169266015,Other Outpatient Services,1515.84,985.3,,,0
NDC,00169266211,INSULIN DEGLUDEC 100 UNITS/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00169280015,LIRAGLUTIDE (WEIGHT LOSS) 3 MG/0.5 ML (18 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169291115,INSULIN DEGLUDEC-LIRAGLUTIDE 100 UNIT-3.6 MG /ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00169320415,INSULIN ASPART (NIACINAMIDE) 100 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00169406012,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169406013,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169413001,SEMAGLUTIDE 1 MG/DOSE (4 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169413211,SEMAGLUTIDE 0.25 MG OR 0.5 MG(2 MG/1.5 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169413212,SEMAGLUTIDE 0.25 MG OR 0.5 MG(2 MG/1.5 ML) SC PNIJ,1465.56,952.61,,,0
NDC,00169413602,SEMAGLUTIDE 1 MG/DOSE (2 MG/1.5 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169430313,SEMAGLUTIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169430330,SEMAGLUTIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169430713,SEMAGLUTIDE 7 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169430730,SEMAGLUTIDE 7 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169431413,SEMAGLUTIDE 14 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169431430,SEMAGLUTIDE 14 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00169452401,SEMAGLUTIDE (WEIGHT LOSS) 2.4 MG/0.75 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169477211,SEMAGLUTIDE 2 MG/DOSE (8 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169477212,SEMAGLUTIDE 2 MG/DOSE (8 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00169706515,GLUCAGON 1 MG IJ SOLR,4586.88,2981.47,239.45,275.37,8
NDC,00169720101,COAGULATION FACTOR VIIA RECOMB 1 MG IV SOLR,19210.77,12487.0,3.13,14761.0,10
NDC,00169720201,COAGULATION FACTOR VIIA RECOMB 2 MG IV SOLR,38421.54,24974.0,3.13,14761.0,10
NDC,00169720501,COAGULATION FACTOR VIIA RECOMB 5 MG IV SOLR,20482.8,13313.82,3.13,3.6,8
NDC,00169721111,COAGULATION FACTOR VIIA RECOMB 1 MG IV SOLR,20482.8,13313.82,3.13,14761.0,10
NDC,00169721211,COAGULATION FACTOR VIIA RECOMB 2 MG IV SOLR,20482.8,13313.82,3.13,14761.0,3
NDC,00169750111,INSULIN ASPART U-100 100 UNITS/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00169750190,INSULIN OTHER PATIENT SUPPLIED PUMP BOLUS,1465.56,952.61,13270.0,14761.0,2
NDC,00172208360,HYDROCHLOROTHIAZIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00172208960,HYDROCHLOROTHIAZIDE 10 MG/ML PO SUSP PEDIATRICS,1465.56,952.61,13270.0,14761.0,2
NDC,00172208960,HYDROCHLOROTHIAZIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00172524160,ANAGRELIDE 0.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00172572860,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00173052100,SALMETEROL 50 MCG/DOSE IN DSDV,3156.48,2051.71,13270.0,14761.0,6
NDC,00173052300,SUMATRIPTAN 20 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00173054700,ATOVAQUONE 750 MG/5 ML PO SUSP,489.28,318.03,13270.0,14761.0,4
NDC,00173060100,FLUTICASONE PROPIONATE 250 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173063302,LAMOTRIGINE 25 MG PO TABS,15849.6,10302.24,13270.0,14761.0,2
NDC,00173064460,LAMOTRIGINE 200 MG PO TABS,11179.2,7266.48,13270.0,14761.0,2
NDC,00173067502,ATOVAQUONE-PROGUANIL 250-100 MG PO TABS,2456.83,1596.94,13270.0,14761.0,2
NDC,00173068224,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,290.0,188.5,13270.0,14761.0,4
NDC,00173069504,FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE IN DSDV,339.25,220.51,13270.0,14761.0,4
NDC,00173069600,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173069604,Other Outpatient Services,1465.56,952.61,,,0
NDC,00173069700,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173069704,Other Outpatient Services,1465.56,952.61,,,0
NDC,00173071204,DUTASTERIDE 0.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00173071215,DUTASTERIDE 0.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00173071620,FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00173071720,FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00173071820,FLUTICASONE PROPIONATE 44 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,4
NDC,00173071920,FLUTICASONE PROPIONATE 110 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,4
NDC,00173072020,FLUTICASONE PROPIONATE 220 MCG/ACTUATION IN HFAA,3170.21,2060.64,13270.0,14761.0,4
NDC,00173073601,SUMATRIPTAN SUCCINATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00173073701,SUMATRIPTAN SUCCINATE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00173075700,LAMOTRIGINE 200 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00173076100,LAMOTRIGINE 300 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00173078100,LAMOTRIGINE 250 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00173080913,DUTASTERIDE-TAMSULOSIN 0.5-0.4 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00173082318,PROPAFENONE 225 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,00173082418,PROPAFENONE 325 MG PO CP12,1465.56,952.61,,,0
NDC,00173085914,FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,4
NDC,00173086906,UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION IN DSDV,498.29,323.89,13270.0,14761.0,4
NDC,00173086910,Other Outpatient Services,3645.6,2369.64,,,0
NDC,00173086910,UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION IN DSDV,3645.6,2369.64,13270.0,14761.0,2
NDC,00173087306,UMECLIDINIUM 62.5 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173087310,UMECLIDINIUM 62.5 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173087410,FLUTICASONE FUROATE 100 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173088101,MEPOLIZUMAB 100 MG SC SOLR,27498.06,17873.74,37.9,43.58,8
NDC,00173088210,Other Outpatient Services,1465.56,952.61,,,0
NDC,00173088214,FLUTICASONE FUROATE-VILANTEROL 200-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,4
NDC,00173088710,FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173088714,FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173089242,MEPOLIZUMAB 100 MG/ML SC SYRG,20482.8,13313.82,37.9,43.58,8
NDC,00173089310,FLUTICASONE-UMECLIDIN-VILANTER 200-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173089314,FLUTICASONE-UMECLIDIN-VILANTER 200-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173089314,Other Outpatient Services,1465.56,952.61,,,0
NDC,00173089361,FLUTICASONE-UMECLIDIN-VILANTER 200-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00173089601,BELANTAMAB MAFODOTIN-BLMF 100 MG IV SOLR,20482.8,13313.82,58.25,66.99,8
NDC,00178061501,POTASSIUM CITRATE 15 MEQ PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,00178074001,METHEN-M.BLUE-S.PHOS-PHSAL-HYO 118-10-40.8-36 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00185001001,LABETALOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00185005501,METOLAZONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00185012801,BUMETANIDE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00185012901,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00185041001,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,2
NDC,00185064901,DIPHENHYDRAMINE HCL 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,00185080101,RIFAMPIN 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00185084201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00185093998,CHOLESTYRAMINE-ASPARTAME 4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,00185094098,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,00185505001,METOLAZONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00185560001,METOLAZONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00186037020,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,1746.24,1135.06,13270.0,14761.0,2
NDC,00186037028,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,454.7,295.56,13270.0,14761.0,4
NDC,00186037220,BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION IN HFAA,10974.18,7133.215,13270.0,14761.0,2
NDC,00186037228,BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION IN HFAA,1031.58,670.53,13270.0,14761.0,2
NDC,00186077660,TICAGRELOR 60 MG PO TABS,6928.32,4503.41,13270.0,14761.0,4
NDC,00186077739,TICAGRELOR 90 MG PO TABS,11547.2,7505.68,13270.0,14761.0,4
NDC,00186091612,BUDESONIDE 180 MCG/ACTUATION IN AEPB,1465.56,952.61,13270.0,14761.0,2
NDC,00186091706,BUDESONIDE 90 MCG/ACTUATION IN AEPB,1472.8,957.32,13270.0,14761.0,2
NDC,00186198804,BUDESONIDE 0.25 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00186198904,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00186504031,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,2
NDC,00187079842,DILTIAZEM HCL 300 MG PO CP24,84507.84,54930.1,13270.0,14761.0,2
NDC,00187079942,DILTIAZEM HCL 360 MG PO CP24,124761.6,81095.04,,,0
NDC,00187149605,TIMOLOL MALEATE (PF) 0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00187170405,PHYTONADIONE 5 MG HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,4
NDC,00187301030,PYRIDOSTIGMINE BROMIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00187301220,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,00187430305,AMOBARBITAL 500 MG IJ SOLR,10927.68,7102.99,,,0
NDC,00187516020,TRETINOIN 0.025 % TP CREA,1465.56,952.61,,,0
NDC,00187518006,CICLOPIROX 8 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00187581207,BUPROPION HBR 522 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00206885216,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,00206885416,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,00206885416,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,10974.18,7133.215,13270.0,14761.0,2
NDC,00206885516,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,00206886001,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,20482.8,13313.82,,,0
NDC,00223176001,SODIUM CHLORIDE 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00223176001,SODIUM CHLORIDE 1000 MG MISC TBSO,,,13270.0,14761.0,2
NDC,00223176002,SODIUM CHLORIDE 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00223176002,SODIUM CHLORIDE 1000 MG MISC TBSO,,,13270.0,14761.0,2
NDC,00225080047,PHENYLEPHRINE HCL 0.25 % NA SPRY,290.0,188.5,13270.0,14761.0,4
NDC,00225080547,Other Outpatient Services,290.0,188.5,,,0
NDC,00225080547,PHENYLEPHRINE HCL 0.5 % NA SPRY,290.0,188.5,13270.0,14761.0,4
NDC,00228163803,LAMOTRIGINE 250 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00228202710,ALPRAZOLAM 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00228202910,ALPRAZOLAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00228207610,Other Outpatient Services,290.0,188.5,,,0
NDC,00228207610,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,00228207650,Other Outpatient Services,648.0,421.2,,,0
NDC,00228207710,Other Outpatient Services,1465.56,952.61,,,0
NDC,00228212710,CLONIDINE HCL 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,00228212810,CLONIDINE HCL 0.2 MG PO TABS,,,13270.0,14761.0,2
NDC,00228234810,PROPYLTHIOURACIL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00228249710,NIFEDIPINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00228255111,DICLOFENAC SODIUM 75 MG PO TBEC,,,13270.0,14761.0,2
NDC,00228259711,INDAPAMIDE 1.25 MG PO TABS,,,13270.0,14761.0,2
NDC,00228262011,ISOSORBIDE MONONITRATE 20 MG PO TABS,1465.56,952.61,,,0
NDC,00228277811,PROPRANOLOL 60 MG PO CS24,,,13270.0,14761.0,2
NDC,00228277911,PROPRANOLOL 80 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00228278111,PROPRANOLOL 160 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00228284803,FLUVOXAMINE 100 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00228284903,FLUVOXAMINE 150 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00228306011,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00228309011,MORPHINE 30 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,00228365803,ROPINIROLE 2 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00228365809,ROPINIROLE 2 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00228365903,ROPINIROLE 4 MG PO TB24,1465.56,952.61,,,0
NDC,00228366003,ROPINIROLE 8 MG PO TB24,1465.56,952.61,,,0
NDC,00228424106,CLONIDINE HCL 0.1 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,00228452903,DONEPEZIL 23 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00228452909,DONEPEZIL 23 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00245003689,CHOLESTYRAMINE-ASPARTAME 4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,00245014430,AMIODARONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00245014489,AMIODARONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00245014701,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00245014789,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00245021111,MIDODRINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00245021201,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00245021211,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00245021289,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00245021311,MIDODRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00245036089,Other Outpatient Services,1465.56,952.61,,,0
NDC,00245055650,VIGABATRIN 500 MG PO PWPK,1465.56,952.61,,,0
NDC,00245055689,VIGABATRIN 500 MG PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,00245081261,SUMATRIPTAN 10 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00245088230,ESTRADIOL 1 MG/GRAM (0.1 %) TD GLPK,1465.56,952.61,13270.0,14761.0,2
NDC,00245107430,TOPIRAMATE 100 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
NDC,00245531589,Other Outpatient Services,1465.56,952.61,,,0
NDC,00245531989,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,00254200801,COLCHICINE 0.6 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00254302802,LUBIPROSTONE 8 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00254302902,LUBIPROSTONE 24 MCG PO CAPS,842.88,547.87,13270.0,14761.0,4
NDC,00259029101,POLYSACCHARIDE IRON COMPLEX 150 MG IRON PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00259160501,INCOBOTULINUMTOXINA 50 UNITS IM SOLR,2680.0,1742.0,6.65,7.64,8
NDC,00259161001,INCOBOTULINUMTOXINA 100 UNITS IM SOLR,5110.0,3321.5,6.65,7.64,8
NDC,00259162001,INCOBOTULINUMTOXINA 200 UNITS IM SOLR,10220.0,6643.0,6.65,7.64,8
NDC,00264151031,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00264151032,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00264180031,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,2
NDC,00264180031,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00264180032,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00264196510,HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN,424.0,275.6,13270.0,14761.0,4
NDC,00264210100,"WATER FOR IRRIGATION, STERILE IR SOLN",,,13270.0,14761.0,2
NDC,00264310311,CEFAZOLIN IN DEXTROSE (ISO-OS) 1 GRAM/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
NDC,00264310511,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,10974.18,7133.215,13270.0,14761.0,2
NDC,00264410090,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",290.0,188.5,,,0
NDC,00264410090,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00264553532,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00264738550,PN - PEDS,1465.56,952.61,13270.0,14761.0,2
NDC,00264751000,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00264751020,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00264761200,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,4
NDC,00264762200,D10 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00264763500,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00264763600,POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00264763800,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00264764500,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00264765200,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00264780000,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00264780009,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00264780020,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00264780020,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,2
NDC,00264780200,Other Outpatient Services,,,,,0
NDC,00264780510,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,4
NDC,00264934155,AMINO ACID (TROPHAMINE) INFUSION 10 % IV SOLP,568.0,369.2,,,0
NDC,00264958720,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",290.0,188.5,,,0
NDC,00264958720,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,2
NDC,00264987210,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00264987210,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00270009101,RUBIDIUM CHLORIDE RB-82,1.01,0.65,13270.0,14761.0,4
NDC,00270014957,DIATRIZOATE MEGLUMINE 30 % UR SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00270044535,DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00270044535,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),290.0,188.5,13270.0,14761.0,4
NDC,00270044540,DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % PO SOLN,311.04,202.18,13270.0,14761.0,2
NDC,00270044540,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),311.04,202.18,13270.0,14761.0,2
NDC,00270055615,SINCALIDE 5 MCG IJ SOLR,1983.73,1289.42,13270.0,14761.0,2
NDC,00270131652,IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN,,,13270.0,14761.0,2
NDC,00270387680,MEDRONATE (TC-99M MDP) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
NDC,00270709916,SULFUR HEXAFLUORIDE MICROSPHR 25 MG IV SUSR,20482.8,13313.82,13270.0,14761.0,2
NDC,00280006501,AZELASTINE 205.5 MCG (0.15 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00280006501,Other Outpatient Services,1465.56,952.61,,,0
NDC,00280210012,ASPIRIN 81 MG PO TBEC,,,13270.0,14761.0,2
NDC,00280800540,ACETAMINOPHEN-CAFF-PYRILAMINE 500-60-15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00281032608,NITROGLYCERIN 2 % TD OINT,,,13270.0,14761.0,4
NDC,00281032630,NITROGLYCERIN 2 % TD OINT,,,13270.0,14761.0,4
NDC,00283067902,BENZOCAINE 20 % MM SPRA,437.76,284.54,13270.0,14761.0,2
NDC,00310008828,ROFLUMILAST 250 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310008839,ROFLUMILAST 250 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310009530,ROFLUMILAST 500 MCG PO TABS,6132.96,3986.42,13270.0,14761.0,2
NDC,00310028260,QUETIAPINE 200 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00310028360,QUETIAPINE 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00310048230,GEFITINIB 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310051260,ACALABRUTINIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00310067912,OLAPARIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310067960,OLAPARIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310067960,Other Outpatient Services,1465.56,952.61,,,0
NDC,00310072010,FULVESTRANT 250 MG/5 ML IM SYRG,14452.88,9394.37,9.35,10.75,8
NDC,00310075190,ROSUVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00310075590,ROSUVASTATIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00310106101,CILGAVIMAB 150 MG/1.5 ML IM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00310110501,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,4
NDC,00310110539,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM PO PWPK,1553.9,1010.04,13270.0,14761.0,4
NDC,00310111001,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,4
NDC,00310111039,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,1553.9,1010.04,13270.0,14761.0,4
NDC,00310134930,OSIMERTINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310135030,OSIMERTINIB 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310183030,BENRALIZUMAB 30 MG/ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
NDC,00310196930,NALOXEGOL 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00310197030,NALOXEGOL 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310197039,NALOXEGOL 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310351260,ACALABRUTINIB MALEATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310450012,DURVALUMAB 50 MG/ML IV SOLN,16168.17,10509.31,101.88,117.16,8
NDC,00310453530,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,365180.4,237367.26,168.66,193.96,8
NDC,00310460012,GLYCOPYRROLATE-FORMOTEROL 9-4.8 MCG IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00310461150,DURVALUMAB 50 MG/ML IV SOLN,67367.2,43788.68,101.88,14761.0,11
NDC,00310461612,BUDESONIDE-GLYCOPYR-FORMOTEROL 160-9-4.8 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00310461628,BUDESONIDE-GLYCOPYR-FORMOTEROL 160-9-4.8 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00310461639,BUDESONIDE-GLYCOPYR-FORMOTEROL 160-9-4.8 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,4
NDC,00310610030,SAXAGLIPTIN 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310610530,SAXAGLIPTIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00310612560,"SAXAGLIPTIN-METFORMIN 2.5-1,000 MG PO TM24",1465.56,952.61,13270.0,14761.0,2
NDC,00310613530,SAXAGLIPTIN-METFORMIN 5-500 MG PO TM24,1465.56,952.61,13270.0,14761.0,2
NDC,00310614530,"SAXAGLIPTIN-METFORMIN 5-1,000 MG PO TM24",1465.56,952.61,13270.0,14761.0,2
NDC,00310620530,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,8940.0,5811.0,13270.0,14761.0,4
NDC,00310621030,DAPAGLIFLOZIN PROPANEDIOL 10 MG PO TABS,8940.0,5811.0,13270.0,14761.0,4
NDC,00310626060,Other Outpatient Services,1465.56,952.61,,,0
NDC,00310628030,"DAPAGLIFLOZ PROPANED-METFORMIN 10-1,000 MG PO TBPH",1465.56,952.61,13270.0,14761.0,2
NDC,00310651201,EXENATIDE 5 MCG/DOSE (250 MCG/ML) 1.2 ML SC PNIJ,12670.41,8235.77,13270.0,14761.0,2
NDC,00310652401,EXENATIDE 10 MCG/DOSE(250 MCG/ML) 2.4 ML SC PNIJ,12670.39,8235.75,13270.0,14761.0,2
NDC,00310653001,EXENATIDE MICROSPHERES 2 MG/0.65 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,00310737020,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00310737220,BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,00310828360,QUETIAPINE 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00310889501,TIXAGEVIMAB 150 MG/1.5 ML IM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00316018601,HYDROCORTISONE 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,00338001304,PN - PEDS,1465.56,952.61,13270.0,14761.0,2
NDC,00338001304,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00338001702,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00338001703,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00338001704,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00338001718,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00338001741,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00338001748,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00338002302,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00338002303,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00338002304,D10W PEDIATRIC HYPOGLYCEMIA,,,13270.0,14761.0,2
NDC,00338002304,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,2
NDC,00338002304,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00338004303,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004303,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,2
NDC,00338004304,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004304,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,2
NDC,00338004747,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00338004804,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00338004902,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00338004902,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00338004902,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004902,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,2
NDC,00338004903,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00338004903,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00338004903,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004903,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,2
NDC,00338004904,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00338004904,HB IV SOLUTION - HYDRATION,0.01,0.01,,,0
NDC,00338004904,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004904,SODIUM CHLORIDE 0.9% INJECTION INTRAPROCEDURE,,,13270.0,14761.0,2
NDC,00338004911,Other Outpatient Services,0.01,0.01,,,0
NDC,00338004918,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004941,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00338004941,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,2
NDC,00338004941,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00338004941,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004941,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,2
NDC,00338004948,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00338004948,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,2
NDC,00338004948,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00338004948,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338004948,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,2
NDC,00338005403,SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP,290.0,188.5,,,0
NDC,00338005403,SODIUM CHLORIDE 3% IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
NDC,00338005403,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,4
NDC,00338005603,SODIUM CHLORIDE 5% FOR APHERESIS ONLY,290.0,188.5,13270.0,14761.0,2
NDC,00338006230,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00338006301,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",1926.08,1251.95,165.71,190.57,8
NDC,00338006701,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",4815.2,3129.88,165.71,190.57,8
NDC,00338006910,KETOROLAC 15 MG/ML IJ SOLN,20482.8,13313.82,0.85,0.98,8
NDC,00338007225,KETOROLAC 30 MG/ML IV PEDIATRIC,290.0,188.5,0.85,14761.0,11
NDC,00338007704,DEXTROSE 5%-1/4 NORMAL SALINE IV SOLP,,,13270.0,14761.0,2
NDC,00338008503,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,6
NDC,00338008503,Other Outpatient Services,0.01,0.01,,,0
NDC,00338008504,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,6
NDC,00338008903,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00338008904,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00338010820,NOREPINEPHRINE (LEVOPHED)(0.032MG/ML) 8 MG IN D5W 250 ML,380.0,247.0,13270.0,14761.0,4
NDC,00338011703,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,00338011704,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,00338012504,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,4
NDC,00338012612,INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) IV SOLN,297.6,193.44,13270.0,14761.0,2
NDC,00338019004,"SOD,POT CHLOR-MAG-SOD,POT PHOS 800-40-20-8.75- 6.25 MG/100 ML IR IRSL",1465.56,952.61,13270.0,14761.0,4
NDC,00338020201,AMINO AC 8 %-D14W-ELECTROLYTES 8-14 % IV SOLP,640.0,416.0,13270.0,14761.0,4
NDC,00338020206,AMINO AC 8 %-D14W-ELECTROLYTES 8-14 % IV SOLP,640.0,416.0,13270.0,14761.0,2
NDC,00338022104,ELECTROLYTE-A IV SOLP,290.0,188.5,13270.0,14761.0,6
NDC,00338032201,THROMBIN (RECOMBINANT) 5000 UNITS TP SOLR,924.32,600.81,13270.0,14761.0,2
NDC,00338035703,MANNITOL 20 % 20 % IV SOLP,360.0,234.0,13270.0,14761.0,2
NDC,00338040903,LIDOCAINE IN 5 % DEXTROSE (PF) 4 MG/ML (0.4 %) IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00338042418,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00338042418,HEPARIN SOLUTION 2 UNITS/ML FOR FLUSH INTRAPROCEDURE (CATH LAB ONLY),290.0,188.5,13270.0,14761.0,2
NDC,00338050206,CSHS PARENTERAL NUTRITITION ORDER ADULT,768.0,499.2,13270.0,14761.0,2
NDC,00338050548,GENTAMICIN IN NACL (ISO-OSM) 100 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338050741,GENTAMICIN IN NACL (ISO-OSM) 60 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338050748,GENTAMICIN IN NACL (ISO-OSM) 120 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338050941,GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338051909,FAT EMULSION 20 % IV EMUL,704.0,457.6,13270.0,14761.0,6
NDC,00338051909,FAT EMULSION 20 % IV PEDS,704.0,457.6,13270.0,14761.0,2
NDC,00338051913,FAT EMULSION 20 % IV EMUL,664.0,431.6,13270.0,14761.0,6
NDC,00338051913,FAT EMULSION 20 % IV PEDS,664.0,431.6,13270.0,14761.0,2
NDC,00338055311,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00338055318,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338055318,SODIUM CHLORIDE 0.9% IV MINI BAG PLUS 100 ML,,,13270.0,14761.0,2
NDC,00338065604,ACETIC ACID (BULK) 5 % MISC LIQD,290.0,188.5,,,0
NDC,00338065604,ACETIC ACID 0.25 % IR SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00338065604,Other Outpatient Services,290.0,188.5,,,0
NDC,00338066304,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338066904,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00338067104,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338067504,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338068304,POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338069104,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338070341,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00338070348,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338070434,POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,6
NDC,00338070541,POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338070548,POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338070948,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00338080304,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338081104,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00338100902,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00338102541,PENICILLIN G POTASSIUM 3 MILLION UNITS IN 0.9% NACL 50ML,10974.18,7133.215,13270.0,14761.0,2
NDC,00338104902,NITROGLYCERIN IN D5W 50 MG/250 ML (0.2 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00338105548,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00338107502,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",290.0,188.5,13270.0,14761.0,2
NDC,00338107702,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",290.0,188.5,13270.0,14761.0,2
NDC,00338113004,AMINO ACID (PREMASOL) 10% NO.7 IV SOLP,512.0,332.8,,,0
NDC,00338113006,AMINO ACID (PREMASOL) 10% NO.7 IV SOLP,1465.56,952.61,,,0
NDC,00338130501,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00338170940,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338361224,Other Outpatient Services,1465.56,952.61,,,0
NDC,00338361250,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00338361650,Other Outpatient Services,1465.56,952.61,,,0
NDC,00338381450,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00338601048,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00338915930,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00338915930,SODIUM CHLORIDE 0.9% IV MINI BAG PLUS 100 ML,,,13270.0,14761.0,2
NDC,00338955712,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00363368004,MENTHOL-ZINC OXIDE 0.44-20.6 % TP OINT,,,13270.0,14761.0,2
NDC,00378003001,CLORAZEPATE DIPOTASSIUM 3.75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378007001,CLORAZEPATE DIPOTASSIUM 15 MG PO TABS,1465.56,952.61,,,0
NDC,00378008801,CARBIDOPA-LEVODOPA 25-100 MG PO TBSR,,,13270.0,14761.0,2
NDC,00378018301,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00378021401,HALOPERIDOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00378022201,CHLORTHALIDONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00378035101,HALOPERIDOL 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00378037301,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00378037301,HYDROXYCHLOROQUINE 200 MG/8 ML ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,4
NDC,00378041501,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,1043.2,678.08,13270.0,14761.0,4
NDC,00378047201,DIVALPROEX 250 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00378048601,THEOPHYLLINE 400 MG PO TB24,,,13270.0,14761.0,2
NDC,00378050991,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,00378087116,CLONIDINE 0.1 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,4
NDC,00378087216,CLONIDINE 0.2 MG/24 HR TD PTWK,392.8,255.32,13270.0,14761.0,4
NDC,00378087216,Other Outpatient Services,392.8,255.32,,,0
NDC,00378087316,CLONIDINE 0.3 MG/24 HR TD PTWK,499.49,324.67,13270.0,14761.0,4
NDC,00378087399,CLONIDINE 0.3 MG/24 HR TD PTWK,1997.95,1298.67,13270.0,14761.0,2
NDC,00378108693,COLCHICINE 0.6 MG PO TABS,903.84,587.5,13270.0,14761.0,4
NDC,00378125891,PROPAFENONE 225 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,00378126191,PROPAFENONE 425 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,00378135201,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO TABS,,,13270.0,14761.0,2
NDC,00378137578,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00378145401,ESTRADIOL 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00378145801,ESTRADIOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00378163132,FORMOTEROL FUMARATE 20 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00378193093,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378194201,LENALIDOMIDE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00378200493,PAROXETINE HCL 25 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00378200593,PAROXETINE HCL 37.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00378233178,RUFINAMIDE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378292293,Other Outpatient Services,479.52,311.69,,,0
NDC,00378306577,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,357.12,232.13,13270.0,14761.0,4
NDC,00378306677,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,869.76,565.34,13270.0,14761.0,4
NDC,00378307501,CLOMIPRAMINE 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00378323177,CANDESARTAN 16 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378323193,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378334916,ESTRADIOL 0.025 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,2
NDC,00378334999,ESTRADIOL 0.025 MG/24 HR TD PTWK,1006.59,654.28,13270.0,14761.0,2
NDC,00378335016,ESTRADIOL 0.05 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,4
NDC,00378335099,ESTRADIOL 0.05 MG/24 HR TD PTWK,1004.03,652.62,13270.0,14761.0,2
NDC,00378335216,ESTRADIOL 0.1 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,4
NDC,00378335299,ESTRADIOL 0.1 MG/24 HR TD PTWK,1005.44,653.54,13270.0,14761.0,4
NDC,00378343393,ARMODAFINIL 250 MG PO TABS,1069.44,695.14,13270.0,14761.0,2
NDC,00378363501,CETIRIZINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00378415493,TRAMADOL 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00378427093,AMBRISENTAN 5 MG PO TABS,9752.64,6339.22,13270.0,14761.0,2
NDC,00378427193,AMBRISENTAN 10 MG PO TABS,10169.28,6610.03,13270.0,14761.0,4
NDC,00378450093,BUDESONIDE 9 MG PO TADE,1465.56,952.61,13270.0,14761.0,2
NDC,00378464016,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00378464116,ESTRADIOL 0.075 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00378464216,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00378464226,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00378505201,CARBIDOPA-LEVODOPA 25-100 MG PO TBDL,,,13270.0,14761.0,2
NDC,00378518693,PRASUGREL 10 MG PO TABS,447.36,290.78,13270.0,14761.0,2
NDC,00378543877,MEMANTINE 28 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
NDC,00378561505,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00378580793,VALSARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00378581477,VALSARTAN 160 MG PO TABS,596.16,387.5,13270.0,14761.0,4
NDC,00378600291,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378623301,CITALOPRAM 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00378638001,VERAPAMIL 180 MG PO C24P,,,13270.0,14761.0,2
NDC,00378644001,VERAPAMIL 240 MG PO C24P,,,13270.0,14761.0,2
NDC,00378647016,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,290.0,188.5,13270.0,14761.0,4
NDC,00378647099,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,963.71,626.41,13270.0,14761.0,4
NDC,00378655053,LEVONORGESTREL-ETHINYL ESTRAD 0.15-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378696112,GLATIRAMER 40 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00378699331,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378699789,SODIUM CHLORIDE 3 % IN NEBU,290.0,188.5,13270.0,14761.0,6
NDC,00378700110,PAROXETINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00378700293,PAROXETINE HCL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00378701293,OLMESARTAN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378705535,BEPOTASTINE BESILATE 1.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00378712477,OLMESARTAN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378715501,BUDESONIDE 3 MG PO CECX,1465.56,952.61,13270.0,14761.0,2
NDC,00378727453,NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378728053,NORETHINDRONE AC-ETH ESTRADIOL 1-20 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00378728153,LEVONORGESTREL-ETHINYL ESTRAD 0.15 MG-30 MCG (91) PO 3MPK,1465.56,952.61,13270.0,14761.0,2
NDC,00378728353,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378728385,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378728853,NORETHINDRONE-E.ESTRADIOL-IRON 1.5 MG-30 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378728853,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378729253,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG PO TABS,,,13270.0,14761.0,4
NDC,00378729285,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG PO TABS,,,13270.0,14761.0,4
NDC,00378729653,DESOG-E.ESTRADIOL/E.ESTRADIOL 0.15-0.02 MGX21 /0.01 MG X 5 PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378730053,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00378797031,IPRATROPIUM BROMIDE 0.02 % IN SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,00378797052,IPRATROPIUM BROMIDE 0.02 % IN SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,00378801593,LANSOPRAZOLE 15 MG PO CPDR,,,13270.0,14761.0,2
NDC,00378815601,METHYLPHENIDATE HCL 27 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00378815701,METHYLPHENIDATE HCL 36 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,00378827031,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,00378830301,CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG PO TABS,1465.56,952.61,,,0
NDC,00378862977,FENOFIBRATE MICRONIZED 134 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00378876098,CYCLOSPORINE 0.05 % OP DPET,290.0,188.5,13270.0,14761.0,2
NDC,00378876516,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,13270.0,14761.0,2
NDC,00378876616,BUPRENORPHINE-NALOXONE 4-1 MG SL FILM,1465.56,952.61,13270.0,14761.0,2
NDC,00378876716,BUPRENORPHINE-NALOXONE 8-2 MG SL FILM,290.0,188.5,13270.0,14761.0,2
NDC,00378907016,Other Outpatient Services,290.0,188.5,,,0
NDC,00378910216,NITROGLYCERIN 0.1 MG/HR TD PT24,,,13270.0,14761.0,2
NDC,00378910416,NITROGLYCERIN 0.2 MG/HR TD PT24,,,13270.0,14761.0,2
NDC,00378911216,NITROGLYCERIN 0.4 MG/HR TD PT24,,,13270.0,14761.0,2
NDC,00378911616,NITROGLYCERIN 0.6 MG/HR TD PT24,,,13270.0,14761.0,2
NDC,00378911916,FENTANYL 12 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
NDC,00378911998,FENTANYL 12 MCG/HR TD PT72,1106.24,719.06,13270.0,14761.0,2
NDC,00378912116,FENTANYL 25 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,2
NDC,00378912216,FENTANYL 50 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
NDC,00378912298,FENTANYL 50 MCG/HR TD PT72,944.0,613.6,13270.0,14761.0,2
NDC,00378912316,FENTANYL 75 MCG/HR TD PT72,1492.16,969.9,13270.0,14761.0,4
NDC,00378912416,FENTANYL 100 MCG/HR TD PT72,410.82,267.03,13270.0,14761.0,4
NDC,00378912498,FENTANYL 100 MCG/HR TD PT72,2054.08,1335.15,13270.0,14761.0,4
NDC,00378932032,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378932132,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378932232,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,00378932232,Other Outpatient Services,1465.56,952.61,,,0
NDC,00378967131,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,00386000802,NORFLURANE-PENTAFLUOROPROPANE TP SPRA,6403.2,4162.08,,,0
NDC,00386000802,Other Outpatient Services,6403.2,4162.08,,,0
NDC,00386000803,NORFLURANE-PENTAFLUOROPROPANE TP SPRA,468.65,304.62,13270.0,14761.0,2
NDC,00394085932,HYDROCORTISONE 1 % TP LOTN,290.0,188.5,13270.0,14761.0,4
NDC,00395232516,POVIDONE-IODINE 10 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00395807043,KETAMINE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,00406012323,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406012362,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,609.6,396.24,13270.0,14761.0,4
NDC,00406012423,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406012462,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,616.0,400.4,13270.0,14761.0,4
NDC,00406012523,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406012562,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,736.0,478.4,13270.0,14761.0,4
NDC,00406048423,ACETAMINOPHEN-CODEINE 300-30 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406048423,Other Outpatient Services,290.0,188.5,,,0
NDC,00406048462,ACETAMINOPHEN-CODEINE 300-30 MG PO TABS,476.8,309.92,13270.0,14761.0,2
NDC,00406048501,ACETAMINOPHEN-CODEINE 300-60 MG PO TABS,665.6,432.64,13270.0,14761.0,2
NDC,00406051223,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,00406051262,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,603.2,392.08,13270.0,14761.0,4
NDC,00406052223,OXYCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406052262,OXYCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,2390.4,1553.76,13270.0,14761.0,2
NDC,00406052323,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406052362,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,2824.0,1835.6,13270.0,14761.0,4
NDC,00406055223,OXYCODONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406055262,OXYCODONE 5 MG PO TABS,624.0,405.6,13270.0,14761.0,4
NDC,00406114201,METHYLPHENIDATE 5 MG HALF-TAB = 2.5 MG,294.4,191.36,13270.0,14761.0,2
NDC,00406114201,METHYLPHENIDATE HCL 5 MG PO TABS,294.4,191.36,13270.0,14761.0,2
NDC,00406222401,LEVORPHANOL TARTRATE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00406324301,HYDROMORPHONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406324901,HYDROMORPHONE 8 MG PO TABS,729.6,474.24,13270.0,14761.0,4
NDC,00406575523,METHADONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406577123,METHADONE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,00406800330,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) PO SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00406800503,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,596.16,387.5,13270.0,14761.0,2
NDC,00406831523,MORPHINE 15 MG PO TBSR,290.0,188.5,13270.0,14761.0,4
NDC,00406831562,MORPHINE 15 MG PO TBSR,904.0,587.6,13270.0,14761.0,4
NDC,00406833023,MORPHINE 30 MG PO TBSR,290.0,188.5,13270.0,14761.0,4
NDC,00406833062,MORPHINE 30 MG PO TBSR,1776.0,1154.4,13270.0,14761.0,4
NDC,00406838023,MORPHINE 60 MG PO TBSR,290.0,188.5,13270.0,14761.0,4
NDC,00406838062,MORPHINE 60 MG PO TBSR,3123.2,2030.08,13270.0,14761.0,4
NDC,00406839023,MORPHINE 100 MG PO TBSR,290.0,188.5,13270.0,14761.0,4
NDC,00406851501,OXYCODONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406851523,OXYCODONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406853001,OXYCODONE 30 MG PO TABS,553.6,359.84,13270.0,14761.0,4
NDC,00406853023,OXYCODONE 30 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00406910076,FENTANYL 100 MCG/HR TD PT72,2054.08,1335.15,13270.0,14761.0,4
NDC,00406911276,FENTANYL 12 MCG/HR TD PT72,1210.56,786.86,13270.0,14761.0,4
NDC,00406912576,FENTANYL 25 MCG/HR TD PT72,531.52,345.49,13270.0,14761.0,4
NDC,00406996101,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,00407069010,GADODIAMIDE 5 MMOL/10 ML (287 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,00407141110,IOHEXOL 180 MG IODINE/ML IT SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141120,IOHEXOL 180 MG IODINE/ML IT SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141210,IOHEXOL 240 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141220,IOHEXOL 240 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141310,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),463.36,301.18,,,0
NDC,00407141351,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),20482.8,13313.82,13270.0,14761.0,2
NDC,00407141360,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),,,13270.0,14761.0,2
NDC,00407141360,IOHEXOL 350 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
NDC,00407141361,IOHEXOL 300 MG IODINE/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00407141361,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),290.0,188.5,13270.0,14761.0,2
NDC,00407141363,IOHEXOL 300 MG IODINE/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00407141363,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),290.0,188.5,13270.0,14761.0,2
NDC,00407141365,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),391.2,254.28,13270.0,14761.0,2
NDC,00407141386,IOHEXOL 300 MG IODINE/ML IV SOLN,2394.4,1556.36,,,0
NDC,00407141386,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),2394.4,1556.36,13270.0,14761.0,2
NDC,00407141387,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),,,13270.0,14761.0,2
NDC,00407141387,IOHEXOL 300 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,10974.18,7133.215,13270.0,14761.0,2
NDC,00407141388,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),20482.8,13313.82,,,0
NDC,00407141472,IOHEXOL 350 MG IODINE/ML IV SOLN,,,13270.0,14761.0,2
NDC,00407141472,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,20482.8,13313.82,,,0
NDC,00407141482,IOHEXOL 350 MG IODINE/ML IV SOLN,,,13270.0,14761.0,2
NDC,00407141482,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,10974.18,7133.215,13270.0,14761.0,2
NDC,00407141484,IOHEXOL 350 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141489,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,10974.18,7133.215,13270.0,14761.0,2
NDC,00407141491,IOHEXOL 350 MG IODINE/ML IV SOLN,,,13270.0,14761.0,2
NDC,00407141491,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,20482.8,13313.82,,,0
NDC,00407141498,IOHEXOL 350 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407141509,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,8
NDC,00407141612,IOHEXOL 12 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00407222306,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407222316,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407222317,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407222323,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
NDC,00407222362,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,00407270703,PERFLUTREN PROTEIN-A MICROSPHR 0.22 MG/ML IV SUSP,20482.8,13313.82,13270.0,14761.0,2
NDC,00407270718,PERFLUTREN PROTEIN-A MICROSPHR 0.22 MG/ML IV SUSP,20482.8,13313.82,,,0
NDC,00409012001,DAPTOMYCIN 350 MG IV SOLR,462.08,300.35,13270.0,14761.0,2
NDC,00409015201,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00409015224,METRONIDAZOLE IN NACL (ISO-OS) 250 MG/50 ML IVPB,290.0,188.5,,,0
NDC,00409018101,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,433.42,281.72,13270.0,14761.0,2
NDC,00409018201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN,781.01,507.66,13270.0,14761.0,2
NDC,00409018301,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN,290.0,188.5,,,0
NDC,00409018601,GEMCITABINE 1 GRAM IV SOLR,730.56,474.86,13270.0,14761.0,2
NDC,00409020102,DOCETAXEL 20 MG/2 ML (10 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,00409021210,MILRINONE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409030201,TOPOTECAN 4 MG IV SOLR,20482.8,13313.82,,,0
NDC,00409036601,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,00409036701,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,1593.92,1036.05,,,0
NDC,00409082901,AZTREONAM 1 GRAM IJ SOLR,368.51,239.53,13270.0,14761.0,2
NDC,00409082911,AZTREONAM 1 GRAM IJ SOLR,368.51,239.53,13270.0,14761.0,6
NDC,00409103630,MEPIVACAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,00409106720,MEPIVACAINE (PF) 20 MG/ML (2 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409109812,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409110311,CISATRACURIUM 10 MG/ML CONC. IV SOLN,1631.36,1060.38,13270.0,14761.0,2
NDC,00409113403,MORPHINE 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409113502,MORPHINE 25 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409114112,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409114401,VERAPAMIL 2.5 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00409114405,VERAPAMIL 2.5 MG/ML IV SOLN,408.45,265.49,13270.0,14761.0,2
NDC,00409114465,Other Outpatient Services,408.45,265.49,,,0
NDC,00409115901,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409115918,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409115919,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409116201,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409116202,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409116218,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409116219,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409116519,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409117603,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00409117603,MEPERIDINE (PF) 25 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409120703,GENTAMICIN 40 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409121501,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409127303,DIAZEPAM 5 MG/ML IJ SYRG,354.78,230.61,13270.0,14761.0,2
NDC,00409127332,DIAZEPAM 5 MG/ML IJ SYRG,354.78,230.61,13270.0,14761.0,2
NDC,00409131632,"HEPARIN, PORCINE (PF) 5000 UNIT/0.5 ML IJ SYRG",290.0,188.5,13270.0,14761.0,2
NDC,00409132315,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409141204,BUMETANIDE 0.25 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,6
NDC,00409141210,BUMETANIDE 0.25 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409141234,BUMETANIDE 0.25 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00409141240,BUMETANIDE (BUMEX) 25MG IN 100ML (STRAIGHT DRUG) INFUSION,1465.56,952.61,13270.0,14761.0,2
NDC,00409141240,BUMETANIDE 0.25 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00409146371,NALBUPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409148202,NITROGLYCERIN IN D5W 50 MG/250 ML (0.2 MG/ML) IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00409156018,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409156019,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,00409156029,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,00409158210,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,6
NDC,00409158218,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409158229,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409163015,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,,,0
NDC,00409163140,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409163201,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409163221,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409163802,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409174630,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409174671,Other Outpatient Services,290.0,188.5,,,0
NDC,00409175250,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409175550,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409176102,BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409177805,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409177815,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409178269,NALOXONE 0.4 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409188602,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409188622,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409189001,MORPHINE 2 MG/ML IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409189003,MORPHINE 2 MG/ML IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409189101,MORPHINE 10 MG/ML IV SOLN,290.0,188.5,,,0
NDC,00409189103,MORPHINE 4 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409190201,PROCAINAMIDE 100 MG/ML IJ SOLN,965.92,627.85,679.95,14761.0,11
NDC,00409190211,PROCAINAMIDE 100 MG/ML IJ SOLN,965.92,627.85,679.95,14761.0,3
NDC,00409205115,Other Outpatient Services,1465.56,952.61,,,0
NDC,00409206605,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409226720,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409226725,LABETALOL 5 MG/ML IV SOLN,20482.8,13313.82,,,0
NDC,00409226754,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409230504,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409230505,MIDAZOLAM (PF) 1 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00409230516,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409230516,MIDAZOLAM PF 50 MG/50 ML (1MG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409230517,MIDAZOLAM (PF) 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409230801,MIDAZOLAM (PF) 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409230821,MIDAZOLAM 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409233715,DEFEROXAMINE 2 GRAM IJ SOLR,576.48,374.71,13270.0,14761.0,2
NDC,00409233725,DEFEROXAMINE 2 GRAM IJ SOLR,576.48,374.71,13270.0,14761.0,2
NDC,00409233924,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409233934,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409234401,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409234462,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409234731,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",10974.18,7133.215,13270.0,14761.0,2
NDC,00409234732,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",290.0,188.5,13270.0,14761.0,2
NDC,00409255201,HYDROMORPHONE 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409259603,MIDAZOLAM 5 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409263410,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409263425,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409272031,HEPARIN (PORCINE) 1000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409272301,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409272330,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409275701,DAPTOMYCIN 500 MG IV SOLR,20482.8,13313.82,,,0
NDC,00409277623,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,1465.56,952.61,13270.0,14761.0,4
NDC,00409317701,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317801,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317802,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317803,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317816,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317817,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409317818,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409318203,"LIDOCAINE-EPINEPHRINE 2 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409318211,Other Outpatient Services,1465.56,952.61,,,0
NDC,00409318231,"LIDOCAINE-EPINEPHRINE 2 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409318301,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,00409318311,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409329461,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409329915,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409329916,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409330803,ACETYLCYSTEINE 200 MG/ML (20 %) ORAL/INHALATION SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409330811,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409335611,HYDROMORPHONE 2 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409336501,HYDROMORPHONE 2 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409336510,HYDROMORPHONE 2 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00409336511,HYDROMORPHONE 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409337514,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409338311,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409338511,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409338511,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,00409339011,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409339011,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,00409341401,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409341418,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409357811,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,290.0,188.5,13270.0,14761.0,2
NDC,00409357811,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409361311,Other Outpatient Services,290.0,188.5,,,0
NDC,00409371801,AMPICILLIN SODIUM 500 MG IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,00409371810,AMPICILLIN SODIUM 500 MG IJ SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,00409379501,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,290.0,188.5,0.85,14761.0,11
NDC,00409379519,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,290.0,188.5,0.85,0.98,8
NDC,00409379519,KETOROLAC 30 MG/ML IV PEDIATRIC,290.0,188.5,0.85,14761.0,3
NDC,00409381411,MORPHINE (PF) 0.5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409381412,MORPHINE (PF) 0.5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409381511,MORPHINE (PF) 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409381511,MORPHINE (PF) 30 MG/30 ML (1 MG/ML) IV PCAS,290.0,188.5,13270.0,14761.0,2
NDC,00409403101,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409403116,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409409001,ZINC CHLORIDE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409409011,ZINC CHLORIDE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409421501,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,558.35,362.93,13270.0,14761.0,2
NDC,00409427501,LIDOCAINE HCL 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409427601,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,00409427617,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,00409427702,LIDOCAINE HCL 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
NDC,00409427801,LIDOCAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409427901,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,00409427902,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,00409427916,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,00409428201,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409428202,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409428211,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409428212,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409428301,LIDOCAINE (PF) 40 MG/ML (4 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
NDC,00409433201,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409433211,FORTIFIED VANCOMYCIN 50 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
NDC,00409433211,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409434616,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409434673,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409452002,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",10974.18,7133.215,13270.0,14761.0,2
NDC,00409468818,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00409469801,LIDOCAINE HCL 4 % LATR SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,00409469953,PROPOFOL 10 MG/ML BOLUS,290.0,188.5,13270.0,14761.0,2
NDC,00409469954,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,6
NDC,00409471302,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409471312,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,00409471325,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409471332,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,00409471342,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,00409471375,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409471375,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),1465.56,952.61,13270.0,14761.0,2
NDC,00409475503,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,,,0
NDC,00409475518,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409477702,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00409477723,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00409488710,TPN - NICU (WEIGHT BASED),1465.56,952.61,13270.0,14761.0,2
NDC,00409488710,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00409488717,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00409488724,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00409488750,TPN - NICU (WEIGHT BASED),1465.56,952.61,13270.0,14761.0,2
NDC,00409488750,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00409488799,TPN - NICU (WEIGHT BASED),1465.56,952.61,13270.0,14761.0,2
NDC,00409488799,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00409488801,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,2
NDC,00409488802,SODIUM CHLORIDE 0.9 % IJ SOLN,,,13270.0,14761.0,2
NDC,00409488802,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00409488802,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409488812,SODIUM CHLORIDE 0.9 % IJ SOLN,,,13270.0,14761.0,2
NDC,00409490234,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,6
NDC,00409490264,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,6
NDC,00409490311,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409490334,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409491111,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409491134,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409492120,EPINEPHRINE 0.1 MG/ML IJ SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00409492134,EPINEPHRINE 0.1 MG/ML IJ SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,00409492811,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409492834,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,00409493301,EPINEPHRINE 0.1 MG/ML IJ SYRG,20482.8,13313.82,,,0
NDC,00409493311,EPINEPHRINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00409508211,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409508216,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409553424,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG,295.2,191.88,13270.0,14761.0,4
NDC,00409553434,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,4
NDC,00409555502,SODIUM BICARBONATE 4.2 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409555512,SODIUM BICARBONATE 4.2 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409582001,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409582011,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409592116,AMINOPHYLLINE 250 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00409592201,AMINOPHYLLINE 500 MG/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409610202,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00409610210,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409610219,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409610220,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409610225,FUROSEMIDE 10 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,00409613803,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00409614109,PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IR SOLN,,,13270.0,14761.0,4
NDC,00409648201,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,898.46,584.0,13270.0,14761.0,2
NDC,00409648211,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,898.46,584.0,13270.0,14761.0,2
NDC,00409650901,VANCOMYCIN 5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409650949,VANCOMYCIN 5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409653112,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409653311,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409653321,VANCOMYCIN 1000 MG IV SOLR,20482.8,13313.82,,,0
NDC,00409662502,SODIUM BICARBONATE 8.4 % IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,00409662514,Other Outpatient Services,290.0,188.5,,,0
NDC,00409662514,SODIUM BICARBONATE 8.4 % IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409662522,SODIUM BICARBONATE 8.4 % IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409662902,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409663518,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409663724,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,00409663734,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,4
NDC,00409665106,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409665119,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409665305,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409665318,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409669501,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409672723,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,290.0,188.5,,,0
NDC,00409672723,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00409672903,MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00409672923,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML ANES-INTRAOP,290.0,188.5,,,0
NDC,00409672923,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
NDC,00409677811,LORAZEPAM 2 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409707426,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,10974.18,7133.215,13270.0,14761.0,4
NDC,00409707714,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
NDC,00409707726,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
NDC,00409710167,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00409710709,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,10974.18,7133.215,13270.0,14761.0,4
NDC,00409711509,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,10974.18,7133.215,13270.0,14761.0,2
NDC,00409713809,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00409713836,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00409713909,"WATER FOR IRRIGATION, STERILE IR SOLN",,,13270.0,14761.0,2
NDC,00409713936,"WATER FOR IRRIGATION, STERILE IR SOLN",,,13270.0,14761.0,2
NDC,00409724101,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409724813,HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409729501,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409729511,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409729973,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409729983,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409733201,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,,,0
NDC,00409733211,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409733304,CEFTRIAXONE 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409733503,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409733513,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00409733701,CEFTRIAXONE 250 MG IJ SOLR,290.0,188.5,,,0
NDC,00409739172,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409739182,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409741803,DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP,440.0,286.0,13270.0,14761.0,2
NDC,00409741813,DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP,440.0,286.0,13270.0,14761.0,2
NDC,00409741903,DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP,528.0,343.2,13270.0,14761.0,2
NDC,00409741914,DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP,528.0,343.2,13270.0,14761.0,2
NDC,00409751716,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,00409751766,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,6
NDC,00409762003,HEPARIN SOLUTION 2 UNITS/ML FOR FLUSH INTRAPROCEDURE (CATH LAB ONLY),290.0,188.5,13270.0,14761.0,2
NDC,00409762013,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00409762013,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00409762013,HEPARIN SOLUTION 5 UNITS/ML FOR INSTRUMENT WASH/RINSE FOR INTRAPROCEDURE (IR ONLY),290.0,188.5,,,0
NDC,00409765052,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00409765062,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00409771503,MANNITOL 20 % 20 % IV SOLP,1465.56,952.61,13270.0,14761.0,4
NDC,00409779352,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,2
NDC,00409779362,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",290.0,188.5,,,0
NDC,00409779362,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,2
NDC,00409781011,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409781022,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409781124,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00409790209,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,10974.18,7133.215,13270.0,14761.0,4
NDC,00409792202,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00409792203,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00409792209,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00409792313,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00409792409,DEXTROSE 5%-1/4 NORMAL SALINE IV SOLP,,,13270.0,14761.0,2
NDC,00409792602,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00409792603,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,4
NDC,00409792609,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,6
NDC,00409792609,"HB EST. PATIENT, LEVEL 5",7127.02,4632.56,,,0
NDC,00409792609,HB IV SOLUTION - HYDRATION,0.01,0.01,13270.0,14761.0,2
NDC,00409792903,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,00409792909,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,4
NDC,00409793002,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,2
NDC,00409793003,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,2
NDC,00409793003,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00409793009,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00409794103,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00409794109,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00409795303,LACTATED RINGERS IRRIGATION INTRAPROCEDURE,,,13270.0,14761.0,2
NDC,00409795303,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,00409795309,LACTATED RINGERS IRRIGATION INTRAPROCEDURE,,,13270.0,14761.0,2
NDC,00409795309,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,00409796905,CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PF SOLN,1072.0,696.8,13270.0,14761.0,4
NDC,00409798108,SORBITOL-MANNITOL 2.7-0.54 GRAM/100 ML TUT SOLN,,,13270.0,14761.0,2
NDC,00409798302,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798303,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798309,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798413,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,2
NDC,00409798413,HYDROMORPHONE 1MG/ML AND KETAMINE 1MG/ML CONT DOSE,,,13270.0,14761.0,2
NDC,00409798413,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798423,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798436,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00409798437,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798503,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798503,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,2
NDC,00409798509,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,2
NDC,00409798509,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,2
NDC,00409799309,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,1465.56,952.61,13270.0,14761.0,2
NDC,00409818301,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409818311,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00409904517,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,00409909332,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409909335,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409909335,FENTANYL PCA HIGH DOSE,290.0,188.5,13270.0,14761.0,2
NDC,00409909412,FENTANYL 150 MCG/3 ML (50 MCG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409909412,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409909422,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,,,0
NDC,00409909425,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409910421,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409915701,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409915731,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409915750,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409915801,PHYTONADIONE (VITAMIN K1) 10 MG/ML IJ SOLN,381.78,248.16,13270.0,14761.0,2
NDC,00409930130,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409955810,ROCURONIUM 10 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00409955811,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00409955849,ROCURONIUM 10 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00409956601,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409956610,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00409973501,CEFEPIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00430042014,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-10 MCG (24)/10 MCG (2) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00436067216,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00436093616,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00436094616,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00440146630,DOCUSATE SODIUM 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,00440250528,TETRACYCLINE 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00450026125,PHENYLEPHRINE-ACETAMINOPHEN-GG 5-325-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00450091012,LACTASE 9000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00450091032,LACTASE 9000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00456045701,THYROID (PORK) 15 MG PO TABS,,,13270.0,14761.0,2
NDC,00456045801,THYROID (PORK) 30 MG PO TABS,,,13270.0,14761.0,2
NDC,00456045901,THYROID (PORK) 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00456046101,THYROID (PORK) 120 MG PO TABS,,,13270.0,14761.0,2
NDC,00456060001,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,4.9,14761.0,13
NDC,00456060010,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,4.9,14761.0,5
NDC,00456074413,"INHALAT. SPACING DEV,SM. MASK MISC SPCR",731.04,475.18,13270.0,14761.0,2
NDC,00456111030,VILAZODONE 10 MG PO TABS,5177.28,3365.23,13270.0,14761.0,2
NDC,00456112030,VILAZODONE 20 MG PO TABS,5177.28,3365.23,13270.0,14761.0,4
NDC,00456114030,VILAZODONE 40 MG PO TABS,5177.28,3365.23,13270.0,14761.0,2
NDC,00456120130,LINACLOTIDE 145 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,4
NDC,00456120230,LINACLOTIDE 290 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,4
NDC,00456120304,LINACLOTIDE 72 MCG PO CAPS,10974.18,7133.215,13270.0,14761.0,4
NDC,00456120330,LINACLOTIDE 72 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00456120730,MEMANTINE-DONEPEZIL 7-10 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
NDC,00456122830,MEMANTINE-DONEPEZIL 28-10 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
NDC,00456140211,NEBIVOLOL 2.5 MG PO TABS,953.76,619.94,13270.0,14761.0,2
NDC,00456140230,NEBIVOLOL 2.5 MG PO TABS,2861.76,1860.14,13270.0,14761.0,2
NDC,00456140511,NEBIVOLOL 5 MG PO TABS,881.6,573.04,13270.0,14761.0,2
NDC,00456140563,NEBIVOLOL 5 MG PO TABS,8816.0,5730.4,13270.0,14761.0,2
NDC,00456140590,NEBIVOLOL 5 MG PO TABS,8583.84,5579.5,13270.0,14761.0,4
NDC,00456141030,NEBIVOLOL 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00456151060,MILNACIPRAN 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00456151060,Other Outpatient Services,1465.56,952.61,,,0
NDC,00456151260,MILNACIPRAN 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00456155060,MILNACIPRAN 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00456200501,ESCITALOPRAM OXALATE 5 MG PO TABS,21923.2,14250.08,13270.0,14761.0,2
NDC,00456202001,ESCITALOPRAM OXALATE 20 MG PO TABS,23918.4,15546.96,13270.0,14761.0,4
NDC,00456221230,LEVOMILNACIPRAN 120 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00456222030,LEVOMILNACIPRAN 20 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00456224030,LEVOMILNACIPRAN 40 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00456228030,LEVOMILNACIPRAN 80 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,00456270001,CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR,5882.34,3823.52,125.24,14761.0,3
NDC,00456315467,INHALATIONAL SPACING DEVICE MISC SPCR,542.24,352.46,13270.0,14761.0,2
NDC,00456321063,MEMANTINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00456430001,FOSFOMYCIN TROMETHAMINE 3 GRAM PO PACK,1047.68,680.99,13270.0,14761.0,2
NDC,00456430008,FOSFOMYCIN TROMETHAMINE 3 GRAM PO PACK,1465.56,952.61,13270.0,14761.0,2
NDC,00469012599,ENZALUTAMIDE 40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00469042001,ISAVUCONAZONIUM SULFATE 372 MG IV SOLR,5700.32,3705.21,1.22,14761.0,5
NDC,00469042099,ISAVUCONAZONIUM SULFATE 372 MG IV SOLR,1465.56,952.61,1.22,14761.0,5
NDC,00469052002,ISAVUCONAZONIUM SULFATE 186 MG PO CAPS,23445.63,15239.66,13270.0,14761.0,4
NDC,00469052014,ISAVUCONAZONIUM SULFATE 186 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00469060773,TACROLIMUS 0.5 MG PO CAPS,2142.4,1392.56,13270.0,14761.0,4
NDC,00469061711,TACROLIMUS 1 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00469061773,Other Outpatient Services,4283.2,2784.08,,,0
NDC,00469061773,TACROLIMUS 1 MG PO CAPS,4283.2,2784.08,13270.0,14761.0,2
NDC,00469062599,ENZALUTAMIDE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00469064773,TACROLIMUS 0.5 MG PO CP24,501.6,326.04,13270.0,14761.0,2
NDC,00469065711,TACROLIMUS 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00469065773,TACROLIMUS 5 MG PO CAPS,21419.2,13922.48,13270.0,14761.0,2
NDC,00469067773,TACROLIMUS 1 MG PO CP24,1003.2,652.08,13270.0,14761.0,2
NDC,00469068773,TACROLIMUS 5 MG PO CP24,5016.48,3260.71,13270.0,14761.0,2
NDC,00469072560,ENZALUTAMIDE 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00469142590,GILTERITINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00469260130,MIRABEGRON 25 MG PO TB24,6861.6,4460.04,13270.0,14761.0,2
NDC,00469260230,MIRABEGRON 50 MG PO TB24,6861.6,4460.04,13270.0,14761.0,2
NDC,00469260290,MIRABEGRON 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00469301601,TACROLIMUS 5 MG/ML IV SOLN,1476.42,959.67,317.24,14761.0,3
NDC,00469305130,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,1540.48,1001.31,29.04,14761.0,11
NDC,00469321110,MICAFUNGIN 100 MG IV SOLR,2787.68,1811.99,13270.0,14761.0,2
NDC,00469650189,REGADENOSON 0.4 MG/5 ML IV SYRG,3842.4,2497.56,13270.0,14761.0,2
NDC,00472008210,ACYCLOVIR 200 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,00472016630,NYSTATIN 100000 UNIT/GRAM TP OINT,312.96,203.42,13270.0,14761.0,4
NDC,00472024260,PERMETHRIN 5 % TP CREA,395.52,257.09,13270.0,14761.0,2
NDC,00472032126,HYDROCORTISONE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00472033730,HYDROCORTISONE 2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00472037915,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,00472110556,Other Outpatient Services,1465.56,952.61,,,0
NDC,00472173803,MICONAZOLE NITRATE 200 MG VA SUPP,595.82,387.28,13270.0,14761.0,2
NDC,00472191501,MESALAMINE 1000 MG PR SUPP,290.0,188.5,13270.0,14761.0,4
NDC,00480204356,VILAZODONE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00480204456,VILAZODONE 20 MG PO TABS,1307.04,849.58,13270.0,14761.0,2
NDC,00480361087,PIRFENIDONE 267 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00480361198,PIRFENIDONE 801 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00486112501,"SOD PHOS DI, MONO-K PHOS MONO 250 MG PO TABS",,,13270.0,14761.0,2
NDC,00487020101,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,00487590199,RACEPINEPHRINE 2.25 % IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,00487900360,SODIUM CHLORIDE 3 % IN NEBU,10974.18,7133.215,13270.0,14761.0,4
NDC,00487900730,SODIUM CHLORIDE 7 % IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00487900760,SODIUM CHLORIDE 7 % IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,00487930133,SODIUM CHLORIDE 0.9 % IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,00487950101,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,00487950103,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,00487970101,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,00487980101,IPRATROPIUM BROMIDE 0.02 % IN SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00487980101,Other Outpatient Services,290.0,188.5,,,0
NDC,00487980125,IPRATROPIUM BROMIDE 0.02 % IN SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00487990130,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,13270.0,14761.0,6
NDC,00487990401,Other Outpatient Services,1465.56,952.61,,,0
NDC,00487990425,Other Outpatient Services,1465.56,952.61,,,0
NDC,00496088206,LIDOCAINE 4 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,00496088206,LIDOCAINE 4 % TP CREA CC,290.0,188.5,13270.0,14761.0,2
NDC,00496088230,LIDOCAINE 4 % TP CREA,491.52,319.49,13270.0,14761.0,2
NDC,00496088315,LIDOCAINE 5 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,00517003101,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,00517003125,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00517037401,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,10974.18,7133.215,10.63,14761.0,13
NDC,00517037405,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,20482.8,13313.82,10.63,12.22,8
NDC,00517037505,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00517040125,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,00517065001,FERRIC CARBOXYMALTOSE 50 IRON MG/ML IV SOLN,12366.119999999999,8037.98,1.37,14761.0,11
NDC,00517071001,FOMEPIZOLE 1 G/ML IV SOLN,8398.08,5458.75,8.02,14761.0,3
NDC,00517072001,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",553.12,359.53,13270.0,14761.0,2
NDC,00517073501,NICARDIPINE 25 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517074001,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,318.51,207.03,13270.0,14761.0,2
NDC,00517074020,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,318.51,207.03,13270.0,14761.0,2
NDC,00517095501,OLANZAPINE 10 MG IM SOLR,619.52,402.69,13270.0,14761.0,2
NDC,00517100401,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,00517102001,VASOPRESSIN 20 UNITS/ML IV SOLN,372.22,241.94,13270.0,14761.0,2
NDC,00517182001,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,775.2,503.88,13270.0,14761.0,2
NDC,00517231001,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,863.0699999999999,561.0,13270.0,14761.0,2
NDC,00517231005,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,664.0,431.6,,,0
NDC,00517231005,IRON SUCROSE 200 MG IRON/10 ML IV SOLN,863.2,561.0799999999999,13270.0,14761.0,2
NDC,00517234001,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,430.03999999999996,279.525,13270.0,14761.0,2
NDC,00517234010,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,430.03999999999996,279.525,13270.0,14761.0,2
NDC,00517250201,CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) IJ SOLN,447.36,290.78,13270.0,14761.0,2
NDC,00517250210,CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) IJ SOLN,447.36,290.78,13270.0,14761.0,2
NDC,00517340525,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00517400225,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517460125,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517481001,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00517481025,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517671001,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517671010,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517760401,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517760425,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517800501,ZINC SULFATE 5 MG/ML IV SOLN,667.44,433.84,13270.0,14761.0,4
NDC,00517800525,ZINC SULFATE 5 MG/ML IV SOLN,667.44,433.84,13270.0,14761.0,2
NDC,00517912001,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00517930501,TRACE ELEMENTS (TRALEMENT) ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN,,,13270.0,14761.0,2
NDC,00517930525,CSHS PARENTERAL NUTRITITION ORDER ADULT,1465.56,952.61,13270.0,14761.0,2
NDC,00517930525,TRACE ELEMENTS (TRALEMENT) ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN,,,13270.0,14761.0,2
NDC,00525110290,LEVOMEFOLATE-ALGAL OIL 15-90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00525113990,LEVOMEFOLATE-ALGAL OIL 7.5-90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00525804918,LEVOMEFOL-B6-MEB12-ALGAL OIL 3 MG-35 MG-2 MG -90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00525804990,LEVOMEFOL-B6-MEB12-ALGAL OIL 3 MG-35 MG-2 MG -90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527128201,DICYCLOMINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00527130101,PRIMIDONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00527131101,TERBUTALINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00527150237,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00527169501,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00527178901,FLUPHENAZINE HCL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00527179001,FLUPHENAZINE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00527192736,Other Outpatient Services,302.4,196.56,,,0
NDC,00527193106,CLARITHROMYCIN 250 MG PO TABS,839.04,545.38,13270.0,14761.0,2
NDC,00527197174,COCAINE 4 % NA SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00527213335,POSACONAZOLE 100 MG PO TBEC,12622.08,8204.35,13270.0,14761.0,4
NDC,00527224832,FEBUXOSTAT 80 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00527296137,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00527296237,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00527328146,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,00527328246,LEVOTHYROXINE 75 MCG PO TABS,,,13270.0,14761.0,2
NDC,00527328446,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,00527409537,BUTALBITAL-ACETAMINOPHEN-CAFF 50-300-40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527495232,LEVOTHYROXINE 25 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527495332,LEVOTHYROXINE 50 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527495432,LEVOTHYROXINE 75 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527495532,LEVOTHYROXINE 88 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00527518070,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,00527551037,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,00527600480,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,417.6,271.44,13270.0,14761.0,2
NDC,00536104610,SODIUM BICARBONATE 325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00536104815,CALCIUM CARBONATE 200 MG CALCIUM (500 MG) PO CHEW,,,13270.0,14761.0,2
NDC,00536105556,BENZOYL PEROXIDE 5 % TP GEL,290.0,188.5,13270.0,14761.0,2
NDC,00536110945,UREA 20 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,00536113560,PSYLLIUM HUSK 0.4 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00536114263,LEVONORGESTREL 1.5 MG PO TABS,290.0,188.5,,,0
NDC,00536117201,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00536120207,LIDOCAINE 4 % TP PTMD,486.72,316.37,13270.0,14761.0,4
NDC,00536120215,LIDOCAINE 4 % TP PTMD,290.0,188.5,13270.0,14761.0,4
NDC,00536121195,DIBUCAINE 1 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,00536121794,TETRAHYDROZOLINE 0.05 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,00536122497,SOD BORATE-BORIC AC-NACL-WATER OP IRSL,290.0,188.5,13270.0,14761.0,2
NDC,00536122858,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,2
NDC,00536124801,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,4
NDC,00536125494,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,00536126328,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,00536126328,Other Outpatient Services,290.0,188.5,,,0
NDC,00536127211,CLOTRIMAZOLE 1 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,00536127780,Other Outpatient Services,1465.56,952.61,,,0
NDC,00536129701,MECLIZINE 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00536130303,SIMETHICONE 40 MG/0.6 ML PO DRPS,,,13270.0,14761.0,2
NDC,00536130375,SIMETHICONE 40 MG/0.6 ML PO DRPS,,,13270.0,14761.0,2
NDC,00536132601,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG PO TABS,,,13270.0,14761.0,2
NDC,00536132926,TOLNAFTATE 1 % TP POWD,,,13270.0,14761.0,2
NDC,00536135201,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,00536136307,COENZYME Q10 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00536136601,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,00536193807,COENZYME Q10 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00536203007,COENZYME Q10 200 MG PO CAPS,1465.56,952.61,,,0
NDC,00536252525,Other Outpatient Services,1465.56,952.61,,,0
NDC,00536322301,CALCIUM CITRATE-VITAMIN D3 200 MG-6.25 MCG (250 UNIT) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00536406901,NIACINAMIDE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00536407601,NIACIN 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00536408501,PNV CMB#95-FERROUS FUMARATE-FA 28 MG IRON- 800 MCG PO TABS,,,13270.0,14761.0,2
NDC,00536430401,PEDIATRIC MULTIVITAMIN PO CHEW,,,13270.0,14761.0,2
NDC,00536440601,PYRIDOXINE (VITAMIN B6) 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00536466138,MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG PO TABS,,,13270.0,14761.0,2
NDC,00536478701,VITAMIN B COMPLEX PO CAPS,,,13270.0,14761.0,2
NDC,00536515026,TOLNAFTATE 1 % TP POWD,,,13270.0,14761.0,2
NDC,00536671701,PANTOTHENIC ACID (VIT B5) 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00536730001,B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG PO TABS,,,13270.0,14761.0,2
NDC,00536741551,SODIUM PHOSPHATES 19-7 GRAM/118 ML PR ENEM,,,13270.0,14761.0,2
NDC,00548540000,MEDROXYPROGESTERONE 150 MG/ML IM SUSP,372.64,242.22,13270.0,14761.0,2
NDC,00548560100,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,00548585000,GLUCAGON 1 MG IJ SOLR,4174.08,2713.15,239.45,14761.0,11
NDC,00548590000,COSYNTROPIN 0.25 MG IJ SOLR,298.14,193.79,13270.0,14761.0,2
NDC,00548590500,GLUCAGON 1 MG IJ SOLR,4174.08,2713.15,239.45,14761.0,11
NDC,00555003302,Other Outpatient Services,1465.56,952.61,,,0
NDC,00555006602,ISONIAZID 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00555007101,ISONIAZID 300 MG PO TABS,,,13270.0,14761.0,2
NDC,00555007102,ISONIAZID 300 MG PO TABS,,,13270.0,14761.0,2
NDC,00555015902,Other Outpatient Services,1465.56,952.61,,,0
NDC,00555021110,NORETHINDRONE ACETATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00555060702,MEGESTROL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00555063302,DANAZOL 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,00555077502,DEXTROAMPHETAMINE-AMPHETAMINE 7.5 MG PO TABS,1291.2,839.28,13270.0,14761.0,4
NDC,00555077902,MEDROXYPROGESTERONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00555087202,MEDROXYPROGESTERONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00555088202,HYDROXYUREA 500 MG PO CAPS,835.2,542.88,13270.0,14761.0,4
NDC,00555088702,ESTRADIOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00555097202,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1291.2,839.28,13270.0,14761.0,2
NDC,00555097202,Other Outpatient Services,1291.2,839.28,,,0
NDC,00555901058,NORETHINDRONE-ETHIN ESTRADIOL 1-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00555901079,NORETHINDRONE-ETHIN ESTRADIOL 1-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00555901658,NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00555902742,NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00555902858,NORETHINDRONE-E.ESTRADIOL-IRON 1.5 MG-30 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00555902858,Other Outpatient Services,1465.56,952.61,,,0
NDC,00555904379,DESOGESTREL-ETHINYL ESTRADIOL 0.15-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00555904558,LEVONORGESTREL-ETHINYL ESTRAD 0.1-20 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00555904579,LEVONORGESTREL-ETHINYL ESTRAD 0.1-20 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,00555904958,NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG PO TABS,,,13270.0,14761.0,4
NDC,00555913167,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00573245114,Other Outpatient Services,1465.56,952.61,,,0
NDC,00574010601,BROMOCRIPTINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00574010714,CLOTRIMAZOLE 10 MG MM TROC,1975.68,1284.19,13270.0,14761.0,4
NDC,00574014560,TROSPIUM 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00574024101,REPAGLINIDE 1 MG PO TABS,754748.8,490586.72,13270.0,14761.0,4
NDC,00574029201,AMILORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00574050811,FERROUS GLUCONATE 324 MG (38 MG IRON) PO TABS,,,13270.0,14761.0,2
NDC,00574052174,ACTIVATED CHARCOAL 25 GRAM/120 ML PO SUSP,,,13270.0,14761.0,2
NDC,00574079001,METHAZOLAMIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00574079101,METHAZOLAMIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00574080500,ACETYLCYSTEINE 20% INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
NDC,00574082001,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,,,0
NDC,00574085005,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,1958.05,1272.73,13270.0,14761.0,2
NDC,00574086601,CYCLOSPORINE 250 MG/5 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,00574086610,CYCLOSPORINE 250 MG/5 ML IV SOLN,583.12,379.03,13270.0,14761.0,2
NDC,00574195906,GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML PO LIQD,,,13270.0,14761.0,2
NDC,00574200815,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,4
NDC,00574402411,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,00574402411,Other Outpatient Services,1465.56,952.61,,,0
NDC,00574402435,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,00574403125,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,565.44,367.54,13270.0,14761.0,4
NDC,00574703412,ASPIRIN 300 MG PR SUPP,,,13270.0,14761.0,2
NDC,00574704001,BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,00574704012,BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG PR SUPP,1465.56,952.61,13270.0,14761.0,4
NDC,00574704501,BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG PR SUPP,1465.56,952.61,13270.0,14761.0,4
NDC,00574704512,BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,00574705012,BISACODYL 10 MG PR SUPP,,,13270.0,14761.0,2
NDC,00574705050,BISACODYL 10 MG PR SUPP,,,13270.0,14761.0,2
NDC,00574709012,HYDROCORTISONE ACETATE 25 MG PR SUPP,641.28,416.83,13270.0,14761.0,4
NDC,00574722406,HYDROMORPHONE 3 MG PR SUPP,873.31,567.65,13270.0,14761.0,2
NDC,00574722612,PROCHLORPERAZINE 25 MG PR SUPP,,,13270.0,14761.0,2
NDC,00575620030,DIAZOXIDE 50 MG/ML PO SUSP,6891.36,4479.38,13270.0,14761.0,4
NDC,00591034501,VERAPAMIL 120 MG PO TABS,,,13270.0,14761.0,2
NDC,00591034701,HYDROCHLOROTHIAZIDE 12.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00591036901,LOXAPINE SUCCINATE 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,00591037101,LOXAPINE SUCCINATE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00591040401,VERAPAMIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00591040501,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00591040710,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00591040905,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00591044401,GUANFACINE 1 MG PO HALF-TAB = 0.5 MG,,,13270.0,14761.0,2
NDC,00591058301,PROPAFENONE 225 MG PO TABS,,,13270.0,14761.0,2
NDC,00591060501,LABETALOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00591060701,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,00591074501,ESTAZOLAM 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00591079410,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00591079601,SULFASALAZINE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00591212779,BRINZOLAMIDE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00591215990,CICLOPIROX 1 % TP SHAM,1465.56,952.61,13270.0,14761.0,2
NDC,00591219101,RAMELTEON 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00591219130,RAMELTEON 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00591225854,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,290.0,188.5,13270.0,14761.0,4
NDC,00591240630,AMBRISENTAN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00591242226,BRIMONIDINE-TIMOLOL 0.2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00591257920,VALGANCICLOVIR 50 MG/ML PO SOLR,11929.98,7754.49,13270.0,14761.0,4
NDC,00591264101,BUTALBITAL-ACETAMINOP-CAF-COD 50-300-40-30 MG PO CAPS,9060.8,5889.52,13270.0,14761.0,2
NDC,00591267911,Other Outpatient Services,1465.56,952.61,,,0
NDC,00591288001,VERAPAMIL 120 MG PO C24P,,,13270.0,14761.0,2
NDC,00591288201,VERAPAMIL 180 MG PO C24P,,,13270.0,14761.0,2
NDC,00591288401,VERAPAMIL 240 MG PO C24P,,,13270.0,14761.0,2
NDC,00591292754,LEVALBUTEROL TARTRATE 45 MCG/ACTUATION IN HFAA,439.32,285.56,13270.0,14761.0,2
NDC,00591294430,PIMECROLIMUS 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,00591299801,URSODIOL 250 MG PO TABS,1329.6,864.24,13270.0,14761.0,4
NDC,00591300501,URSODIOL 500 MG PO TABS,1465.56,952.61,,,0
NDC,00591312879,PROGESTERONE 50 MG/ML IM OIL,20482.8,13313.82,,,0
NDC,00591315901,URSODIOL 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,00591321726,TESTOSTERONE 1 % (50 MG/5 GRAM) TD GLPK,290.0,188.5,13270.0,14761.0,4
NDC,00591336901,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,995.2,646.88,13270.0,14761.0,2
NDC,00591352511,Other Outpatient Services,1465.56,952.61,,,0
NDC,00591354060,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,2
NDC,00591378019,SILDENAFIL 2.5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,00591438579,FOSAPREPITANT 150 MG IV SOLR,798.0,518.7,13270.0,14761.0,2
NDC,00591532101,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,00591533501,TRIHEXYPHENIDYL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00591534701,PROBENECID 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00591544310,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00591555401,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00591559001,TRANYLCYPROMINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00591564301,MINOXIDIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00597002402,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
NDC,00597002402,Other Outpatient Services,1465.56,952.61,,,0
NDC,00597003134,CLONIDINE 0.1 MG/24 HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00597003334,CLONIDINE 0.3 MG/24 HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00597005301,GLUCAGON 1 MG/ML IJ SOLR,10974.18,7133.215,239.45,14761.0,11
NDC,00597005345,GLUCAGON 1 MG/ML IJ SOLR,20482.8,13313.82,239.45,275.37,8
NDC,00597005801,TAMSULOSIN 0.4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00597007541,TIOTROPIUM BROMIDE 18 MCG IN CPDV,1465.56,952.61,13270.0,14761.0,2
NDC,00597008717,IPRATROPIUM BROMIDE 17 MCG/ACTUATION IN HFAA,2287.02,1486.56,13270.0,14761.0,4
NDC,00597010051,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,290.0,188.5,13270.0,14761.0,4
NDC,00597010061,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,3537.86,2299.61,13270.0,14761.0,2
NDC,00597010854,DABIGATRAN ETEXILATE 110 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00597014030,LINAGLIPTIN 5 MG PO TABS,6105.6,3968.64,13270.0,14761.0,2
NDC,00597014061,LINAGLIPTIN 5 MG PO TABS,20352.0,13228.8,13270.0,14761.0,4
NDC,00597014130,AFATINIB 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00597014360,NINTEDANIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00597014560,NINTEDANIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00597014718,LINAGLIPTIN-METFORMIN 2.5-850 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00597014818,"LINAGLIPTIN-METFORMIN 2.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,00597014860,"LINAGLIPTIN-METFORMIN 2.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,00597015237,EMPAGLIFLOZIN 10 MG PO TABS,4472.16,2906.9,13270.0,14761.0,4
NDC,00597015337,EMPAGLIFLOZIN 25 MG PO TABS,4472.16,2906.9,13270.0,14761.0,4
NDC,00597015531,TIOTROPIUM-OLODATEROL 2.5-2.5 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
NDC,00597015561,TIOTROPIUM-OLODATEROL 2.5-2.5 MCG/ACTUATION IN MIST,1465.56,952.61,,,0
NDC,00597016061,Other Outpatient Services,1465.56,952.61,,,0
NDC,00597016061,TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
NDC,00597016818,"EMPAGLIFLOZIN-METFORMIN 12.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,00597016860,"EMPAGLIFLOZIN-METFORMIN 12.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,00597019705,IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN,22846.05,14849.93,13270.0,14761.0,2
NDC,00597026010,GLUCAGON 1 MG/ML IJ SOLR,10974.18,7133.215,239.45,14761.0,11
NDC,00597028517,PRAMIPEXOLE 0.75 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00597028730,PRAMIPEXOLE 3.75 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00597035556,DABIGATRAN ETEXILATE 75 MG PO CAPS,2809.92,1826.45,13270.0,14761.0,2
NDC,00597036082,DABIGATRAN ETEXILATE 150 MG PO CAPS,2809.92,1826.45,13270.0,14761.0,4
NDC,00603020922,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) PO TABS,,,13270.0,14761.0,2
NDC,00603155410,Other Outpatient Services,1465.56,952.61,,,0
NDC,00603158458,PROMETHAZINE 6.25 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,00603158558,Other Outpatient Services,1465.56,952.61,,,0
NDC,00603158558,PROMETHAZINE-CODEINE 6.25-10 MG/5 ML PO SYRP,1465.56,952.61,13270.0,14761.0,2
NDC,00603240621,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00603254021,BUTALBITAL-ACETAMINOPHEN 50-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00603358121,FELODIPINE 2.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00603497821,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00603533532,PREDNISONE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00603533832,PREDNISONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00603544921,PROPAFENONE 225 MG PO TABS,,,13270.0,14761.0,2
NDC,00603544925,PROPAFENONE 225 MG PO TABS,,,13270.0,14761.0,2
NDC,00603548221,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00603548321,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00603548332,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00603548421,PROPRANOLOL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00641012125,HYDROMORPHONE 2 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,00641036721,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00641036721,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641036725,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00641037621,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641037625,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641040012,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641040037,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641047621,PHENOBARBITAL SODIUM 65 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641047625,PHENOBARBITAL SODIUM 65 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641047721,PHENOBARBITAL SODIUM 130 MG/ML IJ SOLN,584.37,379.84,13270.0,14761.0,2
NDC,00641047725,PHENOBARBITAL SODIUM 130 MG/ML IJ SOLN,584.37,379.84,13270.0,14761.0,2
NDC,00641049321,PHENYTOIN SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641049325,PHENYTOIN 50 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
NDC,00641092821,PROMETHAZINE 25 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,00641139731,CHLORPROMAZINE 25 MG/ML IJ SOLN,409.12,265.93,13270.0,14761.0,2
NDC,00641139735,CHLORPROMAZINE 25 MG/ML IJ SOLN,409.12,265.93,13270.0,14761.0,2
NDC,00641139831,CHLORPROMAZINE 25 MG/ML IJ SOLN,338.72,220.17,13270.0,14761.0,2
NDC,00641141031,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641234139,HYDROMORPHONE 2 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,00641255541,PHENYTOIN SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641255545,PHENYTOIN SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641256941,DIPYRIDAMOLE 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641600101,LORAZEPAM 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641600601,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,00641600701,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
NDC,00641600710,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641600801,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641601301,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641601310,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641601401,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641601501,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641601901,MORPHINE (PF) 1 MG/ML IJ SOLN,431.36,280.38,13270.0,14761.0,2
NDC,00641601910,MORPHINE (PF) 1 MG/ML IJ SOLN,431.36,280.38,13270.0,14761.0,4
NDC,00641602001,MORPHINE (PF) 0.5 MG/ML IJ SOLN,431.36,280.38,13270.0,14761.0,2
NDC,00641602010,MORPHINE (PF) 0.5 MG/ML IJ SOLN,431.36,280.38,13270.0,14761.0,2
NDC,00641602701,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641602725,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641602801,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641602901,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641603001,FENTANYL 2500 MCG/50 ML (50 MCG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641603001,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641604001,MORPHINE (PF) 25 MG/ML IJ SOLN,5219.2,3392.48,13270.0,14761.0,2
NDC,00641604001,MORPHINE 25 MG/ML IV SOLN,5219.2,3392.48,13270.0,14761.0,2
NDC,00641604401,HB IV PUSH INITIAL,290.0,188.5,262.35,301.7,8
NDC,00641604401,LORAZEPAM 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641604425,HB IVP ADDL SEQ SAME DRUG,290.0,188.5,,,0
NDC,00641604425,LORAZEPAM 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641605201,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641605225,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641605301,MEPERIDINE (PF) 50 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00641605701,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641605710,MIDAZOLAM 1 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,00641605901,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641606001,MIDAZOLAM 250 MG/50 ML (5 MG/ML) PEDS STRAIGHT DRUG IV SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,00641606001,MIDAZOLAM 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641606010,MIDAZOLAM 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641606101,MIDAZOLAM 5 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,00641610325,METHOCARBAMOL 100 MG/ML IJ SOLN,417.44,271.34,13270.0,14761.0,2
NDC,00641611701,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00641612501,MORPHINE 4 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641612525,MORPHINE 4 MG/ML IV SOLN,290.0,188.5,,,0
NDC,00641612701,MORPHINE 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641613201,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641613501,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641613525,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641614225,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641614501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641614601,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641614901,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641615101,HYDROMORPHONE (PF) 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641616701,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641617301,DICYCLOMINE 10 MG/ML IM SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641617401,OCTREOTIDE ACETATE 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641617410,OCTREOTIDE ACETATE 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641617501,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641617601,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641618801,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641619501,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,2
NDC,00641619901,"HEPARIN, PORCINE (PF) 5000 UNITS/ML IJ SYRG",20482.8,13313.82,,,0
NDC,00641622801,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641623101,HYDRALAZINE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00641623801,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00641625301,REGADENOSON 0.4 MG/5 ML IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,00642747001,DROSPIRENONE (CONTRACEPTIVE) 4 MG (28) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00642747002,DROSPIRENONE (CONTRACEPTIVE) 4 MG (28) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00682004601,HYPOCHLOROUS ACID-SODIUM CHLOR 0.01 % TP SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,00699310002,BENZOCAINE 20 % MM SPRA,858.19,557.82,13270.0,14761.0,4
NDC,00703011001,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703011003,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703011301,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703011303,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703024301,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,00703066601,TREPROSTINIL SODIUM 1 MG/ML IJ SOLN,3613.86,2349.01,69.5,14761.0,3
NDC,00703068601,TREPROSTINIL SODIUM 5 MG/ML IJ SOLN,18068.22,11744.34,69.5,14761.0,11
NDC,00703150102,ALPROSTADIL 500 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,6
NDC,00703203301,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703204501,CISATRACURIUM 10 MG/ML CONC. IV SOLN,4032.32,2621.01,13270.0,14761.0,2
NDC,00703204503,CISATRACURIUM 10 MG/ML CONC. IV SOLN,4032.32,2621.01,13270.0,14761.0,2
NDC,00703291401,VECURONIUM BROMIDE 10 MG IV SOLR,1465.56,952.61,13270.0,14761.0,4
NDC,00703315401,BLEOMYCIN 15 UNITS IJ SOLR,20482.8,13313.82,,,0
NDC,00703321601,PACLITAXEL 6 MG/ML IV CONC,491.92,319.75,13270.0,14761.0,2
NDC,00703321701,PACLITAXEL 6 MG/ML IV CONC,814.4,529.36,13270.0,14761.0,2
NDC,00703321801,PACLITAXEL 6 MG/ML IV CONC,492.0,319.8,13270.0,14761.0,2
NDC,00703331101,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00703367501,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00703367801,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,362.88,235.87,13270.0,14761.0,4
NDC,00703398501,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,745.44,484.54,,,0
NDC,00703398601,OXALIPLATIN 100 MG/20 ML IV SOLN,1490.88,969.07,13270.0,14761.0,2
NDC,00703423901,CARBOPLATIN 10 MG/ML IV SOLN,955.2,620.88,13270.0,14761.0,2
NDC,00703424401,CARBOPLATIN 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703424601,CARBOPLATIN 10 MG/ML IV SOLN,303.6,197.34,13270.0,14761.0,2
NDC,00703424801,CARBOPLATIN 10 MG/ML IV SOLN,939.6,610.74,13270.0,14761.0,2
NDC,00703440211,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703450201,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00703468501,MITOXANTRONE 2 MG/ML IV CONC,1669.28,1085.03,68.05,14761.0,3
NDC,00703471401,TOPOTECAN 4 MG IV SOLR,20482.8,13313.82,,,0
NDC,00703471471,TOPOTECAN 4 MG IV SOLR,20482.8,13313.82,,,0
NDC,00703507501,DACARBAZINE 200 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,00703514501,LEUCOVORIN CALCIUM 350 MG IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,00703523313,DAUNORUBICIN 5 MG/ML IV SOLN,1465.56,952.61,30.43,14761.0,3
NDC,00703565601,ETOPOSIDE (STRAIGHT DRUG) IVPB,1465.56,952.61,13270.0,14761.0,2
NDC,00703574711,CISPLATIN 1 MG/ML IV SOLN,291.2,189.28,13270.0,14761.0,2
NDC,00703574811,CISPLATIN 1 MG/ML IV SOLN,582.4,378.56,13270.0,14761.0,2
NDC,00703680101,MEDROXYPROGESTERONE 150 MG/ML IM SUSP,10974.18,7133.215,13270.0,14761.0,2
NDC,00703851021,ENOXAPARIN 150 MG/ML SC SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,00703851023,ENOXAPARIN 150 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00703861021,ENOXAPARIN 120 MG/0.8 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00703861023,ENOXAPARIN 120 MG/0.8 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,00703950303,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00703951401,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00703951403,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,00703952601,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,400.8,260.52,13270.0,14761.0,2
NDC,00713013506,PROCHLORPERAZINE 25 MG PR SUPP,,,13270.0,14761.0,2
NDC,00713016612,ERGOTAMINE-CAFFEINE 2-100 MG PR SUPP,36743.81,23883.48,13270.0,14761.0,2
NDC,00713022815,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,00713026831,"NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TP OINT",290.0,188.5,13270.0,14761.0,2
NDC,00713035102,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00713050306,HYDROCORTISONE ACETATE 25 MG PR SUPP,290.0,188.5,13270.0,14761.0,4
NDC,00713052606,PROMETHAZINE 25 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,00713053606,PROMETHAZINE 12.5 MG PR SUPP,290.0,188.5,13270.0,14761.0,2
NDC,00713063737,METRONIDAZOLE 0.75 % TP GEL,637.2,414.18,13270.0,14761.0,2
NDC,00713063815,CICLOPIROX 0.77 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,00713065540,TRIAMCINOLONE ACETONIDE 0.1 % DT PSTE,609.12,395.93,13270.0,14761.0,2
NDC,00713067653,TRIAMCINOLONE ACETONIDE 0.1 % TP LOTN,290.0,188.5,13270.0,14761.0,4
NDC,00713070153,MOMETASONE 0.1 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,00713087230,AMLODIPINE-OLMESARTAN 5-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00761081212,CALCIUM CARBONATE-VITAMIN D3 600 MG-5 MCG (200 UNIT) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00766041976,METHYLCELLULOSE (LAXATIVE) 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00781106101,ALPRAZOLAM 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00781106105,Other Outpatient Services,1465.56,952.61,,,0
NDC,00781107701,ALPRAZOLAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00781148601,AMITRIPTYLINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00781148701,AMITRIPTYLINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00781148801,AMITRIPTYLINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00781163501,ISOSORBIDE DINITRATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00781169501,ISOSORBIDE DINITRATE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00781185220,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,338.24,219.86,13270.0,14761.0,4
NDC,00781207401,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00781207601,TAMSULOSIN 0.4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00781208102,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO CAPS,,,13270.0,14761.0,2
NDC,00781210301,TACROLIMUS 1 MG PO CAPS,689.6,448.24,13270.0,14761.0,4
NDC,00781214501,AMPICILLIN 500 MG PO CAPS,745.6,484.64,13270.0,14761.0,2
NDC,00781214801,LANSOPRAZOLE 30 MG PO CPDR,,,13270.0,14761.0,2
NDC,00781232206,APREPITANT 80 MG PO CAPS,2050.56,1332.86,13270.0,14761.0,2
NDC,00781232206,Other Outpatient Services,2050.56,1332.86,,,0
NDC,00781232246,APREPITANT 80 MG PO CAPS,4101.12,2665.73,13270.0,14761.0,2
NDC,00781300094,MEROPENEM 500 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,00781300095,MEROPENEM 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00781304072,PYRIDOSTIGMINE BROMIDE 5 MG/ML IJ SOLN,448.8,291.72,13270.0,14761.0,4
NDC,00781304095,PYRIDOSTIGMINE BROMIDE 5 MG/ML IJ SOLN,448.8,291.72,13270.0,14761.0,2
NDC,00781305972,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781305995,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781307901,FULVESTRANT 250 MG/5 ML IM SYRG,1379.36,896.58,9.35,10.75,8
NDC,00781307912,FULVESTRANT 250 MG/5 ML IM SYRG,1379.36,896.58,9.35,14761.0,11
NDC,00781309894,MEROPENEM 1 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,00781311090,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00781311390,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00781311395,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,,,0
NDC,00781311491,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,00781315075,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00781315095,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00781315401,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,2967.59,1928.93,0.42,14761.0,11
NDC,00781315401,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),2967.59,1928.93,13270.0,14761.0,2
NDC,00781315606,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781315695,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",290.0,188.5,,,0
NDC,00781315695,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781315894,BIVALIRUDIN 250 MG IV SOLR,1118.05,726.73,13270.0,14761.0,2
NDC,00781315972,OLANZAPINE 10 MG IM SOLR,409.92,266.45,13270.0,14761.0,2
NDC,00781320885,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,,,0
NDC,00781320885,CEFTRIAXONE IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,00781320895,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781320990,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781322075,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781323294,PANTOPRAZOLE (PROTONIX) 40 MG/50 ML NS VIAL-TO-BAG IV INFUSION,1465.56,952.61,13270.0,14761.0,2
NDC,00781323294,PANTOPRAZOLE 40 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,6
NDC,00781323295,PANTOPRAZOLE 40 MG IV SOLR,290.0,188.5,,,0
NDC,00781323394,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1022.56,664.66,13270.0,14761.0,2
NDC,00781324494,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1606.88,1044.47,13270.0,14761.0,2
NDC,00781325394,AZACITIDINE 100 MG IJ SOLR,715.84,465.3,13270.0,14761.0,2
NDC,00781325594,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,1679.84,1091.9,13270.0,14761.0,2
NDC,00781326971,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00781328909,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,00781328991,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00781329009,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00781329091,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,10974.18,7133.215,13270.0,14761.0,4
NDC,00781331570,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781331780,OXALIPLATIN 100 MG/20 ML IV SOLN,292.16,189.9,13270.0,14761.0,2
NDC,00781340485,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781340495,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781340778,AMPICILLIN SODIUM 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781340880,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781344071,COSYNTROPIN 0.25 MG IJ SOLR,474.8,308.62,13270.0,14761.0,2
NDC,00781344095,COSYNTROPIN 0.25 MG IJ SOLR,474.8,308.62,,,0
NDC,00781348170,TIGECYCLINE 50 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,00781349775,FOSAPREPITANT 150 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,00781375575,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,00781382571,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00781400332,LEUPROLIDE 1 MG/0.2ML FOR PEDS STIM TEST,8312.46,5403.1,,,0
NDC,00781502201,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00781502207,METHYLPREDNISOLONE 4 MG PO DSPK - ADDITIONAL DAYS,,,13270.0,14761.0,2
NDC,00781523864,ONDANSETRON 4 MG PO TBDL,10974.18,7133.215,13270.0,14761.0,6
NDC,00781531801,Other Outpatient Services,1465.56,952.61,,,0
NDC,00781563701,CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00781571001,POTASSIUM CHLORIDE 10 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,00781601470,BRINZOLAMIDE 1 % OP DRPS,4364.96,2837.22,13270.0,14761.0,2
NDC,00781602352,CLARITHROMYCIN 250 MG/5 ML PO SUSR,1125.6,731.64,13270.0,14761.0,2
NDC,00781603958,Other Outpatient Services,1465.56,952.61,,,0
NDC,00781604155,AMOXICILLIN 250 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
NDC,00781613594,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,00781613957,AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
NDC,00781615394,PENICILLIN G SODIUM 5 MILLION UNITS IJ SOLR,584.56,379.96,13270.0,14761.0,4
NDC,00781615395,PENICILLIN G SODIUM 5 MILLION UNITS IJ SOLR,584.56,379.96,13270.0,14761.0,4
NDC,00781618414,TAFLUPROST (PF) 0.0015 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,00781618667,CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OT DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,00781711958,ESTRADIOL 0.025 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,2
NDC,00781712258,ESTRADIOL 0.0375 MG/24 HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,00781712983,ESTRADIOL 0.025 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00781713593,MOXIFLOXACIN 0.5 % OP DROP,420.96,273.62,13270.0,14761.0,2
NDC,00781716758,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00781716783,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,00781729685,Other Outpatient Services,1465.56,952.61,,,0
NDC,00781730958,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,290.0,188.5,13270.0,14761.0,2
NDC,00781731331,RIVASTIGMINE 13.3 MG/24 HOUR TD PT24,6045.12,3929.33,13270.0,14761.0,2
NDC,00781731358,RIVASTIGMINE 13.3 MG/24 HOUR TD PT24,290.0,188.5,13270.0,14761.0,2
NDC,00781751614,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,13270.0,14761.0,2
NDC,00781808692,PIRFENIDONE 801 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00810079887,Other Outpatient Services,1465.56,952.61,,,0
NDC,00810079888,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",1465.56,952.61,13270.0,14761.0,4
NDC,00832003889,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00832030100,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00832030389,CHLORPROMAZINE 100 MG PO TABS,10974.18,7133.215,13270.0,14761.0,2
NDC,00832031011,VALPROIC ACID 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,00832051189,BETHANECHOL CHLORIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00832051200,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00832051201,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00832051289,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00832054111,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00832059011,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00832059530,EXEMESTANE 25 MG PO TABS,1490.88,969.07,13270.0,14761.0,2
NDC,00832063011,CLOMIPRAMINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00832111360,MEMANTINE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,00832121189,WARFARIN 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121289,WARFARIN 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121389,WARFARIN 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121489,WARFARIN 3 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121589,WARFARIN 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121789,WARFARIN 6 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121889,WARFARIN 7.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00832121989,WARFARIN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00832141003,MOXIFLOXACIN 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,00832152011,HALOPERIDOL 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00832532511,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,00832601700,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00832712389,DIVALPROEX 250 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,00832712489,DIVALPROEX 500 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,00847001200,ARGININE (L-ARGININE) PO POWD,1465.56,952.61,,,0
NDC,00869470410,HYDROGEN PEROXIDE 3 % MISC SOLN,,,13270.0,14761.0,2
NDC,00904001261,CHLORPHENIRAMINE MALEATE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00904020161,AMITRIPTYLINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904020261,AMITRIPTYLINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00904042806,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1522.4,989.56,13270.0,14761.0,4
NDC,00904043004,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904043006,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904052260,ASCORBIC ACID (VITAMIN C) 250 MG PO TABS,,,13270.0,14761.0,2
NDC,00904052361,ASCORBIC ACID (VITAMIN C) 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904052380,ASCORBIC ACID (VITAMIN C) 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904053961,MULTIVITAMIN WITH FOLIC ACID 400 MCG PO TABS,,,13270.0,14761.0,2
NDC,00904072236,TOLNAFTATE 1 % TP CREA,,,13270.0,14761.0,2
NDC,00904110231,POVIDONE-IODINE 10 % TP OINT,,,13270.0,14761.0,2
NDC,00904145361,METRONIDAZOLE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904188260,CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,00904188361,"CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) PO TABS",,,13270.0,14761.0,2
NDC,00904188372,"CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) PO TABS",,,13270.0,14761.0,2
NDC,00904198760,ACETAMINOPHEN 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,00904208560,"VITAMIN A 3,000 MCG (10,000 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,00904227260,NIACIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904253321,CALAMINE-ZINC OXIDE 8-8 % TP LOTN,,,13270.0,14761.0,2
NDC,00904272561,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904282161,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904292461,VERAPAMIL 120 MG PO TABS,,,13270.0,14761.0,2
NDC,00904357161,MEGESTROL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00904385461,CARBAMAZEPINE 100 MG PO CHEW,,,13270.0,14761.0,2
NDC,00904386575,SODIUM CHLORIDE 0.65 % NA SPRA,290.0,188.5,13270.0,14761.0,4
NDC,00904423960,MAGNESIUM OXIDE 500 MG MAGNESIUM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00904505359,PSEUDOEPHEDRINE HCL 30 MG PO TABS,,,13270.0,14761.0,2
NDC,00904506860,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,00904515460,GUAIFENESIN 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00904525944,COAL TAR 0.5 % TP SHAM,,,13270.0,14761.0,2
NDC,00904528261,RIFAMPIN 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00904530660,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904530661,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904530680,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904533260,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,2
NDC,00904535431,DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TP CREA,,,13270.0,14761.0,2
NDC,00904536560,ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG PO CHEW,290.0,188.5,13270.0,14761.0,2
NDC,00904544861,PENTOXIFYLLINE 400 MG PO TBSR,,,13270.0,14761.0,2
NDC,00904546072,CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,00904546080,CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,00904546092,CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,00904550261,ENALAPRIL MALEATE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904552361,DOXAZOSIN 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00904552461,DOXAZOSIN 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00904560961,ENALAPRIL MALEATE 2.5 MG PO TABS,728.0,473.2,13270.0,14761.0,2
NDC,00904561061,ENALAPRIL MALEATE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904561161,ENALAPRIL MALEATE 20 MG PO TABS,1064.0,691.6,13270.0,14761.0,4
NDC,00904567661,PAROXETINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904567761,PAROXETINE HCL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904578461,FLUOXETINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904578561,FLUOXETINE 20 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904578961,ACYCLOVIR 200 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,00904579061,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904579146,ACETAMINOPHEN 80 MG PO CHEW,,,13270.0,14761.0,4
NDC,00904582360,CHOLECALCIFEROL (VITAMIN D3) 400 UNITS PO TABS,,,13270.0,14761.0,2
NDC,00904585360,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,2
NDC,00904585361,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,2
NDC,00904585461,IBUPROFEN 600 MG PO TABS,,,13270.0,14761.0,2
NDC,00904589161,PRAVASTATIN 10 MG PO TABS,536.0,348.4,13270.0,14761.0,4
NDC,00904589261,Other Outpatient Services,678.4,440.96,,,0
NDC,00904589361,PRAVASTATIN 40 MG PO TABS,990.4,643.76,13270.0,14761.0,4
NDC,00904589430,SIMETHICONE 40 MG/0.6 ML PO DRPS,,,13270.0,14761.0,2
NDC,00904592161,DIGOXIN 125 MCG (0.125 MG) PO TABS,,,13270.0,14761.0,2
NDC,00904592261,DIGOXIN 250 MCG (0.25 MG) PO TABS,,,13270.0,14761.0,4
NDC,00904595961,CLINDAMYCIN HCL 150 MG PO CAPS,337.6,219.44,13270.0,14761.0,4
NDC,00904598426,AMMONIUM LACTATE 12 % TP LOTN,290.0,188.5,13270.0,14761.0,4
NDC,00904600761,LORAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904600860,LORAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904600861,LORAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904600961,LORAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904608261,ZOLPIDEM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904608461,CITALOPRAM 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904608561,CITALOPRAM 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904617261,CARBAMAZEPINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00904623761,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904623861,CARBIDOPA-LEVODOPA 25-250 MG PO TABS,,,13270.0,14761.0,2
NDC,00904626908,Other Outpatient Services,2698.88,1754.27,,,0
NDC,00904626908,ZIPRASIDONE HCL 20 MG PO CAPS,2698.88,1754.27,13270.0,14761.0,4
NDC,00904626945,ZIPRASIDONE HCL 20 MG PO CAPS,2654.72,1725.57,13270.0,14761.0,2
NDC,00904627045,ZIPRASIDONE HCL 40 MG PO CAPS,3289.6,2138.24,13270.0,14761.0,4
NDC,00904627145,ZIPRASIDONE HCL 60 MG PO CAPS,2595.84,1687.3,13270.0,14761.0,4
NDC,00904628361,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,00904629006,ATORVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904629061,ATORVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904629161,ATORVASTATIN 20 MG PO TABS,302.4,196.56,13270.0,14761.0,4
NDC,00904629261,ATORVASTATIN 40 MG PO TABS,345.6,224.64,13270.0,14761.0,4
NDC,00904629304,ATORVASTATIN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904629461,CLOPIDOGREL 75 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904630061,CARVEDILOL 3.125 MG PO TABS,,,13270.0,14761.0,2
NDC,00904630161,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904630261,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904630361,CARVEDILOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904630521,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,2
NDC,00904630805,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00904632078,SODIUM PHOSPHATES 19-7 GRAM/118 ML PR ENEM,,,13270.0,14761.0,2
NDC,00904632261,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,00904632361,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,00904632461,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,2
NDC,00904635161,LEVOFLOXACIN 250 MG PO TABS,326.4,212.16,13270.0,14761.0,4
NDC,00904635261,LEVOFLOXACIN 500 MG PO TABS,360.0,234.0,13270.0,14761.0,4
NDC,00904635361,LEVOFLOXACIN 750 MG PO TABS,654.4,425.36,13270.0,14761.0,4
NDC,00904635761,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904635761,RISPERIDONE 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00904635861,RISPERIDONE 0.5 MG PO TABS,294.4,191.36,13270.0,14761.0,4
NDC,00904635961,RISPERIDONE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904636061,RISPERIDONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904636161,RISPERIDONE 3 MG PO TABS,305.6,198.64,13270.0,14761.0,4
NDC,00904636345,DIVALPROEX 250 MG PO TB24,1804.8,1173.12,13270.0,14761.0,4
NDC,00904636461,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904636961,AMLODIPINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904637061,AMLODIPINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904637161,AMLODIPINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904637361,ROPINIROLE 0.25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904637461,ROPINIROLE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00904637761,OLANZAPINE 5 MG PO TABS,,,13270.0,14761.0,4
NDC,00904640161,TAMSULOSIN 0.4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,00904640761,BISACODYL 5 MG PO TBEC,,,13270.0,14761.0,2
NDC,00904641292,CALCIUM CARBONATE 200 MG CALCIUM (500 MG) PO CHEW,,,13270.0,14761.0,2
NDC,00904641861,TIZANIDINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00904642661,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904642761,ESCITALOPRAM OXALATE 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904642761,Other Outpatient Services,290.0,188.5,,,0
NDC,00904643604,TEMAZEPAM 7.5 MG PO CAPS,1566.72,1018.37,13270.0,14761.0,4
NDC,00904644161,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904644261,HYDRALAZINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00904644961,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,2
NDC,00904645061,ISOSORBIDE MONONITRATE 60 MG PO TB24,,,13270.0,14761.0,2
NDC,00904645361,DULOXETINE 30 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,00904645561,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904646161,PROMETHAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904646707,CLOPIDOGREL 300 MG PO TABS,4428.96,2878.82,13270.0,14761.0,4
NDC,00904646710,CLOPIDOGREL 300 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904646861,VENLAFAXINE 37.5 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
NDC,00904646961,VENLAFAXINE 75 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
NDC,00904647061,VENLAFAXINE 150 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
NDC,00904647461,Other Outpatient Services,364.8,237.12,,,0
NDC,00904647461,PANTOPRAZOLE 40 MG PO TBEC,364.8,237.12,13270.0,14761.0,4
NDC,00904647561,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904648838,WHITE PETROLATUM-MINERAL OIL 83-15 % OP OINT,,,13270.0,14761.0,2
NDC,00904650006,FLUCONAZOLE 100 MG PO TABS,988.0,642.2,13270.0,14761.0,4
NDC,00904650006,Other Outpatient Services,988.0,642.2,,,0
NDC,00904650061,FLUCONAZOLE 100 MG PO TABS,1982.4,1288.56,13270.0,14761.0,4
NDC,00904650061,Other Outpatient Services,1982.4,1288.56,,,0
NDC,00904650161,FLUCONAZOLE 200 MG PO TABS,3024.0,1965.6,13270.0,14761.0,4
NDC,00904650261,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904650361,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904650561,MEMANTINE 5 MG PO TABS,600.0,390.0,13270.0,14761.0,4
NDC,00904650661,MEMANTINE 10 MG PO TABS,598.4,388.96,13270.0,14761.0,4
NDC,00904651006,ARIPIPRAZOLE 5 MG PO TABS,6238.4,4054.96,13270.0,14761.0,4
NDC,00904651106,ARIPIPRAZOLE 10 MG PO TABS,6238.4,4054.96,13270.0,14761.0,2
NDC,00904651661,MECLIZINE 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904651761,MECLIZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904651961,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,00904652261,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,00904653061,METHADONE 10 MG PO TABS,379.2,246.48,13270.0,14761.0,6
NDC,00904653061,Other Outpatient Services,379.2,246.48,,,0
NDC,00904655061,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904655161,ONDANSETRON HCL 4 MG PO TABS,739.2,480.48,13270.0,14761.0,6
NDC,00904655261,ONDANSETRON HCL 8 MG PO TABS,939.2,610.48,13270.0,14761.0,4
NDC,00904655761,MORPHINE 15 MG PO TBSR,752.0,488.8,13270.0,14761.0,4
NDC,00904655861,MORPHINE 30 MG PO TBSR,1667.2,1083.68,13270.0,14761.0,4
NDC,00904655961,MORPHINE 60 MG PO TBSR,4212.8,2738.32,13270.0,14761.0,4
NDC,00904656460,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904656461,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904656561,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904657006,OXYBUTYNIN CHLORIDE 5 MG PO TR24,1899.2,1234.48,13270.0,14761.0,4
NDC,00904657304,BUPROPION HCL 300 MG PO TB24,892.8,580.32,13270.0,14761.0,4
NDC,00904657561,PHENOBARBITAL 32.4 MG PO TABS,536.0,348.4,13270.0,14761.0,4
NDC,00904658304,LAMIVUDINE 150 MG PO TABS,3442.56,2237.66,13270.0,14761.0,4
NDC,00904658561,BUPROPION HCL 150 MG PO SR12,,,13270.0,14761.0,2
NDC,00904659204,TOLTERODINE 2 MG PO CP24,2978.4,1935.96,13270.0,14761.0,2
NDC,00904659304,TOLTERODINE 4 MG PO CP24,3104.64,2018.02,13270.0,14761.0,4
NDC,00904659604,VORICONAZOLE 50 MG PO TABS,3615.36,2349.98,13270.0,14761.0,2
NDC,00904659961,PERPHENAZINE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,00904661561,DIVALPROEX 125 MG PO CDRS,1331.2,865.28,13270.0,14761.0,4
NDC,00904661761,HYDROXYZINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904661861,HYDROXYZINE HCL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00904662061,ISOSORBIDE DINITRATE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904662261,PYRIDOSTIGMINE BROMIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00904662361,TACROLIMUS 0.5 MG PO CAPS,1403.2,912.08,13270.0,14761.0,4
NDC,00904662461,TACROLIMUS 5 MG PO CAPS,12315.2,8004.88,13270.0,14761.0,4
NDC,00904662735,CARBAMIDE PEROXIDE 6.5 % OT DROP,,,13270.0,14761.0,2
NDC,00904663661,BUPROPION HCL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904663761,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904663861,QUETIAPINE 25 MG PO TABS,411.2,267.28,13270.0,14761.0,4
NDC,00904663961,QUETIAPINE 50 MG PO TABS,699.2,454.48,13270.0,14761.0,4
NDC,00904664061,Other Outpatient Services,636.8,413.92,,,0
NDC,00904664161,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904664261,QUETIAPINE 300 MG PO TABS,481.6,313.04,13270.0,14761.0,4
NDC,00904664604,ZAFIRLUKAST 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,00904666361,ACETAZOLAMIDE 250 MG PO TABS,5382.4,3498.56,13270.0,14761.0,4
NDC,00904666561,GABAPENTIN 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904666661,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904666761,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904667104,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,340.8,221.52,13270.0,14761.0,4
NDC,00904667106,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,625.6,406.64,13270.0,14761.0,4
NDC,00904668961,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904669161,METFORMIN 1000 MG PO TABS,,,13270.0,14761.0,2
NDC,00904670561,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904670706,SEVELAMER CARBONATE 800 MG PO TABS,1934.4,1257.36,13270.0,14761.0,2
NDC,00904670782,SEVELAMER CARBONATE 800 MG PO TABS,6638.4,4314.96,13270.0,14761.0,4
NDC,00904670806,AZITHROMYCIN 250 MG PO TABS,920.8,598.52,13270.0,14761.0,4
NDC,00904670861,AZITHROMYCIN 250 MG PO TABS,3124.8,2031.12,13270.0,14761.0,4
NDC,00904671146,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,2
NDC,00904671761,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904671772,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904672059,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904672559,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,00904672580,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,00904672846,PSEUDOEPHEDRINE HCL 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00904672852,PSEUDOEPHEDRINE HCL 60 MG PO TABS,,,13270.0,14761.0,2
NDC,00904673061,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904673080,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904673204,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904673361,HALOPERIDOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904673870,ACETAMINOPHEN 160 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
NDC,00904676130,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,2
NDC,00904677361,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,00904677861,ROSUVASTATIN 5 MG PO TABS,1491.2,969.28,13270.0,14761.0,4
NDC,00904677961,Other Outpatient Services,2035.2,1322.88,,,0
NDC,00904678061,ROSUVASTATIN 20 MG PO TABS,1838.4,1194.96,13270.0,14761.0,4
NDC,00904678161,ROSUVASTATIN 40 MG PO TABS,1782.4,1158.56,13270.0,14761.0,4
NDC,00904678604,MYCOPHENOLATE SODIUM 360 MG PO TBEC,1465.56,952.61,13270.0,14761.0,4
NDC,00904678661,MYCOPHENOLATE SODIUM 360 MG PO TBEC,14553.6,9459.84,13270.0,14761.0,4
NDC,00904678744,MAGNESIUM CITRATE PO SOLN,,,13270.0,14761.0,2
NDC,00904679061,BENZTROPINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00904679104,MODAFINIL 100 MG PO TABS,4169.28,2710.03,13270.0,14761.0,2
NDC,00904679430,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,2
NDC,00904679480,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,2
NDC,00904679604,VALGANCICLOVIR 450 MG PO TABS,20592.96,13385.42,13270.0,14761.0,4
NDC,00904679761,LISINOPRIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904679861,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904679961,LISINOPRIL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904680061,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00904680161,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904680161,QUETIAPINE 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,00904680806,MONTELUKAST 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904680861,MONTELUKAST 10 MG PO TABS,464.0,301.6,13270.0,14761.0,4
NDC,00904681761,MIDODRINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904681861,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904682076,ACETAMINOPHEN 650 MG PO SOLN,,,13270.0,14761.0,2
NDC,00904682104,TENOFOVIR DISOPROXIL FUMARATE 300 MG PO TABS,1779.36,1156.58,13270.0,14761.0,4
NDC,00904682461,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904682561,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,596.8,387.92,13270.0,14761.0,4
NDC,00904682561,Other Outpatient Services,596.8,387.92,,,0
NDC,00904682805,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,00904683006,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904683061,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904683104,METAXALONE 800 MG PO TABS,2460.96,1599.62,13270.0,14761.0,2
NDC,00904683973,ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,00904685261,LORATADINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904686061,DIVALPROEX 250 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,00904686061,Other Outpatient Services,290.0,188.5,,,0
NDC,00904686161,DIVALPROEX 500 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,00904686190,Other Outpatient Services,434.88,282.67,,,0
NDC,00904686861,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00904686961,TRAZODONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904687045,PANTOPRAZOLE 40 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,00904687204,CLARITHROMYCIN 500 MG PO TABS,1452.48,944.11,13270.0,14761.0,4
NDC,00904687404,ABACAVIR 300 MG PO TABS,3876.0,2519.4,13270.0,14761.0,4
NDC,00904688210,PHYTONADIONE (VITAMIN K1) 5 MG PO TABS,21996.8,14297.92,13270.0,14761.0,4
NDC,00904688504,CARBAMAZEPINE 200 MG PO CM12,1465.56,952.61,13270.0,14761.0,2
NDC,00904688806,MINOCYCLINE 100 MG PO CAPS,855.2,555.88,13270.0,14761.0,4
NDC,00904690204,Other Outpatient Services,2984.16,1939.7,,,0
NDC,00904691461,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,00904692361,PREDNISONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,00904692661,SERTRALINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904692861,TOPIRAMATE 25 MG PO TABS,408.0,265.2,13270.0,14761.0,4
NDC,00904693061,POTASSIUM CHLORIDE 10 MEQ PO CPSR,,,13270.0,14761.0,2
NDC,00904693186,POLYETHYLENE GLYCOL 3350 17 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,00904693806,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904693961,Other Outpatient Services,1438.4,934.96,,,0
NDC,00904694961,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,00904696661,OXYCODONE 5 MG PO TABS,489.6,318.24,13270.0,14761.0,4
NDC,00904698640,GUAIFENESIN 600 MG PO TA12,,,13270.0,14761.0,2
NDC,00904698861,DICYCLOMINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904699104,PREGABALIN 25 MG PO CAPS,589.92,383.45,13270.0,14761.0,2
NDC,00904699161,PREGABALIN 25 MG PO CAPS,1155.2,750.88,13270.0,14761.0,4
NDC,00904699261,PREGABALIN 50 MG PO CAPS,1124.8,731.12,13270.0,14761.0,4
NDC,00904699361,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00904700061,PREGABALIN 75 MG PO CAPS,1145.6,744.64,13270.0,14761.0,4
NDC,00904700161,PREGABALIN 100 MG PO CAPS,1252.8,814.32,13270.0,14761.0,4
NDC,00904700761,LAMOTRIGINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904700861,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,00904702367,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,290.0,188.5,,,0
NDC,00904702367,Other Outpatient Services,290.0,188.5,,,0
NDC,00904702404,VORICONAZOLE 200 MG PO TABS,9846.24,6400.06,13270.0,14761.0,4
NDC,00904703807,CLOMIPRAMINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904704161,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904704206,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904704261,AMANTADINE HCL 100 MG PO CAPS,1931.2,1255.28,13270.0,14761.0,2
NDC,00904704304,DULOXETINE 20 MG PO CPDR,573.12,372.53,13270.0,14761.0,4
NDC,00904704461,DULOXETINE 30 MG PO CPDR,2136.0,1388.4,13270.0,14761.0,4
NDC,00904704461,Other Outpatient Services,2136.0,1388.4,,,0
NDC,00904704561,DULOXETINE 60 MG PO CPDR,1120.0,728.0,13270.0,14761.0,4
NDC,00904704761,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904704861,LOSARTAN 50 MG PO TABS,470.4,305.76,13270.0,14761.0,4
NDC,00904704961,Other Outpatient Services,1465.56,952.61,,,0
NDC,00904705761,METHOCARBAMOL 500 MG PO TABS,364.8,237.12,13270.0,14761.0,4
NDC,00904705861,METHOCARBAMOL 750 MG PO TABS,425.6,276.64,13270.0,14761.0,4
NDC,00904706441,ATOVAQUONE 750 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,00904707007,NADOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904707061,NADOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904707107,NADOLOL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00904707461,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,928.0,603.2,13270.0,14761.0,4
NDC,00904708361,CIPROFLOXACIN HCL 500 MG PO TABS,464.0,301.6,13270.0,14761.0,4
NDC,00904708661,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,00904709361,Other Outpatient Services,416.0,270.4,,,0
NDC,00904709561,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1785.6,1160.64,13270.0,14761.0,4
NDC,00904709761,Other Outpatient Services,1934.4,1257.36,,,0
NDC,00904709761,TACROLIMUS 1 MG PO CAPS,1934.4,1257.36,,,0
NDC,00904710561,CAPTOPRIL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904710661,CAPTOPRIL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904710961,LABETALOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904711061,LABETALOL 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00904711161,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,00904711561,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904712004,COLCHICINE 0.6 MG PO TABS,2145.6,1394.64,13270.0,14761.0,4
NDC,00904712361,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,00904712461,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904712661,METRONIDAZOLE 500 MG PO TABS,920.0,598.0,13270.0,14761.0,4
NDC,00904712761,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904713061,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904713961,METOLAZONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,00904714461,DRONABINOL 2.5 MG PO CAPS,2776.0,1804.4,13270.0,14761.0,4
NDC,00904715361,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904715661,METRONIDAZOLE 250 MG PO TABS,598.4,388.96,13270.0,14761.0,4
NDC,00904716261,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,00904716461,METFORMIN 1000 MG PO TABS,,,13270.0,14761.0,2
NDC,00904717761,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904717961,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,00904718061,OXYCODONE 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,00904718361,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904718761,ATENOLOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,00904718904,NEBIVOLOL 5 MG PO TABS,1252.32,814.01,13270.0,14761.0,2
NDC,00904719361,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,00904720061,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00904720660,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,00904722461,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,00904722504,NEBIVOLOL 2.5 MG PO TABS,1055.52,686.09,13270.0,14761.0,2
NDC,00904723661,MEGESTROL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,00904723761,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,00904724361,Other Outpatient Services,396.8,257.92,,,0
NDC,00904724468,LACOSAMIDE 50 MG PO TABS,1100.16,715.1,13270.0,14761.0,4
NDC,00904724768,LACOSAMIDE 200 MG PO TABS,2201.28,1430.83,13270.0,14761.0,4
NDC,00904725261,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,00904725761,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,00904726361,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,2
NDC,00904727641,NYSTATIN 100000 UNITS/ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,00904759060,FERROUS SULFATE 325 MG (65 MG IRON) PO TABS,,,13270.0,14761.0,2
NDC,00904759080,FERROUS SULFATE 325 MG (65 MG IRON) PO TABS,,,13270.0,14761.0,2
NDC,00904759161,FERROUS SULFATE 325 MG (65 MG IRON) PO TABS,,,13270.0,14761.0,2
NDC,00904772714,ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML PO SUSP,,,13270.0,14761.0,2
NDC,00904791461,IBUPROFEN 200 MG PO TABS,,,13270.0,14761.0,2
NDC,00904792760,BISACODYL 5 MG PO TBEC,,,13270.0,14761.0,2
NDC,00904880467,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,1465.56,952.61,,,0
NDC,00941040906,PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,512.0,332.8,13270.0,14761.0,4
NDC,00941040907,PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,960.0,624.0,13270.0,14761.0,4
NDC,00941045705,PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,960.0,624.0,13270.0,14761.0,2
NDC,00941045708,PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,640.0,416.0,13270.0,14761.0,2
NDC,00941045905,PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,800.0,520.0,13270.0,14761.0,2
NDC,00941045908,PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,512.0,332.8,13270.0,14761.0,2
NDC,00944265603,IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 GRAM IV SOLR,9731.54,6325.5,13270.0,14761.0,2
NDC,00944265804,IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR,12725.775000000001,8271.755000000001,61.88,14761.0,11
NDC,00944265908,IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR,10974.18,7133.215,61.88,14761.0,11
NDC,00944270002,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,1090.6,708.89,60.49,69.56,8
NDC,00955102208,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,00955105201,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,00955172801,INSULIN GLARGINE 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
NDC,00990613803,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,2
NDC,00990614109,PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IR SOLN,,,13270.0,14761.0,4
NDC,00990707426,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00990707514,POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00990707526,POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00990707714,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,00990707726,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,00990710709,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00990711109,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00990711509,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00990713936,"WATER FOR IRRIGATION, STERILE IR SOLN",,,13270.0,14761.0,2
NDC,00990771503,MANNITOL 20 % 20 % IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00990771513,MANNITOL 20 % 20 % IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00990790109,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00990790209,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00990790409,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,00990792202,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00990792261,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,2
NDC,00990792336,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00990792337,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,00990792402,DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00990792602,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
NDC,00990792909,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,4
NDC,00990793002,D10W PEDIATRIC HYPOGLYCEMIA,,,13270.0,14761.0,2
NDC,00990793002,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00990793003,D10W PEDIATRIC HYPOGLYCEMIA,,,13270.0,14761.0,2
NDC,00990793003,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,2
NDC,00990793003,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00990793009,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,2
NDC,00990793519,DEXTROSE 20 % IN WATER (D20W) 20 % IV SOLP,,,13270.0,14761.0,4
NDC,00990793619,DEXTROSE 50 % IN WATER (D50W) IV SOLP BAG,,,13270.0,14761.0,2
NDC,00990798108,SORBITOL-MANNITOL 2.7-0.54 GRAM/100 ML TUT SOLN,,,13270.0,14761.0,2
NDC,00990798209,RINGER'S IV SOLP,,,13270.0,14761.0,2
NDC,00990798302,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00990798361,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00990798423,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00990798436,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,00990798436,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,2
NDC,00990798436,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,00990799009,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,2
NDC,00990799309,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
NDC,00998040815,ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,4
NDC,00998063006,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OP DRPS",1465.56,952.61,13270.0,14761.0,4
NDC,01320007924,GLYCERIN (ADULT) PR SUPP,,,13270.0,14761.0,2
NDC,01320030140,MINERAL OIL PR ENEM,,,13270.0,14761.0,2
NDC,01671435875,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,03700003230,BISMUTH SUBSALICYLATE 262 MG/15 ML PO SUSP,,,13270.0,14761.0,2
NDC,04142000007,SACCHAROMYCES BOULARDII 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,05038382310,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,05038382320,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,05047450858,SODIUM HYALURONATE 10 MG/ML IO SYRG,1465.56,952.61,,,0
NDC,05388000924,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,05388000927,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO CAPS,,,13270.0,14761.0,2
NDC,05388062777,ALPHA LIPOIC ACID 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,06253000010,UREA 15 GRAM PO PWPK,,,13270.0,14761.0,4
NDC,06330424101,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,2
NDC,06332361701,MILRINONE 1 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,06332364907,LEVOTHYROXINE 100 MCG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,06586249610,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,06586249620,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,07610012012,ALPHA LIPOIC ACID 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,07610017840,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,07610060512,5-HYDROXYTRYPTOPHAN (5-HTP) 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,08065183055,SODIUM HYALURONATE 10 MG/ML IO SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,08290306413,"HEPARIN, PORCINE (PF) 10 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,08290306424,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,08290306513,HEPARIN BOLUS INJECTION-PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
NDC,08290306513,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",20482.8,13313.82,,,0
NDC,08290306515,HEPARIN BOLUS INJECTION-PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
NDC,08290306515,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",20482.8,13313.82,,,0
NDC,08290306545,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,2
NDC,08290306546,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,2
NDC,08290306547,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,2
NDC,08290306553,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,2
NDC,08489800001,SALIVA SUBSTITUTE COMBO NO.2 MM SOLN,,,13270.0,14761.0,2
NDC,09999907700,HEPARIN (PORCINE) IN NACL 1000 UNITS/500ML NS FOR CONGENITAL HEART ECMO FLUSH FROM BAG,1465.56,952.61,13270.0,14761.0,2
NDC,09999999815,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.15 % EP SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,10006070013,MAGNESIUM CHLORIDE 64 MG PO TBEC,,,13270.0,14761.0,2
NDC,10006070022,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,10006070028,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) PO TABS,,,13270.0,14761.0,2
NDC,10006070038,CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,10006073013,FERROUS SULFATE 140 MG (45 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,10006073017,PYRIDOXINE (VITAMIN B6) 50 MG PO TABS,,,13270.0,14761.0,2
NDC,10006073028,MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,10006073043,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,10019009701,TREPROSTINIL DIOLAMINE 1 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,10019055303,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,1897.76,1233.54,,,0
NDC,10019055390,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,290.0,188.5,13270.0,14761.0,4
NDC,10019092501,IFOSFAMIDE 1 GRAM IV SOLR,433.12,281.53,13270.0,14761.0,2
NDC,10019092582,IFOSFAMIDE 1 GRAM IV SOLR,433.12,281.53,13270.0,14761.0,2
NDC,10019092602,IFOSFAMIDE 3 GRAM IV SOLR,1282.08,833.35,13270.0,14761.0,2
NDC,10019092616,IFOSFAMIDE 3 GRAM IV SOLR,1282.08,833.35,13270.0,14761.0,2
NDC,10019095301,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,10019095362,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,10019095501,CYCLOPHOSPHAMIDE 500 MG IV SOLR,867.52,563.89,13270.0,14761.0,2
NDC,10019095550,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1127.84,733.1,13270.0,14761.0,2
NDC,10019095601,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1764.16,1146.7,13270.0,14761.0,2
NDC,10019095616,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1764.16,1146.7,,,0
NDC,10019095701,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,4771.84,3101.7,,,0
NDC,10019095711,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,4771.84,3101.7,13270.0,14761.0,2
NDC,10094020501,CLOBAZAM 5 MG PO FILM,1465.56,952.61,13270.0,14761.0,2
NDC,10119000252,SOD BORATE-BORIC AC-NACL-WATER OP IRSL,290.0,188.5,,,0
NDC,10119002219,PROPYLENE GLYCOL-GLYCERIN 0.6-0.6 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,10119053708,BRIMONIDINE 0.025 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,10122051001,PORACTANT ALFA 240 MG/3 ML ITL SUSP,8326.08,5411.95,13270.0,14761.0,6
NDC,10122051003,PORACTANT ALFA 240 MG/3 ML ITL SUSP,16198.08,10528.75,13270.0,14761.0,6
NDC,10122062001,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,23.44,14761.0,13
NDC,10122062010,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,23.44,14761.0,13
NDC,10122090112,ZILEUTON 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,10135011101,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,10135053201,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,10135060290,FELBAMATE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,10135062101,PHENAZOPYRIDINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,10135067181,CLOTRIMAZOLE 1 % TP SOLN,290.0,188.5,13270.0,14761.0,2
NDC,10135068101,GUAIFENESIN 200 MG PO TABS,,,13270.0,14761.0,2
NDC,10135073501,PYRAZINAMIDE 500 MG PO TABS,,,13270.0,14761.0,2
NDC,10144034201,LEVODOPA 42 MG IN CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,10144042760,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,10147075005,KETOCONAZOLE 2 % TP SHAM,1465.56,952.61,13270.0,14761.0,2
NDC,10147092205,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,735.68,478.19,13270.0,14761.0,2
NDC,10147170003,ITRACONAZOLE 100 MG PO CAPS,3319.2,2157.48,13270.0,14761.0,2
NDC,10310028313,BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MM GEL,290.0,188.5,13270.0,14761.0,4
NDC,10361077831,BARIUM SULFATE 700 MG PO TABS,,,13270.0,14761.0,2
NDC,10361079301,SOD BICARB-CITRIC AC-SIMETH 2.21-1.53 GRAM/4 GRAM PO GREP,,,13270.0,14761.0,2
NDC,10370017511,FLUVOXAMINE 100 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,10370017611,FLUVOXAMINE 150 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,10370017611,Other Outpatient Services,1465.56,952.61,,,0
NDC,10370022111,TRAMADOL 100 MG PO TM24,1465.56,952.61,13270.0,14761.0,2
NDC,10370036811,TOPIRAMATE 200 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,10454071110,RIMABOTULINUMTOXINB 5000 UNITS/ML IM SOLN,6350.8,4128.02,16.17,18.6,8
NDC,10572010001,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,320.0,208.0,13270.0,14761.0,2
NDC,10695004305,NALTREXONE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,10702000301,PROMETHAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,10702000750,CYCLOBENZAPRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,10702007601,METHYLPHENIDATE HCL 20 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,10702018401,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,2430.4,1579.76,13270.0,14761.0,4
NDC,10702020101,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,10702025301,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,10782010130,PRENATAL 25-IRON-FOLATE 6-DHA 30 MG IRON-1MG -200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,10782019830,PRENATAL71-IRON-FOLIC ACID-DHA 30-1.4-200 MG PO CPID,1465.56,952.61,13270.0,14761.0,2
NDC,10782029860,PRENATAL 105-IRON-FOLIC AC-DHA 30 MG IRON- 1.4 MG-300 MG PO CMPK,1465.56,952.61,13270.0,14761.0,2
NDC,10939028233,CALCIUM CARBONATE-VIT D3-MIN 600 MG CALCIUM- 400 UNIT PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,10939031944,CALCIUM-MAGNESIUM-ZINC 333-133-8.3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,10939037733,LYSINE 500 MG PO TABS,,,13270.0,14761.0,2
NDC,10939037933,MICONAZOLE NITRATE 2 % VA CREA,290.0,188.5,13270.0,14761.0,4
NDC,10939041433,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,2
NDC,10939045944,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,2
NDC,10939055633,PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TP SHAM,,,13270.0,14761.0,2
NDC,10939056433,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,10939056833,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",290.0,188.5,13270.0,14761.0,4
NDC,10939060244,SIMETHICONE 40 MG/0.6 ML PO DRPS,,,13270.0,14761.0,2
NDC,10939076644,MINERAL OIL PR ENEM,,,13270.0,14761.0,2
NDC,10939084844,CAFFEINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,10939090844,MAGNESIUM CITRATE PO SOLN,,,13270.0,14761.0,2
NDC,10939095368,FERROUS SULFATE 142 MG (45 MG IRON) PO TBSR,1465.56,952.61,,,0
NDC,11523716202,LORATADINE-PSEUDOEPHEDRINE 5-120 MG PO TB12,,,13270.0,14761.0,2
NDC,11523723401,POLYETHYLENE GLYCOL 3350 17 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,11523726501,OMEPRAZOLE-SODIUM BICARBONATE 20-1.1 MG-GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11523726808,POLYETHYLENE GLYCOL 3350 17 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,11534016503,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,11704037001,HYDROXOCOBALAMIN 5 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,11822054306,CYANOCOBALAMIN (VITAMIN B-12) 5000 MCG SL SUBL,1465.56,952.61,13270.0,14761.0,2
NDC,11822300120,ASCORBIC ACID-MULTIVIT-MIN 1000 MG PO PWEP,1465.56,952.61,13270.0,14761.0,2
NDC,11822574300,ACETAMINOPHEN-CAFFEINE 500-65 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11822576030,MAGNESIUM OXIDE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11822989420,GLUCOSE PO CHEW,,,13270.0,14761.0,2
NDC,11845006011,VITAMIN B COMPLEX PO CAPS,,,13270.0,14761.0,2
NDC,11845007791,PHYTONADIONE (VITAMIN K1) 100 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11845009611,MAGNESIUM 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11845012771,IRON 18 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11845014108,COENZYME Q10 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11845015661,CYANOCOBALAMIN (VITAMIN B-12) 200 MCG/SPRAY SL SPSN,1465.56,952.61,13270.0,14761.0,2
NDC,11845016238,"CHOLECALCIFEROL (VITAMIN D3) 250 MCG (10,000 UNIT) PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,11845016325,BIOTIN 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11845016799,BIOTIN 10000 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11845017228,ALPHA LIPOIC ACID 600 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11845070801,SELENIUM 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,11845076001,ACETAMINOPHEN 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11917007914,Other Outpatient Services,1465.56,952.61,,,0
NDC,11917010715,BIOTIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11917012639,MENTHOL 16 % TP LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,11917014218,COQ10 (UBIQUINOL) 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11917014722,DOCOSAHEXAENOIC ACID 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,11917015136,S-ADENOSYLMETHIONINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,11917017735,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/DROP (400 UNIT/DROP) PO DROP,1465.56,952.61,13270.0,14761.0,2
NDC,11917018412,CALCIUM-VITAMIN D3-VITAMIN K 650 MG-12.5 MCG-40 MCG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,11980017405,PREDNISOLONE ACETATE 0.12 % OP DRPS,2391.04,1554.18,13270.0,14761.0,2
NDC,11980018005,PREDNISOLONE ACETATE 1 % OP DRPS,1936.8,1258.92,,,0
NDC,11980077905,Other Outpatient Services,1465.56,952.61,,,0
NDC,11994000602,BICISATE DIHYDROCHLORIDE (TC-99M) (NEUROLITE) ISOTOPE (NUC ME),1.01,0.65,851.46,14761.0,13
NDC,11994001101,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,20482.8,13313.82,13270.0,14761.0,2
NDC,11994001116,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,,,13270.0,14761.0,2
NDC,11994009001,SODIUM PERTECHNETATE (TC-99M O4) ISOTOPE (NUC MED),1.01,0.65,,,0
NDC,11994012106,GALLIUM (GA-67) CITRATE ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
NDC,12496075705,BUPRENORPHINE HCL 0.3 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,12496120201,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,13270.0,14761.0,2
NDC,12496120801,BUPRENORPHINE-NALOXONE 8-2 MG SL FILM,1465.56,952.61,13270.0,14761.0,2
NDC,12546062380,MENTHOL 3.2 MG MM LOZG,,,13270.0,14761.0,2
NDC,12546062749,MENTHOL 5.8 MG MM LOZG,,,13270.0,14761.0,2
NDC,12547017021,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,12547078020,MINOXIDIL 2 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,12843053637,ASPIRIN 81 MG PO TBEC,,,13270.0,14761.0,2
NDC,12843055519,ACETAMINOPHEN-CAFF-PYRILAMINE 500-60-15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,12870000101,SILVER NITRATE APPLICATORS 75-25 % TP STCK,,,13270.0,14761.0,2
NDC,12870000102,SILVER NITRATE APPLICATORS 75-25 % TP STCK,,,13270.0,14761.0,2
NDC,13107000130,MIRTAZAPINE 7.5 MG PO TABS,,,13270.0,14761.0,2
NDC,13107000334,MIRTAZAPINE 30 MG PO TABS,,,13270.0,14761.0,2
NDC,13107003105,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,13107003134,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,13107006801,AMPHETAMINE-DEXTROAMPHETAMINE 5 MG PO HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,2
NDC,13107007001,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,13107008301,LORAZEPAM 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,13107008301,Other Outpatient Services,1465.56,952.61,,,0
NDC,13517011301,PHENOBARBITAL 97.2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,13533031801,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,10044.16,6528.7,358.25,411.99,8
NDC,13533031805,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,50220.8,32643.52,358.25,14761.0,11
NDC,13533031850,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,10974.18,7133.215,358.25,14761.0,11
NDC,13533060521,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT IV SOLR,35241.28,22906.83,4.8,14761.0,3
NDC,13533063402,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,724.42,14761.0,5
NDC,13533063420,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,724.42,14761.0,10
NDC,13533070511,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG IV SOLR,5700.0,3705.0,6.15,7.07,8
NDC,13533080020,IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) IJ SOLN,5598.0,3638.7,60.77,69.89,8
NDC,13533080021,IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) IJ SOLN,20482.8,13313.82,60.77,69.89,8
NDC,13533080024,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,22392.0,14554.8,60.77,69.89,8
NDC,13533080025,IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) IJ SOLN,22392.0,14554.8,60.77,69.89,8
NDC,13533080040,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,44784.0,29109.6,60.77,69.89,8
NDC,13533080041,IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) IJ SOLN,44784.0,29109.6,60.77,69.89,8
NDC,13533080071,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,14554.8,9460.619999999999,60.77,14761.0,11
NDC,13533080072,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,14554.8,9460.619999999999,60.77,14761.0,11
NDC,13668000801,Other Outpatient Services,1465.56,952.61,,,0
NDC,13668000801,ZOLPIDEM 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,13668000901,CITALOPRAM 10 MG PO TABS,,,13270.0,14761.0,2
NDC,13668001001,CITALOPRAM 20 MG PO TABS,,,13270.0,14761.0,2
NDC,13668001005,CITALOPRAM 20 MG PO TABS,,,13270.0,14761.0,2
NDC,13668001101,CITALOPRAM 40 MG PO TABS,,,13270.0,14761.0,2
NDC,13668010390,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,13668010501,ISOSORBIDE MONONITRATE 60 MG PO TB24,,,13270.0,14761.0,2
NDC,13668010601,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,2
NDC,13668010730,RABEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,13668010960,DULOXETINE 20 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,13668011130,DULOXETINE 60 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,13668019090,TOLTERODINE 4 MG PO CP24,1342.08,872.35,13270.0,14761.0,4
NDC,13668021830,ARIPIPRAZOLE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,13668021890,ARIPIPRAZOLE 10 MG PO TABS,312.48,203.11,13270.0,14761.0,2
NDC,13668058130,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,663.36,431.18,13270.0,14761.0,2
NDC,13668058630,ERYTHROMYCIN 250 MG PO TBEC,2220.0,1443.0,13270.0,14761.0,2
NDC,13668060701,ERYTHROMYCIN 500 MG PO TABS,6902.4,4486.56,13270.0,14761.0,2
NDC,13845120202,CYCLOSERINE 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,13913000419,GABAPENTIN 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,13913000519,GABAPENTIN 600 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,13925051501,PENTAMIDINE 300 MG IJ SOLR,1536.72,998.87,13270.0,14761.0,2
NDC,13925052201,PENTAMIDINE 300 MG IN SOLR,2013.6,1308.84,13270.0,14761.0,4
NDC,14537096775,DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML MISC SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,14789001505,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,2012.48,1308.11,13270.0,14761.0,2
NDC,14789001507,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,2012.48,1308.11,13270.0,14761.0,2
NDC,14789010407,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,14789010708,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,354.4,230.36,13270.0,14761.0,2
NDC,14789010808,POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML IV PGBK,354.4,230.36,13270.0,14761.0,2
NDC,14789010916,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,521.6,339.04,13270.0,14761.0,4
NDC,14789011008,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,14789011605,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,1043.52,678.29,13270.0,14761.0,2
NDC,14789012107,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,14789060007,ARSENIC TRIOXIDE 1 MG/ML IV SOLN,4654.88,3025.67,8.96,14761.0,3
NDC,14789060010,ARSENIC TRIOXIDE 1 MG/ML IV SOLN,4654.88,3025.67,8.96,10.31,8
NDC,15054004301,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,26154.0,17000.1,80.64,14761.0,11
NDC,15054050001,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,8590.0,5583.5,10.75,12.36,8
NDC,15054053006,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,20482.8,13313.82,10.75,12.36,8
NDC,15054112004,LANREOTIDE 120 MG/0.5 ML SC SYRG,86058.0,55937.7,62.22,14761.0,11
NDC,15718091730,LIGHT MINERAL OIL-MIN OIL (PF) 0.5-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,16500008619,PEDIATRIC MULTIVITAMIN PO CHEW,,,13270.0,14761.0,2
NDC,16500050056,"SODIUM BICARBONATE-CITRIC ACID 1,940-1,000 MG PO TBEF",1465.56,952.61,13270.0,14761.0,2
NDC,16571040110,CETIRIZINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,16571060096,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,16571066801,PHENOBARBITAL 97.2 MG PO TABS,326.4,212.16,13270.0,14761.0,2
NDC,16571072906,LACTO NO.76-BIFIDO-FOS-LARCH 25B CELL-25B CELL-50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,16571073706,PROPAFENONE 325 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,16571076209,LEVOCARNITINE 330 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16571077909,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,4
NDC,16571078001,CARISOPRODOL 250 MG PO TABS,2236.8,1453.92,13270.0,14761.0,2
NDC,16571081320,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO CAPS,,,13270.0,14761.0,2
NDC,16714000101,DOXORUBICIN 2 MG/ML IV SOLN,411.2,267.28,13270.0,14761.0,2
NDC,16714000601,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714000701,ISOSORBIDE DINITRATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,16714000801,ISOSORBIDE DINITRATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714001401,Other Outpatient Services,1465.56,952.61,,,0
NDC,16714001402,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,1452.8,944.32,13270.0,14761.0,4
NDC,16714001601,ENOXAPARIN 40 MG/0.4 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714001905,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,13270.0,14761.0,4
NDC,16714002601,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714003401,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,16714003501,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,16714003601,ENOXAPARIN 80 MG/0.8 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714003701,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,16714003902,COLCHICINE 0.6 MG PO TABS,6222.4,4044.56,13270.0,14761.0,2
NDC,16714004110,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,16714004211,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,16714004301,VENLAFAXINE 37.5 MG PO CP24,424.8,276.12,13270.0,14761.0,4
NDC,16714004401,VENLAFAXINE 75 MG PO CP24,491.04,319.18,13270.0,14761.0,4
NDC,16714004601,ENOXAPARIN 100 MG/ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714005601,ENOXAPARIN 120 MG/0.8 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714005901,FEBUXOSTAT 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714006001,FEBUXOSTAT 80 MG PO TABS,303.36,197.18,13270.0,14761.0,2
NDC,16714006601,ENOXAPARIN 150 MG/ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16714007001,FULVESTRANT 250 MG/5 ML IM SYRG,1129.52,734.19,9.35,10.75,8
NDC,16714007002,FULVESTRANT 250 MG/5 ML IM SYRG,1129.52,734.19,9.35,14761.0,11
NDC,16714007104,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714007501,TADALAFIL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714008110,HYDROXYZINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714008210,HYDROXYZINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,16714010102,GEMFIBROZIL 600 MG PO TABS,,,13270.0,14761.0,2
NDC,16714011001,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,16714011501,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,290.0,188.5,13270.0,14761.0,2
NDC,16714012801,CHLORTHALIDONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,16714013001,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,16714013701,PACLITAXEL 6 MG/ML IV CONC,470.4,305.76,,,0
NDC,16714014101,ARIPIPRAZOLE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714014201,ARIPIPRAZOLE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714014401,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714015701,PROGESTERONE MICRONIZED 100 MG PO CAPS,,,13270.0,14761.0,4
NDC,16714015901,ONDANSETRON HCL 4 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,16714016501,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16714017301,ATORVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16714017602,ATORVASTATIN 80 MG PO TABS,832.0,540.8,13270.0,14761.0,4
NDC,16714019501,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714020010,ONDANSETRON 4 MG PO TBDL,290.0,188.5,13270.0,14761.0,6
NDC,16714020030,ONDANSETRON 4 MG PO TBDL,290.0,188.5,13270.0,14761.0,2
NDC,16714020110,ONDANSETRON 8 MG PO TBDL,20482.8,13313.82,,,0
NDC,16714022701,CARVEDILOL PHOSPHATE 10 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,16714023401,PENICILLIN V POTASSIUM 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714024801,FOSAPREPITANT 150 MG IV SOLR,309.88,201.42000000000002,13270.0,14761.0,2
NDC,16714025701,AMITRIPTYLINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714029702,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16714029801,AMOXICILLIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,16714029903,AMOXICILLIN 500 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,16714030901,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,16714034704,NORETHINDRONE-ETHIN ESTRADIOL 0.4-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,16714035401,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,16714035502,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,16714035801,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,16714036501,NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,16714039101,CEFDINIR 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,16714039102,CEFDINIR 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,16714039201,CEFDINIR 125 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
NDC,16714040002,CEFUROXIME AXETIL 250 MG PO TABS,764.16,496.7,13270.0,14761.0,2
NDC,16714040102,CEFUROXIME AXETIL 500 MG PO TABS,1302.72,846.77,13270.0,14761.0,4
NDC,16714041601,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714043901,NITROFURANTOIN 100 MG PO CAPS,1910.4,1241.76,13270.0,14761.0,4
NDC,16714044201,ENALAPRIL MALEATE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714044301,ENALAPRIL MALEATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714044401,ENALAPRIL MALEATE 10 MG PO TABS,761.6,495.04,13270.0,14761.0,4
NDC,16714044501,ENALAPRIL MALEATE 20 MG PO TABS,673.6,437.84,13270.0,14761.0,4
NDC,16714045201,QUETIAPINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714045301,QUETIAPINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714045302,QUETIAPINE 50 MG PO TABS,3376.0,2194.4,13270.0,14761.0,4
NDC,16714045401,QUETIAPINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16714045501,QUETIAPINE 200 MG PO TABS,963.2,626.08,13270.0,14761.0,4
NDC,16714045601,QUETIAPINE 300 MG PO TABS,340.8,221.52,13270.0,14761.0,4
NDC,16714047701,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714047802,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,2244.8,1459.12,13270.0,14761.0,4
NDC,16714049601,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,16714052601,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,16714053601,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16714053625,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16714055901,PRAVASTATIN 20 MG PO TABS,308.16,200.3,13270.0,14761.0,4
NDC,16714057602,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,16714057702,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,16714059001,DIGOXIN 125 MCG (0.125 MG) PO TABS,,,13270.0,14761.0,2
NDC,16714059101,DIGOXIN 250 MCG (0.25 MG) PO TABS,,,13270.0,14761.0,4
NDC,16714061104,SERTRALINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,16714061205,SERTRALINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,16714061305,SERTRALINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,16714062201,ZOLPIDEM 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714063102,ALENDRONATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714063201,ALENDRONATE 35 MG PO TABS,,,13270.0,14761.0,4
NDC,16714065601,VENLAFAXINE 37.5 MG PO TABS,316.8,205.92,13270.0,14761.0,4
NDC,16714065701,VENLAFAXINE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16714065801,VENLAFAXINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16714066101,GABAPENTIN 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,16714066201,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,16714066302,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,2
NDC,16714067401,FLUPHENAZINE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,16714068102,SIMVASTATIN 5 MG PO TABS,,,13270.0,14761.0,2
NDC,16714068202,SIMVASTATIN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714068302,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,2
NDC,16714068303,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,2
NDC,16714068501,SIMVASTATIN 80 MG PO TABS,,,13270.0,14761.0,2
NDC,16714069302,FLUCONAZOLE 200 MG PO TABS,1931.2,1255.28,13270.0,14761.0,4
NDC,16714069401,FLUCONAZOLE 50 MG PO TABS,322.08,209.35,13270.0,14761.0,4
NDC,16714069803,VALACYCLOVIR 500 MG PO TABS,514.08,334.15,13270.0,14761.0,4
NDC,16714070101,LAMOTRIGINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714070301,LAMOTRIGINE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16714071701,ENTECAVIR 0.5 MG PO TABS,964.32,626.81,13270.0,14761.0,4
NDC,16714073302,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,16714074201,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",2512.48,1633.11,165.71,14761.0,3
NDC,16714074302,ITRACONAZOLE 100 MG PO CAPS,1166.88,758.47,13270.0,14761.0,4
NDC,16714075901,ATOMOXETINE 60 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,16714076901,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,4
NDC,16714077101,RASAGILINE 1 MG PO TABS,3444.48,2238.91,13270.0,14761.0,2
NDC,16714078001,EZETIMIBE-SIMVASTATIN 10-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714079501,TERBINAFINE HCL 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16714079601,SUMATRIPTAN SUCCINATE 25 MG PO TABS,,,13270.0,14761.0,4
NDC,16714079701,SUMATRIPTAN SUCCINATE 50 MG PO TABS,,,13270.0,14761.0,4
NDC,16714079801,SUMATRIPTAN SUCCINATE 100 MG PO TABS,,,13270.0,14761.0,4
NDC,16714079903,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16714081303,EZETIMIBE 10 MG PO TABS,2168.0,1409.2,13270.0,14761.0,4
NDC,16714081401,SEVELAMER CARBONATE 800 MG PO TABS,1334.88,867.67,13270.0,14761.0,4
NDC,16714081501,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,16714081601,BICALUTAMIDE 50 MG PO TABS,315.36,204.98,13270.0,14761.0,2
NDC,16714081602,BICALUTAMIDE 50 MG PO TABS,1051.2,683.28,13270.0,14761.0,4
NDC,16714082101,METHYLPHENIDATE HCL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714082901,BUDESONIDE 3 MG PO CECX,3268.8,2124.72,13270.0,14761.0,4
NDC,16714083001,MESALAMINE 1.2 GRAM PO TBEC,,,13270.0,14761.0,4
NDC,16714083401,PALONOSETRON 0.25 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16714084001,DOFETILIDE 125 MCG PO CAPS,4803.84,3122.5,13270.0,14761.0,2
NDC,16714084101,DOFETILIDE 250 MCG PO CAPS,4885.44,3175.54,13270.0,14761.0,2
NDC,16714085201,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,16714085301,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,16714085401,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,2
NDC,16714085701,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1702.4,1106.56,13270.0,14761.0,2
NDC,16714085801,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,2505.92,1628.85,13270.0,14761.0,2
NDC,16714085901,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1364.32,886.81,13270.0,14761.0,2
NDC,16714086201,ATAZANAVIR 300 MG PO CAPS,15179.52,9866.69,13270.0,14761.0,2
NDC,16714087801,LIDOCAINE 5 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,16714088601,BLEOMYCIN 15 UNITS IJ SOLR,298.56,194.06,13270.0,14761.0,2
NDC,16714088701,CLOBAZAM 10 MG PO TABS,708.8,460.72,13270.0,14761.0,2
NDC,16714089201,DAPTOMYCIN 500 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,16714089701,PERMETHRIN 5 % TP CREA,301.44,195.94,13270.0,14761.0,4
NDC,16714089901,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,2
NDC,16714090601,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,16714090702,ALBENDAZOLE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16714090801,BLEOMYCIN 30 UNITS IJ SOLR,737.44,479.34,,,0
NDC,16714090901,GEMCITABINE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,16714093001,GEMCITABINE 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,16714095001,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,542.4,352.56,13270.0,14761.0,2
NDC,16714096401,ASPIRIN-DIPYRIDAMOLE 25-200 MG PO CM12,834.24,542.26,13270.0,14761.0,2
NDC,16714098002,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,2
NDC,16714098801,ROSUVASTATIN 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714098901,ROSUVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714099001,ROSUVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714099101,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16714099601,BETAMETHASONE DIPROPIONATE 0.05 % TP CREA,,,13270.0,14761.0,2
NDC,16729000301,GLIMEPIRIDE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,16729000515,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,2
NDC,16729000615,SIMVASTATIN 40 MG PO TABS,,,13270.0,14761.0,2
NDC,16729000815,PRAVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16729000915,PRAVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729002115,PIOGLITAZONE 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16729003410,LETROZOLE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729003510,ANASTROZOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16729003515,ANASTROZOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729004201,TACROLIMUS 1 MG PO CAPS,747.2,485.68,13270.0,14761.0,2
NDC,16729004515,ATORVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16729006712,LEVETIRACETAM 1000 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16729007329,CAPECITABINE 500 MG PO TABS,983.04,638.98,13270.0,14761.0,2
NDC,16729007901,CARBIDOPA-LEVODOPA 50-200 MG PO TBSR,,,13270.0,14761.0,2
NDC,16729008910,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16729008915,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16729009401,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,16729010811,MITOMYCIN 20 MG IV SOLR,2471.68,1606.59,52.93,14761.0,11
NDC,16729011408,ETOPOSIDE 20 MG/ML IV SOLN,728.0,473.2,13270.0,14761.0,2
NDC,16729011411,ETOPOSIDE 20 MG/ML IV SOLN,20482.8,13313.82,,,0
NDC,16729011431,ETOPOSIDE 20 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729011505,MITOMYCIN 5 MG IV SOLR,3263.84,2121.5,52.93,14761.0,11
NDC,16729013401,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,16729013800,CLONAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729015131,TOPOTECAN 4 MG IV SOLR,2086.88,1356.47,13270.0,14761.0,2
NDC,16729015401,RAMIPRIL 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,16729016801,ESCITALOPRAM OXALATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16729016901,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,16729018301,HYDROCHLOROTHIAZIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,16729018401,HYDROCHLOROTHIAZIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,16729020301,BUSPIRONE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,16729022361,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR,12017.88,7811.62,40.11,46.12,8
NDC,16729022405,DECITABINE 50 MG IV SOLR,1490.56,968.86,13270.0,14761.0,2
NDC,16729022903,PEMETREXED DISODIUM 100 MG IV SOLR,1506.24,979.06,5.21,14761.0,11
NDC,16729023011,PEMETREXED DISODIUM 500 MG IV SOLR,1956.8,1271.92,5.21,14761.0,11
NDC,16729023930,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729023993,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,,,0
NDC,16729026129,MYCOPHENOLATE SODIUM 180 MG PO TBEC,328.32,213.41,13270.0,14761.0,2
NDC,16729026763,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,402.56,261.66,13270.0,14761.0,2
NDC,16729026764,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,1368.51,889.53,,,0
NDC,16729026765,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,16729027210,PRASUGREL 5 MG PO TABS,396.0,257.4,13270.0,14761.0,2
NDC,16729027310,PRASUGREL 10 MG PO TABS,396.0,257.4,13270.0,14761.0,2
NDC,16729027605,FLUOROURACIL 1 GRAM/20 ML IV SOLN,369.6,240.24,,,0
NDC,16729027611,FLUOROURACIL 2.5 GRAM/50 ML IV SOLN,442.4,287.56,,,0
NDC,16729027638,FLUOROURACIL 5 G/100 ML IV SOLN,884.8,575.12,13270.0,14761.0,2
NDC,16729027703,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,16729027730,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,16729027735,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,309.12,200.93,13270.0,14761.0,4
NDC,16729027810,ARIPIPRAZOLE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729028110,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,16729028110,Other Outpatient Services,290.0,188.5,,,0
NDC,16729028710,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,16729028811,CISPLATIN 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729028838,CISPLATIN 1 MG/ML IV SOLN,380.8,247.52,13270.0,14761.0,2
NDC,16729029212,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,16729029512,CARBOPLATIN 10 MG/ML IV SOLN,655.68,426.19,,,0
NDC,16729029531,CARBOPLATIN 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729029533,CARBOPLATIN 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729029534,CARBOPLATIN 10 MG/ML IV SOLN,298.8,194.22,13270.0,14761.0,2
NDC,16729029805,ONDANSETRON HCL 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729032115,OLMESARTAN 20 MG PO TABS,1465.56,952.61,,,0
NDC,16729033205,OXALIPLATIN 100 MG/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,16729036403,TIGECYCLINE 50 MG IV SOLR,476.37,309.64,13270.0,14761.0,2
NDC,16729037210,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,16729041501,DOXAZOSIN 8 MG PO TABS,,,13270.0,14761.0,2
NDC,16729041712,DIMETHYL FUMARATE 240 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,16729043316,EZETIMIBE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,16729043405,DAPTOMYCIN 350 MG IV SOLR,730.56,474.86,13270.0,14761.0,2
NDC,16729044010,CINACALCET 30 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,16729044110,CINACALCET 60 MG PO TABS,432.0,280.8,13270.0,14761.0,4
NDC,16729044210,CINACALCET 90 MG PO TABS,581.28,377.83,13270.0,14761.0,4
NDC,16729044310,BUPROPION HCL 150 MG PO TB24,290.0,188.5,13270.0,14761.0,4
NDC,16729044715,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729044815,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729044915,LEVOTHYROXINE 75 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045015,LEVOTHYROXINE 88 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045115,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045215,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045315,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045415,LEVOTHYROXINE 137 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045515,LEVOTHYROXINE 150 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045615,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729045715,LEVOTHYROXINE 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,16729047163,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,16729048403,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,16729049212,DOFETILIDE 500 MCG PO CAPS,1431.36,930.38,13270.0,14761.0,2
NDC,16729051205,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,16729054235,FLUOROURACIL 5 % TP CREA,1534.72,997.57,,,0
NDC,16729054910,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,290.0,188.5,13270.0,14761.0,4
NDC,16729055010,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,596.16,387.5,13270.0,14761.0,4
NDC,16837085550,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,16864068001,BENZOCAINE-MENTHOL 20-0.5 % TP AERO,290.0,188.5,13270.0,14761.0,2
NDC,16864068002,BENZOCAINE-MENTHOL 20-0.5 % TP AERO,1465.56,952.61,13270.0,14761.0,4
NDC,16864068003,BENZOCAINE-MENTHOL 20-0.5 % TP AERO,290.0,188.5,13270.0,14761.0,4
NDC,17139061740,ESTRADIOL 1.25 GRAM/ACTUATION TD GLPM,1465.56,952.61,13270.0,14761.0,2
NDC,17156021001,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,1.01,0.65,1728.35,1987.6,8
NDC,17156023501,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN,1.01,0.65,2583.53,14761.0,13
NDC,17156025108,PENTETATE INDIUM DISOD. IN-111 1.5 MCI/1.5 ML IT SOLN,1.01,0.65,890.67,14761.0,10
NDC,17238090099,FLUORESCEIN 1 MG OP STRP,,,13270.0,14761.0,2
NDC,17433000001,DOCUSATE SODIUM-BENZOCAINE 283-20 MG/5 ML PR ENEM,1465.56,952.61,13270.0,14761.0,2
NDC,17478003002,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,17478004532,TETRACAINE HCL (PF) 1 % (10 MG/ML) IJ SOLN,1075.46,699.05,,,0
NDC,17478005001,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,17478005002,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,17478006235,WHITE PETROLATUM-MINERAL OIL 83-15 % OP OINT,,,13270.0,14761.0,2
NDC,17478006412,HYPROMELLOSE 2.5 % OP DROP,1465.56,952.61,,,0
NDC,17478006702,ALFENTANIL 500 MCG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,17478006705,ALFENTANIL 500 MCG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,17478010112,TROPICAMIDE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,17478010212,TROPICAMIDE 1 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,17478010720,LEVOFLOXACIN 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,17478017101,Other Outpatient Services,1465.56,952.61,,,0
NDC,17478017224,LEVALBUTEROL HCL 0.31 MG IN NEBU,1465.56,952.61,13270.0,14761.0,4
NDC,17478020102,PHENYLEPHRINE HCL 2.5 % OP DROP,1465.56,952.61,13270.0,14761.0,4
NDC,17478020115,PHENYLEPHRINE HCL 2.5 % OP DROP,1341.6,872.04,13270.0,14761.0,2
NDC,17478020605,PHENYLEPHRINE HCL 10 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478021505,ATROPINE 1 % OP DROP,559.04,363.38,13270.0,14761.0,4
NDC,17478022312,PILOCARPINE HCL 1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478022412,PILOCARPINE HCL 2 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478022612,PILOCARPINE HCL 4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478025310,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,17478026312,PROPARACAINE 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,4
NDC,17478029111,CROMOLYN 4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478038020,METHADONE 10 MG/ML IJ SOLN,4577.28,2975.23,13270.0,14761.0,2
NDC,17478040401,FLUORESCEIN 1 MG OP STRP,,,13270.0,14761.0,2
NDC,17478042020,LABETALOL 5 MG/ML IV SOLN,338.88,220.27,13270.0,14761.0,4
NDC,17478042240,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1103.12,717.03,13270.0,14761.0,4
NDC,17478051701,EPHEDRINE SULFATE 50 MG/ML IV SOLN,315.92,205.35,13270.0,14761.0,2
NDC,17478054202,ADENOSINE 3 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,17478054430,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,17478054602,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,17478060401,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,17478060430,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,17478060510,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478060901,TAFLUPROST (PF) 0.0015 % OP DPET,1465.56,952.61,13270.0,14761.0,4
NDC,17478060930,TAFLUPROST (PF) 0.0015 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,17478062235,SODIUM CHLORIDE 5 % OP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,17478062312,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,17478062512,LATANOPROST 0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,17478070102,INDOCYANINE GREEN 25 MG IJ SOLR,1470.35,955.73,10.63,14761.0,15
NDC,17478070125,INDOCYANINE GREEN 25 MG IJ SOLR,1470.35,955.73,13270.0,14761.0,2
NDC,17478071110,LIDOCAINE HCL 2 % MM JELL,1465.56,952.61,,,0
NDC,17478071110,Other Outpatient Services,1465.56,952.61,,,0
NDC,17478071130,LIDOCAINE HCL 2 % MM JELL,1465.56,952.61,13270.0,14761.0,2
NDC,17478071131,LIDOCAINE HCL 2 % MM JELL,1465.56,952.61,13270.0,14761.0,4
NDC,17478071310,OFLOXACIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,17478071610,APRACLONIDINE 0.5 % OP DROP,695.2,451.88,,,0
NDC,17478076610,PROGESTERONE MICRONIZED 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,17478083005,LOTEPREDNOL ETABONATE 0.5 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
NDC,17478093101,CALCITRIOL 1 MCG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,17478093401,HYDRALAZINE 20 MG/ML IJ SOLN,566.48,368.21,13270.0,14761.0,2
NDC,17478093710,DILTIAZEM HCL 5 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,17478093725,DILTIAZEM HCL 5 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,17555036213,"GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TP SPGE",1465.56,952.61,13270.0,14761.0,4
NDC,17772010101,TOPIRAMATE 25 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,17772010130,TOPIRAMATE 25 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,17772010430,Other Outpatient Services,1465.56,952.61,,,0
NDC,17772012201,OXCARBAZEPINE 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,17772012301,OXCARBAZEPINE 600 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,17856012501,Other Outpatient Services,1465.56,952.61,,,0
NDC,17856060001,GABAPENTIN 250 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
NDC,17856200203,CHLORHEXIDINE GLUCONATE 0.12% ORAL RINSE,,,13270.0,14761.0,2
NDC,18657011701,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,13270.0,14761.0,4
NDC,18657011702,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,13270.0,14761.0,2
NDC,20555000100,ASCORBIC ACID (VITAMIN C) 250 MG PO TABS,,,13270.0,14761.0,2
NDC,20555000301,"CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) PO TABS",,,13270.0,14761.0,2
NDC,20555000600,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,20555002500,CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) PO TABS,,,13270.0,14761.0,2
NDC,20555003300,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,2
NDC,20555003600,MELATONIN 3 MG PO TABS,,,13270.0,14761.0,2
NDC,20555003601,MELATONIN 3 MG PO TABS,,,13270.0,14761.0,4
NDC,21922000909,DICLOFENAC SODIUM 1 % TP GEL,297.6,193.44,13270.0,14761.0,4
NDC,21922001704,CLOBETASOL 0.05 % TP OINT,,,13270.0,14761.0,2
NDC,21922002107,Other Outpatient Services,447.36,290.78,,,0
NDC,21922002107,PERMETHRIN 5 % TP CREA,447.36,290.78,13270.0,14761.0,2
NDC,21922002505,KETOCONAZOLE 2 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,23155002601,VERAPAMIL 80 MG PO TABS,,,13270.0,14761.0,2
NDC,23155004303,LEFLUNOMIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,23155005901,VERAPAMIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,23155007001,METHIMAZOLE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,23155007101,METHIMAZOLE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,23155017801,ISOSORBIDE MONONITRATE 60 MG PO TB24,,,13270.0,14761.0,2
NDC,23155019101,BUPROPION HCL 75 MG PO TABS,,,13270.0,14761.0,2
NDC,23155019201,BUPROPION HCL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,23155019401,NIFEDIPINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,23155021631,CIDOFOVIR 75 MG/ML IV SOLN,9689.76,6298.34,657.46,14761.0,11
NDC,23155024031,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155024901,VENLAFAXINE 75 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,23155028801,Other Outpatient Services,521.6,339.04,,,0
NDC,23155029031,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155029431,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155031331,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,298.08,193.75,13270.0,14761.0,2
NDC,23155047331,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155047333,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155051211,NIMODIPINE 30 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,23155051901,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,2
NDC,23155053102,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO CAPS,,,13270.0,14761.0,2
NDC,23155054731,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155060031,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,23155060601,GLYCOPYRROLATE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,23155064731,CARMUSTINE 100 MG IV SOLR,2892.0,1879.8,412.0,14761.0,11
NDC,23155064941,CARMUSTINE 100 MG IV SOLR,2892.0,1879.8,412.0,14761.0,3
NDC,23155066201,CALCITRIOL 0.25 MCG PO CAPS,,,13270.0,14761.0,2
NDC,23155066203,CALCITRIOL 0.25 MCG PO CAPS,,,13270.0,14761.0,2
NDC,23155066301,CALCITRIOL 0.5 MCG PO CAPS,,,13270.0,14761.0,2
NDC,23155068531,OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN,301.12,195.73,13270.0,14761.0,2
NDC,23155068831,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,23155068931,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,23155074101,THEOPHYLLINE 300 MG PO TB12,,,13270.0,14761.0,2
NDC,23594050501,PREDNISOLONE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,23900001252,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,2
NDC,24201001050,PENTOBARBITAL SODIUM 50 MG/ML IJ SOLN,14973.6,9732.84,13270.0,14761.0,2
NDC,24201010001,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",10974.18,7133.215,13270.0,14761.0,2
NDC,24201020101,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN,1043.52,678.29,13270.0,14761.0,2
NDC,24201020701,ICATIBANT 30 MG/3 ML SC SYRG,5449.95,3542.47,188.82,14761.0,3
NDC,24201040002,CALCITONIN (SALMON) 200 UNITS/ML IJ SOLN,6666.3,4333.1,1460.68,14761.0,3
NDC,24208027715,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,24208029005,TOBRAMYCIN 0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208029525,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,753.92,490.05,13270.0,14761.0,4
NDC,24208029905,LOTEPREDNOL ETABONATE 0.5 % OP DRPS,4742.08,3082.35,13270.0,14761.0,2
NDC,24208031510,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",290.0,188.5,13270.0,14761.0,2
NDC,24208034425,FLUNISOLIDE 25 MCG (0.025 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,24208035305,LOTEPREDNOL ETABONATE 0.2 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,24208035805,TOBRAMYCIN-LOTEPRED 0.3-0.5 % OP DRPS,4934.56,3207.46,13270.0,14761.0,2
NDC,24208039830,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,24208039915,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NA SPRY,290.0,188.5,13270.0,14761.0,2
NDC,24208041105,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,24208043262,"VITAMINS A,C,E-ZINC-COPPER 2,148 MCG-113 MG-45 MG-17.4MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,24208043272,Other Outpatient Services,1465.56,952.61,,,0
NDC,24208043405,OFLOXACIN 0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208043405,Other Outpatient Services,1465.56,952.61,,,0
NDC,24208044605,BESIFLOXACIN 0.6 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,24208046325,LATANOPROST 0.005 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,24208046530,MV-MN-OM3-DHA-EPA-FISH-LUT-ZEA 250 MG (90 MG-160 MG) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,24208046570,MV-MN-OM3-DHA-EPA-FISH-LUT-ZEA 250 MG (90 MG-160 MG) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,24208048510,DORZOLAMIDE 2 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,24208048610,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208050307,LOTEPREDNOL ETABONATE 0.5 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
NDC,24208050402,LATANOPROSTENE BUNOD 0.024 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208050405,LATANOPROSTENE BUNOD 0.024 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208050707,LOTEPREDNOL ETABONATE 0.38 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
NDC,24208053535,GANCICLOVIR 0.15 % OP GEL,1465.56,952.61,13270.0,14761.0,2
NDC,24208055555,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OP OINT",290.0,188.5,13270.0,14761.0,4
NDC,24208058060,GENTAMICIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,24208058564,TROPICAMIDE 1 % OP DROP,480.0,312.0,,,0
NDC,24208060110,KETOTIFEN FUMARATE 0.025 % (0.035 %) OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208060203,BROMFENAC 0.07 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208063110,Other Outpatient Services,1465.56,952.61,,,0
NDC,24208063562,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT DRPS",1187.36,771.78,13270.0,14761.0,4
NDC,24208067004,SULFACETAMIDE SODIUM 10 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,24208069762,"VIT C,E-ZN-COPPR-LUTEIN-ZEAXAN 250-90-40-1 MG PO CAPS",,,13270.0,14761.0,2
NDC,24208072002,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP DROP,803.36,522.18,13270.0,14761.0,4
NDC,24208072002,Other Outpatient Services,803.36,522.18,,,0
NDC,24208073006,PROPARACAINE 0.5 % OP DROP,522.96,339.92,13270.0,14761.0,4
NDC,24208073501,CYCLOPENTOLATE 1 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,24208079062,"NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75 MG-10,000 UNIT-0.025MG/ML OP DROP",708.0,460.2,13270.0,14761.0,2
NDC,24208079535,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OP OINT",290.0,188.5,13270.0,14761.0,2
NDC,24208082555,ATROPINE 1 % OP OINT,290.0,188.5,13270.0,14761.0,2
NDC,24208083060,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OP DRPS",290.0,188.5,13270.0,14761.0,2
NDC,24208091019,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,290.0,188.5,13270.0,14761.0,4
NDC,24208091019,Other Outpatient Services,290.0,188.5,,,0
NDC,24208091055,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,290.0,188.5,13270.0,14761.0,4
NDC,24338013213,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML PO SUSR,3640.0,2366.0,13270.0,14761.0,4
NDC,24338023005,NIMODIPINE 30 MG/5 ML PO SYRG,854.64,555.52,13270.0,14761.0,4
NDC,24338023012,NIMODIPINE 30 MG/5 ML PO SYRG,854.64,555.52,13270.0,14761.0,4
NDC,24338030065,Other Outpatient Services,1465.56,952.61,,,0
NDC,24357030030,POTASSIUM ALUM (BULK) MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,24357070105,LIDOCAINE 4 % TP CREA CC,1465.56,952.61,,,0
NDC,24357070130,LIDOCAINE 4 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,24385011878,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,24510005010,TAPENTADOL 50 MG PO TABS,18145.6,11794.64,13270.0,14761.0,2
NDC,24510010010,TAPENTADOL 100 MG PO TABS,28257.6,18367.44,,,0
NDC,24510011010,OXYCODONE MYRISTATE 9 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
NDC,24510011660,TAPENTADOL 100 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,24510012010,OXYCODONE MYRISTATE 18 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
NDC,24510013010,OXYCODONE MYRISTATE 27 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
NDC,24510014010,OXYCODONE MYRISTATE 36 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
NDC,24510017460,TAPENTADOL 150 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,24571010506,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HD SOLN,720.0,468.0,13270.0,14761.0,2
NDC,24571010806,BICARB DIALY SOLN 11 WITHOUT K CA (2.5 MEQ/L) -MG (1.5 MEQ/L) HD SOLN,640.0,416.0,13270.0,14761.0,4
NDC,24689012001,BUPROPION HCL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,24979000206,DEXLANSOPRAZOLE 60 MG PO CPDM,1465.56,952.61,13270.0,14761.0,2
NDC,24979018646,SEVELAMER CARBONATE 800 MG PO TABS,1563.84,1016.5,13270.0,14761.0,4
NDC,24979070306,DEXLANSOPRAZOLE 30 MG PO CPDM,1465.56,952.61,13270.0,14761.0,2
NDC,24979070406,DEXLANSOPRAZOLE 60 MG PO CPDM,1465.56,952.61,13270.0,14761.0,2
NDC,25010021515,ETHACRYNIC ACID 25 MG PO TABS,36438.4,23684.96,13270.0,14761.0,2
NDC,25021010110,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021010610,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021010720,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021010910,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021011020,CEFOXITIN 2 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021011487,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,25021011502,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021011504,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,4
NDC,25021011506,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021011920,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021012120,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021012120,CEFEPIME IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,25021012250,CEFEPIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,25021012720,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,25021012850,CEFTAZIDIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021013182,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,25021013281,LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,25021013282,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,25021013283,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,25021013720,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021014220,AMPICILLIN-SULBACTAM 1.5 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,25021014330,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,25021014610,OXACILLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021015799,VANCOMYCIN 5 GRAM IV SOLR,294.4,191.36,13270.0,14761.0,2
NDC,25021016224,OXACILLIN 2 GRAM IJ SOLR,342.0,222.3,13270.0,14761.0,2
NDC,25021018482,FLUCONAZOLE CUSTOM IVPB IN NACL,290.0,188.5,13270.0,14761.0,6
NDC,25021018487,FLUCONAZOLE CUSTOM IVPB IN NACL,290.0,188.5,13270.0,14761.0,4
NDC,25021018487,FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK,290.0,188.5,,,0
NDC,25021018510,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,25021018984,FOSCARNET 24 MG/ML IV SOLN,5292.0,3439.8,62.65,14761.0,3
NDC,25021019110,MICAFUNGIN 100 MG IV SOLR,355.52,231.09,13270.0,14761.0,2
NDC,25021020110,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021020111,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021020405,VINORELBINE 50 MG/5 ML IV SOLN,506.88,329.47,13270.0,14761.0,2
NDC,25021021599,FLUOROURACIL 5 G/100 ML IV SOLN,290.0,188.5,,,0
NDC,25021023320,OXALIPLATIN 100 MG/20 ML IV SOLN,432.32,281.01,13270.0,14761.0,2
NDC,25021024410,BORTEZOMIB 3.5 MG IJ SOLR,402.56,261.66,13270.0,14761.0,2
NDC,25021024501,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,25021024504,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,521.79,339.16,13270.0,14761.0,2
NDC,25021030102,ADENOSINE (ADENOCARD) 100 MCG/ML INJECTION FOR INTRAPROCEDURE,10974.18,7133.215,13270.0,14761.0,2
NDC,25021030520,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,471.2,306.28,13270.0,14761.0,2
NDC,25021031102,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021031382,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,25021031599,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021031604,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021040010,HEPARIN BOLUS FOR ACS PROTOCOL,290.0,188.5,13270.0,14761.0,2
NDC,25021040102,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN (ADULT FLUSH)",290.0,188.5,,,0
NDC,25021040102,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,25021045301,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,25021046001,DESMOPRESSIN 4 MCG/ML IJ SOLN,472.56,307.16,6.75,14761.0,13
NDC,25021046110,DESMOPRESSIN 4 MCG/ML IJ SOLN,2489.44,1618.14,6.75,14761.0,13
NDC,25021050002,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021060103,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021060820,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,,,0
NDC,25021060851,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,6
NDC,25021061282,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
NDC,25021066205,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021066805,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,25021067182,ROPIVACAINE 0.2 % EPIDURAL (L&D),290.0,188.5,13270.0,14761.0,2
NDC,25021067187,ROPIVACAINE 0.2 % PERIPHERAL NERVE BLOCK INFUSION,454.4,295.36,13270.0,14761.0,4
NDC,25021067376,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,13270.0,14761.0,4
NDC,25021067650,PENTOBARBITAL SODIUM 50 MG/ML IJ SOLN,15235.2,9902.88,13270.0,14761.0,2
NDC,25021078005,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021078305,PALONOSETRON 0.25 MG/5 ML IV SOLN,290.0,188.5,,,0
NDC,25021079002,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021079120,LACOSAMIDE 200 MG/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021080601,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,25021081230,ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN,618.72,402.17,13270.0,14761.0,2
NDC,25021081630,LEUCOVORIN CALCIUM 350 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,25021082761,IBANDRONATE 3 MG/3 ML IV SYRG,3726.86,2422.46,,,0
NDC,25077016980,"ASCORBATE CALCIUM-BIOFLAVONOID 1,000-200 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,25208000202,TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN,1804.0,1172.6,13270.0,14761.0,2
NDC,25682000101,ECULIZUMAB 300 MG/30 ML IV SOLN,58706.91,38159.49,279.71,14761.0,11
NDC,25682002501,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,58788.72,38212.67,274.88,316.11,16
NDC,25682002801,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,215558.64,140113.12,274.88,316.11,8
NDC,27241004910,ENTACAPONE 200 MG PO TABS,894.4,581.36,13270.0,14761.0,4
NDC,27241009990,DULOXETINE 60 MG PO CPDR,2624.0,1705.6,13270.0,14761.0,4
NDC,27241013421,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,27241015919,VALGANCICLOVIR 50 MG/ML PO SOLR,11929.98,7754.49,13270.0,14761.0,2
NDC,27241016001,CAPTOPRIL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,27241016201,CAPTOPRIL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,27241019990,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,27241020090,DROXIDOPA 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,27241021201,CLOMIPRAMINE 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,27434000198,TAURINE 1000 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,27434001017,COPPER GLUCONATE 2 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,27505000367,DANTROLENE 20 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,27505000401,APOMORPHINE 10 MG/ML SC CRTG,1465.56,952.61,13270.0,14761.0,2
NDC,27505005036,LOFEXIDINE 0.18 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,27808005701,PROMETHAZINE-DM 6.25-15 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,27808015701,ROSUVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,27808020701,FEBUXOSTAT 80 MG PO TABS,521.76,339.14,13270.0,14761.0,2
NDC,28595012049,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,2788.45,1812.49,,,0
NDC,28595012049,Other Outpatient Services,2788.45,1812.49,,,0
NDC,29033000301,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,29033000305,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,29033000412,CARBAMAZEPINE 300 MG PO CM12,1465.56,952.61,13270.0,14761.0,2
NDC,29033002602,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO CAPS,,,13270.0,14761.0,2
NDC,29033003001,ACETAZOLAMIDE 500 MG PO CPSR,,,13270.0,14761.0,2
NDC,29135061515,ALPHA LIPOIC ACID 300 MG PO CAPS,1465.56,952.61,,,0
NDC,29300013701,CLONIDINE HCL 0.3 MG PO TABS,,,13270.0,14761.0,2
NDC,29300014901,QUETIAPINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,29300016903,TIZANIDINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,29300017116,MEMANTINE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,29300017216,MEMANTINE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,29300023916,TOLTERODINE 1 MG PO TABS,744.96,484.22,13270.0,14761.0,2
NDC,29300042901,ZONISAMIDE 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,29943000215,POLYETHYLENE GLYCOL 400 0.25 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,30698045801,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,30698091147,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,4
NDC,30768017965,ALPHA LIPOIC ACID 600 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,31248000301,DIMENHYDRINATE 25 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,31604001328,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG PO CAPS",,,13270.0,14761.0,2
NDC,31604002896,MAGNESIUM CITRATE 125 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,31604041107,S-ADENOSYLMETHIONINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722000760,ZAFIRLUKAST 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722000860,ZAFIRLUKAST 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722001330,DEFERASIROX 360 MG PO TABS,2444.64,1589.02,13270.0,14761.0,2
NDC,31722001490,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,31722013201,POTASSIUM CITRATE 15 MEQ PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,31722014101,CAPTOPRIL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,31722014301,CAPTOPRIL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,31722015130,VALSARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722015290,VALSARTAN 80 MG PO TABS,410.4,266.76,13270.0,14761.0,4
NDC,31722015390,VALSARTAN 160 MG PO TABS,528.48,343.51,13270.0,14761.0,4
NDC,31722015601,DEXTROAMPHETAMINE-AMPHETAMINE 7.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722020320,LACOSAMIDE 200 MG/20 ML IV SOLN,398.08,258.75,13270.0,14761.0,2
NDC,31722050560,NEVIRAPINE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,31722050960,ZIDOVUDINE 300 MG PO TABS,356.16,231.5,13270.0,14761.0,2
NDC,31722053201,TORSEMIDE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,31722054201,INDOMETHACIN 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,31722054301,INDOMETHACIN 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,31722054501,LITHIUM CARBONATE 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,31722055612,LOPINAVIR-RITONAVIR 200-50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722058530,NEBIVOLOL 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722058730,NEBIVOLOL 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,31722058790,NEBIVOLOL 10 MG PO TABS,312.48,203.11,13270.0,14761.0,2
NDC,31722063530,SILODOSIN 4 MG PO CAPS,447.36,290.78,13270.0,14761.0,4
NDC,31722064430,TADALAFIL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,31722064630,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722064730,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,745.44,484.54,13270.0,14761.0,4
NDC,31722070090,LOSARTAN 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722070110,LOSARTAN 50 MG PO TABS,1664.0,1081.6,13270.0,14761.0,4
NDC,31722070230,Other Outpatient Services,1465.56,952.61,,,0
NDC,31722070530,VALACYCLOVIR 1 GRAM PO TABS,315.84,205.3,13270.0,14761.0,4
NDC,31722071630,Other Outpatient Services,1465.56,952.61,,,0
NDC,31722071830,ATOMOXETINE 60 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,31722072030,ATOMOXETINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,31722072150,LEVOFLOXACIN 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722072250,LEVOFLOXACIN 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722072690,MONTELUKAST 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722072790,MONTELUKAST 4 MG PO CHEW,290.0,188.5,13270.0,14761.0,2
NDC,31722072990,IRBESARTAN 75 MG PO TABS,,,13270.0,14761.0,4
NDC,31722073090,IRBESARTAN 150 MG PO TABS,,,13270.0,14761.0,4
NDC,31722073190,IRBESARTAN 300 MG PO TABS,336.96,219.02,13270.0,14761.0,2
NDC,31722077805,ACYCLOVIR 800 MG PO TABS,1448.0,941.2,13270.0,14761.0,4
NDC,31722086831,TOLVAPTAN 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,31722086931,TOLVAPTAN 30 MG PO TABS,1788.86,1162.76,13270.0,14761.0,2
NDC,31722088490,ROSUVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,31722094801,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,2430.4,1579.76,13270.0,14761.0,4
NDC,32909010510,BARIUM SULFATE 81 % (W/W) PO POWD,,,13270.0,14761.0,2
NDC,32909010510,Other Outpatient Services,1465.56,952.61,,,0
NDC,32909011500,BARIUM SULFATE 40 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909011600,BARIUM SULFATE 40 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909012107,"BARIUM SULFATE 40 %(W/V), 29% (W/W)(1500 CPS) PO SUSP",,,13270.0,14761.0,2
NDC,32909012207,"BARIUM SULFATE 40% W/V, 29% W/W (VARIBAR HONEY) ORAL SUSPENSION",,,13270.0,14761.0,2
NDC,32909012522,"BARIUM SULFATE 40 % (W/V), 30% (W/W) PO PSTE",,,13270.0,14761.0,2
NDC,32909071103,BARIUM SULFATE 2 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909074103,BARIUM SULFATE 2 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909074203,BARIUM SULFATE 2 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909074703,BARIUM SULFATE 2 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909075003,BARIUM SULFATE 96 % (W/W) PO SUSR,,,13270.0,14761.0,2
NDC,32909076401,BARIUM SULFATE 98 % PO SUSR,,,13270.0,14761.0,2
NDC,32909081453,BARIUM SULFATE 40 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,32909081455,BARIUM SULFATE 40 % (W/V) PO SUSP,,,13270.0,14761.0,2
NDC,33332032203,FLU VAC QS2022-23 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,20482.8,13313.82,,,0
NDC,33332032204,FLU VAC QS2022-23 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,33342002715,DONEPEZIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,33342004710,IRBESARTAN 75 MG PO TABS,,,13270.0,14761.0,2
NDC,33342005407,PIOGLITAZONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,33342005510,PIOGLITAZONE 30 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,33342005607,PIOGLITAZONE 45 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,33342006707,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,33342007007,OLANZAPINE 10 MG PO TABS,,,13270.0,14761.0,4
NDC,33342008307,Other Outpatient Services,1465.56,952.61,,,0
NDC,33342008407,Other Outpatient Services,562.08,365.35,,,0
NDC,33342008909,RIVASTIGMINE TARTRATE 1.5 MG PO CAPS,294.72,191.57,13270.0,14761.0,2
NDC,33342009709,TOLTERODINE 1 MG PO TABS,362.88,235.87,13270.0,14761.0,2
NDC,33342009809,TOLTERODINE 2 MG PO TABS,367.68,238.99,13270.0,14761.0,2
NDC,33342010707,RISEDRONATE 5 MG PO TABS,1104.48,717.91,13270.0,14761.0,2
NDC,33342010937,RISEDRONATE 35 MG PO TABS,372.48,242.11,13270.0,14761.0,2
NDC,33342011607,Other Outpatient Services,1465.56,952.61,,,0
NDC,33342025666,Other Outpatient Services,290.0,188.5,,,0
NDC,33342032715,TRIAMCINOLONE ACETONIDE 0.025 % TP CREA,,,13270.0,14761.0,2
NDC,33674041051,"MAGNESIUM CITRATE,MAG OXIDE 250 MG PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,33674041071,POTASSIUM CITRATE 99 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,35356054560,MILNACIPRAN 50 MG PO TABS,1465.56,952.61,,,0
NDC,35573041030,TADALAFIL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,35573042851,PANTOPRAZOLE 40 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,35573043302,KETOCONAZOLE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,35573044525,LEVALBUTEROL HCL 1.25 MG IN NEBU,1465.56,952.61,13270.0,14761.0,4
NDC,36000000824,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,36000000924,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,36000003310,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,36000024201,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.88,189.07,13270.0,14761.0,2
NDC,36000028225,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,36000028425,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,36000032201,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,37000002410,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,37000040514,PSYLLIUM HUSK 0.4 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,37000080301,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,2
NDC,37205007178,CALCIUM-MAGNESIUM-ZINC PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,38485086335,SOD.CHLORID-POTASSIUM CHLORIDE 287-180-15 MG PO TABS,,,13270.0,14761.0,2
NDC,38779175403,KETAMINE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,38779256005,PENTOXIFYLLINE 20 MG/ML ORAL SOLUTION,1465.56,952.61,13270.0,14761.0,4
NDC,38779293401,BETAHISTINE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,38779297303,KETOTIFEN FUMARATE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,38779297306,KETOTIFEN FUMARATE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,39328002430,LIDOCAINE 4 % TP CREA,396.96,258.02,13270.0,14761.0,4
NDC,39328006250,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,39328006325,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,39328006412,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,39328010610,"PNV,CALCIUM 72-IRON-FOLIC ACID 27 MG IRON- 1 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,39328035760,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) PO DROP",,,13270.0,14761.0,4
NDC,39822012503,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,39822015101,LIOTHYRONINE 10 MCG/ML IV SOLN,5143.04,3342.98,13270.0,14761.0,2
NDC,39822019001,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,436.0,283.4,13270.0,14761.0,2
NDC,39822031005,NEOMYCIN 500 MG PO TABS,2022.4,1314.56,13270.0,14761.0,2
NDC,39822041206,TOBRAMYCIN 1.2 G SOLN FOR MIXTURE (INTRAPROCEDURE),959.04,623.38,13270.0,14761.0,2
NDC,39822103002,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,3969.06,2579.89,13270.0,14761.0,2
NDC,39822105505,AMPHOTERICIN B 50 MG IJ SOLR,562.72,365.77,13270.0,14761.0,2
NDC,39822107701,VORICONAZOLE 200 MG IV SOLR,324.16,210.7,13270.0,14761.0,4
NDC,39822110001,FOLIC ACID 5 MG/ML IJ SOLN,447.2,290.68,13270.0,14761.0,2
NDC,39822200001,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,13270.0,14761.0,2
NDC,39822210002,DACTINOMYCIN 0.5 MG IV SOLR,5217.6,3391.44,351.31,14761.0,11
NDC,39822301501,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,2
NDC,39822420001,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,39822420002,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,40028512300,SODIUM FLOURIDE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
NDC,40093010118,BIOTIN 5000 MCG PO TBDL,1465.56,952.61,13270.0,14761.0,2
NDC,40093011136,MAGNESIUM GLYCINATE-MAG OXIDE 120 MG MAGNESIUM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,40985027288,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,40985027343,FERROUS SULFATE 142 MG (45 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,40985027343,Other Outpatient Services,1465.56,952.61,,,0
NDC,41100080319,LORATADINE-PSEUDOEPHEDRINE 5-120 MG PO TB12,,,13270.0,14761.0,2
NDC,41163026621,FERROUS SULFATE 250 MG (50 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,41167001100,MENTHOL-ZINC OXIDE 0.15-1 % TP POWD,1465.56,952.61,13270.0,14761.0,2
NDC,41167075142,CAPSAICIN 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,41167580005,TRIAMCINOLONE ACETONIDE 55 MCG NA SPRA,1465.56,952.61,13270.0,14761.0,2
NDC,42023010301,EPINEPHRINE HCL 1 MG/ML NA SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,42023010501,METHOHEXITAL 500 MG IJ SOLR,1372.96,892.42,,,0
NDC,42023011310,KETAMINE 10 MG/ML IJ SOLN,295.04,191.78,13270.0,14761.0,2
NDC,42023011625,OXYTOCIN 10 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023011925,TRIMETHOBENZAMIDE 100 MG/ML IM SOLN,722.24,469.46,13270.0,14761.0,4
NDC,42023012306,DANTROLENE 20 MG IV SOLR,1040.0,676.0,13270.0,14761.0,2
NDC,42023015901,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023015925,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023016401,VASOPRESSIN 20 UNITS/ML IV SOLN,1192.58,775.18,13270.0,14761.0,2
NDC,42023016425,VASOPRESSIN 20 UNITS/ML IV SOLN,1192.58,775.18,13270.0,14761.0,2
NDC,42023016801,EPINEPHRINE 1 MG/ML IJ SOLN,1844.64,1199.02,13270.0,14761.0,2
NDC,42023017204,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1024.88,666.17,13270.0,14761.0,4
NDC,42023017301,GANCICLOVIR SODIUM 500 MG IV SOLR,894.43,581.38,13270.0,14761.0,4
NDC,42023017325,GANCICLOVIR SODIUM 500 MG IV SOLR,894.43,581.38,13270.0,14761.0,4
NDC,42023017901,BUPRENORPHINE HCL 0.3 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023017905,BUPRENORPHINE HCL 0.3 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023020101,LEVOTHYROXINE 100 MCG IV SOLR,1573.92,1023.05,13270.0,14761.0,2
NDC,42023020501,CALCITONIN (SALMON) 200 UNITS/ML IJ SOLN,4947.3,3215.75,1460.68,14761.0,3
NDC,42023020601,TREPROSTINIL SODIUM 1 MG/ML IJ SOLN,3352.86,2179.36,69.5,14761.0,3
NDC,42023020801,TREPROSTINIL SODIUM 5 MG/ML IJ SOLN,16764.48,10896.91,69.5,14761.0,3
NDC,42023020901,TREPROSTINIL SODIUM 10 MG/ML IJ SOLN,39997.98,25998.69,69.5,14761.0,3
NDC,42023021601,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42023021901,VASOPRESSIN 0.4 UNITS/ML IV SOLN,1342.4,872.56,13270.0,14761.0,2
NDC,42023022101,ERTAPENEM 1 GRAM IJ SOLR,745.36,484.48,13270.0,14761.0,2
NDC,42023022101,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,745.36,484.48,,,0
NDC,42023023001,MICAFUNGIN 100 MG IV SOLR,357.78,232.56,13270.0,14761.0,2
NDC,42023023701,VASOPRESSIN 0.2 UNITS/ML IV SOLN,596.8,387.92,13270.0,14761.0,2
NDC,42037010476,CARBAMIDE PEROXIDE 10 % MM SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,42043032101,ESZOPICLONE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42192033901,HYOSCYAMINE SULFATE 0.125 MG SL SUBL,,,13270.0,14761.0,2
NDC,42192060806,GABAPENTIN 300 MG/6 ML (6 ML) PO SOLN,,,13270.0,14761.0,4
NDC,42192060840,GABAPENTIN 300 MG/6 ML (6 ML) PO SOLN,,,13270.0,14761.0,4
NDC,42192061402,PHENYTOIN SODIUM 50 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,42192061405,PHENYTOIN SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,42192061410,PHENYTOIN SODIUM 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,42291009430,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,13270.0,14761.0,2
NDC,42291018790,DILTIAZEM HCL 300 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,42291039930,LIDOCAINE 4 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,42291041260,DOFETILIDE 250 MCG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,42291041360,DOFETILIDE 500 MCG PO CAPS,291.84,189.7,13270.0,14761.0,2
NDC,42291045930,Other Outpatient Services,1465.56,952.61,,,0
NDC,42291046601,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,42291047001,FUROSEMIDE 80 MG PO TABS,,,13270.0,14761.0,2
NDC,42291047201,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,42291077360,RANOLAZINE 500 MG PO TB12,290.0,188.5,13270.0,14761.0,2
NDC,42291078030,RASAGILINE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42291081990,TORSEMIDE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,42291089890,VENLAFAXINE 75 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,42291089990,VENLAFAXINE 150 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,42292003801,LEVOTHYROXINE 88 MCG PO TABS,,,13270.0,14761.0,2
NDC,42292004001,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,2
NDC,42292004101,LEVOTHYROXINE 137 MCG PO TABS,,,13270.0,14761.0,2
NDC,42292005401,COLCHICINE 0.6 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,42367020307,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1465.56,952.61,1.57,14761.0,5
NDC,42367057022,VASOPRESSIN 20 UNITS/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,42367057087,VASOPRESSIN 20 UNITS/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,42385095330,Other Outpatient Services,1465.56,952.61,,,0
NDC,42388002326,CABOZANTINIB 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42388002526,CABOZANTINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42457042001,GLUTAMINE (SICKLE CELL) 5 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,42457042060,GLUTAMINE (SICKLE CELL) 5 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,42494033903,FLUCYTOSINE 250 MG PO CAPS,13416.48,8720.71,13270.0,14761.0,4
NDC,42494034003,FLUCYTOSINE 500 MG PO CAPS,25347.84,16476.1,13270.0,14761.0,4
NDC,42571013021,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,42571013027,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,42571013221,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,42571013251,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,42571013252,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,42571014126,DORZOLAMIDE 2 % OP DROP,506.72,329.37,13270.0,14761.0,4
NDC,42571014726,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,42571016030,AMOXICILLIN-POT CLAVULANATE 250-125 MG PO TABS,969.12,629.93,13270.0,14761.0,2
NDC,42571016201,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,894.4,581.36,13270.0,14761.0,4
NDC,42571016242,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,42571022130,RASAGILINE 1 MG PO TABS,3559.68,2313.79,13270.0,14761.0,2
NDC,42571027560,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,42571031501,CLOBAZAM 10 MG PO TABS,459.2,298.48,13270.0,14761.0,2
NDC,42571038271,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DPET,1465.56,952.61,,,0
NDC,42658001001,CLADRIBINE 10 MG/10 ML IV SOLN,1337.92,869.65,13270.0,14761.0,2
NDC,42658002101,DAUNORUBICIN 5 MG/ML IV SOLN,798.59,519.08,30.43,14761.0,3
NDC,42658012204,IRBESARTAN 150 MG PO TABS,,,13270.0,14761.0,2
NDC,42658012304,IRBESARTAN 300 MG PO TABS,375.84,244.3,13270.0,14761.0,4
NDC,42747060290,ISTRADEFYLLINE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42747060490,ISTRADEFYLLINE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42747072601,GRANISETRON 3.1 MG/24 HOUR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,42794000308,ADEFOVIR 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42794000908,FLUCYTOSINE 250 MG PO CAPS,13416.48,8720.71,13270.0,14761.0,2
NDC,42794001008,FLUCYTOSINE 500 MG PO CAPS,25342.08,16472.35,13270.0,14761.0,4
NDC,42794001710,ASENAPINE MALEATE 10 MG SL SUBL,1465.56,952.61,13270.0,14761.0,2
NDC,42799011901,BUMETANIDE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,42799020801,TINIDAZOLE 500 MG PO TABS,735.04,477.78,13270.0,14761.0,4
NDC,42799080601,IVERMECTIN 3 MG PO TABS,1227.84,798.1,13270.0,14761.0,4
NDC,42806008701,ESTRADIOL 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,42806008801,ESTRADIOL 1 MG PO TABS,,,13270.0,14761.0,2
NDC,42806008901,ESTRADIOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,42806010201,ETHAMBUTOL 400 MG PO TABS,908.8,590.72,13270.0,14761.0,4
NDC,42806026401,ISRADIPINE 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,42806031250,Other Outpatient Services,1465.56,952.61,,,0
NDC,42806033901,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO TABS,540.8,351.52,13270.0,14761.0,2
NDC,42806034101,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,540.8,351.52,13270.0,14761.0,2
NDC,42806034101,Other Outpatient Services,540.8,351.52,,,0
NDC,42806040001,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,42806040021,METHYLPREDNISOLONE 4 MG PO DSPK,,,13270.0,14761.0,2
NDC,42806060209,VENLAFAXINE 75 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,42806065830,ENTECAVIR 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,42806071401,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,42806075760,SULFADIAZINE 500 MG PO TABS,14337.6,9319.44,,,0
NDC,42858000110,OXYCODONE 5 MG PO TABS,539.2,350.48,13270.0,14761.0,4
NDC,42858010450,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,42858030101,HYDROMORPHONE 2 MG PO TABS,353.6,229.84,13270.0,14761.0,2
NDC,42858030125,HYDROMORPHONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,42858030201,HYDROMORPHONE 4 MG PO TABS,510.4,331.76,13270.0,14761.0,2
NDC,42858030225,HYDROMORPHONE 4 MG PO TABS,350.4,227.76,13270.0,14761.0,4
NDC,42858030301,HYDROMORPHONE 8 MG PO TABS,1132.8,736.32,13270.0,14761.0,4
NDC,42858050103,BUPRENORPHINE HCL 2 MG SL SUBL,290.0,188.5,13270.0,14761.0,4
NDC,42858050203,BUPRENORPHINE HCL 8 MG SL SUBL,290.0,188.5,13270.0,14761.0,6
NDC,42858058640,BUPRENORPHINE 15 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,42858072101,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,42858072301,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,42858075040,BUPRENORPHINE 5 MCG/HR TD PTWK,1465.56,952.61,,,0
NDC,42858086706,Other Outpatient Services,1465.56,952.61,,,0
NDC,43063079530,ESZOPICLONE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,43066000710,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43066000801,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,43066002301,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43066009001,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43066099324,Other Outpatient Services,1465.56,952.61,,,0
NDC,43068010402,ILOPERIDONE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,43292055538,RIBOFLAVIN (VITAMIN B2) 25 MG PO TABS,,,13270.0,14761.0,2
NDC,43292055881,CHOLECALCIFEROL (VITAMIN D3) 400 UNITS PO TABS,,,13270.0,14761.0,2
NDC,43353018530,ESZOPICLONE 3 MG PO TABS,1465.56,952.61,,,0
NDC,43386009019,Other Outpatient Services,384.0,249.6,,,0
NDC,43386009019,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,384.0,249.6,13270.0,14761.0,4
NDC,43386033001,TRIMETHOPRIM 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,43386040512,NITAZOXANIDE 500 MG PO TABS,23294.4,15141.36,13270.0,14761.0,4
NDC,43386076101,ZOLPIDEM 3.5 MG SL SUBL,1465.56,952.61,13270.0,14761.0,2
NDC,43386092060,OXYCODONE 20 MG/ML PO CONC,1465.56,952.61,13270.0,14761.0,4
NDC,43528000301,HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG,1948.67,1266.64,13270.0,14761.0,2
NDC,43528000305,HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG,1948.67,1266.64,,,0
NDC,43547004903,TADALAFIL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,43547027609,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,43547028010,ESCITALOPRAM OXALATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,43547028110,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,43547028211,ESCITALOPRAM OXALATE 20 MG PO TABS,1104.0,717.6,13270.0,14761.0,4
NDC,43547028910,BUPROPION HCL 150 MG PO SR12,,,13270.0,14761.0,2
NDC,43547035210,LISINOPRIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,43547035310,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,43547035410,LISINOPRIL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,43547035610,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,43547036109,LOSARTAN 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,43547036809,VALSARTAN 80 MG PO TABS,424.8,276.12,13270.0,14761.0,4
NDC,43547039710,HYDROCHLOROTHIAZIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,43547040110,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,43547040210,FUROSEMIDE 40 MG PO TABS,,,13270.0,14761.0,2
NDC,43547040310,FUROSEMIDE 80 MG PO TABS,,,13270.0,14761.0,2
NDC,43547040710,Other Outpatient Services,290.0,188.5,,,0
NDC,43547052509,NEBIVOLOL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,43547052603,NEBIVOLOL 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,43547054301,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,43547054325,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598012811,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,43598012901,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,43598013074,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,43598014362,AZACITIDINE 100 MG IJ SOLR,462.08,300.35,13270.0,14761.0,2
NDC,43598016430,OLANZAPINE 5 MG PO TABS,,,13270.0,14761.0,4
NDC,43598016530,OLANZAPINE 7.5 MG PO TABS,,,13270.0,14761.0,4
NDC,43598016630,OLANZAPINE 10 MG PO TABS,,,13270.0,14761.0,4
NDC,43598021040,SILVER SULFADIAZINE 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,43598021055,SILVER SULFADIAZINE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,43598023018,COLESEVELAM 625 MG PO TABS,,,13270.0,14761.0,2
NDC,43598024830,FESOTERODINE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,43598026704,ICOSAPENT ETHYL 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,43598028335,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",6708.16,4360.3,165.71,190.57,8
NDC,43598030562,AZACITIDINE 100 MG IJ SOLR,380.16,247.1,13270.0,14761.0,2
NDC,43598032675,Other Outpatient Services,2213.88,1439.02,,,0
NDC,43598038662,PEMETREXED DISODIUM 100 MG IV SOLR,290.0,188.5,5.21,5.99,8
NDC,43598038711,PEMETREXED DISODIUM 500 MG IV SOLR,1084.48,704.91,5.21,14761.0,3
NDC,43598039467,TETRABENAZINE 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,43598040511,PHYTONADIONE (VITAMIN K1) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598044670,NICOTINE 7 MG TD PT24,,,13270.0,14761.0,2
NDC,43598044671,NICOTINE 7 MG TD PT24,,,13270.0,14761.0,2
NDC,43598044770,NICOTINE 14 MG TD PT24,,,13270.0,14761.0,2
NDC,43598044771,NICOTINE 14 MG TD PT24,,,13270.0,14761.0,2
NDC,43598044870,NICOTINE 21 MG TD PT24,,,13270.0,14761.0,2
NDC,43598044871,NICOTINE 21 MG TD PT24,,,13270.0,14761.0,2
NDC,43598045202,ALBENDAZOLE 200 MG PO TABS,1192.48,775.11,13270.0,14761.0,4
NDC,43598047901,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,2
NDC,43598051421,LENALIDOMIDE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,43598054125,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",18634.0,12112.1,165.71,190.57,8
NDC,43598057860,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,744.96,484.22,13270.0,14761.0,2
NDC,43598058201,Other Outpatient Services,1465.56,952.61,,,0
NDC,43598062857,CARMUSTINE 100 MG IV SOLR,2704.0,1757.6,412.0,14761.0,3
NDC,43598065011,THIOTEPA 15 MG IJ SOLR,2981.44,1937.94,260.26,14761.0,3
NDC,43598065530,BUPROPION HCL 150 MG PO TB24,290.0,188.5,13270.0,14761.0,4
NDC,43598066611,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598066625,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598069811,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,564.0,366.6,13270.0,14761.0,2
NDC,43598069858,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,592.86,385.36,13270.0,14761.0,2
NDC,43598072101,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,43598072511,EPHEDRINE SULFATE 50 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,43598075011,NALOXONE 1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,43598075160,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,2
NDC,43598083911,METHOCARBAMOL 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598083936,METHOCARBAMOL 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,43598085430,DEFERASIROX 500 MG PO TBDP,1465.56,952.61,13270.0,14761.0,4
NDC,43598085630,DEFERASIROX 250 MG PO TBDP,1465.56,952.61,13270.0,14761.0,4
NDC,43598090111,ERTAPENEM 1 GRAM IJ SOLR,477.02,310.06,13270.0,14761.0,2
NDC,43598090111,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,477.02,310.06,13270.0,14761.0,2
NDC,43598094511,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,43598094558,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,43825010201,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,43975022010,CARBIDOPA 25 MG PO TABS,,,13270.0,14761.0,2
NDC,43975034903,PALIPERIDONE 1.5 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,43975035003,PALIPERIDONE 3 MG PO TR24,969.12,629.93,13270.0,14761.0,2
NDC,44087353501,AVELUMAB 20 MG/ML IV SOLN,30976.64,20134.82,118.51,14761.0,11
NDC,44206025105,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",466.4,303.16,13270.0,14761.0,2
NDC,44206025110,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",932.8,606.32,13270.0,14761.0,2
NDC,44206025190,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",10974.18,7133.215,13270.0,14761.0,2
NDC,44206025191,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",932.8,606.32,13270.0,14761.0,2
NDC,44206030001,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG",,,13270.0,14761.0,2
NDC,44206030001,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG FOR OB",784.6,509.99,,,0
NDC,44206030090,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG",,,13270.0,14761.0,2
NDC,44206030090,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG FOR OB",784.6,509.99,,,0
NDC,44206031025,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",468.0,304.2,66.09,14761.0,13
NDC,44206031050,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",936.0,608.4,66.09,14761.0,13
NDC,44206031090,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",10974.18,7133.215,66.09,14761.0,13
NDC,44206031091,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",936.0,608.4,66.09,14761.0,13
NDC,44206043605,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,3448.0,2241.2,60.49,69.56,8
NDC,44206043690,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,20482.8,13313.82,60.49,69.56,8
NDC,44206043710,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,8964.8,5827.12,60.49,14761.0,11
NDC,44206043791,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,8964.8,5827.12,60.49,14761.0,11
NDC,44206043820,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,13792.0,8964.8,60.49,69.56,8
NDC,44206043892,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,10974.18,7133.215,60.49,14761.0,11
NDC,44206043940,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,27584.0,17929.6,60.49,69.56,8
NDC,44206043993,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,10974.18,7133.215,60.49,14761.0,11
NDC,44206045404,IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SC SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,44206045824,IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,44567010110,AMPICILLIN SODIUM 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567010310,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567023525,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,44567023610,CEFTAZIDIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567024010,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,44567024110,CEFEPIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,44567024525,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567024625,CEFOXITIN 2 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567031110,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567041024,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,44567042124,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK,290.0,188.5,,,0
NDC,44567042124,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
NDC,44567060004,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,44567061101,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,44567062001,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,44567062024,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,44567062101,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,6
NDC,44567062124,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,44567070125,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567070225,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567070725,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567080210,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,44567080310,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,44567080310,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,44567081110,"ESMOLOL IN STERILE WATER 2,500 MG/250 ML (10 MG/ML) IV SOLP",1504.0,977.6,13270.0,14761.0,2
NDC,44567081210,"ESMOLOL IN STERILE WATER 2,000 MG/100 ML (20 MG/ML) IV SOLP",1513.6,983.84,13270.0,14761.0,4
NDC,44567082001,ERTAPENEM 1 GRAM IJ SOLR,447.22,290.69,13270.0,14761.0,2
NDC,44567082001,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,447.22,290.69,13270.0,14761.0,2
NDC,44677010202,MODIFIED LANOLIN 100 % TP CREA,,,13270.0,14761.0,2
NDC,45567003001,KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC SOLR,1.01,0.65,13270.0,14761.0,4
NDC,45567006001,KIT PREP OF TC-99M-SOD PYROPH 12 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
NDC,45567045502,KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR,1.01,0.65,13270.0,14761.0,6
NDC,45611000938,LIDOCAINE 4 % TP PTMD,1465.56,952.61,13270.0,14761.0,4
NDC,45802002683,AZELASTINE 205.5 MCG (0.15 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,45802004064,SELENIUM SULFIDE 2.5 % TP LOTN,,,13270.0,14761.0,2
NDC,45802004635,GENTAMICIN 0.1 % TP OINT,588.72,382.67,13270.0,14761.0,4
NDC,45802005435,TRIAMCINOLONE ACETONIDE 0.025 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,45802005535,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,45802005536,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,45802005635,GENTAMICIN 0.1 % TP CREA,585.84,380.8,13270.0,14761.0,4
NDC,45802005911,Other Outpatient Services,1465.56,952.61,,,0
NDC,45802005935,NYSTATIN 100000 UNIT/GRAM TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,45802006435,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,45802006436,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,45802006535,Other Outpatient Services,1465.56,952.61,,,0
NDC,45802009735,ESTRADIOL 0.01 % (0.1 MG/GRAM) VA CREA,,,13270.0,14761.0,2
NDC,45802009846,MESALAMINE 4 GRAM/60 ML PR ENEM,290.0,188.5,13270.0,14761.0,4
NDC,45802011222,MUPIROCIN 2 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,45802011222,Other Outpatient Services,290.0,188.5,,,0
NDC,45802014300,Other Outpatient Services,1465.56,952.61,,,0
NDC,45802017453,METHYL SALICYLATE-MENTHOL 15-10 % TP CREA,,,13270.0,14761.0,4
NDC,45802020105,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,45802021001,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,2530.75,1644.99,13270.0,14761.0,4
NDC,45802021002,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,3563.14,2316.04,13270.0,14761.0,2
NDC,45802026937,PERMETHRIN 5 % TP CREA,1475.52,959.09,13270.0,14761.0,4
NDC,45802035758,SODIUM CHLORIDE 0.65 % NA SPRA,290.0,188.5,13270.0,14761.0,4
NDC,45802035803,DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TP CREA,,,13270.0,14761.0,2
NDC,45802036800,IMIQUIMOD 5 % TP CRPK,290.0,188.5,13270.0,14761.0,2
NDC,45802036862,IMIQUIMOD 5 % TP CRPK,703.87,457.52,13270.0,14761.0,2
NDC,45802041059,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,2
NDC,45802043733,CLOBETASOL 0.05 % TP FOAM,1465.56,952.61,13270.0,14761.0,2
NDC,45802043803,HYDROCORTISONE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,45802056201,CLINDAMYCIN PHOSPHATE 1 % TP SOLN,290.0,188.5,13270.0,14761.0,4
NDC,45802057178,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,2
NDC,45802058001,Other Outpatient Services,290.0,188.5,,,0
NDC,45802058001,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,290.0,188.5,13270.0,14761.0,2
NDC,45802059800,SUMATRIPTAN 20 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,45802059806,SUMATRIPTAN 20 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,45802065087,LORATADINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,45802070000,TACROLIMUS 0.1 % TP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,45802073000,ACETAMINOPHEN 650 MG PR SUPP,,,13270.0,14761.0,2
NDC,45802073032,ACETAMINOPHEN 650 MG PR SUPP,,,13270.0,14761.0,2
NDC,45802073200,ACETAMINOPHEN 120 MG PR SUPP,,,13270.0,14761.0,2
NDC,45802073230,ACETAMINOPHEN 120 MG PR SUPP,,,13270.0,14761.0,2
NDC,45802086800,POLYETHYLENE GLYCOL 3350 17 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,45963043965,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,45963060756,VINORELBINE 50 MG/5 ML IV SOLN,1341.6,872.04,,,0
NDC,45963060955,FLUDARABINE 50 MG IV SOLR,1394.72,906.57,167.05,14761.0,11
NDC,45963061451,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,45963061455,IRINOTECAN 100 MG/5 ML IV SOLN,291.36,189.38,,,0
NDC,45963070911,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,45963073355,DOXORUBICIN 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,45963073357,DOXORUBICIN 2 MG/ML IV SOLN,298.08,193.75,13270.0,14761.0,2
NDC,45963073360,DOXORUBICIN 2 MG/ML IV SOLN,1478.4,960.96,,,0
NDC,45963073368,DOXORUBICIN 2 MG/ML IV SOLN,521.6,339.04,13270.0,14761.0,2
NDC,45963073454,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,45963076552,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,2554.43,1660.38,,,0
NDC,46017001840,CAFFEINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,46122053152,LEVOCETIRIZINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,46122053874,ESOMEPRAZOLE MAGNESIUM 20 MG PO CPDR,,,13270.0,14761.0,2
NDC,46144020110,DALFAMPRIDINE (BULK) MISC POWD,1465.56,952.61,,,0
NDC,46241000646,LIDOCAINE HCL 4 % TP GEL,1465.56,952.61,13270.0,14761.0,2
NDC,46287000604,SODIUM POLYSTYRENE SULF-SORBTL 30-40 GRAM/120 ML PR ENEM,,,13270.0,14761.0,2
NDC,46287000660,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML PO SUSP,,,13270.0,14761.0,2
NDC,46287050030,SORBITOL 70 % MISC SOLN,,,13270.0,14761.0,2
NDC,46287050704,WHITE PETROLATUM-MINERAL OIL TP OINT,,,13270.0,14761.0,2
NDC,46581067020,METHYL SALICYLATE-MENTHOL 10-3 % TP PTMD,1465.56,952.61,13270.0,14761.0,2
NDC,46581067501,METHYL SALICYLATE-MENTHOL 10-3 % TP PTMD,1465.56,952.61,13270.0,14761.0,2
NDC,47335000972,TADALAFIL 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,47335004940,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",6708.32,4360.41,165.71,14761.0,11
NDC,47335005040,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",18634.0,12112.1,165.71,190.57,8
NDC,47335018788,CARBIDOPA-LEVODOPA 25-100 MG PO TBDL,,,13270.0,14761.0,2
NDC,47335023683,AMBRISENTAN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,47335023783,AMBRISENTAN 10 MG PO TABS,17173.92,11163.05,13270.0,14761.0,2
NDC,47335033040,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,469.6,305.24,13270.0,14761.0,2
NDC,47335036140,DECITABINE 50 MG IV SOLR,1490.72,968.97,,,0
NDC,47335036141,DECITABINE 50 MG IV SOLR,1490.72,968.97,,,0
NDC,47335047583,IMATINIB 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,4
NDC,47335050696,CYCLOSPORINE 0.09 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,47335060083,CINACALCET 90 MG PO TABS,343.2,223.08,13270.0,14761.0,2
NDC,47335061481,NIACIN 750 MG PO TB24,819.36,532.58,13270.0,14761.0,2
NDC,47335070648,IPRATROPIUM BROMIDE 0.02 % IN SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,47335070652,IPRATROPIUM BROMIDE 0.02 % IN SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,47335089060,TEMOZOLOMIDE 5 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,47335089160,TEMOZOLOMIDE 20 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,47335089260,TEMOZOLOMIDE 100 MG PO CAPS,350.45,227.79,13270.0,14761.0,2
NDC,47335089540,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,530.43,344.78,13270.0,14761.0,2
NDC,47335092960,TEMOZOLOMIDE 140 MG PO CAPS,536.94,349.01,13270.0,14761.0,4
NDC,47335093890,AZELASTINE 0.05 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,47335099202,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK,1465.56,952.61,13270.0,14761.0,2
NDC,47335099301,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
NDC,47469000307,ALPHA LIPOIC ACID 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,47469000465,MELATONIN 1 MG PO TABS,,,13270.0,14761.0,4
NDC,47469005172,5-HYDROXYTRYPTOPHAN (5-HTP) 200 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,47469007530,MELATONIN 1 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,47469007692,MELATONIN 1 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,47781030301,Other Outpatient Services,942.4,612.56,,,0
NDC,47781030701,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,47781035511,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,13270.0,14761.0,2
NDC,47781035711,BUPRENORPHINE-NALOXONE 8-2 MG SL FILM,1465.56,952.61,13270.0,14761.0,2
NDC,47781038426,Other Outpatient Services,1494.72,971.57,,,0
NDC,47781040011,BUPRENORPHINE HCL 300 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,47781042311,FENTANYL 12 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
NDC,47781042411,FENTANYL 25 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
NDC,47781042511,BUPRENORPHINE HCL 450 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,47781042611,FENTANYL 50 MCG/HR TD PT72,290.0,188.5,13270.0,14761.0,4
NDC,47781042711,FENTANYL 75 MCG/HR TD PT72,292.45,190.09,13270.0,14761.0,4
NDC,47781042811,FENTANYL 100 MCG/HR TD PT72,311.65,202.57,13270.0,14761.0,4
NDC,47781046813,OSELTAMIVIR 30 MG PO CAPS,1395.2,906.88,13270.0,14761.0,4
NDC,47781047311,BUPRENORPHINE HCL 600 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,47781047411,BUPRENORPHINE HCL 750 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,47781053326,FLUOCINONIDE 0.05 % TP GEL,1465.56,952.61,13270.0,14761.0,2
NDC,47781058629,LABETALOL 5 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,47781058656,LABETALOL 5 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,47781060730,DISULFIRAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,47781064090,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,47781065190,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,47781065289,TERIPARATIDE 20 MCG/DOSE (620MCG/2.48ML) SC PNIJ,19682.51,12793.63,13270.0,14761.0,2
NDC,47781065490,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,2
NDC,47781065790,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,2
NDC,47781072902,VANCOMYCIN 125 MG PO CAPS,1490.88,969.07,13270.0,14761.0,4
NDC,47781073002,VANCOMYCIN 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,47865099547,COFFEE XT-PHOSPHATIDYL SERINE 100-100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,48433020230,MINERAL OIL PO OIL,,,13270.0,14761.0,2
NDC,48433023015,IODINE STRONG (LUGOLS) 5 % PO SOLN,504.9,328.19,13270.0,14761.0,2
NDC,48582000155,SALIVA STIMULANT COMB. NO.3 MM SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,48582000330,SALIVA SUBSTITUTE COMBO NO.9 MM MWSH,1465.56,952.61,13270.0,14761.0,2
NDC,48815100201,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) PO CAPS,1.01,0.65,13270.0,14761.0,2
NDC,49100038164,LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELLS PO CAPS,,,13270.0,14761.0,2
NDC,49100040007,LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELLS PO CAPS,,,13270.0,14761.0,2
NDC,49100040076,PEDI MV NO.193-L.RHAMNOSUS GG 5 BILLION CELLS PO CHEW,1465.56,952.61,,,0
NDC,49230064551,SUCROFERRIC OXYHYDROXIDE 500 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,49281012265,FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG,20482.8,13313.82,,,0
NDC,49281012288,FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,49281021558,TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG,20482.8,13313.82,,,0
NDC,49281021588,TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG,602.32,391.51,13270.0,14761.0,2
NDC,49281040010,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",734.94,477.71,,,0
NDC,49281054503,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,290.0,188.5,,,0
NDC,49281054758,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,20482.8,13313.82,,,0
NDC,49281058905,"MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN",20482.8,13313.82,,,0
NDC,49281075221,TUBERCULIN PPD 5 TUB. UNIT /0.1 ML ID SOLN,1641.28,1066.83,13270.0,14761.0,4
NDC,49281075278,TUBERCULIN PPD 5 TUB. UNIT /0.1 ML ID SOLN,1641.28,1066.83,13270.0,14761.0,4
NDC,49281079051,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,20482.8,13313.82,,,0
NDC,49281086010,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP,10974.18,7133.215,13270.0,14761.0,2
NDC,49281086078,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP,20482.8,13313.82,,,0
NDC,49348000110,ASPIRIN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,49348000810,MAGNESIUM 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49348004214,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,49348009910,VITAMIN E 268 MG (400 UNIT) PO CAPS,,,13270.0,14761.0,2
NDC,49348011934,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,49348015472,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,49348018810,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,49348027472,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",290.0,188.5,13270.0,14761.0,2
NDC,49348044330,PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TP SHAM,,,13270.0,14761.0,2
NDC,49348044334,PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TP SHAM,,,13270.0,14761.0,2
NDC,49348053077,MICONAZOLE NITRATE 2 % VA CREA,290.0,188.5,13270.0,14761.0,4
NDC,49348057236,NICOTINE (POLACRILEX) 4 MG BU GUM,,,13270.0,14761.0,2
NDC,49348069649,MAGNESIUM CITRATE PO SOLN,,,13270.0,14761.0,2
NDC,49348083361,MICONAZOLE NITRATE 100 MG VA SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,49348087410,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,2
NDC,49401010101,BELIMUMAB 120 MG IV SOLR,10156.0,6601.4,67.43,77.54,8
NDC,49401010201,BELIMUMAB 400 MG IV SOLR,19041.3,12376.84,67.43,77.54,8
NDC,49411005030,AMINOCAPROIC ACID 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,49411005208,AMINOCAPROIC ACID 250 MG/ML (25 %) PO SOLN,,,13270.0,14761.0,2
NDC,49452392302,KETOTIFEN FUMARATE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,49483034010,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,49483060201,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,2
NDC,49483068703,PARICALCITOL 1 MCG PO CAPS,446.88,290.47,13270.0,14761.0,4
NDC,49502047626,PRETOMANID 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49502060595,FORMOTEROL FUMARATE 20 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,49502080632,REVEFENACIN 175 MCG/3 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,49502090201,SELEGILINE 12 MG/24 HR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,49502090230,SELEGILINE 12 MG/24 HR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,49702020548,LAMIVUDINE 10 MG/ML PO SOLN,1651.2,1073.28,13270.0,14761.0,4
NDC,49702021301,ZIDOVUDINE 10 MG/ML IV SOLN,435.2,282.88,13270.0,14761.0,2
NDC,49702022248,ABACAVIR 20 MG/ML PO SOLN,2188.8,1422.72,13270.0,14761.0,2
NDC,49702022318,MARAVIROC 150 MG PO TABS,25790.4,16763.76,13270.0,14761.0,2
NDC,49702022418,MARAVIROC 300 MG PO TABS,25790.4,16763.76,13270.0,14761.0,2
NDC,49702022813,DOLUTEGRAVIR 50 MG PO TABS,34661.76,22530.14,13270.0,14761.0,4
NDC,49702023113,ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49702024213,DOLUTEGRAVIR-RILPIVIRINE 50-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49702024613,DOLUTEGRAVIR-LAMIVUDINE 50-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49702025018,FOSTEMSAVIR 600 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,49708075441,BROMFENAC 0.075 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,49884005401,IMIPRAMINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,49884005501,IMIPRAMINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,49884012201,LABETALOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,49884015576,VARENICLINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49884016111,CALCITONIN (SALMON) 200 UNIT/ACTUATION NA SPRY,298.16,193.8,13270.0,14761.0,2
NDC,49884017004,SODIUM PHENYLBUTYRATE 500 MG PO TABS,1465.56,952.61,,,0
NDC,49884028901,MEGESTROL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,49884030101,OXANDROLONE 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49884030602,CLONAZEPAM 0.125 MG PO TBDL,1465.56,952.61,13270.0,14761.0,2
NDC,49884030652,CLONAZEPAM 0.125 MG PO TBDL,290.0,188.5,13270.0,14761.0,2
NDC,49884030702,CLONAZEPAM 0.25 MG PO TBDL,826.56,537.26,13270.0,14761.0,4
NDC,49884030752,CLONAZEPAM 0.25 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,49884031152,RISPERIDONE 0.5 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,49884031191,RISPERIDONE 0.5 MG PO TBDL,1459.14,948.44,13270.0,14761.0,2
NDC,49884031552,RISPERIDONE 1 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,49884032052,OLANZAPINE 5 MG PO TBDL,1465.56,952.61,13270.0,14761.0,4
NDC,49884032152,Other Outpatient Services,1465.56,952.61,,,0
NDC,49884040152,RISPERIDONE 2 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,49884040191,RISPERIDONE 2 MG PO TBDL,1486.91,966.49,13270.0,14761.0,4
NDC,49884042511,ALISKIREN 300 MG PO TABS,3126.72,2032.37,13270.0,14761.0,2
NDC,49884046566,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO POWD,,,13270.0,14761.0,2
NDC,49884060411,LAMOTRIGINE 250 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,49884064001,METHIMAZOLE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,49884064101,METHIMAZOLE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,49884067314,CABERGOLINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,49884070152,CLOMIPHENE CITRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,49884076852,Other Outpatient Services,894.42,581.37,,,0
NDC,49884076852,TOLVAPTAN 15 MG PO TABS,894.42,581.37,13270.0,14761.0,4
NDC,49884089911,ZOLPIDEM 3.5 MG SL SUBL,1465.56,952.61,13270.0,14761.0,2
NDC,49884089952,ZOLPIDEM 3.5 MG SL SUBL,1465.56,952.61,13270.0,14761.0,2
NDC,49884090252,MAFENIDE ACETATE 50 GRAM TP PACK,1465.56,952.61,13270.0,14761.0,2
NDC,49884092202,MERCAPTOPURINE (PURINETHOL) ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
NDC,49884098501,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,2
NDC,49938010130,DAPSONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,49938010230,DAPSONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,49938011001,AMIFAMPRIDINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50000093560,LACTOBACILLUS REUTERI 100 MILLION CELL/5 DROP PO DRPS,,,13270.0,14761.0,2
NDC,50000093570,B. ANIMALIS-VITAMIN D3 1 BILLION CELL- 10 MCG/5 DROPS PO DROP,,,13270.0,14761.0,2
NDC,50016095711,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IX SYRG",20482.8,13313.82,665.53,765.36,8
NDC,50072020042,TECOVIRIMAT 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50090172300,DARUNAVIR-COBICISTAT 800-150 MG-MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50090345900,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION IN HFAB,1465.56,952.61,13270.0,14761.0,2
NDC,50111032701,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,50111032803,HYDRALAZINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,50111033301,METRONIDAZOLE 250 MG PO TABS,452.8,294.32,13270.0,14761.0,4
NDC,50111033402,METRONIDAZOLE 500 MG PO TABS,3608.0,2345.2,13270.0,14761.0,4
NDC,50111039801,HYDRALAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,50111056001,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,50111064701,FLUOXETINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,50111064801,FLUOXETINE 20 MG PO CAPS,,,13270.0,14761.0,2
NDC,50111064802,FLUOXETINE 20 MG PO CAPS,,,13270.0,14761.0,2
NDC,50111078710,AZITHROMYCIN 250 MG PO TABS,950.4,617.76,13270.0,14761.0,4
NDC,50111078910,AZITHROMYCIN 600 MG PO TABS,2059.68,1338.79,13270.0,14761.0,4
NDC,50111091501,TORSEMIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50111091601,TORSEMIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,50111091701,TORSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,50190014263,Other Outpatient Services,290.0,188.5,,,0
NDC,50222030260,Other Outpatient Services,1465.56,952.61,,,0
NDC,50228010901,CARISOPRODOL 350 MG PO TABS,,,13270.0,14761.0,2
NDC,50228017501,BUPROPION HCL 150 MG PO SR12,,,13270.0,14761.0,2
NDC,50228018960,LEVETIRACETAM 500 MG PO TB24,,,13270.0,14761.0,2
NDC,50228019060,LEVETIRACETAM 750 MG PO TB24,,,13270.0,14761.0,2
NDC,50228037905,EZETIMIBE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,50228045801,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,50228046601,NABUMETONE 750 MG PO TABS,,,13270.0,14761.0,2
NDC,50242003706,HB THROMBOLYSIS CEREBRAL IV INFUSION,69575.04,45223.78,413.02,14761.0,3
NDC,50242003706,TENECTEPLASE 50 MG IV SOLR,69575.04,45223.78,196.4,14761.0,5
NDC,50242004062,OMALIZUMAB 150 MG SC SOLR,12037.02,7824.0599999999995,47.68,14761.0,11
NDC,50242004164,ALTEPLASE 2 MG CATH SOLR,2760.32,1794.21,113.9,14761.0,11
NDC,50242004406,ALTEPLASE 50 MG IV SOLR,36896.85,23982.95,113.9,14761.0,11
NDC,50242004406,HB THROMBOLYSIS CEREBRAL IV INFUSION,36896.85,23982.95,413.02,14761.0,3
NDC,50242004413,ALTEPLASE 50 MG IV SOLR,36896.85,23982.95,113.9,14761.0,3
NDC,50242005121,RITUXIMAB 10 MG/ML IV CONC,11274.24,7328.255,96.27,14761.0,11
NDC,50242005306,RITUXIMAB 10 MG/ML IV CONC,56371.200000000004,36641.28,96.27,14761.0,11
NDC,50242006001,BEVACIZUMAB (AVASTIN) INTRAVITREAL INJECTION,12751.04,8288.18,2.26,2.6,8
NDC,50242006001,BEVACIZUMAB 25 MG/ML IV SOLN,12751.04,8288.18,90.53,14761.0,11
NDC,50242006101,BEVACIZUMAB 25 MG/ML IV SOLN,51004.16,33152.7,90.53,104.11,8
NDC,50242007001,OBINUTUZUMAB 1000 MG/40 ML IV SOLN,77514.48,50384.41,92.88,14761.0,11
NDC,50242007401,SOMATROPIN 10 MG/2 ML (5 MG/ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,50242007601,SOMATROPIN 20 MG/2 ML (10 MG/ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,50242007701,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SC SOLN",42077.16,27350.15,79.43,91.34,8
NDC,50242008527,ALTEPLASE 2 MG CATH SOLR (PEDIATRIC),73793.7,47965.9,113.9,14761.0,3
NDC,50242008701,ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR,57450.6,37342.89,50.36,14761.0,11
NDC,50242008801,ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR,35906.67,23339.34,50.36,14761.0,11
NDC,50242010039,DORNASE ALFA 1 MG/ML IN SOLN,1994.2,1296.23,13270.0,14761.0,2
NDC,50242010040,DORNASE ALFA 1 MG/ML IN SOLN,1994.2,1296.23,13270.0,14761.0,2
NDC,50242010040,DORNASE ALFA 1 MG/ML VIA CHEST TUBE,1994.2,1296.23,,,0
NDC,50242010801,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SC SOLN",52612.65,34198.22,46.0,52.9,8
NDC,50242012047,HB THROMBOLYSIS CEREBRAL IV INFUSION,69575.04,45223.78,413.02,14761.0,3
NDC,50242012047,TENECTEPLASE 50 MG IV SOLR,69575.04,45223.78,196.4,14761.0,5
NDC,50242012101,PIRFENIDONE 267 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50242012301,PIRFENIDONE 801 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50242013001,ALECTINIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50242013201,TRASTUZUMAB 150 MG IV SOLR,14025.78,9116.76,97.05,111.61,8
NDC,50242013501,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,8498.56,5524.06,7.42,14761.0,11
NDC,50242013601,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN,21246.56,13810.26,7.42,14761.0,11
NDC,50242013701,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,42493.12,27620.53,7.42,14761.0,11
NDC,50242013801,TOCILIZUMAB 162 MG/0.9 ML SC SYRG,17513.12,11383.53,13270.0,14761.0,2
NDC,50242014001,VISMODEGIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50242014201,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,299642.4,194767.56,13270.0,14761.0,4
NDC,50242014501,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,61384.43,39899.88,20.07,14761.0,11
NDC,50242015001,OCRELIZUMAB 30 MG/ML IV SOLN,185768.64,120749.62,74.46,14761.0,11
NDC,50242015901,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,9988.0,6492.2,791.27,909.96,8
NDC,50242021401,OMALIZUMAB 75 MG/0.5 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,50242021501,OMALIZUMAB 150 MG/ML SC SYRG,12037.02,7824.0599999999995,47.68,14761.0,11
NDC,50242024501,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SC SOLN",125248.82,81411.73,80.41,92.47,8
NDC,50242026001,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SC SOLN,83495.88,54272.32,80.41,92.47,8
NDC,50242086001,BALOXAVIR MARBOXIL 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50242091701,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",101266.38,65823.15,107.39,123.5,8
NDC,50242091801,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,70886.47,46076.21,107.39,14761.0,11
NDC,50261010408,ESTRADIOL 4 MCG VA INST,1465.56,952.61,13270.0,14761.0,2
NDC,50261011008,ESTRADIOL 10 MCG VA INST,1465.56,952.61,13270.0,14761.0,2
NDC,50268006911,AMANTADINE HCL 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,50268009311,ATORVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268009511,ATORVASTATIN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50268011115,BENAZEPRIL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,50268013111,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,50268015111,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268015211,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268016911,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268017113,CARBAMAZEPINE 200 MG PO CM12,1465.56,952.61,13270.0,14761.0,2
NDC,50268017611,CILOSTAZOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,50268017711,CILOSTAZOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,50268017811,CLARITHROMYCIN 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268019011,CYCLOBENZAPRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268026811,DOCUSATE SODIUM 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268027011,DULOXETINE 30 MG PO CPDR,1465.56,952.61,13270.0,14761.0,4
NDC,50268027811,DOXYCYCLINE HYCLATE 100 MG PO CAPS,290.0,188.5,,,0
NDC,50268027911,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268027915,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268029911,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,50268030911,FENOFIBRATE MICRONIZED 134 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50268031411,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268036111,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268036211,GLIPIZIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,50268040111,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268040211,Other Outpatient Services,290.0,188.5,,,0
NDC,50268043011,INDOMETHACIN 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268043111,INDOMETHACIN 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268044711,ISOSORBIDE DINITRATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268045311,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,2
NDC,50268045315,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,2
NDC,50268047611,Other Outpatient Services,290.0,188.5,,,0
NDC,50268050411,LOSARTAN 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268052011,METHOCARBAMOL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268052011,Other Outpatient Services,290.0,188.5,,,0
NDC,50268052111,METHOCARBAMOL 750 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268052511,MELOXICAM 7.5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268052515,MELOXICAM 7.5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268052611,MELOXICAM 15 MG PO TABS,,,13270.0,14761.0,2
NDC,50268052615,MELOXICAM 15 MG PO TABS,,,13270.0,14761.0,2
NDC,50268053511,Other Outpatient Services,290.0,188.5,,,0
NDC,50268054111,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,50268057311,MONTELUKAST 4 MG PO CHEW,290.0,188.5,13270.0,14761.0,2
NDC,50268057311,Other Outpatient Services,290.0,188.5,,,0
NDC,50268057411,MONTELUKAST 5 MG PO CHEW,290.0,188.5,13270.0,14761.0,4
NDC,50268058511,Other Outpatient Services,290.0,188.5,,,0
NDC,50268058511,PANTOPRAZOLE 20 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,50268060311,NORTRIPTYLINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268060411,NORTRIPTYLINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268062811,OXYBUTYNIN CHLORIDE 10 MG PO TR24,290.0,188.5,13270.0,14761.0,2
NDC,50268062815,OXYBUTYNIN CHLORIDE 10 MG PO TR24,2008.8,1305.72,13270.0,14761.0,2
NDC,50268063111,QUETIAPINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268063211,QUETIAPINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268063311,QUETIAPINE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268063911,Other Outpatient Services,290.0,188.5,,,0
NDC,50268067111,POTASSIUM CHLORIDE 10 MEQ PO CPSR,,,13270.0,14761.0,2
NDC,50268068411,PROCHLORPERAZINE MALEATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,50268068711,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,50268070911,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268071011,Other Outpatient Services,290.0,188.5,,,0
NDC,50268071111,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268071711,Other Outpatient Services,290.0,188.5,,,0
NDC,50268071811,SIROLIMUS 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268072011,SEVELAMER CARBONATE 800 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268072811,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268073212,Other Outpatient Services,1465.56,952.61,,,0
NDC,50268073811,TADALAFIL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268075511,TORSEMIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,50268075611,TORSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,50268075911,TIZANIDINE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,50268076011,TIZANIDINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,50268076411,TERAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268076611,TERAZOSIN 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,50268077211,Other Outpatient Services,290.0,188.5,,,0
NDC,50268077211,TRANEXAMIC ACID 650 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50268078711,VALGANCICLOVIR 450 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50268081811,VENLAFAXINE 75 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
NDC,50268085111,THIAMINE HCL (VITAMIN B1) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,50268085211,CYANOCOBALAMIN (VITAMIN B-12) 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,50268085511,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,50268085515,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,50268085811,PYRIDOXINE (VITAMIN B6) 50 MG PO TABS,,,13270.0,14761.0,2
NDC,50268085815,PYRIDOXINE (VITAMIN B6) 50 MG PO TABS,,,13270.0,14761.0,2
NDC,50268085911,PYRIDOXINE (VITAMIN B6) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,50268086011,ASCORBIC ACID (VITAMIN C) 250 MG PO TABS,,,13270.0,14761.0,2
NDC,50289325001,GLYCERIN-WITCH HAZEL 12.5-50 % TP PADM,,,13270.0,14761.0,2
NDC,50383008705,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,2
NDC,50383008705,Other Outpatient Services,290.0,188.5,,,0
NDC,50383008710,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,2
NDC,50383008712,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,2
NDC,50383017290,LEVOCARNITINE 330 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,50383023210,DORZOLAMIDE 2 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,50383023210,Other Outpatient Services,290.0,188.5,,,0
NDC,50383023310,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,50383024116,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,50383024971,BROMFENAC 0.09 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,50383028616,LEVOFLOXACIN 250 MG/10 ML PO SOLN,7188.48,4672.51,13270.0,14761.0,4
NDC,50383034910,DOCUSATE SODIUM 50 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,50383035730,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,50383036315,LIDOCAINE HCL 2 % MM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,50383036317,LIDOCAINE HCL 2 % MM SOLN,20482.8,13313.82,,,0
NDC,50383066730,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,455.04,295.78,13270.0,14761.0,2
NDC,50383074120,ALBUTEROL SULFATE 5 MG/ML IN NEBU,715.52,465.09,13270.0,14761.0,2
NDC,50383077515,LIDOCAINE HCL 2 % MM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,50383077517,LIDOCAINE HCL 2 % MM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,50383077915,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,50383077916,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,50383077930,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,50383077933,LACTULOSE ENEMA,,,13270.0,14761.0,4
NDC,50383081010,ACYCLOVIR 200 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,50383081016,ACYCLOVIR 200 MG/5 ML PO SUSP,938.43,609.98,13270.0,14761.0,4
NDC,50383082316,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,50383082416,Other Outpatient Services,1465.56,952.61,,,0
NDC,50383090110,HYDROCORTISONE-ACETIC ACID 1-2 % OT DROP,1218.4,791.96,13270.0,14761.0,2
NDC,50383091750,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) PO DROP,,,13270.0,14761.0,2
NDC,50383092493,BUPRENORPHINE HCL 2 MG SL SUBL,323.04,209.98,13270.0,14761.0,4
NDC,50383094323,OLOPATADINE 0.6 % NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,50419017101,REGORAFENIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419017103,REGORAFENIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419017105,REGORAFENIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419020801,"RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN",,,205.77,236.63,8
NDC,50419025001,RIOCIGUAT 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419025091,RIOCIGUAT 0.5 MG PO TABS,22134.24,14387.26,13270.0,14761.0,2
NDC,50419025101,RIOCIGUAT 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419025191,RIOCIGUAT 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419025401,RIOCIGUAT 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419025491,RIOCIGUAT 2.5 MG PO TABS,22134.24,14387.26,13270.0,14761.0,2
NDC,50419032001,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032005,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032015,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032501,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032502,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032507,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032511,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032512,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419032513,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,2
NDC,50419032513,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,,,0
NDC,50419032515,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,,,0
NDC,50419032537,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,13270.0,14761.0,2
NDC,50419039501,DAROLUTAMIDE 300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419040501,Other Outpatient Services,1465.56,952.61,,,0
NDC,50419042201,LEVONORGESTREL 14 MCG/24 HR (3 YRS) 13.5 MG IU IUD,16182.08,10518.35,,,0
NDC,50419042301,LEVONORGESTREL 20 MCG/24 HOURS (8 YRS) 52 MG IU IUD,19434.08,12632.15,,,0
NDC,50419042401,LEVONORGESTREL 17.5 MCG/24 HR (5 YRS) 19.5 MG IU IUD,19434.08,12632.15,,,0
NDC,50419045401,ESTRADIOL 0.025 MG/24 HR TD PTWK,290.0,188.5,13270.0,14761.0,4
NDC,50419054001,FINERENONE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419054002,FINERENONE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419054101,FINERENONE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50419077701,CIPROFLOXACIN 250 MG/5 ML PO SUMC,1944.0,1263.6,13270.0,14761.0,2
NDC,50428008162,CRANBERRY CONC-C-BACILLUS COAG 450-30-50 MG-MG-MILLION PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50428015168,DOCUSATE SODIUM 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,50428016183,"CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,50428034400,MELATONIN 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,50428057523,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO TABS,1465.56,952.61,,,0
NDC,50428739583,SOD BIC-GINGER-FENNEL-CHAMOM 14-2.5-2-13 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,50458009801,PENTOSAN POLYSULFATE SODIUM 100 MG PO CAPS,17852.8,11604.32,13270.0,14761.0,2
NDC,50458029515,ITRACONAZOLE 10 MG/ML PO SOLN,5212.8,3388.32,13270.0,14761.0,4
NDC,50458030201,RISPERIDONE 0.5 MG PO TABS,6870.4,4465.76,13270.0,14761.0,2
NDC,50458033001,RISPERIDONE 3 MG PO TABS,14339.2,9320.48,13270.0,14761.0,2
NDC,50458033006,RISPERIDONE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50458055010,PALIPERIDONE 3 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,50458056401,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,1465.56,952.61,18.38,14761.0,3
NDC,50458057701,RIVAROXABAN 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50458057710,RIVAROXABAN 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50458057801,RIVAROXABAN 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50458057810,RIVAROXABAN 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50458057901,RIVAROXABAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50458057910,RIVAROXABAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50458057990,RIVAROXABAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50458058001,RIVAROXABAN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,50458058010,RIVAROXABAN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,50458059601,RISPERIDONE 1 MG/ML PO SOLN,1815.36,1179.98,13270.0,14761.0,2
NDC,50458064165,TOPIRAMATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50474000263,LEVETIRACETAM 500 MG/5 ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,50474047066,BRIVARACETAM 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,50474050014,MIDAZOLAM 5 MG/SPRAY (0.1 ML) NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,50474057066,BRIVARACETAM 50 MG PO TABS,21958.08,14272.75,13270.0,14761.0,2
NDC,50474057066,Other Outpatient Services,21958.08,14272.75,,,0
NDC,50474059766,LEVETIRACETAM 1000 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50474059966,LEVETIRACETAM 750 MG PO TB24,,,13270.0,14761.0,2
NDC,50474067066,BRIVARACETAM 75 MG PO TABS,21958.08,14272.75,13270.0,14761.0,2
NDC,50474070062,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SC KIT,53994.87,35096.67,5.79,14761.0,11
NDC,50474071079,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SC SYKT,49552.47,32209.11,5.79,14761.0,3
NDC,50474077009,BRIVARACETAM 100 MG PO TABS,36596.8,23787.92,13270.0,14761.0,2
NDC,50474077066,BRIVARACETAM 100 MG PO TABS,21958.08,14272.75,13270.0,14761.0,2
NDC,50474080103,ROTIGOTINE 1 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,50474080203,ROTIGOTINE 2 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,4
NDC,50474080303,ROTIGOTINE 3 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,50474080403,ROTIGOTINE 4 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,50474080503,ROTIGOTINE 6 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,50474080603,ROTIGOTINE 8 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,50474087015,BRIVARACETAM 10 MG/ML PO SOLN,21960.0,14274.0,13270.0,14761.0,4
NDC,50484001030,COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TP OINT,4211.52,2737.49,13270.0,14761.0,2
NDC,50484001030,Other Outpatient Services,4211.52,2737.49,,,0
NDC,50484081015,BECAPLERMIN 0.01 % TP GEL,1465.56,952.61,13270.0,14761.0,2
NDC,50580045711,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,50580045811,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,50580049090,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,50580053604,PSEUDOEPHEDRINE HCL 15 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,50580061405,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,50632000101,"SMALLPOX,MPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8 UNIT/0.5 SC SUSP",4190.4,2723.76,,,0
NDC,50632001001,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",5071.36,3296.38,435.99,14761.0,11
NDC,50632001301,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",5071.36,3296.38,435.99,501.39,8
NDC,50633012011,DIGOXIN IMMUNE FAB 40 MG IV SOLR,40106.88,26069.47,6086.61,14761.0,11
NDC,50633012012,DIGOXIN IMMUNE FAB 40 MG IV SOLR,40106.88,26069.47,6086.61,14761.0,3
NDC,50633021011,GLUCARPIDASE 1000 UNITS IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,50633031011,HYDROXOCOBALAMIN 5 GRAM IV SOLR,14877.44,9670.34,13270.0,14761.0,4
NDC,50742011201,DESIPRAMINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,50742011301,DESIPRAMINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,50742011808,Other Outpatient Services,372.61,242.2,,,0
NDC,50742017501,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,2
NDC,50742017701,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,2
NDC,50742024890,DILTIAZEM HCL 120 MG PO CP24,290.0,188.5,13270.0,14761.0,4
NDC,50742024990,DILTIAZEM HCL 180 MG PO CP24,290.88,189.07,13270.0,14761.0,4
NDC,50742025090,DILTIAZEM HCL 240 MG PO CP24,321.12,208.73,13270.0,14761.0,4
NDC,50742025190,DILTIAZEM HCL 300 MG PO CP24,480.96,312.62,13270.0,14761.0,2
NDC,50742025290,DILTIAZEM HCL 360 MG PO CP24,532.8,346.32,13270.0,14761.0,4
NDC,50742026003,NIFEDIPINE 30 MG PO TR24,,,13270.0,14761.0,2
NDC,50742026103,NIFEDIPINE 60 MG PO TR24,,,13270.0,14761.0,4
NDC,50742050501,Other Outpatient Services,290.0,188.5,,,0
NDC,50742050501,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,290.0,188.5,13270.0,14761.0,2
NDC,50742051501,NITROGLYCERIN 0.3 MG/HR TD PT24,789.95,513.47,13270.0,14761.0,2
NDC,50742061501,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,50742061601,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,50742061701,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,2
NDC,50742064501,TRIAZOLAM 0.125 MG PO TABS,1118.4,726.96,13270.0,14761.0,2
NDC,50742064601,TRIAZOLAM 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50742066701,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG PO TABS,1505.6,978.64,13270.0,14761.0,2
NDC,50881000560,RUXOLITINIB 5 MG PO TABS,274399.68,178359.79,13270.0,14761.0,4
NDC,50881001060,RUXOLITINIB 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50881001560,RUXOLITINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50881002060,RUXOLITINIB 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,50930009802,ARTIFICIAL SALIVA (YERBAS-LYT) MM SPRA,,,13270.0,14761.0,2
NDC,50930009808,ARTIFICIAL SALIVA (YERBAS-LYT) MM SPRA,,,13270.0,14761.0,2
NDC,51079002301,METOLAZONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079002320,METOLAZONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079002401,METOLAZONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079002420,METOLAZONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079005101,Other Outpatient Services,290.0,188.5,,,0
NDC,51079005801,CHLORTHALIDONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007201,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007220,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007320,FUROSEMIDE 40 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007401,HYDRALAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007501,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007520,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079007601,HYDRALAZINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008301,ISONIAZID 300 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008320,ISONIAZID 300 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008601,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008620,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008701,MIRTAZAPINE 30 MG PO TABS,,,13270.0,14761.0,2
NDC,51079008720,MIRTAZAPINE 30 MG PO TABS,,,13270.0,14761.0,2
NDC,51079009301,Other Outpatient Services,290.0,188.5,,,0
NDC,51079010301,SPIRONOLACTONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079010903,BUPROPION HCL 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,51079011820,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079014101,Other Outpatient Services,1465.56,952.61,,,0
NDC,51079014201,LITHIUM CARBONATE 450 MG PO TBSR,,,13270.0,14761.0,2
NDC,51079016401,VORICONAZOLE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079016901,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,51079017001,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,51079020520,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079020601,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,51079020620,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,51079020801,Other Outpatient Services,1465.56,952.61,,,0
NDC,51079020820,Other Outpatient Services,1465.56,952.61,,,0
NDC,51079021101,ATORVASTATIN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079025501,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079025520,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079028401,DIAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079028420,DIAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079028501,DIAZEPAM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079028520,DIAZEPAM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079037501,Other Outpatient Services,1465.56,952.61,,,0
NDC,51079037901,MYCOPHENOLATE MOFETIL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079043601,DOXEPIN 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079043620,DOXEPIN 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079043701,DOXEPIN 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079043801,DOXEPIN 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079043820,DOXEPIN 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079044001,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,51079044301,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,2
NDC,51079045120,AMLODIPINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079045301,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079045820,PRAVASTATIN 20 MG PO TABS,924.8,601.12,13270.0,14761.0,2
NDC,51079052520,ONDANSETRON 4 MG PO TBDL,20482.8,13313.82,,,0
NDC,51079052701,FUROSEMIDE 80 MG PO TABS,,,13270.0,14761.0,2
NDC,51079052720,FUROSEMIDE 80 MG PO TABS,,,13270.0,14761.0,2
NDC,51079054120,PROCHLORPERAZINE MALEATE 5 MG PO HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
NDC,51079054720,FEXOFENADINE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,51079058201,LEUCOVORIN CALCIUM 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51079059701,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079059720,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079059901,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51079059901,Other Outpatient Services,290.0,188.5,,,0
NDC,51079062006,AZATHIOPRINE 50 MG HALF-TAB = 25 MG,1465.56,952.61,13270.0,14761.0,4
NDC,51079063001,PRAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079063020,PRAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079063120,PRAZOSIN 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079067001,METHOTREXATE SODIUM 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,51079068401,ATENOLOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079068420,ATENOLOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079068501,ATENOLOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079068520,ATENOLOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079069001,LOPERAMIDE 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079069020,LOPERAMIDE 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079072101,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,51079072420,ZOLPIDEM 5 MG HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,2
NDC,51079073301,HALOPERIDOL 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073320,HALOPERIDOL 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073401,HALOPERIDOL 1 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073501,HALOPERIDOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073520,HALOPERIDOL 2 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073601,HALOPERIDOL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079073620,HALOPERIDOL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079074620,DILTIAZEM ORAL SUSPENSION 12 MG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,51079075301,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,51079075320,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,51079075901,ATENOLOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079075920,ATENOLOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079077101,CARVEDILOL 3.125 MG PO TABS,,,13270.0,14761.0,2
NDC,51079077120,CARVEDILOL 3.125 MG PO TABS,,,13270.0,14761.0,2
NDC,51079077620,HYDROCHLOROTHIAZIDE 12.5 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079078220,PRAVASTATIN 40 MG PO TABS,1222.4,794.56,13270.0,14761.0,4
NDC,51079080101,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079080120,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081001,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081020,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081101,GLIPIZIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081201,NADOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081220,NADOLOL 20 MG PO HALF-TAB = 10 MG,,,13270.0,14761.0,2
NDC,51079081301,NADOLOL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,51079081801,TACROLIMUS 1 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,51079081820,TACROLIMUS 1 MG PO CAPS,1715.2,1114.88,13270.0,14761.0,4
NDC,51079082101,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,51079082120,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,51079088220,CLONAZEPAM 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51079088601,METOCLOPRAMIDE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079088801,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079090501,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079091701,VERAPAMIL 120 MG PO C24P,,,13270.0,14761.0,2
NDC,51079091720,VERAPAMIL 120 MG PO C24P,,,13270.0,14761.0,2
NDC,51079092101,CLOZAPINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079092201,CLOZAPINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079092220,CLOZAPINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079092320,CARBIDOPA-LEVODOPA 50-200 MG PO TBSR,,,13270.0,14761.0,2
NDC,51079092920,LABETALOL 200 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093001,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093020,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093101,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093120,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093220,CARVEDILOL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,51079093620,TERAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079093820,TERAZOSIN 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,51079094320,BUPROPION HCL 75 MG PO TABS,,,13270.0,14761.0,2
NDC,51079096001,BUSPIRONE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,51079096020,BUSPIRONE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,51079097801,CARBIDOPA-LEVODOPA 25-100 MG PO TBSR,,,13270.0,14761.0,2
NDC,51079097901,SPIRONOLACTONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51079098001,SPIRONOLACTONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079098008,SPIRONOLACTONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51079098501,BUSPIRONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,51079098601,BUSPIRONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079098620,BUSPIRONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51079099120,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,51144000301,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,64107.0,41669.55,226.12,14761.0,18
NDC,51144002001,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,25281.0,16432.65,45.75,52.61,8
NDC,51144003001,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,37921.5,24648.98,45.75,52.61,8
NDC,51144005001,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,109800.0,71370.0,298.67,14761.0,11
NDC,51167020001,IVACAFTOR 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51167033101,ELEXACAFTOR-TEZACAFTOR-IVACAFT 100-50-75 MG(D) /150 MG (N) PO TBSQ,1465.56,952.61,,,0
NDC,51224001220,PHENTOLAMINE 5 MG IJ SOLR,4755.36,3090.98,457.13,14761.0,3
NDC,51248015101,SOLIFENACIN 10 MG PO TABS,5747.04,3735.58,13270.0,14761.0,2
NDC,51285008787,L NORGEST/E.ESTRADIOL-E.ESTRAD 0.15 MG-30 MCG (84)/10 MCG (7) PO 3MPK,,,13270.0,14761.0,2
NDC,51293064601,BETHANECHOL CHLORIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,51407044530,PRASUGREL 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51407066230,FESOTERODINE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,51407066305,Other Outpatient Services,1465.56,952.61,,,0
NDC,51525011301,HYOSCYAMINE SULFATE 0.125 MG SL SUBL,,,13270.0,14761.0,2
NDC,51525043101,Other Outpatient Services,1465.56,952.61,,,0
NDC,51552005506,ACETIC ACID (BULK) 5 % MISC LIQD,312.0,202.8,13270.0,14761.0,2
NDC,51645070310,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,51672020021,CLOTRIMAZOLE 1 % TP CREA,1465.56,952.61,13270.0,14761.0,4
NDC,51672125901,CLOBETASOL 0.05 % TP OINT,,,13270.0,14761.0,2
NDC,51672126401,FLUOCINONIDE 0.05 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,51672127201,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TP OINT",290.0,188.5,,,0
NDC,51672127502,Other Outpatient Services,329.76,214.34,,,0
NDC,51672128901,NYSTATIN 100000 UNIT/GRAM TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,51672130200,TERCONAZOLE 0.8 % VA CREA,386.56,251.26,13270.0,14761.0,2
NDC,51672131200,Other Outpatient Services,1465.56,952.61,,,0
NDC,51672131201,MUPIROCIN 2 % TP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,51672131808,CICLOPIROX 0.77 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,51672138601,FLUOCINONIDE 0.05 % TP CREA,,,13270.0,14761.0,2
NDC,51672200201,CLOTRIMAZOLE 1 % TP CREA,290.0,188.5,13270.0,14761.0,2
NDC,51672200202,Other Outpatient Services,1465.56,952.61,,,0
NDC,51672201302,Other Outpatient Services,1465.56,952.61,,,0
NDC,51672202001,TOLNAFTATE 1 % TP CREA,,,13270.0,14761.0,2
NDC,51672203506,MICONAZOLE NITRATE 2 % VA CREA,290.0,188.5,13270.0,14761.0,4
NDC,51672203506,Other Outpatient Services,290.0,188.5,,,0
NDC,51672203701,CLOTRIMAZOLE 1 % TP SOLN,460.64,299.42,13270.0,14761.0,2
NDC,51672211400,ACETAMINOPHEN 80 MG PR SUPP,,,13270.0,14761.0,2
NDC,51672211402,ACETAMINOPHEN 80 MG PR SUPP,,,13270.0,14761.0,2
NDC,51672211600,ACETAMINOPHEN 325 MG PR SUPP,,,13270.0,14761.0,2
NDC,51672211602,ACETAMINOPHEN 325 MG PR SUPP,,,13270.0,14761.0,2
NDC,51672300701,HYDROCORTISONE-ACETIC ACID 1-2 % OT DROP,2019.36,1312.58,13270.0,14761.0,2
NDC,51672400101,NORTRIPTYLINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,51672400201,NORTRIPTYLINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,51672402201,ACETAZOLAMIDE 125 MG PO TABS,387.2,251.68,13270.0,14761.0,2
NDC,51672402301,ACETAZOLAMIDE 250 MG PO TABS,521.6,339.04,13270.0,14761.0,2
NDC,51672404709,CARBAMAZEPINE 100 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,51672404801,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,,,0
NDC,51672405506,AMIODARONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,51672411806,FLUOROURACIL 5 % TP CREA,1522.56,989.66,13270.0,14761.0,2
NDC,51672413001,LAMOTRIGINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51672413101,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51672413204,Other Outpatient Services,1465.56,952.61,,,0
NDC,51672413304,LAMOTRIGINE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,51672529701,PROMETHAZINE 25 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,51754010801,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",290.0,188.5,13270.0,14761.0,2
NDC,51754020301,VERAPAMIL 2.5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,51754050001,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,51754100001,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,51754200104,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,51754420001,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,51754420004,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,,,0
NDC,51754500101,Other Outpatient Services,290.0,188.5,,,0
NDC,51754500101,SODIUM BICARBONATE 8.4 % IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,51754501101,SODIUM BICARBONATE 8.4 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,51754506001,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",551.52,358.49,13270.0,14761.0,2
NDC,51754600001,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,51759020410,FREMANEZUMAB-VFRM 225 MG/1.5 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,51801001101,POTASSIUM BICARB-CITRIC ACID 20 MEQ PO TBEF,,,13270.0,14761.0,4
NDC,51801001130,POTASSIUM BICARB-CITRIC ACID 20 MEQ PO TBEF,,,13270.0,14761.0,4
NDC,51801001201,POTASSIUM BICARB-CITRIC ACID 20 MEQ PO TBEF,,,13270.0,14761.0,4
NDC,51801001330,POTASSIUM BICARB-CITRIC ACID 10 MEQ PO TBEF,,,13270.0,14761.0,4
NDC,51801001430,POTASSIUM BICARB-CITRIC ACID 10 MEQ PO TBEF,,,13270.0,14761.0,4
NDC,51862018015,PRAMOXINE 1 % TP FOAM,611.28,397.33,13270.0,14761.0,4
NDC,51862027906,NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51862032001,LIOTHYRONINE 5 MCG PO TABS,,,13270.0,14761.0,2
NDC,51862032101,LIOTHYRONINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,51862034690,DEXTROAMPHETAMINE SULFATE 15 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,51862045801,CYCLOSPORINE MODIFIED 25 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,51862046001,CYCLOSPORINE MODIFIED 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,51862048601,TRIMETHOPRIM 100 MG PO TABS,2777.6,1805.44,,,0
NDC,51862068201,TAMOXIFEN 20 MG/10 ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,51927441100,GLUTAMINE (BULK) MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,51991000633,DESVENLAFAXINE SUCCINATE 25 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,51991014499,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,51991020399,POLYSACCHARIDE IRON COMPLEX 150 MG IRON PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,51991031133,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,337.44,219.34,13270.0,14761.0,2
NDC,51991031190,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,51991031233,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,337.44,219.34,13270.0,14761.0,2
NDC,51991031290,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,51991034806,Other Outpatient Services,1465.56,952.61,,,0
NDC,51991035106,Other Outpatient Services,1465.56,952.61,,,0
NDC,51991037999,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,51991054390,Other Outpatient Services,1465.56,952.61,,,0
NDC,51991073520,GRANISETRON HCL 1 MG PO TABS,1073.28,697.63,13270.0,14761.0,2
NDC,51991073599,GRANISETRON HCL 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,51991075933,LETROZOLE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,51991079798,AZACITIDINE 100 MG IJ SOLR,20482.8,13313.82,,,0
NDC,51991080990,LEVOMEFOLATE CALCIUM 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51991081390,MECOBAL-LEVOMEFOLAT CA-B6 PHOS 3-35-2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,51991082001,Other Outpatient Services,1465.56,952.61,,,0
NDC,51991082001,PROPRANOLOL 160 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,51991083716,CETIRIZINE 1 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,51991087733,EPLERENONE 25 MG PO TABS,326.88,212.47,13270.0,14761.0,4
NDC,51991089830,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,51991089899,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,51991094298,DEXRAZOXANE HCL 500 MG IV SOLR,8830.88,5740.07,108.95,14761.0,5
NDC,52015008001,FIDAXOMICIN 200 MG PO TABS,74248.96,48261.82,13270.0,14761.0,4
NDC,52015008001,Other Outpatient Services,74248.96,48261.82,,,0
NDC,52244010010,THEOPHYLLINE 100 MG PO CP24,,,13270.0,14761.0,2
NDC,52268001201,"SODIUM,POTASSIUM,MAG SULFATES 17.5-3.13-1.6 GRAM PO SOLR",1465.56,952.61,13270.0,14761.0,2
NDC,52268010001,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,320.0,208.0,13270.0,14761.0,4
NDC,52268020001,SOD SULF-POT CHLORIDE-MAG SULF 1.479-0.188- 0.225 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,52268020101,SOD SULF-POT CHLORIDE-MAG SULF 1.479-0.188- 0.225 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,52343016201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,52380190502,Other Outpatient Services,1465.56,952.61,,,0
NDC,52380190504,POVIDONE-IODINE 10 % TP SOLN,290.0,188.5,13270.0,14761.0,4
NDC,52427028501,Other Outpatient Services,1465.56,952.61,,,0
NDC,52536018003,ERYTHROMYCIN 250 MG PO TBEC,2394.72,1556.57,13270.0,14761.0,2
NDC,52536062501,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,,,0
NDC,52544015130,SILODOSIN 4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,52565000950,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,52565008515,GENTAMICIN 0.1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,52652500101,AMLODIPINE BENZOATE 1 MG/ML PO SUSP,8748.0,5686.2,13270.0,14761.0,4
NDC,52652600101,BACLOFEN 25 MG/5 ML (5 MG/ML) PO SUSP,10821.12,7033.73,13270.0,14761.0,4
NDC,52747050130,"IRON FUM, POLY #1-VITC-L.CASEI 130 MG IRON-25 MG-30 MG PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,52817023530,RAMELTEON 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,52817026010,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,52817027010,BISOPROLOL FUMARATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,52817027030,Other Outpatient Services,1465.56,952.61,,,0
NDC,52817031910,BACLOFEN 5 MG PO TABS,,,13270.0,14761.0,4
NDC,52817032510,MIDODRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,52817033050,CYCLOBENZAPRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,52817033210,CYCLOBENZAPRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,52817036010,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,52937000120,ICOSAPENT ETHYL 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,52937000340,ICOSAPENT ETHYL 0.5 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,52959033620,TETRACYCLINE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,53329030124,CHLORHEXIDINE GLUCONATE 0.12 % MM MWSH,,,13270.0,14761.0,2
NDC,53436008401,PATIROMER CALCIUM SORBITEX 8.4 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,53436016801,PATIROMER CALCIUM SORBITEX 16.8 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,53436025201,PATIROMER CALCIUM SORBITEX 25.2 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,53451010101,GABAPENTIN ENACARBIL 600 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,53451010301,GABAPENTIN ENACARBIL 300 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,53489011802,DOXYCYCLINE HYCLATE 50 MG PO CAPS,301.6,196.04,13270.0,14761.0,4
NDC,53489011902,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1465.56,952.61,,,0
NDC,53489038601,MINOXIDIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,53703010003,IMMUNE GLOB-PLASMA FRA BOVINE 5 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,53746036101,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,53746044210,MECLIZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,53746054205,POTASSIUM CHLORIDE 10 MEQ PO CPSR,,,13270.0,14761.0,2
NDC,53746054501,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,53746057101,BETHANECHOL CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,53746057201,BETHANECHOL CHLORIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,53746057301,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,53746064101,FLECAINIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,53746071101,GUANFACINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,54092017212,CARBAMAZEPINE 200 MG PO CM12,1465.56,952.61,13270.0,14761.0,2
NDC,54092017312,CARBAMAZEPINE 300 MG PO CM12,1465.56,952.61,13270.0,14761.0,2
NDC,54092018981,MESALAMINE 250 MG PO CPSR,,,13270.0,14761.0,2
NDC,54092019112,MESALAMINE 500 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,54092025290,LANTHANUM 500 MG PO CHEW,16109.28,10471.03,13270.0,14761.0,2
NDC,54092025490,LANTHANUM 1000 MG PO CHEW,16109.28,10471.03,13270.0,14761.0,2
NDC,54092047612,MESALAMINE 1.2 GRAM PO TBEC,,,13270.0,14761.0,2
NDC,54092054601,PRUCALOPRIDE 1 MG PO TABS,8306.4,5399.16,13270.0,14761.0,4
NDC,54092054701,PRUCALOPRIDE 2 MG PO TABS,8306.4,5399.16,13270.0,14761.0,4
NDC,54092070104,VELAGLUCERASE ALFA 400 UNITS IV SOLR,11862.16,7710.4,460.97,530.11,8
NDC,54123090730,BUPRENORPHINE-NALOXONE 0.7-0.18 MG SL SUBL,2372.16,1541.9,13270.0,14761.0,2
NDC,54288010301,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,54288010310,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,54288010502,ETHYL ALCOHOL 99 % IA SOLN,12223.92,7945.55,,,0
NDC,54288010515,ETHYL ALCOHOL 99 % IA SOLN,12223.92,7945.55,13270.0,14761.0,2
NDC,54288012501,Other Outpatient Services,1465.56,952.61,,,0
NDC,54288014201,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,54436002002,METHOTREXATE (PF) 20 MG/0.4 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
NDC,54436020002,TESTOSTERONE ENANTHATE 100 MG/0.5 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
NDC,54436027502,TESTOSTERONE ENANTHATE 75 MG/0.5 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
NDC,54482014508,LEVOCARNITINE (WITH SUGAR) 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,54482014701,LEVOCARNITINE 200 MG/ML IV SOLN,579.52,376.69,13270.0,14761.0,2
NDC,54629005024,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,2
NDC,54629007501,MULTIVITAMIN WITH MINERALS PO TABS,,,13270.0,14761.0,2
NDC,54629009501,RIBOFLAVIN (VITAMIN B2) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,54629060101,DOCUSATE SODIUM 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,54643564901,"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,54643565002,"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,54838000530,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML PO DROP",,,13270.0,14761.0,2
NDC,54838050221,HYDROXYZINE HCL 10 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,54838051240,DOXEPIN 10 MG/ML PO CONC,,,13270.0,14761.0,2
NDC,54838057059,ARIPIPRAZOLE 1 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,54859080810,SENNOSIDES 8.8 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,54879002101,CYCLOPHOSPHAMIDE 25 MG PO CAPS,4248.0,2761.2,13270.0,14761.0,4
NDC,54879002201,CYCLOPHOSPHAMIDE 50 MG PO CAPS,5963.2,3876.08,13270.0,14761.0,2
NDC,55111011230,MOXIFLOXACIN 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,4
NDC,55111016330,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,55111018015,TIZANIDINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,55111026279,OLANZAPINE 5 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,55111026379,OLANZAPINE 10 MG PO TBDL,290.0,188.5,13270.0,14761.0,4
NDC,55111027950,Other Outpatient Services,1465.56,952.61,,,0
NDC,55111028130,LEVOFLOXACIN 750 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,55111030230,DONEPEZIL 23 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,55111032001,GLIMEPIRIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,55111032101,GLIMEPIRIDE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,55111032890,NATEGLINIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,55111032990,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,2
NDC,55111035260,RIVASTIGMINE TARTRATE 1.5 MG PO CAPS,522.24,339.46,13270.0,14761.0,2
NDC,55111035360,RIVASTIGMINE TARTRATE 3 MG PO CAPS,522.24,339.46,13270.0,14761.0,2
NDC,55111041930,LAMOTRIGINE 250 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,55111053201,DIVALPROEX 125 MG PO CDRS,628.8,408.72,13270.0,14761.0,2
NDC,55111055610,DECITABINE 50 MG IV SOLR,1118.08,726.75,13270.0,14761.0,2
NDC,55111062560,ZAFIRLUKAST 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,55111065207,BIVALIRUDIN 250 MG IV SOLR,722.99,469.94,13270.0,14761.0,2
NDC,55111065237,BIVALIRUDIN 250 MG IV SOLR,722.99,469.94,13270.0,14761.0,2
NDC,55111065401,SIROLIMUS 2 MG PO TABS,15702.4,10206.56,13270.0,14761.0,4
NDC,55111065930,ROPINIROLE 2 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,55111067106,CLOPIDOGREL 300 MG PO TABS,309.63,201.26,13270.0,14761.0,2
NDC,55111067131,CLOPIDOGREL 300 MG PO TABS,9288.96,6037.82,13270.0,14761.0,2
NDC,55111068011,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,809.76,526.34,13270.0,14761.0,2
NDC,55111068110,FONDAPARINUX 10 MG/0.8 ML SC SYRG,824.37,535.84,13270.0,14761.0,2
NDC,55111068507,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55111068852,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,475.0,308.75,,,0
NDC,55111069407,PALONOSETRON 0.25 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55111072901,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,55111073390,VALSARTAN 160 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,55111078301,FEXOFENADINE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,55111078401,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,2
NDC,55135013201,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,22619.16,14702.45,43.17,14761.0,11
NDC,55150011310,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150011420,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150011720,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,55150012030,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,55150012715,OXACILLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150012824,OXACILLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150015410,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150015520,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150015872,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,55150015974,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,55150016072,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,20482.8,13313.82,,,0
NDC,55150016102,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150016102,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,55150016205,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150016205,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,55150016330,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150016330,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,55150016613,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,1807.6,1174.94,13270.0,14761.0,2
NDC,55150016710,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150016710,BUPIVACAINE 0.25% INFUSION (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
NDC,55150016910,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,55150017230,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,55150017301,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150017410,AZITHROMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150017410,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,290.0,188.5,13270.0,14761.0,2
NDC,55150017705,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150018301,NICARDIPINE 25 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,55150018703,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,55150019410,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,55150019410,ESMOLOL LOADING DOSE FROM BAG/PUMP,290.0,188.5,13270.0,14761.0,2
NDC,55150019410,Other Outpatient Services,290.0,188.5,,,0
NDC,55150020200,PANTOPRAZOLE 40 MG IV SOLR,290.0,188.5,13270.0,14761.0,6
NDC,55150020720,MEROPENEM 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,55150020830,MEROPENEM 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,55150021910,EPTIFIBATIDE 2 MG/ML IV SOLN,309.92,201.45,13270.0,14761.0,2
NDC,55150022110,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,55150022505,ROCURONIUM 10 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,55150022610,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150022810,TIGECYCLINE 50 MG IV SOLR,433.79,281.96,13270.0,14761.0,2
NDC,55150023000,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,4
NDC,55150023200,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,4
NDC,55150023210,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,55150023300,FONDAPARINUX 10 MG/0.8 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,55150023410,POLYMYXIN B SULFATE 500000 UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150023501,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150023510,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,55150024251,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,55150028209,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,20482.8,13313.82,,,0
NDC,55150028220,ERTAPENEM 1 GRAM IJ SOLR,383.71,249.41,13270.0,14761.0,4
NDC,55150029701,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150030401,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150030701,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150030801,OLANZAPINE 10 MG IM SOLR,290.0,188.5,13270.0,14761.0,2
NDC,55150031801,CHLORPROMAZINE 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150032201,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150033501,CARBOPLATIN 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,55150034501,NALOXONE 1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,55150043101,DACTINOMYCIN 0.5 MG IV SOLR,5634.88,3662.67,351.31,14761.0,11
NDC,55150043901,KETAMINE 50 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,55292014301,PASIREOTIDE PAMOATE 60 MG IM SUSR,171609.21,111545.99,597.49,687.12,16
NDC,55390000210,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,55390001910,MILRINONE IN 0.9% NACL 20 MG/50 ML (0.4 MG/ML) INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
NDC,55390004601,FLUCONAZOLE CUSTOM IVPB IN NACL DOSES <=800 MG (CSMC),10974.18,7133.215,13270.0,14761.0,2
NDC,55390007310,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,55390012610,MIDAZOLAM 250 MG/50 ML (5 MG/ML) ADULT STRAIGHT DRUG IV SOLUTION,1465.56,952.61,13270.0,14761.0,2
NDC,55390012610,MIDAZOLAM 5 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,55513002801,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML IJ SYRG,12967.47,8428.86,3.78,4.35,8
NDC,55513003201,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML IJ SYRG,32418.63,21072.11,3.78,14761.0,11
NDC,55513007330,CINACALCET 30 MG PO TABS,7816.8,5080.92,13270.0,14761.0,4
NDC,55513007530,CINACALCET 90 MG PO TABS,23449.92,15242.45,13270.0,14761.0,2
NDC,55513011101,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML IJ SYRG,19451.25,12643.31,3.78,4.35,8
NDC,55513013201,TRASTUZUMAB-ANNS 420 MG IV SOLR,31294.08,20341.15,30.3,34.84,8
NDC,55513013728,APREMILAST 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,55513013760,APREMILAST 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,55513013760,Other Outpatient Services,1465.56,952.61,,,0
NDC,55513014101,TRASTUZUMAB-ANNS 150 MG IV SOLR,11176.56,7264.76,30.3,34.84,8
NDC,55513015001,BLINATUMOMAB 35 MCG IV KIT,46301.85,30096.2,189.49,14761.0,11
NDC,55513015001,BLINATUMOMAB 35 MCG IV SOLR,46301.85,30096.2,13270.0,14761.0,2
NDC,55513016001,BLINATUMOMAB 35 MCG IV KIT,46301.85,30096.2,189.49,14761.0,11
NDC,55513019001,PEGFILGRASTIM 6 MG/0.6 ML SC SYRG,38865.87,25262.82,38.78,14761.0,11
NDC,55513019201,PEGFILGRASTIM 6 MG/0.6 ML SC OBISYRINGE,38865.87,25262.82,38.78,14761.0,11
NDC,55513020601,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,10193.28,6625.63,33.1,14761.0,11
NDC,55513020701,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,40772.1,26501.87,33.1,14761.0,11
NDC,55513022101,ROMIPLOSTIM 250 MCG SC SOLR,23594.94,15336.71,13270.0,14761.0,2
NDC,55513022201,ROMIPLOSTIM 500 MCG SC SOLR,47189.79,30673.36,13270.0,14761.0,2
NDC,55513022301,ROMIPLOSTIM 125 MCG SC SOLR,20973.6,13632.84,13270.0,14761.0,2
NDC,55513022401,RITUXIMAB-ARRX 10 MG/ML IV SOLN,8548.32,5556.41,48.12,55.34,8
NDC,55513032601,RITUXIMAB-ARRX 10 MG/ML IV SOLN,42741.6,27782.04,48.12,55.34,8
NDC,55513067001,INFLIXIMAB-AXXQ 100 MG IV SOLR,6335.52,4118.09,26.51,14761.0,13
NDC,55513071001,DENOSUMAB 60 MG/ML SC SYRG,14145.105,9194.32,33.57,14761.0,11
NDC,55513073001,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SC SOLN,26016.46,16910.7,33.57,14761.0,11
NDC,55513075001,EVOLOCUMAB 140 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,55513076001,EVOLOCUMAB 140 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,55513080060,IVABRADINE 5 MG PO TABS,8885.76,5775.74,13270.0,14761.0,4
NDC,55513081060,IVABRADINE 7.5 MG PO TABS,8885.76,5775.74,13270.0,14761.0,2
NDC,55513084301,ERENUMAB-AOOE 140 MG/ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
NDC,55513088001,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SC SYRG,20482.8,13313.82,13.91,16.0,8
NDC,55513088002,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SC SYRG,11830.14,7689.59,13.91,14761.0,11
NDC,55513095401,PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN,15189.75,9873.34,198.39,14761.0,11
NDC,55513095601,PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN,60759.0,39493.35,198.39,228.15,8
NDC,55566220000,DESMOPRESSIN 4 MCG/ML IJ SOLN,1209.57,786.22,6.75,7.76,8
NDC,55566280000,DINOPROSTONE 10 MG VA INSR,7811.04,5077.18,13270.0,14761.0,4
NDC,55566280001,DINOPROSTONE 10 MG VA INSR,7811.04,5077.18,13270.0,14761.0,4
NDC,55566410000,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IX SYRG,20482.8,13313.82,151.06,173.71,8
NDC,55566410001,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IX SYRG,20482.8,13313.82,151.06,173.71,8
NDC,55566670000,SOD PICOSULF-MAG OX-CITRIC AC 10 MG-3.5 GRAM- 12 GRAM/160 ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,55566670002,SOD PICOSULF-MAG OX-CITRIC AC 10 MG-3.5 GRAM- 12 GRAM/160 ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,55566830101,DEGARELIX 80 MG SC SOLR,20482.8,13313.82,5.2,5.98,8
NDC,55566830301,DEGARELIX 80 MG SC SOLR,7281.44,4732.94,5.2,14761.0,11
NDC,55566840200,DEGARELIX 120 MG SC SOLR,11360.64,7384.42,5.2,14761.0,11
NDC,55566840301,DEGARELIX 120 MG SC SOLR,22721.28,14768.83,5.2,14761.0,11
NDC,55571003120,LACTOBAC-BIFIDOBAC-GLOB PR CON 15 BILLION CELL-170 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,55859000300,CRANBERRY EXTRACT 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,55933000020,XYLITOL 550 MG MM MABT,1465.56,952.61,13270.0,14761.0,2
NDC,56151161011,GLUCOSE PO CHEW,,,13270.0,14761.0,2
NDC,56151161051,GLUCOSE PO CHEW,,,13270.0,14761.0,2
NDC,56151161151,GLUCOSE 4 GRAM PO CHEW HYPOGLYCEMIA PROTOCOL (USE DISPLAY NAME),,,13270.0,14761.0,2
NDC,56151162501,Other Outpatient Services,1465.56,952.61,,,0
NDC,56184012105,PHENYLEPHRINE HCL 0.125 % NA DROP,1465.56,952.61,13270.0,14761.0,2
NDC,57141000499,CALCIUM-VITAMIN D3-VITAMIN K 650 MG-12.5 MCG-40 MCG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,57237000805,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,2
NDC,57237000930,MIRTAZAPINE 30 MG PO TABS,,,13270.0,14761.0,2
NDC,57237001206,MIRTAZAPINE 30 MG PO TBDL,,,13270.0,14761.0,4
NDC,57237001401,Other Outpatient Services,358.4,232.96,,,0
NDC,57237001401,TAMSULOSIN 0.4 MG PO CAPS,358.4,232.96,13270.0,14761.0,4
NDC,57237001760,DULOXETINE 20 MG PO CPDR,290.0,188.5,13270.0,14761.0,4
NDC,57237001890,DULOXETINE 30 MG PO CPDR,290.0,188.5,13270.0,14761.0,4
NDC,57237005920,Other Outpatient Services,1465.56,952.61,,,0
NDC,57237007630,ONDANSETRON HCL 8 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,57237009650,CEFADROXIL 500 MG PO CAPS,443.2,288.08,13270.0,14761.0,2
NDC,57237009960,CEFDINIR 300 MG PO CAPS,745.92,484.85,13270.0,14761.0,2
NDC,57237010201,METOPROLOL TARTRATE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,57237010901,FELODIPINE 5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,57237015035,Other Outpatient Services,1465.56,952.61,,,0
NDC,57237016190,OMEPRAZOLE 20 MG PO CPDR,,,13270.0,14761.0,2
NDC,57237016990,ROSUVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,57237017190,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,57237018090,PRAMIPEXOLE 0.125 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,57237018190,PRAMIPEXOLE 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,57237018290,PRAMIPEXOLE 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,57237018590,PRAMIPEXOLE 1.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,57237022030,Other Outpatient Services,1465.56,952.61,,,0
NDC,57237022090,PIOGLITAZONE 30 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,57237022130,Other Outpatient Services,290.0,188.5,,,0
NDC,57664022888,METHYLPHENIDATE HCL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,57664037708,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,57664066583,CARVEDILOL PHOSPHATE 40 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
NDC,57664068331,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,374.4,243.36,13270.0,14761.0,4
NDC,57664078686,CLONAZEPAM 1 MG PO TBDL,1465.56,952.61,13270.0,14761.0,2
NDC,57771000701,COQ10 (LIPOSOMAL UBIQUINOL) 80 MG/10 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
NDC,57782039726,CROMOLYN 5.2 MG/SPRAY (4 %) NA SPRY,290.0,188.5,13270.0,14761.0,2
NDC,57841130001,NALOXEGOL 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,57841130101,NALOXEGOL 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,57844010501,Other Outpatient Services,1465.56,952.61,,,0
NDC,57844011001,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,17488.0,11367.2,13270.0,14761.0,4
NDC,57894003001,INFLIXIMAB 100 MG IV SOLR,9243.92,6008.545,40.12,14761.0,11
NDC,57894005427,USTEKINUMAB 130 MG/26 ML IV SOLN,18211.52,11837.49,16.15,18.57,8
NDC,57894006103,USTEKINUMAB 90 MG/ML SC SYRG,233470.62,151755.9,199.12,14761.0,11
NDC,57894035001,GOLIMUMAB 12.5 MG/ML IV SOLN,16755.41,10891.02,13.82,15.89,8
NDC,57894044901,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,13270.0,14761.0,8
NDC,57894045001,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,39.82,14761.0,11
NDC,57894050101,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,32817.14,21331.14,25.74,29.6,8
NDC,57894050205,DARATUMUMAB 20 MG/ML IV SOLN,6980.67,4537.44,81.08,14761.0,11
NDC,57894050220,DARATUMUMAB 20 MG/ML IV SOLN,27922.68,18149.74,81.08,14761.0,11
NDC,57894050301,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SC SOLN",89752.73,58339.27,64.02,14761.0,11
NDC,57896011109,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,1465.56,952.61,,,0
NDC,57896011109,Other Outpatient Services,1465.56,952.61,,,0
NDC,57896011114,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,1465.56,952.61,,,0
NDC,57896013101,DIBUCAINE 1 % TP OINT,290.0,188.5,13270.0,14761.0,2
NDC,57896030301,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,2
NDC,57896030401,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,4
NDC,57896050101,MULTIVITAMIN PO TABS,,,13270.0,14761.0,2
NDC,57896075201,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,57896079101,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,57896084401,"POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG PO PWPK",,,13270.0,14761.0,2
NDC,57896090101,ASPIRIN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,57896092101,ASPIRIN 325 MG PO TBEC,,,13270.0,14761.0,2
NDC,57962001428,IBRUTINIB 140 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,57962014009,IBRUTINIB 140 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,57962028028,IBRUTINIB 280 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,57962042028,IBRUTINIB 420 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,57962056028,IBRUTINIB 560 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,58160081043,"DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG",10974.18,7133.215,13270.0,14761.0,2
NDC,58160081601,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,290.0,188.5,13270.0,14761.0,2
NDC,58160081912,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,20482.8,13313.82,,,0
NDC,58160082043,HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG,296.96,193.02,13270.0,14761.0,2
NDC,58160082101,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP,684.02,444.61,13270.0,14761.0,2
NDC,58160082111,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP,684.02,444.61,,,0
NDC,58160082143,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,13270.0,14761.0,2
NDC,58160082152,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,,,0
NDC,58160082311,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,2773.06,1802.49,,,0
NDC,58160082643,HEPATITIS A VIRUS VACCINE (PF) 1440 UNITS IM SUSP,1024.22,665.74,,,0
NDC,58160084201,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",560.37,364.24,13270.0,14761.0,2
NDC,58160084211,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",560.37,364.24,13270.0,14761.0,2
NDC,58160084243,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",560.37,364.24,,,0
NDC,58160089041,FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,58160095509,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",1650.59,1072.88,,,0
NDC,58160095801,"MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR",1650.59,1072.88,13270.0,14761.0,2
NDC,58160096412,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",4599.84,2989.9,435.99,14761.0,11
NDC,58160097602,"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG",2556.08,1661.45,13270.0,14761.0,2
NDC,58160097620,"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG",2556.08,1661.45,13270.0,14761.0,2
NDC,58406002101,ETANERCEPT 50 MG/ML (1 ML) SC SYRG,1465.56,952.61,984.67,14761.0,3
NDC,58406005501,ETANERCEPT 25 MG/0.5 ML SC SOLN,14206.4,9234.16,984.67,14761.0,3
NDC,58468003001,THYROTROPIN ALFA 0.9 MG IM SOLR,10974.18,7133.215,2581.7,14761.0,11
NDC,58468003002,THYROTROPIN ALFA 0.9 MG IM SOLR,10974.18,7133.215,2581.7,14761.0,11
NDC,58468008001,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,12538.08,8149.75,1191.32,14761.0,5
NDC,58468009001,HYLAN G-F 20 16 MG/2 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
NDC,58468009003,HYLAN G-F 20 48 MG/6 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
NDC,58468013001,SEVELAMER CARBONATE 800 MG PO TABS,23824.8,15486.12,13270.0,14761.0,4
NDC,58468013101,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,23945.76,15564.74,13270.0,14761.0,4
NDC,58468013102,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,23945.76,15564.74,13270.0,14761.0,4
NDC,58468013202,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,23945.76,15564.74,13270.0,14761.0,4
NDC,58468022501,CAPLACIZUMAB-YHDP 11 MG IJ KIT,1465.56,952.61,13270.0,14761.0,2
NDC,58468035701,ALEMTUZUMAB 30 MG/ML IV SOLN,1465.56,952.61,2910.87,14761.0,6
NDC,58468035703,ALEMTUZUMAB 30 MG/ML IV SOLN,1465.56,952.61,2910.87,3347.5,16
NDC,58468466301,IMIGLUCERASE 400 UNITS IV SOLR,13873.04,9017.48,54.31,62.46,8
NDC,58487000231,INOSITOL 650 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,58487001361,IODINE 150 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,58487002101,MAGNESIUM AMINO ACID CHELATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,58487002982,BROMELAINS 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,58487003301,"PRENAT.VITS,CAL,MIN-IRON-FOLIC PO TABS",1465.56,952.61,13270.0,14761.0,2
NDC,58487003311,PEDIATRIC MULTIVIT NO.36-IRON 10 MG IRON PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,58602000739,OLOPATADINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,58657045601,METHEN-M.BLUE-S.PHOS-PHSAL-HYO 118-10-40.8-36 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,58657064801,CLONIDINE HCL 0.2 MG PO TABS,,,13270.0,14761.0,2
NDC,58657070101,HALOPERIDOL 1 MG PO TABS,,,13270.0,14761.0,2
NDC,58790000030,CARBOXYMETHYLCELLULOSE SODIUM 0.25 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,58914008052,DICYCLOMINE 10 MG/ML IM SOLN,1253.06,814.49,13270.0,14761.0,2
NDC,58914017110,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,58914050101,MESALAMINE 1000 MG PR SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,58914050156,MESALAMINE 1000 MG PR SUPP,18588.48,12082.51,13270.0,14761.0,4
NDC,58914078510,URSODIOL 250 MG PO TABS,8209.6,5336.24,13270.0,14761.0,4
NDC,58980001110,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,58980001205,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",290.0,188.5,13270.0,14761.0,4
NDC,58980040912,GLYCERIN (CHILD) PR SUPP,,,13270.0,14761.0,2
NDC,58980040925,GLYCERIN (CHILD) PR SUPP,,,13270.0,14761.0,2
NDC,58980078021,BALSAM PERU-CASTOR OIL TP OINT,440.9,286.58,13270.0,14761.0,2
NDC,59011041010,OXYCODONE 10 MG PO TR12,6518.4,4236.96,13270.0,14761.0,2
NDC,59011041020,OXYCODONE 10 MG PO TR12,1338.56,870.06,13270.0,14761.0,4
NDC,59011041510,OXYCODONE 15 MG PO TR12,1465.56,952.61,13270.0,14761.0,2
NDC,59011041520,OXYCODONE 15 MG PO TR12,1465.56,952.61,13270.0,14761.0,2
NDC,59011042010,OXYCODONE 20 MG PO TR12,12156.8,7901.92,13270.0,14761.0,4
NDC,59011042020,OXYCODONE 20 MG PO TR12,2493.44,1620.74,13270.0,14761.0,4
NDC,59011044020,OXYCODONE 40 MG PO TR12,1465.56,952.61,13270.0,14761.0,4
NDC,59011048010,OXYCODONE 80 MG PO TR12,36326.4,23612.16,13270.0,14761.0,2
NDC,59011048020,OXYCODONE 80 MG PO TR12,7452.16,4843.9,13270.0,14761.0,2
NDC,59011075204,BUPRENORPHINE 20 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,59148000613,ARIPIPRAZOLE 2 MG PO TABS,8702.88,5656.87,13270.0,14761.0,2
NDC,59148000913,ARIPIPRAZOLE 15 MG PO TABS,8702.88,5656.87,13270.0,14761.0,2
NDC,59148002050,TOLVAPTAN 15 MG PO TABS,82815.36,53829.98,13270.0,14761.0,4
NDC,59148002150,TOLVAPTAN 30 MG PO TABS,85911.2,55842.28,13270.0,14761.0,2
NDC,59148003613,BREXPIPRAZOLE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59148003713,BREXPIPRAZOLE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59148003813,BREXPIPRAZOLE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59148003913,BREXPIPRAZOLE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59148004013,BREXPIPRAZOLE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59212042510,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG PO TABS,19827.2,12887.68,13270.0,14761.0,2
NDC,59267030401,"COVID-19 VAC, BV (PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",10974.18,7133.215,13270.0,14761.0,2
NDC,59267102501,"COVID-19 VAC, TRIS(PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",1465.56,952.61,13270.0,14761.0,2
NDC,59267102504,"COVID-19 VAC, TRIS(PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",10974.18,7133.215,13270.0,14761.0,2
NDC,59310030240,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION IN HFAB,1631.98,1060.79,13270.0,14761.0,4
NDC,59310041012,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION NA HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,59310057922,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,1465.56,952.61,,,0
NDC,59338077501,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,1783.03,1158.9650000000001,0.42,14761.0,11
NDC,59338077501,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),1783.03,1158.9650000000001,13270.0,14761.0,2
NDC,59365512801,COPPER 380 SQUARE MM IU IUD,9765.0,6347.25,13270.0,14761.0,4
NDC,59365606500,FERRIC SUBSULFATE 259 MG/G TP SOLN,290.0,188.5,13270.0,14761.0,4
NDC,59385002501,BUPRENORPHINE HCL 600 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,59385002560,BUPRENORPHINE HCL 600 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
NDC,59385004130,NALDEMEDINE 0.2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59417010210,LISDEXAMFETAMINE 20 MG PO CAPS,19268.8,12524.72,13270.0,14761.0,2
NDC,59417010410,LISDEXAMFETAMINE 40 MG PO CAPS,19268.8,12524.72,13270.0,14761.0,2
NDC,59417011601,LISDEXAMFETAMINE 20 MG PO CHEW,1465.56,952.61,,,0
NDC,59572010201,AZACITIDINE 100 MG IJ SOLR,9363.84,6086.5,13270.0,14761.0,2
NDC,59572021015,THALIDOMIDE 100 MG PO CAPS,124278.78,80781.21,13270.0,14761.0,2
NDC,59572041028,LENALIDOMIDE 10 MG PO CAPS,399414.4,259619.36,13270.0,14761.0,2
NDC,59572042521,LENALIDOMIDE 25 MG PO CAPS,299561.14,194714.74,13270.0,14761.0,2
NDC,59572050300,POMALIDOMIDE 3 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,59572050400,POMALIDOMIDE 4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,59572071030,ENASIDENIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59572071101,LUSPATERCEPT-AAMT 25 MG SC SOLR,36292.41,23590.07,50.57,58.16,8
NDC,59572077501,LUSPATERCEPT-AAMT 75 MG SC SOLR,108876.78,70769.91,50.57,58.16,8
NDC,59572098401,ROMIDEPSIN 10 MG/2 ML IV SOLR,28787.85,18712.1,37.19,42.76,8
NDC,59630026601,CEFIDEROCOL 1 GRAM IV SOLR,3470.99,2256.14,2.84,14761.0,5
NDC,59651001890,NIACIN 500 MG PO TB24,470.88,306.07,13270.0,14761.0,2
NDC,59651009530,SILODOSIN 4 MG PO CAPS,446.88,290.47,13270.0,14761.0,4
NDC,59651009630,SILODOSIN 8 MG PO CAPS,347.04,225.58,13270.0,14761.0,4
NDC,59651012060,DOFETILIDE 500 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,59651013890,NEBIVOLOL 5 MG PO TABS,298.08,193.75,13270.0,14761.0,2
NDC,59651013990,NEBIVOLOL 10 MG PO TABS,298.08,193.75,13270.0,14761.0,4
NDC,59651015301,PROGESTERONE MICRONIZED 200 MG PO CAPS,1465.56,952.61,,,0
NDC,59651018030,LETROZOLE 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,59651021430,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,13270.0,14761.0,2
NDC,59651024601,MIDODRINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,59651025601,PROPAFENONE 150 MG PO TABS,,,13270.0,14761.0,2
NDC,59651029960,TAMOXIFEN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,59651034830,LEFLUNOMIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,59676027801,RILPIVIRINE HCL 25 MG PO TABS,22112.64,14373.22,13270.0,14761.0,4
NDC,59676036001,SODIUM HYALURONATE (VISCOSUP) 30 MG/2 ML IX SYRG,20482.8,13313.82,153.05,176.01,8
NDC,59676056201,DARUNAVIR 600 MG PO TABS,32172.48,20912.11,13270.0,14761.0,2
NDC,59676056501,DARUNAVIR 100 MG/ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,59676056630,DARUNAVIR 800 MG PO TABS,32172.0,20911.8,13270.0,14761.0,4
NDC,59676057001,ETRAVIRINE 100 MG PO TABS,22329.6,14514.24,13270.0,14761.0,4
NDC,59676057101,ETRAVIRINE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59676057530,DARUNAVIR-COBICISTAT 800-150 MG-MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59676060012,APALUTAMIDE 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59676061001,TRABECTEDIN 1 MG IV SOLR,31031.82,20170.68,451.78,519.55,8
NDC,59676070101,BEDAQUILINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59676080030,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG PO TABS,70316.16,45705.5,13270.0,14761.0,4
NDC,59676082001,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IX SYRG",20482.8,13313.82,850.67,978.27,8
NDC,59730420201,HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN,1465.56,952.61,174.24,14761.0,3
NDC,59730420301,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",10974.18,7133.215,174.24,14761.0,11
NDC,59746000103,METHYLPREDNISOLONE 4 MG PO DSPK,,,13270.0,14761.0,2
NDC,59746000106,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,59746002022,RISPERIDONE 1 MG PO TBDL,499.07,324.4,13270.0,14761.0,4
NDC,59746003022,RISPERIDONE 2 MG PO TBDL,474.88,308.67,13270.0,14761.0,4
NDC,59746011306,PROCHLORPERAZINE MALEATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,59746011506,PROCHLORPERAZINE MALEATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,59746017110,PREDNISONE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,59746017206,PREDNISONE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,59746030612,OLANZAPINE 5 MG PO TBDL,1465.56,952.61,13270.0,14761.0,4
NDC,59746032530,VALACYCLOVIR 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,59746036290,Other Outpatient Services,1465.56,952.61,,,0
NDC,59746038306,TERAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,2
NDC,59746038406,TERAZOSIN 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,59746038506,TERAZOSIN 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,59762001601,Other Outpatient Services,1465.56,952.61,,,0
NDC,59762007301,HYDROCORTISONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,59762007401,HYDROCORTISONE 10 MG PO TABS,424.0,275.6,13270.0,14761.0,4
NDC,59762007501,HYDROCORTISONE 20 MG PO TABS,718.4,466.96,13270.0,14761.0,4
NDC,59762010405,SULFASALAZINE 500 MG PO TBEC,424.0,275.6,13270.0,14761.0,2
NDC,59762011701,MESALAMINE 400 MG PO CDTI,4947.84,3216.1,13270.0,14761.0,2
NDC,59762011803,MESALAMINE 1000 MG PR SUPP,2521.92,1639.25,13270.0,14761.0,2
NDC,59762026001,COLESTIPOL 5 GRAM PO PACK,,,13270.0,14761.0,2
NDC,59762033302,LATANOPROST 0.005 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,59762040101,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,59762100401,NIFEDIPINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,59762106101,Other Outpatient Services,656.0,426.4,,,0
NDC,59762120601,LIOTHYRONINE 5 MCG PO TABS,,,13270.0,14761.0,2
NDC,59762122203,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,296.64,192.82,13270.0,14761.0,2
NDC,59762135001,RIFABUTIN 150 MG PO CAPS,20864.0,13561.6,13270.0,14761.0,2
NDC,59762171001,EPLERENONE 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59762201201,ASENAPINE MALEATE 5 MG SL SUBL,895.04,581.78,13270.0,14761.0,2
NDC,59762213509,AMLODIPINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,59762285801,EXEMESTANE 25 MG PO TABS,745.44,484.54,13270.0,14761.0,2
NDC,59762306003,AZITHROMYCIN 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59762313001,AZITHROMYCIN 200 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
NDC,59762371809,TRIAZOLAM 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59762372001,ALPRAZOLAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,59762372001,Other Outpatient Services,290.0,188.5,,,0
NDC,59762444002,METHYLPREDNISOLONE 4 MG PO DSPK,,,13270.0,14761.0,2
NDC,59762500001,SULFASALAZINE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59762500005,SULFASALAZINE 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,59762500006,SULFASALAZINE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,59762500701,MISOPROSTOL 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,59762500702,MISOPROSTOL 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,59762500801,MISOPROSTOL 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,59762500802,MISOPROSTOL 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,59762500901,CLINDAMYCIN PHOSPHATE 2 % VA CREA,1295.36,841.98,13270.0,14761.0,2
NDC,59762502901,FLUCONAZOLE 10 MG/ML PO SUSR,290.0,188.5,13270.0,14761.0,4
NDC,59922063101,FERRIC CITRATE 210 MG IRON PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,59923060402,FLUDARABINE 50 MG/2 ML IV SOLN,20482.8,13313.82,167.05,192.1,8
NDC,60219172107,ETRAVIRINE 100 MG PO TABS,14520.96,9438.62,13270.0,14761.0,2
NDC,60219174802,Other Outpatient Services,1465.56,952.61,,,0
NDC,60219174903,ATROPINE 1 % OP DROP,652.8,424.32,13270.0,14761.0,4
NDC,60219204301,DEXAMETHASONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,60219205601,DEXAMETHASONE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,60258000601,"POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG PO PWPK",,,13270.0,14761.0,2
NDC,60258000615,"POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG PO PWPK",,,13270.0,14761.0,2
NDC,60258016001,B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG PO TABS,,,13270.0,14761.0,2
NDC,60258017201,Other Outpatient Services,1465.56,952.61,,,0
NDC,60267070550,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IV SOLN,1584.0,1029.6,,,0
NDC,60267070550,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IVPB,1584.0,1029.6,13270.0,14761.0,4
NDC,60432006575,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,4
NDC,60432006575,Other Outpatient Services,1465.56,952.61,,,0
NDC,60432021208,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,60432026415,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,1465.56,952.61,13270.0,14761.0,4
NDC,60432046550,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,60432046551,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,60432056060,TRIAMCINOLONE ACETONIDE 0.025 % TP LOTN,,,13270.0,14761.0,2
NDC,60432056161,TRIAMCINOLONE ACETONIDE 0.1 % TP LOTN,1465.56,952.61,13270.0,14761.0,4
NDC,60432074116,ACETIC ACID 2 % OT SOLN,417.36,271.28,13270.0,14761.0,2
NDC,60432083110,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,60505001406,DILTIAZEM HCL 120 MG PO CDCR,,,13270.0,14761.0,2
NDC,60505003306,PENTOXIFYLLINE 400 MG PO TBSR,,,13270.0,14761.0,2
NDC,60505005501,SELEGILINE HCL 5 MG PO CAPS,,,13270.0,14761.0,2
NDC,60505006500,OMEPRAZOLE 20 MG PO CPDR,,,13270.0,14761.0,2
NDC,60505013300,CYCLOSPORINE 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,60505013400,CYCLOSPORINE 100 MG PO CAPS,20482.8,13313.82,,,0
NDC,60505014100,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60505014200,GLIPIZIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60505016401,FLUVOXAMINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,60505016501,FLUVOXAMINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60505016809,PRAVASTATIN 10 MG PO TABS,345.6,224.64,13270.0,14761.0,4
NDC,60505017007,PRAVASTATIN 40 MG PO TABS,2192.0,1424.8,13270.0,14761.0,4
NDC,60505022301,SOTALOL 120 MG PO TABS,,,13270.0,14761.0,2
NDC,60505025103,TIZANIDINE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,60505025701,DESMOPRESSIN 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,60505025801,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505036301,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505056000,OFLOXACIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,60505056000,OFLOXACIN 0.3 % OP DROP FOR EAR,290.0,188.5,13270.0,14761.0,2
NDC,60505056001,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505056401,BRIMONIDINE 0.15 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,60505056403,BRIMONIDINE 0.15 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,60505057804,AZELASTINE 0.05 % OP DROP,745.44,484.54,13270.0,14761.0,2
NDC,60505058204,MOXIFLOXACIN 0.5 % OP DROP,997.92,648.65,13270.0,14761.0,2
NDC,60505058304,BIMATOPROST 0.03 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,60505058604,OLOPATADINE 0.2 % OP DROP,1465.56,952.61,,,0
NDC,60505059304,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,60505075905,CEFOXITIN 95 MG/ML IV PUSH,10974.18,7133.215,13270.0,14761.0,2
NDC,60505076005,CEFOXITIN 2 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,60505081301,BUTORPHANOL 10 MG/ML NA SPRY,1465.56,952.61,13270.0,14761.0,2
NDC,60505081500,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NA SPRP,849.92,552.45,13270.0,14761.0,2
NDC,60505082306,CALCITONIN (SALMON) 200 UNIT/ACTUATION NA SPRY,543.99,353.59,13270.0,14761.0,4
NDC,60505082901,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,290.0,188.5,13270.0,14761.0,2
NDC,60505082901,Other Outpatient Services,290.0,188.5,,,0
NDC,60505083001,MOMETASONE 50 MCG/ACTUATION NA SPRY,894.34,581.32,13270.0,14761.0,2
NDC,60505083305,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,13270.0,14761.0,2
NDC,60505131703,PAROXETINE HCL 25 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,60505131803,PAROXETINE HCL 37.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,60505132001,MIDODRINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60505132305,PRAVASTATIN 80 MG PO TABS,2856.0,1856.4,13270.0,14761.0,4
NDC,60505132309,PRAVASTATIN 80 MG PO TABS,514.08,334.15,13270.0,14761.0,2
NDC,60505132501,MIDODRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60505250301,LEFLUNOMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60505252101,CILOSTAZOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60505252603,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505258009,ATORVASTATIN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505260500,ZOLPIDEM 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505265401,TRAZODONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,60505265701,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505290009,IMATINIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505296507,MYCOPHENOLATE SODIUM 180 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,60505299703,DULOXETINE 60 MG PO CPDR,290.0,188.5,13270.0,14761.0,2
NDC,60505311000,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,60505311100,OLANZAPINE 5 MG PO TABS,,,13270.0,14761.0,4
NDC,60505311300,OLANZAPINE 10 MG PO TABS,,,13270.0,14761.0,4
NDC,60505324703,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505325006,LAMIVUDINE 100 MG PO TABS,8218.56,5342.06,13270.0,14761.0,2
NDC,60505327500,OLANZAPINE 5 MG PO TBDL,1419.2,922.48,13270.0,14761.0,4
NDC,60505327600,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505328506,RILUZOLE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505345406,TROSPIUM 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505403301,ICOSAPENT ETHYL 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,60505432701,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505451803,PAROXETINE HCL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60505463203,CYCLOSPORINE MODIFIED 100 MG PO CAPS,1966.08,1277.95,13270.0,14761.0,2
NDC,60505464203,PRASUGREL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60505464303,PRASUGREL 10 MG PO TABS,369.12,239.93,13270.0,14761.0,2
NDC,60505470500,TOLVAPTAN 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505477403,VILAZODONE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60505609700,IBANDRONATE 3 MG/3 ML IV SYRG,940.66,611.43,,,0
NDC,60505610501,FOSAPREPITANT 150 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,60505612800,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,60505612801,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,60505613000,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,60505613005,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,60505613206,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,,,0
NDC,60505614200,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,60505614600,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,60505614700,CEFEPIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,60505614800,CEFTRIAXONE 1 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,60505614900,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,60505615900,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,4
NDC,60505619301,PALONOSETRON 0.25 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,60505619600,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,447.22,290.69,,,0
NDC,60505621401,ICATIBANT 30 MG/3 ML SC SYRG,23443.56,15238.31,188.82,14761.0,3
NDC,60505622600,Other Outpatient Services,1465.56,952.61,,,0
NDC,60505623100,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,60505623105,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,60505623700,DEFEROXAMINE 2 GRAM IJ SOLR,614.16,399.2,13270.0,14761.0,2
NDC,60505706300,NICOTINE 21 MG TD PT24,,,13270.0,14761.0,2
NDC,60505708100,FENTANYL 25 MCG/HR TD PT72,1465.56,952.61,13270.0,14761.0,4
NDC,60505708102,FENTANYL 25 MCG/HR TD PT72,1465.56,952.61,13270.0,14761.0,4
NDC,60505708300,FENTANYL 75 MCG/HR TD PT72,1465.56,952.61,13270.0,14761.0,2
NDC,60631004030,AZILSARTAN MEDOXOMIL 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60631008030,AZILSARTAN MEDOXOMIL 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60631041230,AZILSARTAN MED-CHLORTHALIDONE 40-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60631042530,AZILSARTAN MED-CHLORTHALIDONE 40-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687011211,Other Outpatient Services,290.0,188.5,,,0
NDC,60687011311,CLONIDINE HCL 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687012195,ACAMPROSATE 333 MG PO TBEC,,,13270.0,14761.0,2
NDC,60687012801,VALSARTAN 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687012911,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687014311,METFORMIN 850 MG PO TABS,,,13270.0,14761.0,2
NDC,60687014511,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60687015211,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687015695,PHENYTOIN 50 MG PO CHEW,,,13270.0,14761.0,2
NDC,60687015711,ARIPIPRAZOLE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687016211,METFORMIN 1000 MG PO TABS,,,13270.0,14761.0,2
NDC,60687016311,CEPHALEXIN 500 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687016811,Other Outpatient Services,290.0,188.5,,,0
NDC,60687016911,PRAVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687017311,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687017811,PRAVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687017911,ARIPIPRAZOLE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687019111,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687019511,DILTIAZEM HCL 120 MG PO CDCR,290.0,188.5,13270.0,14761.0,2
NDC,60687019511,DILTIAZEM HCL 120 MG PO CP24,290.0,188.5,13270.0,14761.0,4
NDC,60687019511,Other Outpatient Services,290.0,188.5,,,0
NDC,60687020611,DILTIAZEM HCL 180 MG PO CP24,290.0,188.5,13270.0,14761.0,4
NDC,60687020611,Other Outpatient Services,290.0,188.5,,,0
NDC,60687021111,DIVALPROEX 125 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,60687021411,METHADONE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,60687021701,DILTIAZEM HCL 240 MG PO CP24,913.6,593.84,13270.0,14761.0,2
NDC,60687021711,DILTIAZEM HCL 240 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,60687021711,Other Outpatient Services,290.0,188.5,,,0
NDC,60687022411,GEMFIBROZIL 600 MG PO TABS,,,13270.0,14761.0,2
NDC,60687022811,DILTIAZEM HCL 300 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,60687022811,Other Outpatient Services,290.0,188.5,,,0
NDC,60687022911,LOPERAMIDE 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687023011,ZONISAMIDE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687023101,SERTRALINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,60687023111,SERTRALINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,60687023411,ROSUVASTATIN 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687024201,SERTRALINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60687024211,SERTRALINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60687024440,FLUOXETINE 20 MG/5 ML (4 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,60687024511,ROSUVASTATIN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687025240,ONDANSETRON HCL 4 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,60687025311,SERTRALINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,60687025611,Other Outpatient Services,290.0,188.5,,,0
NDC,60687026611,RALOXIFENE 60 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687026621,RALOXIFENE 60 MG PO TABS,2550.24,1657.66,13270.0,14761.0,2
NDC,60687027211,CEFUROXIME AXETIL 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687027840,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687028211,AZITHROMYCIN 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687029201,DONEPEZIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687029211,DONEPEZIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687029311,NORTRIPTYLINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687029511,PROPRANOLOL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,60687030311,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,4
NDC,60687030411,CAPTOPRIL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687030611,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60687031495,AZITHROMYCIN 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,60687031911,TOLTERODINE 2 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,60687032711,QUETIAPINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687032811,SEVELAMER CARBONATE 800 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687033611,MINOCYCLINE 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687034011,BUPROPION HCL 75 MG PO TABS,,,13270.0,14761.0,2
NDC,60687035501,LORAZEPAM 1 MG PO TABS,1465.56,952.61,,,0
NDC,60687035511,LORAZEPAM 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,60687035601,BENZTROPINE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687035611,BENZTROPINE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687035711,METHIMAZOLE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687036211,LAMIVUDINE 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687036801,BENZTROPINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687036811,BENZTROPINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687036911,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687037011,METHIMAZOLE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687037311,EZETIMIBE 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687037511,DRONABINOL 2.5 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687038111,PHYTONADIONE (VITAMIN K1) 5 MG PO TABS,974.94,633.71,13270.0,14761.0,4
NDC,60687038411,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687038495,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687038911,COLCHICINE 0.6 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687038921,Other Outpatient Services,4155.36,2700.98,,,0
NDC,60687039111,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687039479,IPRATROPIUM BROMIDE 0.02 % IN SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,60687039579,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,60687039811,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687040411,CLOZAPINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,60687040579,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,60687040895,MESALAMINE 800 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,60687041311,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,2
NDC,60687041511,CLOZAPINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,60687041611,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687041621,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687041911,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687042811,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687042945,MAGNESIUM HYDROXIDE 400 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,60687043611,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687043711,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,60687043811,MYCOPHENOLATE MOFETIL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687044311,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60687044611,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,2
NDC,60687044711,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687045111,Other Outpatient Services,290.0,188.5,,,0
NDC,60687045311,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687045411,TRAZODONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,60687045711,IBUPROFEN 600 MG PO TABS,,,13270.0,14761.0,2
NDC,60687046101,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,60687046111,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,60687046411,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687047311,PREGABALIN 25 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687047511,LEVOTHYROXINE 75 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687047611,SPIRONOLACTONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,60687048111,Other Outpatient Services,290.0,188.5,,,0
NDC,60687048401,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687048411,PREGABALIN 50 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687048711,SPIRONOLACTONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,60687048811,AMLODIPINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687049111,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687049211,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687049411,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687049511,Other Outpatient Services,290.0,188.5,,,0
NDC,60687049511,PREGABALIN 75 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687049711,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687050211,PYRIDOSTIGMINE BROMIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,60687050311,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687050611,PREGABALIN 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687050811,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687051311,DOXYCYCLINE HYCLATE 100 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687051501,VERAPAMIL 240 MG PO TBSR,,,13270.0,14761.0,2
NDC,60687051911,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687052311,POSACONAZOLE 100 MG PO TBEC,656.06,426.44,13270.0,14761.0,4
NDC,60687052611,METRONIDAZOLE 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687053011,LEVOTHYROXINE 150 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687053611,METOLAZONE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687054111,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687054401,CLONAZEPAM 0.5 MG PO TABS,816.0,530.4,13270.0,14761.0,4
NDC,60687054411,CLONAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687054911,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687055011,METRONIDAZOLE 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687055211,LEVOTHYROXINE 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,60687055501,CLONAZEPAM 1 MG PO TABS,595.2,386.88,13270.0,14761.0,2
NDC,60687055511,CLONAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687055811,CYCLOBENZAPRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687055911,METHOCARBAMOL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687056211,DILTIAZEM HCL 30 MG PO TABS,,,13270.0,14761.0,2
NDC,60687056811,METHOCARBAMOL 750 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687056911,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,60687057511,RIFAMPIN 150 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687057603,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687057640,MIDAZOLAM 2 MG/ML PO SYRP,1465.56,952.61,13270.0,14761.0,2
NDC,60687057911,HYDROMORPHONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687058011,GABAPENTIN 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687058111,Other Outpatient Services,290.0,188.5,,,0
NDC,60687058111,PRAMIPEXOLE 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687058311,CARBAMAZEPINE 200 MG PO TB12,,,13270.0,14761.0,2
NDC,60687058501,PANTOPRAZOLE 20 MG PO TBEC,299.2,194.48,,,0
NDC,60687058511,PANTOPRAZOLE 20 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,60687058611,RIFAMPIN 300 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,60687059011,HYDROMORPHONE 4 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687059101,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687059111,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687059211,PRAMIPEXOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687059311,HYDROCHLOROTHIAZIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,60687059511,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60687059811,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,60687060211,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,2
NDC,60687060911,PROPRANOLOL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,60687061511,ACETAMINOPHEN-CODEINE 300-60 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687061811,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687062311,Other Outpatient Services,290.0,188.5,,,0
NDC,60687062711,LORAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687062911,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,60687063111,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687063311,NITROFURANTOIN 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,60687063411,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687063801,LORAZEPAM 1 MG PO TABS,290.0,188.5,,,0
NDC,60687063811,LORAZEPAM 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687065511,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687065611,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687065711,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,60687066111,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,2
NDC,60687066911,METHIMAZOLE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687067011,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,60687067211,Other Outpatient Services,1465.56,952.61,,,0
NDC,60687067311,NATEGLINIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,60687067611,LACOSAMIDE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687067657,LACOSAMIDE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687068011,METHIMAZOLE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,60687068111,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,60687068411,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,2
NDC,60687069811,LACOSAMIDE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,60687069811,Other Outpatient Services,290.0,188.5,,,0
NDC,60687069857,LACOSAMIDE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60687071111,OXCARBAZEPINE 150 MG PO TABS,,,13270.0,14761.0,2
NDC,60687072211,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,2
NDC,60758011905,PREDNISOLONE ACETATE 1 % OP DRPS,655.84,426.3,13270.0,14761.0,4
NDC,60758011910,Other Outpatient Services,1465.56,952.61,,,0
NDC,60758011910,PREDNISOLONE ACETATE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,60758018805,GENTAMICIN 0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,60758080105,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,60758080205,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,60758080210,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,60758088005,FLUOROMETHOLONE 0.1 % OP DRPS,1154.4,750.36,13270.0,14761.0,2
NDC,60758088005,Other Outpatient Services,1154.4,750.36,,,0
NDC,60758090810,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",1465.56,952.61,,,0
NDC,60793011501,LIOTHYRONINE 5 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793011601,LIOTHYRONINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793013601,METAXALONE 800 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,60793021505,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,13270.0,14761.0,6
NDC,60793021721,Other Outpatient Services,1465.56,952.61,,,0
NDC,60793031501,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,13270.0,14761.0,4
NDC,60793070010,PENICILLIN G BENZATHINE 600000 UNITS/ML IM SYRG,3176.0,2064.4,30.34,14761.0,3
NDC,60793070102,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,5000.8,3250.52,30.34,14761.0,11
NDC,60793070110,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,5500.93,3575.6,30.34,34.89,8
NDC,60793070204,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,10247.87,6661.12,30.34,14761.0,11
NDC,60793070210,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,11272.7,7327.26,30.34,14761.0,11
NDC,60793085010,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085101,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085201,LEVOTHYROXINE 75 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085301,LEVOTHYROXINE 88 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085410,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085501,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085610,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085710,LEVOTHYROXINE 137 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085801,LEVOTHYROXINE 150 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793085901,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,2
NDC,60793086001,LEVOTHYROXINE 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,61269010556,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,61269073607,MICONAZOLE NITRATE 100 MG VA SUPP,1465.56,952.61,13270.0,14761.0,2
NDC,61314001601,Other Outpatient Services,523.2,340.08,,,0
NDC,61314001601,PROPARACAINE 0.5 % OP DROP,523.2,340.08,13270.0,14761.0,4
NDC,61314001910,DORZOLAMIDE 2 % OP DROP,372.48,242.11,13270.0,14761.0,2
NDC,61314001910,Other Outpatient Services,372.48,242.11,,,0
NDC,61314003002,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314003002,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314004475,TRIFLURIDINE 1 % OP DROP,2921.88,1899.22,13270.0,14761.0,2
NDC,61314012605,KETOROLAC 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,61314014305,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314014405,BRIMONIDINE 0.15 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314014405,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314014410,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314020315,PILOCARPINE HCL 1 % OP DROP,1169.52,760.19,13270.0,14761.0,2
NDC,61314020415,PILOCARPINE HCL 2 % OP DROP,1196.4,777.66,13270.0,14761.0,2
NDC,61314022605,Other Outpatient Services,290.0,188.5,,,0
NDC,61314022605,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314022610,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314022705,Other Outpatient Services,290.0,188.5,,,0
NDC,61314022705,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314022710,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314022715,TIMOLOL MALEATE 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314023710,CROMOLYN 4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314023805,CARTEOLOL 1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314030802,AZELASTINE 0.05 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314031801,FILGRASTIM-SNDZ 300 MCG IJ SYRG,2126.88,1382.47,0.45,14761.0,11
NDC,61314031805,FILGRASTIM-SNDZ 300 MCG IJ SYRG,2126.8,1382.42,0.45,14761.0,11
NDC,61314032601,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.88,2211.87,0.45,14761.0,11
NDC,61314032605,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.87,2211.87,0.45,14761.0,11
NDC,61314032610,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.87,2211.87,0.45,0.52,8
NDC,61314035401,TROPICAMIDE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314035502,TROPICAMIDE 1 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,61314039601,CYCLOPENTOLATE 1 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314039601,Other Outpatient Services,290.0,188.5,,,0
NDC,61314054701,LATANOPROST 0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,4
NDC,61314054701,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314054703,LATANOPROST 0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,61314062810,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",290.0,188.5,13270.0,14761.0,4
NDC,61314063006,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OP DRPS",290.0,188.5,13270.0,14761.0,2
NDC,61314063136,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OP OINT",290.0,188.5,13270.0,14761.0,2
NDC,61314063136,Other Outpatient Services,290.0,188.5,,,0
NDC,61314063705,PREDNISOLONE ACETATE 1 % OP DRPS,659.68,428.79,13270.0,14761.0,4
NDC,61314063710,Other Outpatient Services,1465.56,952.61,,,0
NDC,61314064305,TOBRAMYCIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,61314064610,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT SOLN",1465.56,952.61,13270.0,14761.0,4
NDC,61314064725,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,565.28,367.43,13270.0,14761.0,4
NDC,61314065605,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,61314065625,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,61314086601,PEGFILGRASTIM-BMEZ 6 MG/0.6 ML SC SYRG,20482.8,13313.82,431.78,496.54,8
NDC,61442011405,ACYCLOVIR 200 MG PO CAPS,880.0,572.0,13270.0,14761.0,4
NDC,61570013150,SILVER SULFADIAZINE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,61703030346,CYTARABINE (PF) 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703030538,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703030558,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703030906,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703030916,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703031922,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703032418,PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703032618,PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN,557.92,362.65,13270.0,14761.0,2
NDC,61703033918,CARBOPLATIN 10 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,61703033922,CARBOPLATIN 10 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,61703033950,CARBOPLATIN 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703033956,CARBOPLATIN 10 MG/ML IV SOLN,391.68,254.59,,,0
NDC,61703034209,PACLITAXEL 6 MG/ML IV CONC,290.0,188.5,13270.0,14761.0,2
NDC,61703034222,PACLITAXEL 6 MG/ML IV CONC,416.57,270.77,13270.0,14761.0,2
NDC,61703034250,PACLITAXEL 6 MG/ML IV CONC,1059.2,688.48,,,0
NDC,61703034318,MITOXANTRONE 2 MG/ML IV CONC,2571.68,1671.59,68.05,14761.0,3
NDC,61703034909,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,,,0
NDC,61703035037,METHOTREXATE SODIUM 25 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,61703036322,OXALIPLATIN 100 MG/20 ML IV SOLN,1352.96,879.42,13270.0,14761.0,2
NDC,61703040825,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,61703040841,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,61748001201,PYRAZINAMIDE 500 MG PO TABS,,,13270.0,14761.0,2
NDC,61748001860,RIFAMPIN 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61755000101,RILONACEPT 220 MG SC SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,61755000501,AFLIBERCEPT 2 MG/0.05 ML IAV SYRG,1465.56,952.61,1023.52,14761.0,3
NDC,61755000801,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,95460.81,62049.53,35.16,40.44,8
NDC,61755002002,ALIROCUMAB 75 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,61755002102,ALIROCUMAB 150 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,61874007508,ELUXADOLINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61874007560,ELUXADOLINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61874010008,ELUXADOLINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61874010060,ELUXADOLINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61874011511,CARIPRAZINE 1.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874011520,CARIPRAZINE 1.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874011530,CARIPRAZINE 1.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874013011,CARIPRAZINE 3 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874013030,CARIPRAZINE 3 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874014530,CARIPRAZINE 4.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61874016030,CARIPRAZINE 6 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,61958040101,TENOFOVIR DISOPROXIL FUMARATE 300 MG PO TABS,18686.4,12146.16,13270.0,14761.0,2
NDC,61958070101,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,27463.2,17851.08,13270.0,14761.0,2
NDC,61958080201,AMBRISENTAN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61958100301,RANOLAZINE 500 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,61958120101,ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG PO TABS,65929.92,42854.45,13270.0,14761.0,2
NDC,61958140101,COBICISTAT 150 MG PO TABS,4691.52,3049.49,13270.0,14761.0,4
NDC,61958190101,ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG PO TABS,62850.24,40852.66,13270.0,14761.0,4
NDC,61958200201,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG PO TABS,32830.08,21339.55,13270.0,14761.0,4
NDC,61958210101,EMTRICITAB-RILPIVIR-TENOFO ALA 200-25-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61958220101,SOFOSBUVIR-VELPATASVIR 400-100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,61958230101,TENOFOVIR ALAFENAMIDE 25 MG PO TABS,22758.24,14792.86,13270.0,14761.0,4
NDC,61958250101,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG PO TABS,62850.24,40852.66,13270.0,14761.0,4
NDC,61958290101,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,7.91,14761.0,13
NDC,61958290102,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,7.91,14761.0,13
NDC,61990012001,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,61990041100,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,650.7,422.96,13270.0,14761.0,2
NDC,61990061100,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,62011042301,"DEXTROMETHORPHAN-GUAIFENESIN 60-1,200 MG PO TB12",1465.56,952.61,13270.0,14761.0,2
NDC,62037059790,DILTIAZEM HCL 120 MG PO CDCR,290.0,188.5,13270.0,14761.0,2
NDC,62037059790,DILTIAZEM HCL 120 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,62037059890,DILTIAZEM HCL 180 MG PO CP24,753.12,489.53,13270.0,14761.0,2
NDC,62064024130,TESAMORELIN 2 MG SC SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,62103033302,ZINC OXIDE 16 % TP OINT,,,13270.0,14761.0,2
NDC,62135019222,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO TABS,,,13270.0,14761.0,2
NDC,62135030801,CIPROFLOXACIN HCL 250 MG PO TABS,4382.4,2848.56,13270.0,14761.0,4
NDC,62135042812,DICYCLOMINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,62135043690,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,62135053230,VERAPAMIL 100 MG PO CPCT,1465.56,952.61,13270.0,14761.0,2
NDC,62175012837,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,2
NDC,62175012937,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,2
NDC,62175026055,NIFEDIPINE 30 MG PO TR24,,,13270.0,14761.0,2
NDC,62175045232,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,290.0,188.5,13270.0,14761.0,4
NDC,62175045832,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,417.12,271.13,13270.0,14761.0,2
NDC,62327044404,STERILE TALC 4 GRAM PL SUSR,1465.56,952.61,13270.0,14761.0,4
NDC,62327044444,STERILE TALC 4 GRAM PL SUSR,2720.0,1768.0,13270.0,14761.0,4
NDC,62332000131,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,62332004390,IRBESARTAN 300 MG PO TABS,597.6,388.44,13270.0,14761.0,4
NDC,62332006230,LEFLUNOMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,62332017830,TADALAFIL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,62332031631,DESIPRAMINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,62332036506,CLONAZEPAM 0.25 MG PO TBDL,836.16,543.5,13270.0,14761.0,4
NDC,62332041510,Other Outpatient Services,1465.56,952.61,,,0
NDC,62332050503,MOXIFLOXACIN 0.5 % OP DROP,298.08,193.75,13270.0,14761.0,2
NDC,62332058204,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,62484000202,MERCAPTOPURINE 20 MG/ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,62484002001,MERCAPTOPURINE 20 MG/ML PO SUSP,22009.6,14306.24,13270.0,14761.0,2
NDC,62530000011,UREA 15 GRAM PO PWPK,,,13270.0,14761.0,4
NDC,62559013807,HYDROCORTISONE 100 MG/60 ML PR ENEM,319.68,207.79,13270.0,14761.0,2
NDC,62559022530,AMINOCAPROIC ACID 500 MG PO TABS,2641.92,1717.25,13270.0,14761.0,4
NDC,62559023001,PROPAFENONE 150 MG PO TABS,,,13270.0,14761.0,2
NDC,62559024101,METHAZOLAMIDE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,62559025001,ETODOLAC 200 MG PO CAPS,,,13270.0,14761.0,2
NDC,62559055016,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,62559059030,PROPRANOLOL 80 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,62559059130,PROPRANOLOL 120 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,62559062037,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO POWD,,,13270.0,14761.0,2
NDC,62559065190,CANDESARTAN-HYDROCHLOROTHIAZID 32-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,62559072101,TERBUTALINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,62559072201,TERBUTALINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,62559073101,FELBAMATE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,62559082001,MEXILETINE 150 MG PO CAPS,,,13270.0,14761.0,2
NDC,62584026511,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,62584026611,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,62584026711,METOPROLOL TARTRATE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,62584073311,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,62584073411,HYDRALAZINE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,62584089701,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,62584089711,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,62584098411,WARFARIN 2 MG PO TABS,,,13270.0,14761.0,2
NDC,62584099411,WARFARIN 5 MG PO TABS,,,13270.0,14761.0,2
NDC,62756005940,EPOPROSTENOL 0.5 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,62756006040,EPOPROSTENOL 1.5 MG IV SOLR,2892.0,1879.8,13270.0,14761.0,2
NDC,62756007160,Other Outpatient Services,1465.56,952.61,,,0
NDC,62756012940,PANTOPRAZOLE (PROTONIX) 40 MG/50 ML NS VIAL-TO-BAG IV INFUSION,1465.56,952.61,13270.0,14761.0,2
NDC,62756012940,PANTOPRAZOLE 40 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,6
NDC,62756018388,OXCARBAZEPINE 150 MG PO TABS,,,13270.0,14761.0,2
NDC,62756018488,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,2
NDC,62756023290,LOTEPREDNOL ETABONATE 0.5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,62756045983,BUPRENORPHINE HCL 2 MG SL SUBL,290.0,188.5,13270.0,14761.0,4
NDC,62756051240,AZITHROMYCIN 500 MG IV SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,62756051240,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,1465.56,952.61,13270.0,14761.0,2
NDC,62756052069,SUMATRIPTAN SUCCINATE 25 MG PO TABS,,,,,0
NDC,62756052940,DESMOPRESSIN 4 MCG/ML IJ SOLN,2803.2,1822.08,6.75,14761.0,13
NDC,62756079688,DIVALPROEX 125 MG PO TBEC,290.0,188.5,13270.0,14761.0,2
NDC,62756079688,Other Outpatient Services,290.0,188.5,,,0
NDC,62756079713,DIVALPROEX 250 MG PO TBEC,904.0,587.6,13270.0,14761.0,4
NDC,62756079813,DIVALPROEX 500 MG PO TBEC,1248.0,811.2,13270.0,14761.0,4
NDC,62756097083,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,415.2,269.88,13270.0,14761.0,2
NDC,62795700307,HOMEOPATHIC PRODUCTS TP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,62795700407,HOMEOPATHIC PRODUCTS TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,62795700506,HOMEOPATHIC PRODUCTS TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,62795948708,HOMEOPATHIC PRODUCTS TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,62856027230,PERAMPANEL 2 MG PO TABS,9257.28,6017.23,13270.0,14761.0,4
NDC,62856027430,PERAMPANEL 4 MG PO TABS,18295.2,11891.88,13270.0,14761.0,2
NDC,62856027630,PERAMPANEL 6 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,62856027830,PERAMPANEL 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,62856038901,ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN,12690.0,8248.5,169.08,14761.0,11
NDC,62856058352,RUFINAMIDE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,62856070405,LENVATINIB 4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,62856071030,LENVATINIB 10 MG/DAY (10 MG X 1) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,62856071205,LENVATINIB 12 MG/DAY (4 MG X 3) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,62856072005,LENVATINIB 20 MG/DAY (10 MG X 2) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,62856072030,LENVATINIB 20 MG/DAY (10 MG X 2) PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,62935075375,LEUPROLIDE 7.5 MG (1 MONTH) SC SYRG,1401.28,910.83,219.79,14761.0,11
NDC,62991309501,MAGNESIUM GLYCINATE (BULK) 10 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
NDC,63004871001,CORTICOTROPIN 80 UNITS/ML IJ GEL,1465.56,952.61,13270.0,14761.0,4
NDC,63010002770,NELFINAVIR 625 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63020004901,BORTEZOMIB 3.5 MG IJ SOLR,25648.0,16671.2,13270.0,14761.0,2
NDC,63020018023,BRIGATINIB 180 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63020018030,BRIGATINIB 180 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63020053330,PONATINIB 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63020053430,PONATINIB 45 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63020053530,PONATINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63029050002,CARBAMIDE PEROXIDE 10 % MM SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63090010030,PIMAVANSERIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63090034030,PIMAVANSERIN 34 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,63187032514,AMOXICILLIN 875 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63261025021,ISOSULFAN BLUE 1 % SC SOLN,10974.18,7133.215,10.63,14761.0,11
NDC,63304001760,RANOLAZINE 500 MG PO TB12,1465.56,952.61,13270.0,14761.0,4
NDC,63304018501,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63304047901,CEVIMELINE 30 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,63304069201,CLINDAMYCIN HCL 150 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,63304071990,DILTIAZEM HCL 180 MG PO CP24,521.28,338.83,13270.0,14761.0,2
NDC,63304072090,DILTIAZEM HCL 240 MG PO CP24,889.92,578.45,13270.0,14761.0,2
NDC,63304083005,ATORVASTATIN 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,63323001001,GENTAMICIN 40 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323001002,GENTAMICIN 40 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323001003,GENTAMICIN 40 MG/ML IJ SOLN,371.84,241.7,13270.0,14761.0,2
NDC,63323001020,GENTAMICIN 40 MG/ML IJ SOLN,371.84,241.7,,,0
NDC,63323001201,OXYTOCIN 10 UNITS/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323001203,OXYTOCIN 10 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323001211,OXYTOCIN 10 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323001301,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323001302,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323002425,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323004400,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,63323006401,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323006402,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323006403,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323006404,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323006404,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,,,0
NDC,63323006423,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,20482.8,13313.82,,,0
NDC,63323008305,SODIUM BICARBONATE 4.2 % IV SOLN,350.64,227.92,13270.0,14761.0,2
NDC,63323008605,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,63323008950,SODIUM BICARBONATE 8.4 % IV SOLN,370.4,240.76,13270.0,14761.0,4
NDC,63323009301,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
NDC,63323009502,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323010351,CISPLATIN 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323010364,CISPLATIN 1 MG/ML IV SOLN,1024.0,665.6,,,0
NDC,63323010365,CISPLATIN 1 MG/ML IV SOLN,512.0,332.8,13270.0,14761.0,2
NDC,63323010425,ETOPOSIDE 20 MG/ML IV SOLN,302.8,196.82,,,0
NDC,63323010600,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
NDC,63323010615,MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,63323010800,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,63323011310,PENTAMIDINE 300 MG IJ SOLR,730.3,474.69,13270.0,14761.0,2
NDC,63323011700,FLUOROURACIL 500 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323011701,FLUOROURACIL 1 GRAM/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323011710,FLUOROURACIL 500 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323011720,FLUOROURACIL 1 GRAM/20 ML IV SOLN,290.0,188.5,,,0
NDC,63323011751,FLUOROURACIL 2.5 GRAM/50 ML IV SOLN,290.0,188.5,,,0
NDC,63323011761,FLUOROURACIL 5 G/100 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323012020,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323012250,METHOTREXATE SODIUM (PF) 1 GRAM IJ SOLR,938.56,610.06,13270.0,14761.0,2
NDC,63323012310,METHOTREXATE SODIUM 25 MG/ML IJ SOLN,385.12,250.33,13270.0,14761.0,2
NDC,63323012820,DACARBAZINE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323013002,DOXYCYCLINE (VIBRAMYCIN) 100 MG/250 ML D5W VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,4
NDC,63323013002,DOXYCYCLINE HYCLATE 100 MG IV SOLR,20482.8,13313.82,,,0
NDC,63323013011,DOXYCYCLINE HYCLATE 100 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63323013210,MITOXANTRONE 2 MG/ML IV CONC,1449.6,942.24,68.05,14761.0,3
NDC,63323014010,CLADRIBINE 10 MG/10 ML IV SOLN,1609.92,1046.45,17.74,14761.0,13
NDC,63323014210,IFOSFAMIDE 1 GRAM IV SOLR,864.64,562.02,13270.0,14761.0,2
NDC,63323016200,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,10974.18,7133.215,0.85,14761.0,11
NDC,63323016212,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,20482.8,13313.82,0.85,0.98,8
NDC,63323016476,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,2
NDC,63323016501,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,63323016501,DEXAMETHASONE 4 MG/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,63323016501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,63323016502,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,63323016503,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,63323016505,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323016530,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,505.92,328.85,,,0
NDC,63323017015,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,339.84,220.9,13270.0,14761.0,2
NDC,63323017260,CARBOPLATIN 10 MG/ML IV SOLN,751.68,488.59,,,0
NDC,63323017301,GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323017302,GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323018000,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323018001,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323018410,FOLIC ACID 5 MG/ML IJ SOLN,343.52,223.29,13270.0,14761.0,2
NDC,63323018730,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,6
NDC,63323019202,FLUDARABINE 50 MG/2 ML IV SOLN,616.0,400.4,167.05,14761.0,11
NDC,63323020102,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,63323020301,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323020521,FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL,894.4,581.36,13270.0,14761.0,2
NDC,63323020550,FAT EMULSION WITH FISH OIL (OMEGAVEN) (NEO-PEDS) 10% IV SYRINGE,894.4,581.36,13270.0,14761.0,2
NDC,63323020805,LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323022905,PROTAMINE 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323022930,PROTAMINE 10 MG/ML IV SOLN,488.0,317.2,13270.0,14761.0,2
NDC,63323023610,CEFAZOLIN 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323023710,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323025410,"MINERAL OIL, LIGHT STERILE MISC OIL",,,13270.0,14761.0,2
NDC,63323025803,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323026001,MEPIVACAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,63323026201,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323026203,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323026206,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323026530,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,509.92,331.45,13270.0,14761.0,2
NDC,63323026929,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,4
NDC,63323026950,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,6
NDC,63323026965,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,6
NDC,63323027601,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN (ADULT FLUSH)",290.0,188.5,,,0
NDC,63323027601,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323027602,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323027810,VINBLASTINE 1 MG/ML IV SOLN,793.28,515.63,13270.0,14761.0,2
NDC,63323028001,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323028110,FLUPHENAZINE HCL 2.5 MG/ML IJ SOLN,1635.2,1062.88,13270.0,14761.0,2
NDC,63323028510,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323028510,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
NDC,63323028523,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323028523,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
NDC,63323028564,ROPIVACAINE 0.2% IN 0.9% NACL 500 ML FOR PERIPHERAL NERVE CATETHER,588.8,382.72,13270.0,14761.0,2
NDC,63323028565,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
NDC,63323028611,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,,,0
NDC,63323028620,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323028631,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323029561,VANCOMYCIN 5 GRAM IV SOLR,1185.12,770.33,13270.0,14761.0,2
NDC,63323030602,FORTIFIED TOBRAMYCIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
NDC,63323030602,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323031110,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,63323031461,VANCOMYCIN 10 GRAM IV SOLR,417.6,271.44,13270.0,14761.0,2
NDC,63323031501,GANCICLOVIR SODIUM 500 MG IV SOLR,719.57,467.72,13270.0,14761.0,4
NDC,63323031801,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323032201,IMIPENEM-CILASTATIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323032225,IMIPENEM-CILASTATIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323032225,IMIPENEM-CILASTATIN 500 MG/100 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,63323032503,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323034101,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323034225,CEFOXITIN 2 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323034601,CEFTRIAXONE 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323035120,RIFAMPIN 600 MG IV SOLR,2280.64,1482.42,13270.0,14761.0,2
NDC,63323036001,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,290.0,188.5,13270.0,14761.0,6
NDC,63323036003,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323036005,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,572.8,372.32,13270.0,14761.0,4
NDC,63323036019,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,290.0,188.5,13270.0,14761.0,6
NDC,63323036601,DIMENHYDRINATE 50 MG/ML IJ SOLN,,,13270.0,14761.0,2
NDC,63323037600,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323037601,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323037700,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323037701,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323037805,OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN,359.04,233.38,13270.0,14761.0,2
NDC,63323039306,COLISTIN (COLISTIMETHATE NA) 150 MG IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63323039810,AZITHROMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323039810,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,290.0,188.5,13270.0,14761.0,2
NDC,63323040005,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323040101,AZTREONAM 1 GRAM IJ SOLR,329.01,213.86,13270.0,14761.0,6
NDC,63323040120,AZTREONAM 1 GRAM IJ SOLR,329.01,213.86,13270.0,14761.0,4
NDC,63323040201,AZTREONAM 2 GRAM IJ SOLR,671.87,436.72,13270.0,14761.0,6
NDC,63323040220,AZTREONAM 2 GRAM IJ SOLR,671.87,436.72,13270.0,14761.0,6
NDC,63323041112,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323041115,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323041118,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323041218,MIDAZOLAM (PF) 5 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,63323041218,MIDAZOLAM 5 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,63323041510,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323041605,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323041820,CISATRACURIUM 10 MG/ML CONC. IV SOLN,769.92,500.45,13270.0,14761.0,2
NDC,63323042405,FLUMAZENIL 0.1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323042602,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323045100,MORPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323045101,MORPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323045400,MORPHINE 4 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323045401,MORPHINE 4 MG/ML IV SOLN,20482.8,13313.82,,,0
NDC,63323046201,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323046217,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323046237,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,,,0
NDC,63323046401,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323046402,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323046417,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,63323046437,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323046437,BUPIVACAINE 0.25% INFUSION (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,2
NDC,63323046601,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323046603,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,63323046617,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,63323046637,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,,,0
NDC,63323046801,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323046801,Other Outpatient Services,290.0,188.5,,,0
NDC,63323046817,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323047201,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323047237,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323047400,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323047401,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323047637,CHLOROPROCAINE 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
NDC,63323047701,CHLOROPROCAINE (PF) 20 MG/ML (2 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,63323047727,CHLOROPROCAINE (PF) 20 MG/ML (2 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,63323047801,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,13270.0,14761.0,2
NDC,63323047827,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,13270.0,14761.0,4
NDC,63323048201,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323048203,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,63323048205,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323048217,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323048301,"LIDOCAINE-EPINEPHRINE 2 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323048527,LIDOCAINE 10 MG/ML (1 %) IJ SOLN (CC),290.0,188.5,13270.0,14761.0,2
NDC,63323048627,LIDOCAINE HCL 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
NDC,63323048701,Other Outpatient Services,290.0,188.5,,,0
NDC,63323048707,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 IJ SOLN",290.0,188.5,,,0
NDC,63323048731,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323048901,Other Outpatient Services,290.0,188.5,,,0
NDC,63323048902,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",291.84,189.7,13270.0,14761.0,4
NDC,63323048917,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
NDC,63323049204,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323049204,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,63323049207,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323049207,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,63323049208,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
NDC,63323049209,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323049209,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,63323049209,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY BLUE TRAY,290.0,188.5,,,0
NDC,63323049227,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,,,0
NDC,63323049227,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,13270.0,14761.0,2
NDC,63323049237,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323049237,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
NDC,63323049297,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323049401,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323049441,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,63323049504,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,20482.8,13313.82,,,0
NDC,63323049507,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
NDC,63323050601,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323050801,MEROPENEM 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63323050830,MEROPENEM 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63323051610,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323051701,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,63323051774,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,63323051902,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,63323051902,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP,290.0,188.5,13270.0,14761.0,2
NDC,63323052301,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",290.0,188.5,,,0
NDC,63323052301,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,2
NDC,63323053021,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,4
NDC,63323054005,HEPARIN BOLUS FOR ACS PROTOCOL,290.0,188.5,13270.0,14761.0,2
NDC,63323054011,HEPARIN BOLUS FOR ACS PROTOCOL,10974.18,7133.215,13270.0,14761.0,2
NDC,63323054015,HEPARIN (PORCINE) 1000 UNIT/ML IJ SOLN,290.0,188.5,,,0
NDC,63323054015,HEPARIN (PORCINE) 1000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323054209,HEPARIN (PORCINE) 10000 UNITS/ML IJ SOLN,290.0,188.5,,,0
NDC,63323054213,HEPARIN (PORCINE) 10000 UNITS/ML IJ SOLN,290.0,188.5,,,0
NDC,63323055921,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,63323056421,ENOXAPARIN 40 MG/0.4 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,63323056621,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,63323059303,GLUCAGON HCL 1 MG/ML IJ SOLR,1465.56,952.61,239.45,14761.0,3
NDC,63323059710,DEFEROXAMINE 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323059930,DEFEROXAMINE 2 GRAM IJ SOLR,366.24,238.06,13270.0,14761.0,2
NDC,63323060401,PROPRANOLOL 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323061400,HYDRALAZINE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323061401,HYDRALAZINE 20 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,63323061601,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323061602,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323061603,AMIODARONE 150MG-D5W 150ML CSHS,290.0,188.5,13270.0,14761.0,2
NDC,63323061603,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323061710,MILRINONE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323062353,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,2
NDC,63323062353,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,2
NDC,63323062353,FENTANYL PCA HIGH DOSE,1465.56,952.61,13270.0,14761.0,2
NDC,63323062353,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,2
NDC,63323062406,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,2
NDC,63323064201,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323064202,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323064907,LEVOTHYROXINE 100 MCG IV SOLR,1253.28,814.63,13270.0,14761.0,2
NDC,63323065102,ADENOSINE 3 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323065820,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,633.6,411.84,13270.0,14761.0,2
NDC,63323065903,INDOMETHACIN SODIUM 1 MG IV SOLR,4322.88,2809.87,13270.0,14761.0,2
NDC,63323066005,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,63323066400,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323066401,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,63323066501,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323067305,PALONOSETRON 0.25 MG/5 ML IV SOLN,328.0,213.2,13270.0,14761.0,2
NDC,63323069030,ACETYLCYSTEINE 200 MG/ML (20 %) ORAL/INHALATION SOLN,387.84,252.1,13270.0,14761.0,4
NDC,63323069404,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323071303,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,63323071501,FULVESTRANT 250 MG/5 ML IM SYRG,20482.8,13313.82,9.35,10.75,8
NDC,63323071505,FULVESTRANT 250 MG/5 ML IM SYRG,7453.6,4844.84,9.35,10.75,8
NDC,63323072401,REMIFENTANIL 2 MG IV SOLR,1917.22,1246.19,13270.0,14761.0,2
NDC,63323072901,MICAFUNGIN 100 MG IV SOLR,506.69,329.35,13270.0,14761.0,2
NDC,63323073911,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323073912,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323075105,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,328.64,213.62,13270.0,14761.0,2
NDC,63323076316,PACLITAXEL 6 MG/ML IV CONC,643.68,418.39,,,0
NDC,63323076350,PACLITAXEL 6 MG/ML IV CONC,1927.2,1252.68,,,0
NDC,63323077821,METHOCARBAMOL 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323080612,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323080613,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323080614,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323081201,OXACILLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323081301,OXACILLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,63323081502,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323081521,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
NDC,63323082000,FAT EMULSION 20% (SMOFLIPID) IV PEDS,1465.56,952.61,13270.0,14761.0,2
NDC,63323082001,FAT EMULSION 20% (SMOFLIPID) ADULT,324.8,211.12,13270.0,14761.0,4
NDC,63323082003,FAT EMULSION 20% (SMOFLIPID) ADULT,480.0,312.0,13270.0,14761.0,4
NDC,63323082004,FAT EMULSION 20% (SMOFLIPID) ADULT,384.0,249.6,13270.0,14761.0,4
NDC,63323082005,FAT EMULSION 20% (SMOFLIPID) ADULT,816.0,530.4,13270.0,14761.0,2
NDC,63323082005,FAT EMULSION 20% (SMOFLIPID) IV PEDS,816.0,530.4,13270.0,14761.0,2
NDC,63323082074,FAT EMULSION 20% (SMOFLIPID) ADULT,384.0,249.6,13270.0,14761.0,4
NDC,63323085107,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323085203,HYDROMORPHONE (PF) 1 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,63323085225,HYDROMORPHONE (PF) 1 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,63323085303,HYDROMORPHONE (PF) 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63323088101,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,348.48,226.51,13270.0,14761.0,4
NDC,63323088401,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323088510,LEVOTHYROXINE 100 MCG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,63323096501,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323096502,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323096503,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323096600,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,438.0,284.7,,,0
NDC,63323096701,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,63323098123,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63323098323,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,63402019110,ESZOPICLONE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402020407,ESLICARBAZEPINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402020430,ESLICARBAZEPINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402020660,ESLICARBAZEPINE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402020807,ESLICARBAZEPINE 800 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402030230,LURASIDONE 20 MG PO TABS,20514.24,13334.26,13270.0,14761.0,2
NDC,63402030430,LURASIDONE 40 MG PO TABS,20514.24,13334.26,13270.0,14761.0,4
NDC,63402030830,LURASIDONE 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63402031230,LURASIDONE 120 MG PO TABS,30622.08,19904.35,13270.0,14761.0,4
NDC,63402051001,LEVALBUTEROL TARTRATE 45 MCG/ACTUATION IN HFAA,534.12,347.18,13270.0,14761.0,2
NDC,63459010310,RITUXIMAB-ABBS 10 MG/ML IV SOLN,8193.12,5325.53,41.83,48.11,8
NDC,63459010450,RITUXIMAB-ABBS 10 MG/ML IV SOLN,40965.6,26627.64,41.83,48.11,8
NDC,63459021530,ARMODAFINIL 150 MG PO TABS,16302.72,10596.77,13270.0,14761.0,2
NDC,63459022530,ARMODAFINIL 250 MG PO TABS,16302.72,10596.77,13270.0,14761.0,2
NDC,63459034804,BENDAMUSTINE 25 MG/ML IV SOLN,12446.1,8089.97,16.12,14761.0,11
NDC,63459091011,TBO-FILGRASTIM 300 MCG SC SYRG,2234.88,1452.67,0.48,14761.0,5
NDC,63459091012,TBO-FILGRASTIM 300 MCG SC SYRG,2234.88,1452.67,0.48,14761.0,5
NDC,63459091211,TBO-FILGRASTIM 480 MCG SC SYRG,3576.64,2324.82,0.48,14761.0,3
NDC,63459091212,TBO-FILGRASTIM 480 MCG SC SYRG,3576.64,2324.82,0.48,14761.0,3
NDC,63629191301,INDOMETHACIN 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,63629221401,LABETALOL 200 MG PO TABS,,,13270.0,14761.0,2
NDC,63629246401,Other Outpatient Services,1465.56,952.61,,,0
NDC,63629247401,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,63646001004,KETOCONAZOLE 2 % TP SHAM,1465.56,952.61,13270.0,14761.0,2
NDC,63736012002,Other Outpatient Services,1465.56,952.61,,,0
NDC,63739001610,DILTIAZEM HCL 240 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
NDC,63739006933,ARIPIPRAZOLE 2 MG PO TABS,3109.92,2021.45,13270.0,14761.0,4
NDC,63739007233,Other Outpatient Services,290.0,188.5,,,0
NDC,63739007233,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,63739007633,VALGANCICLOVIR 450 MG PO TABS,16333.92,10617.05,13270.0,14761.0,4
NDC,63739007710,Other Outpatient Services,1648.0,1071.2,,,0
NDC,63739007710,VALACYCLOVIR 500 MG PO TABS,1648.0,1071.2,13270.0,14761.0,4
NDC,63739008702,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,63739014310,Other Outpatient Services,702.4,456.56,,,0
NDC,63739014310,TAMOXIFEN 10 MG PO TABS,702.4,456.56,13270.0,14761.0,6
NDC,63739014510,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,63739015770,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,63739016070,NYSTATIN 100000 UNITS/ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,63739016474,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,290.0,188.5,13270.0,14761.0,4
NDC,63739016610,METHOCARBAMOL 500 MG PO HALF-TAB = 250 MG,1465.56,952.61,13270.0,14761.0,4
NDC,63739017013,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63739017013,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,,,0
NDC,63739017830,CLOPIDOGREL 300 MG PO TABS,3287.04,2136.58,13270.0,14761.0,4
NDC,63739019210,PHENOBARBITAL 16.2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63739021202,ASPIRIN 81 MG PO TBEC,,,13270.0,14761.0,2
NDC,63739022510,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,63739023610,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,63739026910,TAMOXIFEN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,63739029410,PHENOBARBITAL 32.4 MG PO TABS,1052.8,684.32,13270.0,14761.0,2
NDC,63739034910,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63739035401,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) PO TABS,,,13270.0,14761.0,2
NDC,63739035733,VALGANCICLOVIR 450 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,63739041010,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,2
NDC,63739041510,RIFAMPIN 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,63739043401,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,2
NDC,63739043401,ASPIRIN ORAL SUSPENSION 1 MG/ML PEDIATRIC,1465.56,952.61,13270.0,14761.0,4
NDC,63739043402,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,2
NDC,63739047910,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63739048310,HYDROXYZINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63739048610,HYDROXYZINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,63739052510,VALACYCLOVIR 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,63739052610,Other Outpatient Services,1465.56,952.61,,,0
NDC,63739052610,ZOLPIDEM 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,63739054410,SPIRONOLACTONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,63739054510,SPIRONOLACTONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,63739056410,PANTOPRAZOLE 40 MG PO TBEC,427.2,277.68,13270.0,14761.0,4
NDC,63739056710,TAMSULOSIN 0.4 MG PO CAPS,419.2,272.48,13270.0,14761.0,4
NDC,63739056910,ISOSORBIDE DINITRATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63739057010,SIMVASTATIN 5 MG PO TABS,,,13270.0,14761.0,2
NDC,63739057110,SIMVASTATIN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,63739057210,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,2
NDC,63739057310,SIMVASTATIN 40 MG PO TABS,,,13270.0,14761.0,2
NDC,63739064510,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,63739067210,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,2
NDC,63739067310,LOSARTAN 25 MG PO TABS,731.2,475.28,13270.0,14761.0,2
NDC,63739067310,Other Outpatient Services,731.2,475.28,,,0
NDC,63739068610,LOSARTAN 50 MG PO TABS,782.4,508.56,13270.0,14761.0,4
NDC,63739079610,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,63739079733,NIMODIPINE 30 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,63739090210,GABAPENTIN 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,63739090310,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,63739090410,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,2
NDC,63739093114,HEPARIN BOLUS FOR ACS PROTOCOL,290.0,188.5,13270.0,14761.0,2
NDC,63739095311,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63739095325,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,63739097310,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,63739098410,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,2
NDC,63739098832,Other Outpatient Services,1465.56,952.61,,,0
NDC,63739099210,METHOCARBAMOL 750 MG PO TABS,401.6,261.04,13270.0,14761.0,4
NDC,63807010001,SODIUM CHLORIDE 0.9 % IJ SOLN,,,13270.0,14761.0,2
NDC,63807010011,SODIUM CHLORIDE 0.9 % IJ SOLN,,,13270.0,14761.0,2
NDC,63807060005,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",1465.56,952.61,13270.0,14761.0,2
NDC,63807060055,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,63824000850,GUAIFENESIN 600 MG PO TA12,,,13270.0,14761.0,2
NDC,63824005632,DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG PO TB12,290.0,188.5,13270.0,14761.0,2
NDC,63824005632,Other Outpatient Services,290.0,188.5,,,0
NDC,63824007214,"DEXTROMETHORPHAN-GUAIFENESIN 60-1,200 MG PO TB12",1465.56,952.61,13270.0,14761.0,2
NDC,63824017163,DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML PO SU12,1465.56,952.61,13270.0,14761.0,2
NDC,63824017563,Other Outpatient Services,1465.56,952.61,,,0
NDC,63833038602,HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) IV SOLR,14400.0,9360.0,2.79,14761.0,3
NDC,63833038702,"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) IV SOLR",28800.0,18720.0,2.79,14761.0,3
NDC,63833039601,HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) IV SOLR,14400.0,9360.0,2.79,14761.0,3
NDC,63833039701,"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) IV SOLR",28800.0,18720.0,2.79,14761.0,3
NDC,63833061602,"ANTIHEMOPHILIC FACTOR-VWF 500-1,200 UNIT IV SOLR",22080.0,14352.0,1.74,14761.0,10
NDC,63833061702,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV SOLR",44160.0,28704.0,1.74,14761.0,10
NDC,63833062501,ANTIHEMOPHILIC FACTOR-VWF 250-600 UNIT IV SOLR,11040.0,7176.0,1.74,14761.0,10
NDC,63833062601,"ANTIHEMOPHILIC FACTOR-VWF 500-1,200 UNIT IV SOLR",22080.0,14352.0,1.74,14761.0,10
NDC,63833062701,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV SOLR",20482.8,13313.82,1.74,14761.0,10
NDC,63833082502,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT,31924.98,20751.24,85.12,14761.0,11
NDC,63833083501,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT,1465.56,952.61,85.12,14761.0,3
NDC,64067021601,METHOXSALEN 20 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,64193042402,"ANTI-INHIBITOR COAGULANT CMPLX 700-1,300 UNIT IV SOLR",32320.0,21008.0,2.92,14761.0,3
NDC,64193042502,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",80800.0,52520.0,2.92,14761.0,3
NDC,64253022233,"HEPARIN, PORCINE (PF) 10 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,64253033335,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,64281010000,METHACHOLINE 50 MG IN 0.9% NACL WITH 0.4% PHENOL 2 ML (25 MG/ML) (TEST SOLUTION A),1237.31,804.25,,,0
NDC,64281010000,METHACHOLINE CHLORIDE 100 MG IN SOLR,1237.31,804.25,,,0
NDC,64281010006,METHACHOLINE 50 MG IN 0.9% NACL WITH 0.4% PHENOL 2 ML (25 MG/ML) (TEST SOLUTION A),1237.31,804.25,,,0
NDC,64281010006,METHACHOLINE CHLORIDE 100 MG IN SOLR,1237.31,804.25,,,0
NDC,64380015201,TESTOSTERONE 1 % (50 MG/5 GRAM) TD GLPK,290.0,188.5,13270.0,14761.0,2
NDC,64380015801,MEGESTROL 20 MG PO TABS,,,13270.0,14761.0,4
NDC,64380018402,PROPAFENONE 225 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,64380018601,Other Outpatient Services,1465.56,952.61,,,0
NDC,64380071003,LAMIVUDINE 150 MG PO TABS,596.16,387.5,13270.0,14761.0,4
NDC,64380072406,CALCITRIOL 0.5 MCG PO CAPS,,,13270.0,14761.0,2
NDC,64380072606,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,292.8,190.32,13270.0,14761.0,4
NDC,64380073706,"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,64380075806,ACARBOSE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,64380076006,ACARBOSE 100 MG PO TABS,580.8,377.52,13270.0,14761.0,2
NDC,64380079701,OSELTAMIVIR 30 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,64380079901,OSELTAMIVIR 75 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,64380083306,ACETAZOLAMIDE 125 MG PO TABS,395.2,256.88,13270.0,14761.0,2
NDC,64380083406,ACETAZOLAMIDE 250 MG PO TABS,521.6,339.04,13270.0,14761.0,4
NDC,64380091806,URSODIOL 250 MG PO TABS,1118.4,726.96,13270.0,14761.0,4
NDC,64380097025,HYDROCORTISONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,64380097106,HYDROCORTISONE 10 MG PO TABS,832.0,540.8,13270.0,14761.0,4
NDC,64406000801,NATALIZUMAB 300 MG/15 ML IV SOLN,68301.72,44396.12,30.08,34.59,8
NDC,64406002001,DIROXIMEL FUMARATE 231 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,64406002003,DIROXIMEL FUMARATE 231 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,64597030160,DEXTROMETHORPHAN-QUINIDINE 20-10 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,64679001202,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,64679001202,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,64679002101,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,64679003402,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,64679003402,PIPERACILLIN-TAZOBACTAM IVPB VIAL 2.25 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,64679005601,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,64679005602,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,64679005602,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,64679010201,BUPROPION HCL 150 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,64679069802,OXACILLIN IVPB VIAL 1 G/50 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,64679069902,OXACILLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,64679072801,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,357.76,232.54,13270.0,14761.0,4
NDC,64679072808,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,357.76,232.54,13270.0,14761.0,6
NDC,64727330501,THYROID (PORK) 97.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,64764008060,LUBIPROSTONE 8 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,64764017530,DEXLANSOPRAZOLE 60 MG PO CPDM,1465.56,952.61,13270.0,14761.0,2
NDC,64764024060,LUBIPROSTONE 24 MCG PO CAPS,5532.48,3596.11,13270.0,14761.0,2
NDC,64764030020,VEDOLIZUMAB 300 MG IV SOLR,84239.19,54755.47,27.72,14761.0,11
NDC,64764054411,LANSOPRAZOLE 30 MG PO TBLD,20627.2,13407.68,13270.0,14761.0,2
NDC,64764072030,VORTIOXETINE 5 MG PO TABS,7664.64,4982.02,13270.0,14761.0,2
NDC,64764073030,VORTIOXETINE 10 MG PO TABS,7664.64,4982.02,13270.0,14761.0,2
NDC,64764075030,Other Outpatient Services,1465.56,952.61,,,0
NDC,64764080028,MARIBAVIR 200 MG PO TABS,99599.36,64739.58,13270.0,14761.0,4
NDC,64764080056,MARIBAVIR 200 MG PO TABS,199198.72,129479.17,13270.0,14761.0,4
NDC,64764091830,FEBUXOSTAT 40 MG PO TABS,4920.0,3198.0,13270.0,14761.0,4
NDC,64875000101,MIFEPRISTONE 200 MG PO TABS,688.0,447.2,13270.0,14761.0,2
NDC,64896066101,CARBIDOPA-LEVODOPA 23.75-95 MG PO CPSR,6193.6,4025.84,13270.0,14761.0,2
NDC,64896066109,CARBIDOPA-LEVODOPA 23.75-95 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,64896066201,CARBIDOPA-LEVODOPA 36.25-145 MG PO CPSR,6193.6,4025.84,13270.0,14761.0,2
NDC,64896066201,Other Outpatient Services,6193.6,4025.84,,,0
NDC,64896066209,CARBIDOPA-LEVODOPA 36.25-145 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,64896066301,CARBIDOPA-LEVODOPA 48.75-195 MG PO CPSR,6193.6,4025.84,13270.0,14761.0,2
NDC,64896066401,CARBIDOPA-LEVODOPA 61.25-245 MG PO CPSR,7782.4,5058.56,13270.0,14761.0,2
NDC,64896066401,Other Outpatient Services,7782.4,5058.56,,,0
NDC,64896067410,DEXTROAMPHETAMINE SULFATE 10 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
NDC,64896070101,OXYMORPHONE 40 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,64950034205,HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) PO SYRP,290.0,188.5,13270.0,14761.0,4
NDC,64980010401,"SOD PHOS DI, MONO-K PHOS MONO 250 MG PO TABS",,,13270.0,14761.0,2
NDC,64980020501,LITHIUM CARBONATE 300 MG PO TBSR,,,13270.0,14761.0,2
NDC,64980020901,OXYBUTYNIN CHLORIDE 5 MG PO TR24,290.0,188.5,13270.0,14761.0,2
NDC,64980021001,OXYBUTYNIN CHLORIDE 10 MG PO TR24,290.0,188.5,13270.0,14761.0,2
NDC,64980022003,PYRIDOSTIGMINE BROMIDE 180 MG PO TBSR,2966.4,1928.16,13270.0,14761.0,2
NDC,64980029410,SODIUM BICARBONATE 650 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,64980032005,TRIAMCINOLONE ACETONIDE 0.1 % DT PSTE,961.12,624.73,13270.0,14761.0,2
NDC,64980032430,Other Outpatient Services,296.16,192.5,,,0
NDC,64980033990,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) PO TABS,,,13270.0,14761.0,2
NDC,64980040709,EFAVIRENZ 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,64980041812,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,64980043801,ATENOLOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,64980050448,CYPROHEPTADINE 2 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,64980051301,TIMOLOL MALEATE 0.25 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,64980051305,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,64980051401,Other Outpatient Services,1465.56,952.61,,,0
NDC,64980051405,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,64980051505,Other Outpatient Services,290.0,188.5,,,0
NDC,64980052810,SODIUM BICARBONATE 650 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65162014904,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,65162014908,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,65162015004,ESTRADIOL 0.075 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,65162015008,ESTRADIOL 0.075 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,65162018810,NAPROXEN 250 MG PO TABS,,,13270.0,14761.0,2
NDC,65162018910,NAPROXEN 375 MG PO TABS,,,13270.0,14761.0,2
NDC,65162032109,NIACIN 500 MG PO TB24,476.64,309.82,13270.0,14761.0,2
NDC,65162032109,Other Outpatient Services,476.64,309.82,,,0
NDC,65162032309,NIACIN 1000 MG PO TB24,744.48,483.91,13270.0,14761.0,2
NDC,65162036111,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,65162037210,OXYBUTYNIN CHLORIDE 10 MG PO TR24,290.0,188.5,13270.0,14761.0,4
NDC,65162041503,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,888.96,577.82,13270.0,14761.0,2
NDC,65162041603,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,496.8,322.92,13270.0,14761.0,4
NDC,65162043606,DICLOFENAC-MISOPROSTOL 50-200 MG-MCG PO TBID,1465.56,952.61,13270.0,14761.0,2
NDC,65162044211,MECLIZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,65162051210,SALSALATE 500 MG PO TABS,,,13270.0,14761.0,2
NDC,65162057110,BETHANECHOL CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,65162057210,BETHANECHOL CHLORIDE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,65162057310,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,65162062710,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,65162063609,PANTOPRAZOLE 20 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,65162067684,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,13270.0,14761.0,2
NDC,65162068110,PHENAZOPYRIDINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,65162068210,PHENAZOPYRIDINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,65162071110,GUANFACINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,65162073503,FELBAMATE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65162077810,BUDESONIDE 3 MG PO CECX,3316.8,2155.92,13270.0,14761.0,4
NDC,65162079104,Other Outpatient Services,1465.56,952.61,,,0
NDC,65162089129,MOMETASONE 50 MCG/ACTUATION NA SPRY,751.4,488.41,13270.0,14761.0,2
NDC,65162089374,ARIPIPRAZOLE 1 MG/ML PO SOLN,3727.2,2422.68,13270.0,14761.0,2
NDC,65162089703,Other Outpatient Services,1465.56,952.61,,,0
NDC,65162089709,Other Outpatient Services,1465.56,952.61,,,0
NDC,65162089803,Other Outpatient Services,1465.56,952.61,,,0
NDC,65162089809,ARIPIPRAZOLE 10 MG PO TABS,408.96,265.82,13270.0,14761.0,4
NDC,65162091446,TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,65162099208,ESTRADIOL 0.0375 MG/24 HR TD PTSW,1465.56,952.61,,,0
NDC,65162099704,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,65174027030,KIT FOR PREP OF TC-99M-ALBUMIN 2.5 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
NDC,65174028801,DIETHYLENE TRIAMINE PENTAACETIC ACID (TC-99M DTPA) ISOTOPE (NUC MED) N,1.01,0.65,,,0
NDC,65174028830,KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
NDC,65219001000,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
NDC,65219001801,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,65219002003,AMPICILLIN SODIUM 2 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,65219005209,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,65219005409,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,714.72,464.57,13270.0,14761.0,4
NDC,65219005429,Other Outpatient Services,714.72,464.57,,,0
NDC,65219005609,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,840.0,546.0,13270.0,14761.0,4
NDC,65219016201,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,65219019030,VORICONAZOLE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,65219020005,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR,7546.77,4905.4,40.11,46.12,8
NDC,65219020401,LACOSAMIDE 200 MG/20 ML IV SOLN,314.56,204.46,13270.0,14761.0,2
NDC,65219025700,EPHEDRINE SULFATE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,65219025905,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,65219025905,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
NDC,65219042950,ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,65219042950,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1465.56,952.61,1.57,14761.0,5
NDC,65219044501,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,65219057001,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,65219057201,BUMETANIDE (BUMEX) 25MG IN 100ML (STRAIGHT DRUG) INFUSION,290.0,188.5,13270.0,14761.0,2
NDC,65219057201,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,65224089031,DESVENLAFAXINE 100 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
NDC,65250000301,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,9058.72,5888.17,22.1,25.41,8
NDC,65282160501,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,65597010330,OLMESARTAN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65597020230,EDOXABAN 30 MG PO TABS,1465.56,952.61,,,0
NDC,65597040601,FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR,26412.75,17168.29,34.63,14761.0,11
NDC,65597070118,COLESEVELAM 625 MG PO TABS,,,13270.0,14761.0,2
NDC,65628005001,"DIPHEN-LIDOCAINE-MAG,AL-SIMETH 25-200-400-40 MG/30ML MM MWSH",1465.56,952.61,13270.0,14761.0,4
NDC,65628007005,OMEPRAZOLE COMPOUNDING KIT 2 MG/ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
NDC,65628010102,BACLOFEN (LIORESAL) ORAL SUSPENSION 5 MG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,65628020405,VANCOMYCIN 25 MG/ML PO SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,65649000330,PLECANATIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65649010302,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,65649015090,METHYLNALTREXONE 150 MG PO TABS,37625.76,24456.74,13270.0,14761.0,2
NDC,65649020175,PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM PO PWPK,1876.32,1219.61,,,0
NDC,65649030103,RIFAXIMIN 200 MG PO TABS,4736.16,3078.5,13270.0,14761.0,4
NDC,65649030302,RIFAXIMIN 550 MG PO TABS,48705.6,31658.64,13270.0,14761.0,4
NDC,65649030303,RIFAXIMIN 550 MG PO TABS,48705.6,31658.64,13270.0,14761.0,4
NDC,65649031112,CHLOROTHIAZIDE 250 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,65649055103,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,4
NDC,65649055107,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.6,1553.24,13270.0,14761.0,2
NDC,65649055204,METHYLNALTREXONE 8 MG/0.4 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,4
NDC,65857010010,FLUORODEOXYGLUCOSE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,4
NDC,65857015030,FLUORODEOXYGLUCOSE (F-18) ISOTOPE (NUC MED),1.01,0.65,,,0
NDC,65857050510,MEDRONATE (TC-99M MDP) ISOTOPE (NUC MED),1.01,0.65,,,0
NDC,65862000605,CITALOPRAM 20 MG PO TABS,,,13270.0,14761.0,2
NDC,65862000801,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,65862000805,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,65862001705,AMOXICILLIN 500 MG PO CAPS,624.0,405.6,13270.0,14761.0,4
NDC,65862002106,MIRTAZAPINE 15 MG PO TBDL,,,13270.0,14761.0,2
NDC,65862002206,MIRTAZAPINE 30 MG PO TBDL,,,13270.0,14761.0,2
NDC,65862002460,ZIDOVUDINE 300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65862002760,NEVIRAPINE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65862005090,SIMVASTATIN 5 MG PO TABS,,,13270.0,14761.0,2
NDC,65862006201,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,65862006399,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,65862006401,METOPROLOL TARTRATE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,65862007701,CIPROFLOXACIN HCL 500 MG PO TABS,454.4,295.36,13270.0,14761.0,4
NDC,65862009620,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862010701,ZIDOVUDINE 100 MG PO CAPS,2257.6,1467.44,13270.0,14761.0,2
NDC,65862011801,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862014405,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,65862014990,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,65862017601,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862017760,Other Outpatient Services,745.92,484.85,,,0
NDC,65862018501,CLINDAMYCIN HCL 150 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,65862019105,CYCLOBENZAPRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,65862020190,LOSARTAN 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862020190,Other Outpatient Services,290.0,188.5,,,0
NDC,65862020390,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862021150,MINOCYCLINE 100 MG PO CAPS,410.4,266.76,13270.0,14761.0,4
NDC,65862022660,CLARITHROMYCIN 500 MG PO TABS,757.44,492.34,13270.0,14761.0,4
NDC,65862022801,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862022960,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862023060,LAMOTRIGINE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862024508,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,65862024608,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,65862029084,RIBAVIRIN 200 MG PO CAPS,1670.59,1085.88,13270.0,14761.0,4
NDC,65862029590,ROSUVASTATIN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,65862029690,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862035705,CLOPIDOGREL 75 MG PO TABS,568.0,369.2,13270.0,14761.0,4
NDC,65862035790,CLOPIDOGREL 75 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862037301,ESCITALOPRAM OXALATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862037401,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,65862037501,Other Outpatient Services,290.0,188.5,,,0
NDC,65862037505,ESCITALOPRAM OXALATE 20 MG PO TABS,680.0,442.0,13270.0,14761.0,2
NDC,65862039010,ONDANSETRON 4 MG PO TBDL,290.0,188.5,,,0
NDC,65862041901,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862046890,LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65862049647,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,635.71,413.21,13270.0,14761.0,4
NDC,65862050220,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862050301,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,715.2,464.88,13270.0,14761.0,4
NDC,65862050320,Other Outpatient Services,290.0,188.5,,,0
NDC,65862051230,PIOGLITAZONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862052790,VENLAFAXINE 37.5 MG PO CP24,290.0,188.5,13270.0,14761.0,2
NDC,65862052830,VENLAFAXINE 75 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,65862052890,Other Outpatient Services,290.0,188.5,,,0
NDC,65862052890,VENLAFAXINE 75 MG PO CP24,290.0,188.5,13270.0,14761.0,4
NDC,65862053450,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862053575,Other Outpatient Services,290.0,188.5,,,0
NDC,65862053650,LEVOFLOXACIN 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862053750,LEVOFLOXACIN 500 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862053820,LEVOFLOXACIN 750 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,65862055990,PANTOPRAZOLE 20 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,65862056090,PANTOPRAZOLE 40 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,65862057490,MONTELUKAST 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862059801,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862060330,MOXIFLOXACIN 400 MG PO TABS,1308.96,850.82,13270.0,14761.0,2
NDC,65862060330,Other Outpatient Services,1308.96,850.82,,,0
NDC,65862062503,RIZATRIPTAN 5 MG PO TBDL,,,13270.0,14761.0,4
NDC,65862064169,AZITHROMYCIN 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862065401,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862067001,Other Outpatient Services,363.2,236.08,,,0
NDC,65862067001,REPAGLINIDE 0.5 MG PO TABS,363.2,236.08,13270.0,14761.0,4
NDC,65862067101,REPAGLINIDE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862067201,REPAGLINIDE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,65862067601,ALPRAZOLAM 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,65862067701,ALPRAZOLAM 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65862067801,Other Outpatient Services,1465.56,952.61,,,0
NDC,65862068730,RITONAVIR 100 MG PO TABS,997.92,648.65,13270.0,14761.0,2
NDC,65862071260,ATAZANAVIR 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,65862073205,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,65862076990,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,298.08,193.75,13270.0,14761.0,2
NDC,65862077828,NORGESTIMATE-ETHINYL ESTRADIOL 0.18/0.215/0.25 MG-25 MCG PO TABS,,,13270.0,14761.0,2
NDC,65862077885,NORGESTIMATE-ETHINYL ESTRADIOL 0.18/0.215/0.25 MG-25 MCG PO TABS,,,13270.0,14761.0,2
NDC,65862078201,METHENAMINE HIPPURATE 1 GRAM PO TABS,,,13270.0,14761.0,2
NDC,65862078430,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,2
NDC,65862083030,PRASUGREL 10 MG PO TABS,367.2,238.68,13270.0,14761.0,4
NDC,65862084003,MOXIFLOXACIN 0.5 % OP DROP,498.86,324.26,13270.0,14761.0,2
NDC,65862084130,ENTECAVIR 0.5 MG PO TABS,891.84,579.7,13270.0,14761.0,4
NDC,65862090801,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,65862092127,SEVELAMER CARBONATE 800 MG PO TABS,1192.32,775.01,13270.0,14761.0,4
NDC,65862092730,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,65862093008,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,2
NDC,65862093090,Other Outpatient Services,2534.4,1647.36,,,0
NDC,65862093108,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,290.0,188.5,13270.0,14761.0,4
NDC,65862093630,PARICALCITOL 1 MCG PO CAPS,663.36,431.18,13270.0,14761.0,4
NDC,65862094601,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,65862094715,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
NDC,66215010106,BOSENTAN 62.5 MG PO TABS,239833.92,155892.05,13270.0,14761.0,2
NDC,66215040201,EPOPROSTENOL 1.5 MG IV SOLR,1042.72,677.77,13270.0,14761.0,4
NDC,66215040301,EPOPROSTENOL 0.5 MG IV SOLR,521.44,338.94,13270.0,14761.0,4
NDC,66215050115,MACITENTAN 10 MG PO TABS,113212.32,73588.01,13270.0,14761.0,2
NDC,66215050130,MACITENTAN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66215060206,SELEXIPAG 200 MCG PO TABS,259342.08,168572.35,13270.0,14761.0,4
NDC,66215060214,SELEXIPAG 200 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66215060406,SELEXIPAG 400 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
NDC,66215060606,SELEXIPAG 600 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
NDC,66215060806,SELEXIPAG 800 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,4
NDC,66215061606,SELEXIPAG 1600 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
NDC,66220020730,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN INTRAPROCEDURE,3270.72,2125.97,,,0
NDC,66220020730,ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN,3270.72,2125.97,13270.0,14761.0,2
NDC,66302010101,TREPROSTINIL SODIUM 1 MG/ML IJ SOLN,1465.56,952.61,69.5,14761.0,3
NDC,66302010201,TREPROSTINIL SODIUM 2.5 MG/ML IJ SOLN,1465.56,952.61,69.5,14761.0,3
NDC,66302020603,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) IN NEBU,51746.21,33635.04,13270.0,14761.0,2
NDC,66302020604,TREPROSTINIL-NEBULIZER-ACCESOR 1.74 MG/2.9 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,66302030201,TREPROSTINIL DIOLAMINE 0.25 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,66302030210,TREPROSTINIL DIOLAMINE 0.25 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,66302031001,TREPROSTINIL DIOLAMINE 1 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,66302035010,TREPROSTINIL DIOLAMINE 5 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,66302046760,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66302060002,TREPROSTINIL 16 MCG (112)- 32 MCG (84) IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302061002,TREPROSTINIL 16(112)-32(112) -48(28) MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302061601,TREPROSTINIL 16 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302063201,TREPROSTINIL 32 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302063203,TREPROSTINIL 32 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302064801,TREPROSTINIL 48 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302064803,TREPROSTINIL 48 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66302066401,TREPROSTINIL 64 MCG IN CTDV,1465.56,952.61,,,0
NDC,66302066403,TREPROSTINIL 64 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
NDC,66553000101,ASPIRIN 325 MG PO TABS,,,13270.0,14761.0,2
NDC,66553000201,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,2
NDC,66553000401,CALCIUM CARBONATE 200 MG CALCIUM (500 MG) PO CHEW,,,13270.0,14761.0,2
NDC,66553000801,SODIUM BICARBONATE 650 MG PO TABS,696.0,452.4,13270.0,14761.0,4
NDC,66658023001,PALIVIZUMAB 50 MG/0.5 ML IM SOLN,16385.94,10650.86,896.37,14761.0,3
NDC,66658023101,PALIVIZUMAB 50 MG/0.5 ML IM SOLN,30941.28,20111.83,896.37,14761.0,3
NDC,66658023401,ANAKINRA 100 MG/0.67 ML SC SYRG,3370.95,2191.12,13270.0,14761.0,4
NDC,66658023407,ANAKINRA 100 MG/0.67 ML SC SYRG,3370.95,2191.12,13270.0,14761.0,4
NDC,66685100100,Other Outpatient Services,1465.56,952.61,,,0
NDC,66685100101,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,66685100202,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,66689000501,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,66689002001,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,66689002050,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,290.0,188.5,13270.0,14761.0,2
NDC,66689002301,Other Outpatient Services,1465.56,952.61,,,0
NDC,66689003601,PHENYTOIN 100 MG/4 ML PO SUSP,,,13270.0,14761.0,2
NDC,66689003650,PHENYTOIN 100 MG/4 ML PO SUSP,,,13270.0,14761.0,2
NDC,66689003701,NYSTATIN 100000 UNITS/ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,66689003701,Other Outpatient Services,1465.56,952.61,,,0
NDC,66689003750,NYSTATIN 100000 UNITS/ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,66689003801,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,66689003901,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,2
NDC,66689004701,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,290.0,188.5,13270.0,14761.0,4
NDC,66689004750,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,290.0,188.5,13270.0,14761.0,2
NDC,66689004801,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,338.88,220.27,13270.0,14761.0,4
NDC,66689004850,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,338.88,220.27,13270.0,14761.0,2
NDC,66689005301,MAGNESIUM HYDROXIDE 400 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,66689005601,ACETAMINOPHEN 650 MG PO SOLN,,,13270.0,14761.0,2
NDC,66689006101,ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,66689006201,ATOVAQUONE 750 MG/5 ML PO SUSP,452.4,294.06,13270.0,14761.0,4
NDC,66689010502,LEVOTHYROXINE 20 MCG/ML PO SOLN,1976.0,1284.4,13270.0,14761.0,2
NDC,66689010801,LACOSAMIDE 10 MG/ML PO SOLN,561.44,364.94,13270.0,14761.0,4
NDC,66689020108,Other Outpatient Services,1465.56,952.61,,,0
NDC,66689020204,ACTIVATED CHARCOAL 25 GRAM/120 ML PO SUSP,,,13270.0,14761.0,2
NDC,66689030708,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,6745.6,4384.64,13270.0,14761.0,2
NDC,66689040101,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,66689040150,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,66733094823,CETUXIMAB 100 MG/50 ML IV SOLN,11986.4,7791.16,93.99,108.08,8
NDC,66733095823,CETUXIMAB 200 MG/100 ML IV SOLN,13484.7,8765.06,93.99,108.08,8
NDC,66758019013,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,66758095985,ALBUTEROL 90 MCG/ACTUATION IN AERO - PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
NDC,66758095985,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,1465.56,952.61,,,0
NDC,66794016202,MORPHINE (PF) 25 MG/ML IJ SOLN,4774.4,3103.36,,,0
NDC,66794016202,MORPHINE 25 MG/ML IV SOLN,4774.4,3103.36,13270.0,14761.0,2
NDC,66794020702,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
NDC,66794021963,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
NDC,66794023002,Other Outpatient Services,290.0,188.5,,,0
NDC,66869010490,PITAVASTATIN CALCIUM 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66869020490,PITAVASTATIN CALCIUM 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66869040490,PITAVASTATIN CALCIUM 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66887000301,COLLAGENASE CLOSTRIDIUM HISTO. 0.9 MG IJ SOLR,20482.8,13313.82,88.61,101.9,8
NDC,66993000210,ESTRADIOL 0.01 % (0.1 MG/GRAM) VA CREA,,,13270.0,14761.0,2
NDC,66993001968,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,290.0,188.5,13270.0,14761.0,2
NDC,66993001968,Other Outpatient Services,290.0,188.5,,,0
NDC,66993006602,PHENOXYBENZAMINE 10 MG PO CAPS,40995.2,26646.88,,,0
NDC,66993007896,FLUTICASONE PROPIONATE 44 MCG/ACTUATION IN HFAA,990.97,644.13,13270.0,14761.0,4
NDC,66993007896,Other Outpatient Services,990.97,644.13,,,0
NDC,66993007996,FLUTICASONE PROPIONATE 110 MCG/ACTUATION IN HFAA,1326.62,862.3,13270.0,14761.0,4
NDC,66993008096,FLUTICASONE PROPIONATE 220 MCG/ACTUATION IN HFAA,2060.64,1339.42,13270.0,14761.0,4
NDC,66993016502,COLCHICINE 0.6 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,66993042247,LANTHANUM 500 MG PO CHEW,7241.04,4706.68,13270.0,14761.0,2
NDC,66993042475,LANTHANUM 1000 MG PO CHEW,1355.04,880.78,13270.0,14761.0,2
NDC,66993048983,DACTINOMYCIN 0.5 MG IV SOLR,20482.8,13313.82,351.31,404.0,8
NDC,66993058597,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,66993058697,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,2
NDC,66993059402,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO CP24,1640.0,1066.0,13270.0,14761.0,2
NDC,66993081530,DOXYCYCLINE MONOHYDRATE 40 MG PO CPID,1465.56,952.61,13270.0,14761.0,2
NDC,67066000501,SECRETIN (HUMAN) 16 MCG IV SOLR,10281.6,6683.04,53.01,14761.0,11
NDC,67157010150,ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN,4033.6,2621.84,13270.0,14761.0,2
NDC,67253065110,PROPYLTHIOURACIL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,67253090010,ALPRAZOLAM 0.25 MG HALF-TAB = 0.125 MG,1465.56,952.61,13270.0,14761.0,2
NDC,67286081201,NICARDIPINE 25 MG/10 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,67386013051,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,16993.35,11045.68,23.28,26.77,8
NDC,67386031321,CLOBAZAM 2.5 MG/ML PO SUSP,23352.96,15179.42,13270.0,14761.0,4
NDC,67386031401,CLOBAZAM 10 MG PO TABS,46670.4,30335.76,13270.0,14761.0,2
NDC,67386082119,DROXIDOPA 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,67386082219,DROXIDOPA 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,67457000100,KETAMINE 50 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,67457015300,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457015309,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457015309,AMIODARONE IV INFUSION (1 MG/ML),290.0,188.5,13270.0,14761.0,2
NDC,67457015318,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457015399,AMIODARONE 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,67457016302,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN,1161.66,755.08,,,0
NDC,67457017750,DIMETHYL SULFOXIDE 50 % IS SOLN,10360.0,6734.0,891.43,14761.0,3
NDC,67457018210,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,6
NDC,67457019600,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,67457020725,DEXRAZOXANE HCL 250 MG IV SOLR,1156.8,751.92,108.95,125.29,8
NDC,67457020850,DEXRAZOXANE HCL 500 MG IV SOLR,2017.6,1311.44,108.95,125.29,8
NDC,67457021720,METHADONE 10 MG/ML IJ SOLN,6372.8,4142.32,13270.0,14761.0,2
NDC,67457021810,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,13270.0,14761.0,2
NDC,67457022000,ISOSULFAN BLUE 1 % SC SOLN,15656.72,10176.87,10.63,12.22,8
NDC,67457022005,ISOSULFAN BLUE 1 % SC SOLN,15656.72,10176.87,10.63,12.22,8
NDC,67457022800,ROCURONIUM 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457029101,HYDRALAZINE 20 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,67457029200,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457029750,ETHACRYNATE SODIUM 50 MG IV SOLR,13949.44,9067.14,13270.0,14761.0,2
NDC,67457031625,DECITABINE 50 MG IV SOLR,2757.76,1792.54,,,0
NDC,67457032325,MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML IV PGBK,656.0,426.4,13270.0,14761.0,2
NDC,67457033900,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457034000,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457034001,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457034105,VANCOMYCIN 5 GRAM IV SOLR,1310.72,851.97,13270.0,14761.0,2
NDC,67457034903,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,4
NDC,67457035101,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457035202,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457035210,AMPICILLIN SODIUM 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457037412,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457037499,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457038510,HEPARIN BOLUS FOR ACS PROTOCOL,290.0,188.5,13270.0,14761.0,2
NDC,67457038600,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,4
NDC,67457038681,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1080.72,702.47,13270.0,14761.0,4
NDC,67457039054,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,423.93,275.555,13270.0,14761.0,2
NDC,67457042000,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,67457042000,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457042010,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457042200,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,2
NDC,67457042200,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,67457042254,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,67457042300,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,67457042300,DEXAMETHASONE 4 MG/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,67457042312,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457042600,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457042612,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457043010,PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457043300,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,67457043322,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,,,0
NDC,67457043650,DOXORUBICIN 50 MG IV SOLR (FOR CHEMOEMBOLIZATION),2607.2,1694.68,13270.0,14761.0,2
NDC,67457043700,DOXYCYCLINE HYCLATE 100 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,67457043800,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457044560,RIFAMPIN 600 MG IV SOLR,1933.12,1256.53,13270.0,14761.0,2
NDC,67457044610,PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN,418.08,271.75,13270.0,14761.0,2
NDC,67457047300,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,1465.56,952.61,13270.0,14761.0,4
NDC,67457047322,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,290.0,188.5,13270.0,14761.0,4
NDC,67457051305,DACTINOMYCIN 0.5 MG IV SOLR,5634.88,3662.67,351.31,404.0,8
NDC,67457051805,MITOMYCIN 5 MG IV SOLR,731.84,475.7,52.93,14761.0,11
NDC,67457051920,MITOMYCIN 20 MG IV SOLR,20482.8,13313.82,52.93,60.87,8
NDC,67457052433,IBANDRONATE 3 MG/3 ML IV SYRG,3652.32,2374.01,,,0
NDC,67457053035,LEUCOVORIN CALCIUM 350 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457056700,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,67457058200,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,67457058210,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
NDC,67457061730,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457061810,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN,402.29,261.49,,,0
NDC,67457061910,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,606.0,393.9,,,0
NDC,67457067502,CALCITONIN (SALMON) 200 UNITS/ML IJ SOLN,5506.65,3579.32,1460.68,14761.0,3
NDC,67457070500,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67457078108,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,67457079000,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457082312,VANCOMYCIN 1.25 GRAM IV SOLR,290.69,188.95,13270.0,14761.0,2
NDC,67457083306,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SC SYRG,20482.8,13313.82,168.77,194.08,8
NDC,67457085200,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457085350,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,596.16,387.5,13270.0,14761.0,2
NDC,67457085400,ADENOSINE 3 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457085500,ADENOSINE 3 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457085502,ADENOSINE 3 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,67457086301,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,67457088910,FOSAPREPITANT 150 MG IV SOLR,503.04,326.975,13270.0,14761.0,2
NDC,67457090200,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,67457092500,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,438.4,284.96,13270.0,14761.0,2
NDC,67546011112,Other Outpatient Services,60210.24,39136.66,,,0
NDC,67546011114,NITAZOXANIDE 500 MG PO TABS,25923.65,16850.37,13270.0,14761.0,2
NDC,67546021221,NITAZOXANIDE 100 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
NDC,67618010130,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,67618010760,MAGNESIUM CHLORIDE 71.5 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,67618011128,DOCUSATE SODIUM 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,67618015004,POVIDONE-IODINE 10 % TP SOLN,10974.18,7133.215,,,0
NDC,67618015009,POVIDONE-IODINE 10 % TP SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,67684190101,ETHIODIZED OIL 480 MG IODINE/ML IJ OIL,20482.8,13313.82,13270.0,14761.0,2
NDC,67684190102,ETHIODIZED OIL 480 MG IODINE/ML IJ OIL,12321.0,8008.65,13270.0,14761.0,2
NDC,67850002200,AMPICILLIN SODIUM 2 GRAM IJ SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,67850002400,AMPICILLIN SODIUM 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,67850004100,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,67877012405,Other Outpatient Services,1465.56,952.61,,,0
NDC,67877012450,Other Outpatient Services,290.0,188.5,,,0
NDC,67877012450,SILVER SULFADIAZINE 1 % TP CREA,290.0,188.5,13270.0,14761.0,4
NDC,67877014601,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,67877019705,AMLODIPINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,67877019805,AMLODIPINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,67877019905,AMLODIPINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,67877022001,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,67877022001,Other Outpatient Services,290.0,188.5,,,0
NDC,67877022305,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,2
NDC,67877024201,QUETIAPINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,67877024601,QUETIAPINE 200 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,67877024910,QUETIAPINE 50 MG PO TABS,896.0,582.4,13270.0,14761.0,4
NDC,67877025145,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,297.82,193.58,13270.0,14761.0,2
NDC,67877026030,Other Outpatient Services,3564.96,2317.22,,,0
NDC,67877028660,RILUZOLE 50 MG PO TABS,595.2,386.88,13270.0,14761.0,4
NDC,67877041401,METFORMIN 750 MG PO TB24,,,13270.0,14761.0,2
NDC,67877041933,LINEZOLID 600 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,67877041984,LINEZOLID 600 MG PO TABS,1565.28,1017.43,13270.0,14761.0,4
NDC,67877043003,ARIPIPRAZOLE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,67877043303,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,67877044460,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
NDC,67877047379,LIDOCAINE 5 % TP OINT,1465.56,952.61,13270.0,14761.0,4
NDC,67877047380,Other Outpatient Services,1465.56,952.61,,,0
NDC,67877049030,Other Outpatient Services,1465.56,952.61,,,0
NDC,67877049090,Other Outpatient Services,1465.56,952.61,,,0
NDC,67877054360,CEFDINIR 300 MG PO CAPS,745.92,484.85,13270.0,14761.0,2
NDC,67877054568,CEPHALEXIN 250 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
NDC,67877054588,Other Outpatient Services,290.0,188.5,,,0
NDC,67877056105,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,2
NDC,67877058901,Other Outpatient Services,290.0,188.5,,,0
NDC,67877059001,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,67877059101,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,67877063633,TOLVAPTAN 30 MG PO TABS,71632.8,46561.32,13270.0,14761.0,2
NDC,67877070590,DROXIDOPA 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,67877071712,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,67877071712,Other Outpatient Services,1465.56,952.61,,,0
NDC,67877071833,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,67877071933,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,67877073101,CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG PO CAPS,633.6,411.84,13270.0,14761.0,4
NDC,67877074957,FOSFOMYCIN TROMETHAMINE 3 GRAM PO PACK,1465.56,952.61,13270.0,14761.0,2
NDC,67919003001,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR,2364.96,1537.22,10.25,14761.0,5
NDC,67979000201,HISTRELIN 50 MG (65 MCG/DAY) IL KIT,451634.58,293562.48,56469.54,64939.98,8
NDC,68001028333,CISPLATIN 1 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,68001043900,FEXOFENADINE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,68001046561,VANCOMYCIN 500 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,68001048600,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,68001050753,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,68001050753,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,2
NDC,68001052428,FLUOROURACIL 500 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,68001052429,FLUOROURACIL 1 GRAM/20 ML IV SOLN,20482.8,13313.82,,,0
NDC,68001052532,FLUOROURACIL 5 G/100 ML IV SOLN,822.4,534.56,13270.0,14761.0,2
NDC,68025006701,ESTRADIOL 1 MG/GRAM (0.1 %) TD GLPK,1465.56,952.61,13270.0,14761.0,2
NDC,68040075043,LEVOMEFOLATE-B12-HERB 236 1-1-500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,68084002111,ABACAVIR 300 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084004001,MISOPROSTOL 100MCG QUARTER-TAB = 25MCG,,,13270.0,14761.0,2
NDC,68084004111,MISOPROSTOL 200 MCG PO TABS,,,13270.0,14761.0,2
NDC,68084004511,PAROXETINE HCL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,68084004611,PAROXETINE HCL 30 MG PO TABS,,,13270.0,14761.0,2
NDC,68084007001,CIPROFLOXACIN HCL 500 MG PO TABS,520.0,338.0,13270.0,14761.0,4
NDC,68084007011,CIPROFLOXACIN HCL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084007511,TRETINOIN (ANTINEOPLASTIC) 10 MG PO CAPS,349.17,226.96,13270.0,14761.0,2
NDC,68084008211,ISOSORBIDE DINITRATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084009411,CARBIDOPA-LEVODOPA 25-250 MG PO TABS,,,13270.0,14761.0,2
NDC,68084009711,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084009811,ATORVASTATIN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084009911,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084010811,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084010911,ACYCLOVIR 800 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084011111,GLIPIZIDE 5 MG PO TR24,,,13270.0,14761.0,2
NDC,68084011211,GLIPIZIDE 10 MG PO TR24,,,13270.0,14761.0,2
NDC,68084014911,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,68084015411,PROMETHAZINE 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084015801,MORPHINE 30 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,68084018911,ZOLPIDEM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084019911,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,2
NDC,68084020211,PRIMIDONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68084020311,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,68084020411,MINOXIDIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084020511,MINOXIDIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084021411,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,68084021511,Other Outpatient Services,290.0,188.5,,,0
NDC,68084021511,VALACYCLOVIR 500 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68084022011,ONDANSETRON HCL 4 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,68084022111,ONDANSETRON HCL 8 MG PO TABS,10974.18,7133.215,13270.0,14761.0,4
NDC,68084022911,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,6
NDC,68084024311,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084024811,LORATADINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084025211,BUPROPION HCL 300 MG PO TB24,1090.56,708.86,13270.0,14761.0,4
NDC,68084025301,HYDROXYZINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084025411,HYDROXYZINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,68084025501,HYDROXYZINE HCL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68084026911,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,68084028011,ETHAMBUTOL 400 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68084028111,CARBIDOPA-LEVODOPA 25-100 MG PO TBSR,,,13270.0,14761.0,2
NDC,68084028211,CARBIDOPA-LEVODOPA 50-200 MG PO TBSR,,,13270.0,14761.0,2
NDC,68084028411,HYDROXYUREA 500 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,68084028811,FLUDROCORTISONE 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,68084029111,NALTREXONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68084029911,TAMSULOSIN 0.4 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,68084030011,DANTROLENE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,68084031301,DIVALPROEX 125 MG PO CDRS,1121.6,729.04,13270.0,14761.0,4
NDC,68084031311,DIVALPROEX 125 MG PO CDRS,290.0,188.5,13270.0,14761.0,4
NDC,68084031811,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084031911,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084032611,GLIMEPIRIDE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,68084032811,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084034211,TOPIRAMATE 25 MG PO TABS,364.8,237.12,13270.0,14761.0,4
NDC,68084034411,TOPIRAMATE 100 MG PO TABS,641.6,417.04,13270.0,14761.0,4
NDC,68084034511,TOPIRAMATE 200 MG PO TABS,345.6,224.64,13270.0,14761.0,2
NDC,68084034611,LOSARTAN 25 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084034701,LOSARTAN 50 MG PO TABS,547.2,355.68,13270.0,14761.0,4
NDC,68084034711,LOSARTAN 50 MG PO TABS,547.2,355.68,13270.0,14761.0,4
NDC,68084034811,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084035411,OXYCODONE 5 MG PO TABS,672.0,436.8,13270.0,14761.0,4
NDC,68084036011,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,68084039611,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084040001,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084044611,NITROFURANTOIN 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,68084044911,Other Outpatient Services,1604.8,1043.12,,,0
NDC,68084045011,Other Outpatient Services,2056.0,1336.4,,,0
NDC,68084045011,TACROLIMUS 1 MG PO CAPS,2056.0,1336.4,13270.0,14761.0,4
NDC,68084045111,TACROLIMUS 5 MG PO CAPS,16833.6,10941.84,13270.0,14761.0,4
NDC,68084045811,NATEGLINIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,68084045911,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,2
NDC,68084049411,PYRIDOSTIGMINE BROMIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,68084051111,SIMVASTATIN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084053611,Other Outpatient Services,290.0,188.5,,,0
NDC,68084053911,TORSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,68084054111,ACETAZOLAMIDE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68084056111,CARBAMAZEPINE 200 MG PO TB12,,,13270.0,14761.0,2
NDC,68084057211,GUAIFENESIN 600 MG PO TA12,,,13270.0,14761.0,2
NDC,68084059111,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,2
NDC,68084059211,ISOSORBIDE MONONITRATE 60 MG PO TB24,,,13270.0,14761.0,2
NDC,68084059701,NIFEDIPINE 30 MG PO TR24,,,13270.0,14761.0,2
NDC,68084059711,NIFEDIPINE 30 MG PO TR24,,,13270.0,14761.0,2
NDC,68084059801,NIFEDIPINE 60 MG PO TR24,,,13270.0,14761.0,4
NDC,68084059811,NIFEDIPINE 60 MG PO TR24,,,13270.0,14761.0,4
NDC,68084060611,DESMOPRESSIN 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,68084060711,PERPHENAZINE 8 MG PO TABS,,,13270.0,14761.0,2
NDC,68084061011,OXYBUTYNIN CHLORIDE 10 MG PO TR24,290.0,188.5,13270.0,14761.0,4
NDC,68084061711,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084062111,MODAFINIL 100 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68084062121,MODAFINIL 100 MG PO TABS,4894.56,3181.46,13270.0,14761.0,2
NDC,68084065411,SOTALOL 80 MG PO TABS,,,13270.0,14761.0,2
NDC,68084065511,LITHIUM CARBONATE 450 MG PO TBSR,,,13270.0,14761.0,2
NDC,68084067511,Other Outpatient Services,1465.56,952.61,,,0
NDC,68084067601,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084067611,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084068311,DULOXETINE 30 MG PO CPDR,1465.56,952.61,13270.0,14761.0,4
NDC,68084069711,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,2
NDC,68084070911,Other Outpatient Services,290.0,188.5,,,0
NDC,68084071011,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084071311,VENLAFAXINE 150 MG PO CP24,290.0,188.5,13270.0,14761.0,4
NDC,68084072811,FLUCONAZOLE 100 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084072911,GALANTAMINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,68084073711,CITALOPRAM 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68084075395,CYCLOBENZAPRINE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084076511,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084076521,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084077595,TIZANIDINE 2 MG PO TABS,,,13270.0,14761.0,2
NDC,68084077611,DIVALPROEX 250 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,68084078211,DIVALPROEX 500 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,68084079095,CLOMIPRAMINE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,68084080511,METHYLPHENIDATE HCL 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084080521,Other Outpatient Services,917.76,596.54,,,0
NDC,68084080811,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68084081311,Other Outpatient Services,290.0,188.5,,,0
NDC,68084081311,PANTOPRAZOLE 40 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,68084084411,Other Outpatient Services,290.0,188.5,,,0
NDC,68084084411,VENLAFAXINE 37.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084084511,OXCARBAZEPINE 150 MG PO TABS,,,13270.0,14761.0,2
NDC,68084085195,DOXAZOSIN 2 MG PO TABS,,,13270.0,14761.0,2
NDC,68084085301,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,2
NDC,68084085311,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,2
NDC,68084085611,Other Outpatient Services,290.0,188.5,,,0
NDC,68084085611,VENLAFAXINE 75 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084085911,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,2
NDC,68084087011,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,68084087511,MONTELUKAST 10 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084089511,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,68084089695,VENLAFAXINE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68084090711,MYCOPHENOLATE SODIUM 180 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,68084091595,Other Outpatient Services,290.0,188.5,,,0
NDC,68084091595,SIROLIMUS 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68084091895,MYCOPHENOLATE SODIUM 360 MG PO TBEC,290.0,188.5,13270.0,14761.0,4
NDC,68084092825,PILOCARPINE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084092895,PILOCARPINE HCL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68084094733,QUININE SULFATE 324 MG PO CAPS,,,13270.0,14761.0,2
NDC,68084096495,PROPYLTHIOURACIL 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68084096595,VALGANCICLOVIR 450 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084097511,OXYCODONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68084099711,PRAZOSIN 2 MG PO CAPS,,,13270.0,14761.0,2
NDC,68094000159,MORPHINE 10 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,68094000559,OXYCODONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68094000859,CARBAMAZEPINE 200 MG/10 ML PO SUSP,,,13270.0,14761.0,2
NDC,68094000862,CARBAMAZEPINE 200 MG/10 ML PO SUSP,,,13270.0,14761.0,2
NDC,68094002259,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO ELIX,,,13270.0,14761.0,2
NDC,68094003159,METHADONE 1 MG/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
NDC,68094003159,METHADONE 5 MG/5 ML PO SOLN (2.5MG<DOSE<=10MG),290.0,188.5,13270.0,14761.0,2
NDC,68094003459,SEVELAMER CARBONATE 800 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68094004359,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,68094004361,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,68094012959,LOPERAMIDE 1 MG/7.5 ML PO LIQD,,,13270.0,14761.0,2
NDC,68094017161,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,68094023159,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,68094025059,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,68094049459,IBUPROFEN 100 MG/5 ML PO SUSP,,,13270.0,14761.0,4
NDC,68094058758,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,68094075062,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) PO SOLN",290.0,188.5,13270.0,14761.0,2
NDC,68094076359,ONDANSETRON HCL 4 MG/5 ML PO SOLN,1465.56,952.61,13270.0,14761.0,4
NDC,68094076362,ONDANSETRON HCL 4 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,2
NDC,68094076459,MIDAZOLAM 2 MG/ML PO SYRP,1465.56,952.61,,,0
NDC,68176000010,PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML PO LIQD,,,13270.0,14761.0,2
NDC,68180011302,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,2
NDC,68180011707,LEVETIRACETAM 500 MG PO TB24,,,13270.0,14761.0,2
NDC,68180011807,LEVETIRACETAM 750 MG PO TB24,,,13270.0,14761.0,2
NDC,68180012202,CEPHALEXIN 500 MG PO CAPS,1064.0,691.6,13270.0,14761.0,4
NDC,68180013701,ESCITALOPRAM OXALATE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68180015001,FAMOTIDINE 40 MG/5 ML (8 MG/ML) PO SUSR,447.2,290.68,13270.0,14761.0,4
NDC,68180016611,VANCOMYCIN 125 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,68180028001,ETHAMBUTOL 100 MG PO TABS,675.2,438.88,13270.0,14761.0,2
NDC,68180028001,Other Outpatient Services,675.2,438.88,,,0
NDC,68180028706,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,68180030360,Other Outpatient Services,2913.6,1893.84,,,0
NDC,68180033107,ZIPRASIDONE HCL 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,68180042311,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180042901,BIMATOPROST 0.03 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,68180044701,QUETIAPINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,68180044901,QUETIAPINE 300 MG PO TABS,376.0,244.4,13270.0,14761.0,4
NDC,68180046409,SIMVASTATIN 40 MG PO TABS,,,13270.0,14761.0,2
NDC,68180046901,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180047802,SIMVASTATIN 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68180047902,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,2
NDC,68180051201,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68180051301,LISINOPRIL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68180059101,RAMIPRIL 10 MG PO CAPS,,,13270.0,14761.0,2
NDC,68180059206,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,68180059306,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,436.32,283.61,13270.0,14761.0,2
NDC,68180061207,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180061507,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180065701,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,2
NDC,68180065906,RIFAMPIN 300 MG PO CAPS,518.4,336.96,13270.0,14761.0,4
NDC,68180065907,RIFAMPIN 300 MG PO CAPS,988.8,642.72,13270.0,14761.0,4
NDC,68180067511,OSELTAMIVIR 30 MG PO CAPS,387.52,251.89,13270.0,14761.0,4
NDC,68180067711,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180071160,CEFDINIR 300 MG PO CAPS,596.16,387.5,13270.0,14761.0,2
NDC,68180072304,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180072320,Other Outpatient Services,1465.56,952.61,,,0
NDC,68180074006,SILODOSIN 4 MG PO CAPS,447.36,290.78,13270.0,14761.0,4
NDC,68180081942,LANTHANUM 500 MG PO CHEW,7453.44,4844.74,13270.0,14761.0,2
NDC,68180081952,LANTHANUM 500 MG PO CHEW,3726.72,2422.37,13270.0,14761.0,2
NDC,68180082053,LANTHANUM 750 MG PO CHEW,1242.24,807.46,13270.0,14761.0,2
NDC,68180082110,LANTHANUM 1000 MG PO CHEW,828.16,538.3,13270.0,14761.0,2
NDC,68180082811,NORETHINDRONE AC-ETH ESTRADIOL 1-5 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68180086571,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68180087573,NORETHINDRONE-ETHIN ESTRADIOL 0.4-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,68180090271,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68180094111,TESTOSTERONE 20.25 MG/1.25 GRAM (1.62 %) TD GLPM,1465.56,952.61,13270.0,14761.0,2
NDC,68180096301,Other Outpatient Services,290.0,188.5,,,0
NDC,68180097409,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,2
NDC,68180098003,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68180098101,LISINOPRIL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,68180098103,LISINOPRIL 20 MG PO TABS,,,13270.0,14761.0,2
NDC,68308015215,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,4
NDC,68308015215,Other Outpatient Services,290.0,188.5,,,0
NDC,68308048047,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,68308066830,DOXYCYCLINE MONOHYDRATE 40 MG PO CPID,1465.56,952.61,13270.0,14761.0,2
NDC,68382005101,MELOXICAM 15 MG PO TABS,,,13270.0,14761.0,2
NDC,68382007901,HALOPERIDOL 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68382009401,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68382012105,AMLODIPINE 2.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68382012305,AMLODIPINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,68382013201,Other Outpatient Services,1465.56,952.61,,,0
NDC,68382013210,TAMSULOSIN 0.4 MG PO CAPS,3456.0,2246.4,13270.0,14761.0,4
NDC,68382024916,ATORVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68382025501,OXYBUTYNIN CHLORIDE 5 MG PO TR24,449.6,292.24,13270.0,14761.0,4
NDC,68382025601,OXYBUTYNIN CHLORIDE 10 MG PO TR24,518.4,336.96,13270.0,14761.0,2
NDC,68382026012,RIBAVIRIN 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,68382043528,Other Outpatient Services,1465.56,952.61,,,0
NDC,68382044614,BOSENTAN 62.5 MG PO TABS,17079.36,11101.58,13270.0,14761.0,2
NDC,68382045219,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,68382047130,TELMISARTAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68382047178,TELMISARTAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68382047230,TELMISARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68382047278,TELMISARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68382047330,TELMISARTAN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,68382047378,TELMISARTAN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68382052001,SIROLIMUS 0.5 MG PO TABS,6648.0,4321.2,13270.0,14761.0,2
NDC,68382052960,CHOLESTYRAMINE-ASPARTAME 4 GRAM PO PWPK,,,13270.0,14761.0,2
NDC,68382071119,MESALAMINE 1.2 GRAM PO TBEC,,,13270.0,14761.0,2
NDC,68382077305,EZETIMIBE 10 MG PO TABS,2360.0,1534.0,13270.0,14761.0,2
NDC,68382078301,DOXAZOSIN 1 MG PO TABS,,,13270.0,14761.0,2
NDC,68382078401,DOXAZOSIN 2 MG PO TABS,,,13270.0,14761.0,2
NDC,68382078501,DOXAZOSIN 4 MG PO TABS,,,13270.0,14761.0,2
NDC,68382078601,DOXAZOSIN 8 MG PO TABS,,,13270.0,14761.0,2
NDC,68382080501,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68382080505,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,68382080605,TRAZODONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,68382091001,DOXYCYCLINE HYCLATE 100 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,68382091601,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,68382092386,ELETRIPTAN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68462010130,FLUCONAZOLE 50 MG PO TABS,298.08,193.75,,,0
NDC,68462010130,Other Outpatient Services,298.08,193.75,,,0
NDC,68462010230,Other Outpatient Services,447.36,290.78,,,0
NDC,68462012801,ZONISAMIDE 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,68462013279,NORETHINDRONE AC-ETH ESTRADIOL 1-20 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,68462013508,ABIRATERONE 250 MG PO TABS,1465.56,952.61,,,0
NDC,68462015740,ONDANSETRON 4 MG PO TBDL,290.0,188.5,13270.0,14761.0,6
NDC,68462015840,ONDANSETRON 8 MG PO TBDL,20482.8,13313.82,,,0
NDC,68462018022,MUPIROCIN 2 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,68462019590,PRAVASTATIN 10 MG PO TABS,364.32,236.81,13270.0,14761.0,2
NDC,68462020011,TELMISARTAN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68462025401,ROPINIROLE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,68462025501,ROPINIROLE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,68462026290,Other Outpatient Services,290.0,188.5,,,0
NDC,68462026390,Other Outpatient Services,290.0,188.5,,,0
NDC,68462029735,CICLOPIROX 0.77 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,68462029792,CICLOPIROX 0.77 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,68462030201,INDOMETHACIN 50 MG PO CAPS,,,13270.0,14761.0,2
NDC,68462030450,NORETHINDRONE ACETATE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,68462030984,NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG PO TABS,,,13270.0,14761.0,2
NDC,68462031417,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TP CREA",1465.56,952.61,13270.0,14761.0,4
NDC,68462033190,PRAMIPEXOLE 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,68462035701,POTASSIUM CHLORIDE 10 MEQ PO CPSR,,,13270.0,14761.0,2
NDC,68462040560,ASPIRIN-DIPYRIDAMOLE 25-200 MG PO CM12,719.04,467.38,13270.0,14761.0,2
NDC,68462040601,INDOMETHACIN 25 MG PO CAPS,,,13270.0,14761.0,2
NDC,68462040860,PROPAFENONE 225 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
NDC,68462041820,Other Outpatient Services,411.1,267.22,,,0
NDC,68462042169,ATOVAQUONE 750 MG/5 ML PO SUSP,439.76,285.84,13270.0,14761.0,4
NDC,68462043518,ACAMPROSATE 333 MG PO TBEC,,,13270.0,14761.0,2
NDC,68462043630,Other Outpatient Services,1465.56,952.61,,,0
NDC,68462043730,Other Outpatient Services,1465.56,952.61,,,0
NDC,68462043790,Other Outpatient Services,1465.56,952.61,,,0
NDC,68462046160,TROSPIUM 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68462049630,DEFERASIROX 500 MG PO TBDP,1465.56,952.61,13270.0,14761.0,4
NDC,68462050479,NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68462053435,TACROLIMUS 0.1 % TP OINT,1465.56,952.61,13270.0,14761.0,2
NDC,68462058001,Other Outpatient Services,1465.56,952.61,,,0
NDC,68462058458,Other Outpatient Services,2698.56,1754.06,,,0
NDC,68462058540,APREPITANT 125 MG PO CAPS,3008.96,1955.82,13270.0,14761.0,2
NDC,68462060935,PIMECROLIMUS 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,68462063925,NITROGLYCERIN 0.4 MG SL SUBL,,,13270.0,14761.0,2
NDC,68462067291,LEVONORGESTREL-ETHINYL ESTRAD 0.15 MG-30 MCG (91) PO 3MPK,1465.56,952.61,13270.0,14761.0,2
NDC,68462073129,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68462079201,TRETINOIN (ANTINEOPLASTIC) 10 MG PO CAPS,43899.2,28534.48,13270.0,14761.0,2
NDC,68462079917,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TP OINT",1465.56,952.61,13270.0,14761.0,2
NDC,68516320202,"FACTOR IX CPLX(PCC)NO4,3FACTOR 1,000 (+/-) UNIT IV SOLR",20482.8,13313.82,2.06,14761.0,3
NDC,68516320401,"FACTOR IX CPLX(PCC)NO4,3FACTOR 500 (+/-) UNIT IV SOLR",10720.0,6968.0,2.06,14761.0,3
NDC,68516320502,"FACTOR IX CPLX(PCC)NO4,3FACTOR 1,000 (+/-) UNIT IV SOLR",21794.53,14166.44,2.06,14761.0,3
NDC,68516320701,"FACTOR IX CPLX(PCC)NO4,3FACTOR 500 (+/-) UNIT IV SOLR",1465.56,952.61,13270.0,14761.0,2
NDC,68516320802,"FACTOR IX CPLX(PCC)NO4,3FACTOR 1,000 (+/-) UNIT IV SOLR",21794.53,14166.44,2.06,14761.0,3
NDC,68516360802,"COAGULATION FACTOR IX 1,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.75,14761.0,3
NDC,68516521401,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",636.0,413.4,66.09,14761.0,5
NDC,68516521402,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",1272.0,826.8,66.09,14761.0,13
NDC,68516521403,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",636.0,413.4,13270.0,14761.0,2
NDC,68516521404,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",10974.18,7133.215,66.09,14761.0,13
NDC,68516521405,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",482.4,313.56,66.09,14761.0,13
NDC,68516521406,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",482.4,313.56,66.09,14761.0,5
NDC,68516521601,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",636.8,413.92,13270.0,14761.0,2
NDC,68516521602,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1275.2,828.88,13270.0,14761.0,2
NDC,68516521603,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",636.8,413.92,13270.0,14761.0,2
NDC,68516521604,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1465.56,952.61,13270.0,14761.0,2
NDC,68516521605,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",408.64,265.62,13270.0,14761.0,2
NDC,68516521606,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",408.64,265.62,13270.0,14761.0,2
NDC,68546014256,RASAGILINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68546017260,DEUTETRABENAZINE 12 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68546032512,GLATIRAMER 40 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,68547050102,ANGIOTENSIN II 2.5 MG/ML IV SOLN,15884.55,10324.96,13270.0,14761.0,2
NDC,68585000801,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,2
NDC,68682029905,LOTEPREDNOL ETABONATE 0.5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,68682036790,Other Outpatient Services,1465.56,952.61,,,0
NDC,68682036890,Other Outpatient Services,1465.56,952.61,,,0
NDC,68682036990,Other Outpatient Services,1465.56,952.61,,,0
NDC,68682037190,Other Outpatient Services,1465.56,952.61,,,0
NDC,68682081305,Other Outpatient Services,290.0,188.5,,,0
NDC,68682081305,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,68682085060,LULICONAZOLE 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
NDC,68682099398,DILTIAZEM HCL 120 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,68727035101,SOLRIAMFETOL 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,68727071201,LURBINECTEDIN 4 MG IV SOLR,20482.8,13313.82,253.53,291.55,8
NDC,68727074502,DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR,94095.0,61161.75,301.95,347.24,8
NDC,68727090001,ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN,1465.56,952.61,65.73,14761.0,3
NDC,68817013450,PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR,13249.26,8612.02,16.62,14761.0,11
NDC,68850001201,ETHAMBUTOL 400 MG PO TABS,1163.2,756.08,13270.0,14761.0,2
NDC,68850001202,ETHAMBUTOL 400 MG PO TABS,1163.2,756.08,13270.0,14761.0,4
NDC,68968017201,ASENAPINE 3.8 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
NDC,68968052501,ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,68968345001,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,68968661001,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
NDC,68982034701,"FIBRINOGEN 1 GRAM (700 MG- 1,300 MG) IV SOLR",290.0,188.5,1.38,14761.0,3
NDC,68982062303,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",1184.0,769.6,66.09,14761.0,13
NDC,68982064301,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",590.4,383.76,,,0
NDC,68982064302,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1180.8,767.52,13270.0,14761.0,2
NDC,68992301001,TACROLIMUS 1 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,68992301003,TACROLIMUS 1 MG PO TB24,2669.76,1735.34,13270.0,14761.0,6
NDC,68992304001,TACROLIMUS 4 MG PO TB24,4449.6,2892.24,13270.0,14761.0,4
NDC,68992307501,TACROLIMUS 0.75 MG PO TB24,6673.6,4337.84,13270.0,14761.0,2
NDC,68992307503,TACROLIMUS 0.75 MG PO TB24,2002.08,1301.35,13270.0,14761.0,2
NDC,69097012203,TOPIRAMATE 25 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,69097012215,TOPIRAMATE 25 MG PO TABS,512.0,332.8,13270.0,14761.0,2
NDC,69097012412,TOPIRAMATE 100 MG PO TABS,720.0,468.0,13270.0,14761.0,2
NDC,69097014260,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,69097031602,EXEMESTANE 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,69097031832,BUDESONIDE 0.25 MG IN NBSP,1465.56,952.61,13270.0,14761.0,4
NDC,69097031886,BUDESONIDE 0.25 MG IN NBSP,290.0,188.5,13270.0,14761.0,2
NDC,69097032303,DIMETHYL FUMARATE 240 MG PO CPDR,1465.56,952.61,13270.0,14761.0,2
NDC,69097038702,AMBRISENTAN 10 MG PO TABS,18432.48,11981.11,13270.0,14761.0,2
NDC,69097041002,CINACALCET 30 MG PO TABS,290.0,188.5,13270.0,14761.0,2
NDC,69097045805,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,298.08,193.75,13270.0,14761.0,4
NDC,69097052444,DICLOFENAC SODIUM 1 % TP GEL,290.0,188.5,13270.0,14761.0,4
NDC,69097064202,EMTRICITABINE 200 MG PO CAPS,6909.6,4491.24,13270.0,14761.0,2
NDC,69097070930,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,69097074102,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,447.36,290.78,13270.0,14761.0,4
NDC,69097080232,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,,,0
NDC,69097084905,ESCITALOPRAM OXALATE 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,69097085067,DAPTOMYCIN 350 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,69097091203,TROSPIUM 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,69097096453,VIGABATRIN 500 MG PO PWPK,1465.56,952.61,13270.0,14761.0,2
NDC,69097096793,SEVELAMER CARBONATE 800 MG PO TABS,1192.32,775.01,13270.0,14761.0,4
NDC,69238105103,Other Outpatient Services,1465.56,952.61,,,0
NDC,69238105601,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,69238106901,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,2
NDC,69238110005,DOXYCYCLINE HYCLATE 100 MG PO CAPS,2088.0,1357.2,13270.0,14761.0,4
NDC,69238112601,ETHACRYNIC ACID 25 MG PO TABS,3353.6,2179.84,13270.0,14761.0,2
NDC,69238120202,BUPRENORPHINE 5 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,69238120302,BUPRENORPHINE 10 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
NDC,69238131009,Other Outpatient Services,1465.56,952.61,,,0
NDC,69238131309,Other Outpatient Services,1465.56,952.61,,,0
NDC,69238138003,DIFLUPREDNATE 0.05 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,69238142003,Other Outpatient Services,290.0,188.5,,,0
NDC,69238142003,SILODOSIN 8 MG PO CAPS,290.0,188.5,13270.0,14761.0,2
NDC,69238142009,SILODOSIN 8 MG PO CAPS,447.84,291.1,13270.0,14761.0,4
NDC,69238147201,ERYTHROMYCIN 333 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,69238148901,BUMETANIDE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,69238149001,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,69238153205,CLOBETASOL 0.05 % TP CREA,,,13270.0,14761.0,4
NDC,69238153405,FLUOCINONIDE 0.05 % TP CREA,,,13270.0,14761.0,2
NDC,69238154401,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,69238159502,Other Outpatient Services,1465.56,952.61,,,0
NDC,69238160502,METHYLERGONOVINE 0.2 MG PO TABS,2951.62,1918.55,13270.0,14761.0,4
NDC,69238160508,METHYLERGONOVINE 0.2 MG PO TABS,6887.1,4476.62,13270.0,14761.0,4
NDC,69238161701,Other Outpatient Services,1465.56,952.61,,,0
NDC,69238173105,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,69238173165,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,69238207701,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,69292053001,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,2
NDC,69292056601,METOLAZONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,69315011601,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,2
NDC,69315011701,FUROSEMIDE 40 MG PO TABS,,,13270.0,14761.0,2
NDC,69315013401,IMIPRAMINE HCL 25 MG PO TABS,,,13270.0,14761.0,2
NDC,69315013601,BENZTROPINE 0.5 MG PO TABS,,,13270.0,14761.0,2
NDC,69315013701,BENZTROPINE 1 MG PO TABS,,,13270.0,14761.0,2
NDC,69315018201,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,2
NDC,69315030410,DORZOLAMIDE 2 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,69315030510,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,69315030615,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,4
NDC,69315030802,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,69315030805,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,69315090401,LORAZEPAM 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,69315090401,Other Outpatient Services,290.0,188.5,,,0
NDC,69315090501,Other Outpatient Services,290.0,188.5,,,0
NDC,69315090601,Other Outpatient Services,290.0,188.5,,,0
NDC,69315091001,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,692.8,450.32,13270.0,14761.0,4
NDC,69339014801,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,2
NDC,69339014905,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,13270.0,14761.0,4
NDC,69339015301,MAGNESIUM HYDROXIDE 400 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,69344010233,INDOMETHACIN 50 MG PR SUPP,96896.64,62982.82,13270.0,14761.0,4
NDC,69367020301,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,995.2,646.88,13270.0,14761.0,4
NDC,69367025810,SODIUM BICARBONATE 650 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,69367033630,PAROXETINE HCL 25 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
NDC,69374031410,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,69374031410,"MIDAZOLAM IN NACL,ISO-OSMO(PF) 1 MG/ML IV SOLN",1465.56,952.61,13270.0,14761.0,2
NDC,69374090205,NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,69374094604,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,69374095710,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,69374098750,ROPIVACAINE 0.2% IN 0.9% NACL 500 ML FOR PERIPHERAL NERVE CATETHER,784.0,509.6,13270.0,14761.0,2
NDC,69374098810,ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,69452013317,DOFETILIDE 500 MCG PO CAPS,680.64,442.42,13270.0,14761.0,2
NDC,69452014320,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,69452015020,VALPROIC ACID 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,69452015774,RIZATRIPTAN 10 MG PO TBDL,,,13270.0,14761.0,4
NDC,69452020713,CALCITRIOL 0.25 MCG PO CAPS,,,13270.0,14761.0,2
NDC,69452020820,CALCITRIOL 0.5 MCG PO CAPS,,,13270.0,14761.0,2
NDC,69488000140,GALLIUM DOTATATE (GA-68)(NETSPOT) ISOTOPE (NUC MED),1.01,0.65,63.62,73.16,16
NDC,69488000301,LU-177 DOTATATE (LUTATHERA) ISOTOPE (NUC MED),1.01,0.65,368.89,424.22,8
NDC,69488000370,LU-177 DOTATATE (LUTATHERA) ISOTOPE (NUC MED),1.01,0.65,368.89,424.22,8
NDC,69488001061,"LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",1465.56,952.61,300.39,345.45,24
NDC,69489041101,GLYCOPYRRONIUM TOSYLATE 2.4 % TP TOWL,1465.56,952.61,13270.0,14761.0,2
NDC,69543037101,PALONOSETRON 0.25 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,69543038030,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,69543038090,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,4
NDC,69543045101,Other Outpatient Services,1465.56,952.61,,,0
NDC,69557011101,LIDOCAINE 1.8 % TP PTMD,1465.56,952.61,13270.0,14761.0,2
NDC,69584009210,BUSPIRONE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,69584011110,CARISOPRODOL 350 MG PO TABS,,,13270.0,14761.0,2
NDC,69584068410,PRIMIDONE 50 MG PO TABS,,,13270.0,14761.0,2
NDC,69584068510,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,69584084110,SOTALOL 80 MG PO TABS,,,13270.0,14761.0,2
NDC,69584084210,SOTALOL 120 MG PO TABS,,,13270.0,14761.0,2
NDC,69616021103,AMIFAMPRIDINE PHOSPHATE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,69618001501,ASPIRIN 325 MG PO TBEC,,,13270.0,14761.0,2
NDC,69618003301,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,69618006401,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,69618006501,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,4
NDC,69656010330,NIRAPARIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,69680012035,LIDOCAINE 5 % TP OINT,323.78,210.46,13270.0,14761.0,4
NDC,69784000206,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,10974.18,7133.215,13270.0,14761.0,4
NDC,69784000306,FLUCONAZOLE CUSTOM IVPB IN NACL,1465.56,952.61,13270.0,14761.0,2
NDC,69784020096,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,2
NDC,69784020530,CROMOLYN 20 MG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,69784023020,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.4,188.76,13270.0,14761.0,4
NDC,69784023120,SODIUM ACETATE 2 MEQ/ML IV SOLN,371.2,241.28,13270.0,14761.0,4
NDC,69800420201,HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN,2369.28,1540.03,174.24,14761.0,3
NDC,69800420301,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",8711.68,5662.59,174.24,14761.0,11
NDC,69800420302,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",1465.56,952.61,174.24,14761.0,3
NDC,69842068410,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,2
NDC,69853010201,"FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR",22500.0,14625.0,164.36,14761.0,5
NDC,69918010101,DESMOPRESSIN 0.1 MG PO TABS,,,13270.0,14761.0,2
NDC,69918030130,TRANEXAMIC ACID 650 MG PO TABS,1121.28,728.83,13270.0,14761.0,4
NDC,69918073501,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,869.2,564.98,13270.0,14761.0,2
NDC,69918089901,DESMOPRESSIN 4 MCG/ML IJ SOLN,320.24,208.16,6.75,14761.0,3
NDC,69918090110,DESMOPRESSIN 4 MCG/ML IJ SOLN,2500.32,1625.21,6.75,14761.0,13
NDC,69932001030,F-18 FLUCICLOVINE,1.01,0.65,334.23,384.37,8
NDC,69945009240,KIT FOR TC 99M-SESTAMIBI NO.1 IV SOLR,1.01,0.65,13270.0,14761.0,4
NDC,69945009620,KIT TC-99M-MERTIATIDE (BETIAT) 1 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
NDC,69968006009,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OIPK",529.92,344.45,13270.0,14761.0,4
NDC,69968006009,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM TP PACK",529.92,344.45,13270.0,14761.0,2
NDC,69993045006,LIDOCAINE 4 % TP PTMD,1465.56,952.61,13270.0,14761.0,4
NDC,70004020232,Other Outpatient Services,1465.56,952.61,,,0
NDC,70010000201,Other Outpatient Services,448.0,291.2,,,0
NDC,70010004301,METHYLPHENIDATE HCL 20 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
NDC,70010004301,Other Outpatient Services,1465.56,952.61,,,0
NDC,70010004401,BUTALBITAL-ACETAMINOPHEN-CAFF 50-300-40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70010006401,METFORMIN 850 MG PO TABS,,,13270.0,14761.0,2
NDC,70010006505,METFORMIN 1000 MG PO TABS,,,13270.0,14761.0,2
NDC,70010049101,METFORMIN 500 MG PO TB24,,,13270.0,14761.0,2
NDC,70010075401,METHOCARBAMOL 500 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,70010077001,METHOCARBAMOL 750 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,70010077005,METHOCARBAMOL 750 MG PO TABS,464.0,301.6,13270.0,14761.0,4
NDC,70069000501,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069000701,OLOPATADINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,70069000701,Other Outpatient Services,1465.56,952.61,,,0
NDC,70069001101,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70069002101,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069002501,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,20482.8,13313.82,,,0
NDC,70069006401,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069007101,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069010101,METHOCARBAMOL 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069012101,TROPICAMIDE 1 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,70069013101,TOBRAMYCIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,70069014101,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70069014110,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069015101,CISATRACURIUM 10 MG/ML CONC. IV SOLN,685.76,445.74,13270.0,14761.0,2
NDC,70069023101,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,70069026101,SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069027101,VERAPAMIL 2.5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069036201,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70069036210,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70069042101,LATANOPROST 0.005 % OP DROP,290.0,188.5,13270.0,14761.0,4
NDC,70092109236,Other Outpatient Services,1465.56,952.61,,,0
NDC,70092161144,Other Outpatient Services,1465.56,952.61,,,0
NDC,70092958838,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % EP SOLN,2048.0,1331.2,13270.0,14761.0,2
NDC,70100042401,INDOCYANINE GREEN 25 MG IJ SOLR,2365.81,1537.78,10.63,14761.0,15
NDC,70100042402,INDOCYANINE GREEN 25 MG IJ SOLR,2365.81,1537.78,10.63,12.22,8
NDC,70121104901,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,70121104902,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,70121116801,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
NDC,70121123801,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1159.2,753.48,13270.0,14761.0,2
NDC,70121123901,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,2385.12,1550.33,13270.0,14761.0,2
NDC,70121124001,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,4844.8,3149.12,13270.0,14761.0,2
NDC,70121139401,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70121145401,MEROPENEM 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,70121157301,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,70121157305,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,70121157401,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,,,0
NDC,70121157601,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70121157801,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70121158501,VERAPAMIL 2.5 MG/ML IV SOLN,310.66,201.93,13270.0,14761.0,4
NDC,70121158505,VERAPAMIL 2.5 MG/ML IV SOLN,310.66,201.93,13270.0,14761.0,4
NDC,70127010001,CANNABIDIOL 100 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,70127010001,Other Outpatient Services,1465.56,952.61,,,0
NDC,70127010010,CANNABIDIOL 100 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,70127010010,Other Outpatient Services,1465.56,952.61,,,0
NDC,70194000330,PLECANATIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70199002611,VITAMIN A PALMITATE 50000 UNITS/ML IM SOLN,20482.8,13313.82,,,0
NDC,70255001002,BINIMETINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70255002501,ENCORAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70255002504,ENCORAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70257056001,BACLOFEN 500 MCG/ML IT SOLN,2960.0,1924.0,,,0
NDC,70257056020,BACLOFEN 500 MCG/ML IT SOLN,20482.8,13313.82,217.39,249.99,8
NDC,70257056255,BACLOFEN 50 MCG/ML IT SOLN,447.23,290.7,,,0
NDC,70257056302,BACLOFEN 2000 MCG/ML IT SOLN,6205.14,4033.34,13270.0,14761.0,2
NDC,70257056320,BACLOFEN 2000 MCG/ML IT SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,70301100101,CALCIFEDIOL 30 MCG PO CS24,1465.56,952.61,13270.0,14761.0,2
NDC,70312046129,Other Outpatient Services,1465.56,952.61,,,0
NDC,70370104001,VALBENAZINE 40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70370108001,VALBENAZINE 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70370204001,VALBENAZINE 40 MG PO CAPS,10974.18,7133.215,13270.0,14761.0,2
NDC,70370305002,OPICAPONE 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,70436000506,GALANTAMINE 8 MG PO TABS,,,13270.0,14761.0,2
NDC,70436000704,Other Outpatient Services,2534.4,1647.36,,,0
NDC,70436000804,CINACALCET 60 MG PO TABS,4993.92,3246.05,13270.0,14761.0,2
NDC,70436001004,BUPROPION HCL 150 MG PO TB24,340.32,221.21,13270.0,14761.0,4
NDC,70436001104,Other Outpatient Services,1465.56,952.61,,,0
NDC,70436001982,AZITHROMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70436002082,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70436002182,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70436005801,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,2
NDC,70436005901,BUPROPION HCL 150 MG PO SR12,,,13270.0,14761.0,2
NDC,70436008955,GANCICLOVIR SODIUM 500 MG IV SOLR,470.32,305.71,13270.0,14761.0,4
NDC,70436018301,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,2
NDC,70461032204,FLU VAC QS 2022(6 MS UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,70482008560,AMANTADINE HCL 68.5 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,70482017060,AMANTADINE HCL 137 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
NDC,70510217101,EDARAVONE 30 MG/100 ML IV SOLN,1465.56,952.61,27.57,14761.0,3
NDC,70510232201,EDARAVONE 105 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,70515026010,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,1883.65,1224.37,,,0
NDC,70515071101,CICLESONIDE 80 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,70515071201,CICLESONIDE 160 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,70515071205,CICLESONIDE 160 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,70515073760,CICLESONIDE 37 MCG/ACTUATION NA HFAA,1465.56,952.61,13270.0,14761.0,2
NDC,70539000101,"ABALOPARATIDE 80 MCG (3,120 MCG/1.56 ML) SC PNIJ",1465.56,952.61,13270.0,14761.0,2
NDC,70539000102,"ABALOPARATIDE 80 MCG (3,120 MCG/1.56 ML) SC PNIJ",1465.56,952.61,13270.0,14761.0,2
NDC,70539000102,Other Outpatient Services,1465.56,952.61,,,0
NDC,70539000198,"ABALOPARATIDE 80 MCG (3,120 MCG/1.56 ML) SC PNIJ",1465.56,952.61,13270.0,14761.0,2
NDC,70564080260,CROFELEMER 125 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,70594003701,MICAFUNGIN 100 MG/100 ML D5W VIAL-TO-BAG IVPB,2787.68,1811.99,13270.0,14761.0,2
NDC,70594005301,DAPTOMYCIN 350 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70594007901,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70594007901,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,70594008001,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,70594008001,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
NDC,70594008501,AMPICILLIN SODIUM 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70677002101,CAFFEINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,70677007402,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,2
NDC,70700010184,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG(24) /75 MG (4) PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,70700011484,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.02 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70700011584,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70700012084,NORGESTIMATE-ETHINYL ESTRADIOL 0.18/0.215/0.25 MG-25 MCG PO TABS,,,13270.0,14761.0,2
NDC,70700012284,DESOG-E.ESTRADIOL/E.ESTRADIOL 0.15-0.02 MGX21 /0.01 MG X 5 PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70700015901,MIDODRINE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,70700016522,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,290.0,188.5,,,0
NDC,70700017022,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70700017222,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70700018622,FLUOROURACIL 500 MG/10 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70700018623,FLUOROURACIL 500 MG/10 ML IV SOLN,290.0,188.5,,,0
NDC,70700018722,FLUOROURACIL 1 GRAM/20 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,70700018922,FLUOROURACIL 5 G/100 ML IV SOLN,884.8,575.12,,,0
NDC,70700026894,FOSFOMYCIN TROMETHAMINE 3 GRAM PO PACK,1465.56,952.61,13270.0,14761.0,2
NDC,70700027030,DEFERASIROX 180 MG PO TABS,447.36,290.78,13270.0,14761.0,2
NDC,70700027130,DEFERASIROX 360 MG PO TABS,894.24,581.26,13270.0,14761.0,2
NDC,70710111001,CYPROHEPTADINE 4 MG PO TABS,,,13270.0,14761.0,2
NDC,70710119601,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,290.0,188.5,13270.0,14761.0,2
NDC,70710122901,AMITRIPTYLINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,70710134403,RAMELTEON 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,70710135901,LACOSAMIDE 200 MG/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70710137701,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70710138909,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,70710139109,Other Outpatient Services,1465.56,952.61,,,0
NDC,70710153001,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",1788.8,1162.72,165.71,14761.0,11
NDC,70710153101,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",4099.6,2664.74,165.71,190.57,8
NDC,70710161001,ARSENIC TRIOXIDE 2 MG/ML IV SOLN,969.02,629.86,8.96,10.31,8
NDC,70710164301,VERAPAMIL 2.5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70710165501,PEMETREXED DISODIUM 500 MG IV SOLR,1639.84,1065.9,5.21,14761.0,11
NDC,70710166301,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70710166307,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70710166407,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,70710168808,FULVESTRANT 250 MG/5 ML IM SYRG,20482.8,13313.82,9.35,10.75,8
NDC,70710171604,SILDENAFIL (PULM.HYPERTENSION) 10 MG/ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
NDC,70710172601,NELARABINE 250 MG/50 ML IV SOLN,3922.4,2549.56,90.31,14761.0,3
NDC,70710172601,NELARABINE 250 MG/50 ML IVPB,3922.4,2549.56,90.31,103.86,8
NDC,70720095036,GOSERELIN 3.6 MG SC IMPL,16822.4,10934.56,840.22,14761.0,11
NDC,70720095130,GOSERELIN 10.8 MG SC IMPL,26280.18,17082.12,840.22,966.25,8
NDC,70726030301,RILUZOLE 50 MG/10 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
NDC,70726030302,Other Outpatient Services,1465.56,952.61,,,0
NDC,70727049725,NETARSUDIL 0.02 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,70727049799,NETARSUDIL 0.02 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,70727049799,Other Outpatient Services,1465.56,952.61,,,0
NDC,70727052925,NETARSUDIL-LATANOPROST 0.02-0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,4
NDC,70748025701,ARFORMOTEROL 15 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,70752012905,TRIAMCINOLONE ACETONIDE 0.025 % TP LOTN,,,13270.0,14761.0,2
NDC,70756060730,OFLOXACIN 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,70756062925,PHENYLEPHRINE HCL 2.5 % OP DROP,484.32,314.81,13270.0,14761.0,6
NDC,70756064935,PHENYLEPHRINE HCL 2.5 % OP DROP,1465.56,952.61,,,0
NDC,70756070360,RANOLAZINE 500 MG PO TB12,290.0,188.5,13270.0,14761.0,4
NDC,70801000101,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,20482.8,13313.82,22.1,25.41,8
NDC,70801000301,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,10974.18,7133.215,22.1,14761.0,11
NDC,70839015030,ALISKIREN 150 MG PO TABS,5957.76,3872.54,13270.0,14761.0,2
NDC,70839030030,ALISKIREN 300 MG PO TABS,6494.4,4221.36,13270.0,14761.0,2
NDC,70842012001,MEROPENEM-VABORBACTAM 2 GRAM IV SOLR,3110.4,2021.76,2.61,14761.0,3
NDC,70842012006,MEROPENEM-VABORBACTAM 2 GRAM IV SOLR,3110.4,2021.76,2.61,14761.0,3
NDC,70842014001,ORITAVANCIN 400 MG IV SOLR,17269.65,11225.27,35.44,40.75,8
NDC,70842016001,MINOCYCLINE 100 MG IV SOLR,4008.0,2605.2,3.22,14761.0,3
NDC,70842016010,MINOCYCLINE 100 MG IV SOLR,4008.0,2605.2,3.22,14761.0,3
NDC,70860010041,AZITHROMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70860010341,Other Outpatient Services,1465.56,952.61,,,0
NDC,70860010520,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,20482.8,13313.82,,,0
NDC,70860012641,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,70860020005,PACLITAXEL 6 MG/ML IV CONC,290.0,188.5,13270.0,14761.0,2
NDC,70860020017,PACLITAXEL 6 MG/ML IV CONC,372.74,242.28,13270.0,14761.0,2
NDC,70860020050,PACLITAXEL 6 MG/ML IV CONC,745.6,484.64,,,0
NDC,70860020210,PEMETREXED DISODIUM 100 MG IV SOLR,894.4,581.36,5.21,5.99,8
NDC,70860021141,FULVESTRANT 250 MG/5 ML IM SYRG,20482.8,13313.82,9.35,10.75,8
NDC,70860021174,FULVESTRANT 250 MG/5 ML IM SYRG,834.8,542.62,9.35,10.75,8
NDC,70860021567,PACLITAXEL 6 MG/ML IV CONC,290.0,188.5,13270.0,14761.0,2
NDC,70860022510,BORTEZOMIB 3.5 MG IJ SOLR,520.96,338.62,13270.0,14761.0,2
NDC,70860030141,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70860030142,DILTIAZEM HCL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70860030143,DILTIAZEM HCL 5 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,70860030241,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70860040041,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,70860040504,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70860040541,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70860040641,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
NDC,70860045110,LEVOTHYROXINE 100 MCG IV SOLR,848.96,551.82,13270.0,14761.0,4
NDC,70860045410,DESMOPRESSIN 4 MCG/ML IJ SOLN,2757.12,1792.13,6.75,14761.0,13
NDC,70860045441,DESMOPRESSIN 4 MCG/ML IJ SOLN,10974.18,7133.215,6.75,14761.0,11
NDC,70860060041,MIDAZOLAM 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70860060142,MIDAZOLAM 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70860060241,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,70860060282,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
NDC,70860060541,Other Outpatient Services,290.0,188.5,,,0
NDC,70860070141,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,290.0,188.5,0.85,0.98,8
NDC,70860070141,KETOROLAC 30 MG/ML IV PEDIATRIC,290.0,188.5,0.85,14761.0,3
NDC,70860070142,KETOROLAC 60 MG/2 ML IM SOLN,20482.8,13313.82,0.85,0.98,8
NDC,70860075102,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,,,0
NDC,70860075141,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,70860077841,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,70954004110,RIFABUTIN 150 MG PO CAPS,18777.6,12205.44,13270.0,14761.0,4
NDC,70954013510,DAPSONE 25 MG PO TABS,,,13270.0,14761.0,2
NDC,70954013620,DAPSONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,70954014805,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,70954014865,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,70954018809,ACYCLOVIR 200 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,4
NDC,70954040110,DEXAMETHASONE 1.5 MG PO TABS,,,13270.0,14761.0,2
NDC,70954044310,MISOPROSTOL 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,70954049210,LEVOCARNITINE 330 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,71143037501,FLUTICASONE PROPIONATE 93 MCG/ACTUATION NA AERB,1465.56,952.61,13270.0,14761.0,2
NDC,71149000008,"MAGNESIUM MALATE, CHELATE 125 MG MAGNESIUM PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,71149000125,MAGNESIUM CITRATE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,71205090900,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,71205098172,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,71247012701,LABETALOL 200 MG PO TABS,,,13270.0,14761.0,2
NDC,71247013001,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,2
NDC,71258002201,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML IV SOLN",1.01,0.65,413.95,476.04,8
NDC,71285020201,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PF SOLN",1465.56,952.61,13270.0,14761.0,4
NDC,71286201201,HYDROMORPHONE (PF)-0.9 % NACL 1 MG/ML IV SPCA,10974.18,7133.215,13270.0,14761.0,2
NDC,71286207101,FENTANYL 10 MCG/ML IV PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
NDC,71286207105,FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML IV SOLN,884.0,574.6,13270.0,14761.0,2
NDC,71286302001,KETAMINE 50 MG/ML (1 ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,71287011901,HB AXICABTAGENE CILOLEUCEL CAR+ VIABLE T CELLS,1700090.0,1105058.5,13270.0,609464.69,3
NDC,71288000631,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,10974.18,7133.215,13270.0,14761.0,2
NDC,71288000631,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,71288000921,CEFEPIME 2 GRAM IJ SOLR,10974.18,7133.215,13270.0,14761.0,2
NDC,71288001615,DAPTOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,71288001715,DAPTOMYCIN 350 MG IV SOLR,372.64,242.22,13270.0,14761.0,2
NDC,71288001910,TIGECYCLINE 50 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,71288010110,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,,,0
NDC,71288010120,OXALIPLATIN 100 MG/20 ML IV SOLN,298.24,193.86,13270.0,14761.0,2
NDC,71288010610,BLEOMYCIN 15 UNITS IJ SOLR,300.0,195.0,13270.0,14761.0,2
NDC,71288011450,GEMCITABINE 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,71288011706,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN,20482.8,13313.82,,,0
NDC,71288011810,BORTEZOMIB 3.5 MG IJ SOLR,626.08,406.95,13270.0,14761.0,2
NDC,71288011920,DECITABINE 50 MG IV SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,71288012902,DACTINOMYCIN 0.5 MG IV SOLR,7453.6,4844.84,351.31,14761.0,11
NDC,71288013850,MITOMYCIN 20 MG IV SOLR,10974.18,7133.215,52.93,14761.0,11
NDC,71288016610,PEMETREXED DISODIUM 100 MG IV SOLR,290.0,188.5,5.21,5.99,8
NDC,71288016750,PEMETREXED DISODIUM 500 MG IV SOLR,731.68,475.59,5.21,14761.0,11
NDC,71288040210,HEPARIN BOLUS FOR ACS PROTOCOL,290.0,188.5,13270.0,14761.0,2
NDC,71288040301,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,71288040302,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,71288071205,CISATRACURIUM 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,71288071611,METHOCARBAMOL 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,71288071910,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,71288080320,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,4
NDC,71332000101,FOSTAMATINIB 100 MG PO TABS,1465.56,952.61,,,0
NDC,71332000201,FOSTAMATINIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,71334010001,IVOSIDENIB 250 MG PO TABS,1465.56,952.61,,,0
NDC,71336100001,PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN,88065.0,57242.25,123.12,141.59,8
NDC,71336100301,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,6133.8,14761.0,11
NDC,71369002010,AVATROMBOPAG 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,71384050105,PREDNISOLONE ACETATE (PF) 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,71384050203,PREDNISOLONE ACET-GATIFLOXACIN 1-0.5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,71384050505,PREDNISOLONE ACETATE-BROMFENAC 1-0.075 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,71384051910,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,71399012204,VITS A AND D-WHITE PET-LANOLIN TP OINT,,,13270.0,14761.0,2
NDC,71399282901,DIBUCAINE 1 % TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,71399788901,MAGNESIUM CITRATE PO SOLN,,,13270.0,14761.0,2
NDC,71399824503,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,2
NDC,71571012128,LOTEPREDNOL ETABONATE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,71699010030,CENOBAMATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,71740011230,POTASSIUM IODIDE 1 G/ML PO SOLN,,,13270.0,14761.0,4
NDC,71776000515,NATAMYCIN 5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
NDC,71839010401,FOSAPREPITANT 150 MG IV SOLR,361.48,234.96,13270.0,14761.0,2
NDC,71839010801,DAPTOMYCIN 350 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,71858004004,LEVOTHYROXINE 125 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,71930005712,VALPROIC ACID 250 MG PO CAPS,,,13270.0,14761.0,2
NDC,72060014201,LUMATEPERONE 42 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,72060014230,LUMATEPERONE 42 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,72060014240,LUMATEPERONE 42 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,72140003147,WHITE PETROLATUM 41 % TP OINT,,,13270.0,14761.0,2
NDC,72140045231,AQUAPHOR OINTMENT,,,13270.0,14761.0,2
NDC,72196604401,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72196607301,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,1465.56,952.61,13270.0,14761.0,2
NDC,72196607301,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,72196607401,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,20482.8,13313.82,,,0
NDC,72196701901,EPINEPHRINE IN D5W 8 MG/250ML (0.032 MG/ML)IV PREMIX,10974.18,7133.215,13270.0,14761.0,4
NDC,72205000390,ROSUVASTATIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,72205000530,ROSUVASTATIN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,72205001030,SILODOSIN 8 MG PO CAPS,447.36,290.78,13270.0,14761.0,2
NDC,72205003092,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,72205004211,OSELTAMIVIR 30 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
NDC,72205005108,ALBENDAZOLE 200 MG PO TABS,890.72,578.97,13270.0,14761.0,2
NDC,72205005401,FOSAPREPITANT 150 MG IV SOLR,331.32,215.36,13270.0,14761.0,2
NDC,72205006301,PACLITAXEL 6 MG/ML IV CONC,880.0,572.0,,,0
NDC,72205010101,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,72205010201,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72266010101,DEXRAZOXANE HCL 500 MG IV SOLR,1963.04,1275.98,108.95,125.29,8
NDC,72266010201,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,72266010301,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,72266011801,KETOROLAC 30 MG/ML IV PEDIATRIC,290.0,188.5,0.85,14761.0,11
NDC,72266011825,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,290.0,188.5,0.85,14761.0,11
NDC,72266012701,DICYCLOMINE 10 MG/ML IM SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72266014201,BROMFENAC 0.09 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,72266014601,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72266015801,MOXIFLOXACIN 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,2
NDC,72266015901,ERTAPENEM 1 GRAM IJ SOLR,310.82,202.03,13270.0,14761.0,2
NDC,72266016001,ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR,290.0,188.5,13270.0,14761.0,2
NDC,72266019601,TOBRAMYCIN 0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,72266023501,DEXRAZOXANE HCL 250 MG IV SOLR,819.84,532.9,108.95,125.29,8
NDC,72426011803,Other Outpatient Services,1465.56,952.61,,,0
NDC,72482010012,PACRITINIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,72485010101,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72485010401,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,72485010501,SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
NDC,72485010601,LEVETIRACETAM 500 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72485010701,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,72485010710,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,2
NDC,72485040901,OXACILLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,2
NDC,72485041701,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,290.0,188.5,,,0
NDC,72511076002,EVOLOCUMAB 140 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
NDC,72516003001,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,2
NDC,72516003201,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,2
NDC,72578000314,MEMANTINE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,72578008904,NYSTATIN 100000 UNIT/GRAM TP OINT,290.0,188.5,13270.0,14761.0,4
NDC,72578009001,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO CAPS,,,13270.0,14761.0,2
NDC,72579001102,ZANUBRUTINIB 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,72603010101,OXALIPLATIN 100 MG/20 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72603010701,DECITABINE 50 MG IV SOLR,522.56,339.66,,,0
NDC,72603011501,TAMSULOSIN 0.4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
NDC,72603011801,MEMANTINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,72611071601,DEXRAZOXANE HCL 500 MG IV SOLR,2131.04,1385.18,108.95,14761.0,13
NDC,72611072201,KETOROLAC 30 MG/ML IV PEDIATRIC,10974.18,7133.215,0.85,14761.0,11
NDC,72611072225,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,20482.8,13313.82,0.85,0.98,8
NDC,72611073401,LABETALOL 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,72611074101,MIDAZOLAM 1 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,72611074901,MIDAZOLAM 250 MG/50 ML (5 MG/ML) PEDS STRAIGHT DRUG IV SOLUTION,1465.56,952.61,13270.0,14761.0,2
NDC,72611074901,MIDAZOLAM 5 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,72611075601,ROCURONIUM 10 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,72611075610,ROCURONIUM 10 MG/ML IV SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,72611076101,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
NDC,72611078502,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR,5519.16,3587.45,40.11,46.12,8
NDC,72618300002,RIMEGEPANT 75 MG PO TBDL,1465.56,952.61,13270.0,14761.0,2
NDC,72626270101,SOFOSBUVIR-VELPATASVIR 400-100 MG PO TABS,119257.6,77517.44,13270.0,14761.0,4
NDC,72694051501,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,232056.99,150837.04,13270.0,14761.0,2
NDC,72694061760,IVOSIDENIB 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,72694095401,PEGASPARGASE 750 UNITS/ML IJ SOLN,229844.16,149398.7,13270.0,38764.09,11
NDC,72786010101,VOXELOTOR 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,72789018330,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO TABS,,,13270.0,14761.0,2
NDC,72865023090,Other Outpatient Services,1465.56,952.61,,,0
NDC,72874000101,"FLUOROESTRADIOL F-18 148 MBQ/ML TO 3,700 MBQ/ML IV SOLN",1.01,0.65,620.94,714.08,8
NDC,72888000901,BACLOFEN 5 MG PO TABS,,,13270.0,14761.0,2
NDC,72888003501,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,2
NDC,72888003905,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,72888004601,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,2
NDC,72888004801,ACETAZOLAMIDE 250 MG PO TABS,521.6,339.04,13270.0,14761.0,2
NDC,72888006030,AMIODARONE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,72893000101,MELPHALAN HCL-BETADEX SBES 50 MG IV SOLR,9643.14,6268.04,21.61,14761.0,13
NDC,72893000501,PRALATREXATE 40 MG/2 ML (20 MG/ML) IV SOLN,133376.22,86694.54,465.41,14761.0,11
NDC,72903085301,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
NDC,72919012410,MELOXICAM 7.5 MG/5 ML PO SUSP,1465.56,952.61,,,0
NDC,72959042040,SODIUM CITRATE 230 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,72974012001,RELUGOLIX 120 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,73090042101,HB MISCELLANEOUS PHARMACY,1465.56,952.61,195.58,224.92,8
NDC,73090042101,Other Outpatient Services,1465.56,952.61,,,0
NDC,73090042101,SILTUXIMAB 400 MG IV SOLR,10974.18,7133.215,195.58,224.92,16
NDC,73154005060,TENAPANOR 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,73293000101,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
NDC,73336007507,VIBEGRON 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,73336007530,VIBEGRON 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,73336007590,VIBEGRON 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,73475304105,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,55713.42,36213.72,34.63,46.64,16
NDC,73521003001,VARENICLINE 0.03 MG/SPRAY NA SPRM,1465.56,952.61,13270.0,14761.0,2
NDC,73534050501,PREDNISOLONE 5 MG PO TABS,23027.2,14967.68,13270.0,14761.0,2
NDC,73535020801,TAFASITAMAB-CXIX 200 MG IV SOLR,12316.5,8005.73,17.07,19.63,8
NDC,73562011301,"LIPASE-PROTEASE-AMYLASE 3,000-10,000 -14,000-UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,73562011401,"LIPASE-PROTEASE-AMYLASE 40,000-126,000- 168,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
NDC,73604091404,RILONACEPT 220 MG SC SOLR,1465.56,952.61,13270.0,14761.0,2
NDC,73607000201,ARTESUNATE 110 MG IV SOLR,48406.5,31464.23,13270.0,14761.0,2
NDC,74300000071,ZINC OXIDE-COD LIVER OIL 40 % TP PSTE,,,13270.0,14761.0,2
NDC,74300000412,PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TP SHAM,,,13270.0,14761.0,2
NDC,74312000650,PYRIDOXINE (VITAMIN B6) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,74312001380,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,2
NDC,74312002832,MELATONIN 1 MG PO TABS,,,13270.0,14761.0,4
NDC,74312003201,SELENIUM 200 MCG PO TABS,290.0,188.5,13270.0,14761.0,4
NDC,74312029176,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO CAPS,,,13270.0,14761.0,2
NDC,74312036015,COQ10 (UBIQUINOL) 100 MG PO CAPS,1465.56,952.61,,,0
NDC,74312041383,FERROUS SULFATE 325 MG (65 MG IRON) PO TABS,,,13270.0,14761.0,2
NDC,74676590201,TRIPTORELIN PAMOATE 3.75 MG IM SUSR,11180.48,7267.31,581.16,668.34,8
NDC,74676590401,TRIPTORELIN PAMOATE 11.25 MG IM SUSR,18866.97,12263.53,581.16,668.34,8
NDC,75826011410,PHENAZOPYRIDINE 100 MG PO TABS,,,13270.0,14761.0,2
NDC,75826011510,PHENAZOPYRIDINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,75826011810,Other Outpatient Services,2936.0,1908.4,,,0
NDC,75834017001,ZINC OXIDE 20 % TP OINT,,,13270.0,14761.0,2
NDC,75834020501,NATEGLINIDE 60 MG PO TABS,,,13270.0,14761.0,2
NDC,75834020601,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,2
NDC,75834022101,CARBAMAZEPINE 200 MG PO TABS,,,13270.0,14761.0,2
NDC,75834024330,ERYTHROMYCIN 500 MG PO TABS,3708.0,2410.2,13270.0,14761.0,2
NDC,75987013015,TEPROTUMUMAB-TRBW 500 MG IV SOLR,153158.58,99553.08,428.2,492.43,8
NDC,76014000410,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,10974.18,7133.215,13270.0,14761.0,2
NDC,76014000525,EPHEDRINE SULFATE 50 MG/ML IV SOLN,20482.8,13313.82,,,0
NDC,76014000530,EPHEDRINE SULFATE 50 MG/ML IV SOLN,20482.8,13313.82,13270.0,14761.0,4
NDC,76045000401,MORPHINE 2 MG/ML IV SYRG,10974.18,7133.215,13270.0,14761.0,2
NDC,76045000501,MORPHINE 4 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,76045000510,MORPHINE 4 MG/ML IJ SYRG,1465.56,952.61,13270.0,14761.0,2
NDC,76075010101,CARFILZOMIB 60 MG IV SOLR,29473.65,19157.87,61.73,14761.0,11
NDC,76075010201,CARFILZOMIB 30 MG IV SOLR,14736.87,9578.97,61.73,70.99,8
NDC,76075010301,CARFILZOMIB 10 MG IV SOLR,8732.96,5676.42,61.73,14761.0,11
NDC,76125079025,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",544.0,353.6,66.09,14761.0,3
NDC,76125079026,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",10974.18,7133.215,66.09,14761.0,11
NDC,76125079210,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1084.8,705.12,13270.0,14761.0,2
NDC,76125079211,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",10974.18,7133.215,13270.0,14761.0,2
NDC,76128015575,PORFIMER 75 MG IV SOLR,209907.0,136439.55,13270.0,34181.23,11
NDC,76204010001,IPRATROPIUM BROMIDE 0.02 % IN SOLN,290.0,188.5,13270.0,14761.0,4
NDC,76204020001,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,76204060001,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,2
NDC,76204070001,LEVALBUTEROL HCL 0.31 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204070011,LEVALBUTEROL HCL 0.31 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204080001,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204080011,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204090001,LEVALBUTEROL HCL 1.25 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204090011,LEVALBUTEROL HCL 1.25 MG IN NEBU,290.0,188.5,13270.0,14761.0,4
NDC,76204090025,LEVALBUTEROL HCL 1.25 MG IN NEBU,1465.56,952.61,13270.0,14761.0,2
NDC,76282025010,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,2
NDC,76282030290,ALFUZOSIN 10 MG PO TB24,,,13270.0,14761.0,2
NDC,76282066339,DICLOFENAC SODIUM 1 % TP GEL,1465.56,952.61,13270.0,14761.0,4
NDC,76310002415,FOSCARNET 24 MG/ML IV SOLN,4792.0,3114.8,62.65,14761.0,3
NDC,76310002425,FOSCARNET 24 MG/ML IV SOLN,4792.0,3114.8,62.65,14761.0,3
NDC,76329146901,NALOXONE 1 MG/ML IJ SYRG,312.32,203.01,13270.0,14761.0,2
NDC,76329191201,MORPHINE (PF) 30 MG/30 ML (1 MG/ML) IV PCAS,290.0,188.5,13270.0,14761.0,2
NDC,76329301105,Other Outpatient Services,1465.56,952.61,,,0
NDC,76329301305,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,13270.0,14761.0,4
NDC,76329301505,Other Outpatient Services,1465.56,952.61,,,0
NDC,76329330201,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,76329330401,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,76329331601,EPINEPHRINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,76329334001,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
NDC,76329335201,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,290.0,188.5,13270.0,14761.0,4
NDC,76329336901,NALOXONE 1 MG/ML IJ SYRG,312.32,203.01,13270.0,14761.0,2
NDC,76329339001,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,2
NDC,76329630005,LIDOCAINE HCL 4 % LATR SOLN,423.04,274.98,13270.0,14761.0,4
NDC,76329906000,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,2528.16,1643.3,13270.0,14761.0,2
NDC,76385010201,PRIMAQUINE 26.3 MG PO TABS,,,13270.0,14761.0,2
NDC,76385011401,SOTALOL 80 MG PO TABS,,,13270.0,14761.0,2
NDC,76388063525,CHLORAMBUCIL 2 MG PO TABS,1465.56,952.61,,,0
NDC,76388088025,THIOGUANINE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,76420035560,SENNA-PSYLL-CASC-L.ACID-HRB279 545 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,76478000105,TIMOLOL 0.25 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,76478000205,TIMOLOL 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
NDC,76478050120,PENTOBARBITAL SODIUM 50 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,77333051625,MELATONIN 3 MG PO TABS,,,13270.0,14761.0,4
NDC,77333081225,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,2
NDC,77333083125,SODIUM BICARBONATE 650 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,77333083510,SODIUM CHLORIDE 1000 MG MISC TBSO,,,13270.0,14761.0,2
NDC,77333093425,THIAMINE HCL (VITAMIN B1) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,77333093725,CYANOCOBALAMIN (VITAMIN B-12) 500 MCG PO TABS,,,13270.0,14761.0,2
NDC,77333094825,CHOLECALCIFEROL (VITAMIN D3) 400 UNITS PO TABS,,,13270.0,14761.0,2
NDC,77333098310,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,2
NDC,77333098325,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,2
NDC,78112001103,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,2
NDC,78112069480,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,2
NDC,78206011801,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",650.08,422.55,,,0
NDC,78206012101,LOSARTAN 25 MG PO TABS,4487.04,2916.58,13270.0,14761.0,4
NDC,78206012202,LOSARTAN 50 MG PO TABS,6009.12,3905.93,13270.0,14761.0,4
NDC,78206014501,ETONOGESTREL 68 MG SD IMPL,10406.52,6764.24,13270.0,14761.0,2
NDC,78206016201,INFLIXIMAB-ABDA 100 MG IV SOLR,20482.8,13313.82,33.85,38.92,8
NDC,78613020130,DRONABINOL 5 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,79802020030,BELUMOSUDIL 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
NDC,79854001445,ST. JOHN'S WORT 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,79854004097,ACETYLCYSTEINE 600 MG PO CAPS,,,13270.0,14761.0,2
NDC,79854005024,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,2
NDC,79854020080,VITAMIN B COMPLEX PO CAPS,,,13270.0,14761.0,2
NDC,79854020195,RIBOFLAVIN (VITAMIN B2) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,79854040050,MULTIVITAMIN WITH MINERALS PO TABS,,,13270.0,14761.0,2
NDC,79854051280,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,2
NDC,79854090010,"VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,80203034701,SUTIMLIMAB-JOME 50 MG/ML IV SOLN,17258.47,11218.01,22.57,25.96,8
NDC,80446040101,TEBENTAFUSP-TEBN 100 MCG/0.5 ML IV SOLN,184320.0,119808.0,267.41,14761.0,18
NDC,80681000300,MULTIVITAMIN WITH FOLIC ACID 400 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681000800,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,80681001100,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,80681001900,NIACINAMIDE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,80681002000,MULTIVITAMIN PO TABS,,,13270.0,14761.0,2
NDC,80681004100,MELATONIN 1 MG PO TABS,,,13270.0,14761.0,4
NDC,80681005700,NIACIN 100 MG PO TABS,,,13270.0,14761.0,2
NDC,80681007100,CYANOCOBALAMIN (VITAMIN B-12) 100 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681007200,CYANOCOBALAMIN (VITAMIN B-12) 500 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681009700,THIAMINE HCL (VITAMIN B1) 50 MG PO TABS,,,13270.0,14761.0,2
NDC,80681009800,THIAMINE HCL (VITAMIN B1) 100 MG PO TABS,,,13270.0,14761.0,2
NDC,80681009900,FOLIC ACID 400 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681010000,GLUCOSE PO CHEW,,,13270.0,14761.0,2
NDC,80681010400,Other Outpatient Services,1465.56,952.61,,,0
NDC,80681012800,CYANOCOBALAMIN (VITAMIN B-12) 500 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681013500,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,2
NDC,80681014000,CALCIUM CITRATE 200 MG (950 MG) PO TABS,,,13270.0,14761.0,2
NDC,80681015900,"VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) PO CAPS",,,13270.0,14761.0,2
NDC,80681016000,MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG PO TABS,,,13270.0,14761.0,4
NDC,80681016500,CYANOCOBALAMIN (VITAMIN B-12) 250 MCG PO TABS,,,13270.0,14761.0,2
NDC,80681016900,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,2
NDC,80725025001,PAROMOMYCIN 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,80739081218,ADAGRASIB 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,80803015350,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR,71806.77,46674.4,142.21,163.54,8
NDC,81033000220,ACETAMINOPHEN 650 MG PO SOLN,,,13270.0,14761.0,2
NDC,81284031500,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,5068.48,3294.51,13270.0,14761.0,2
NDC,81284061100,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,4
NDC,81421002600,MAGNESIUM HYDROXIDE 1200 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
NDC,81643927001,FLOXURIDINE 0.5 GRAM IJ SOLR,33912.27,22042.98,4803.97,5524.57,8
NDC,81952011502,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN (ADULT FLUSH)",290.0,188.5,,,0
NDC,81952011502,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",290.0,188.5,13270.0,14761.0,2
NDC,81952011507,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",10974.18,7133.215,13270.0,14761.0,2
NDC,81968035101,SOLRIAMFETOL 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,82154044901,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,16597.92,10788.65,13270.0,14761.0,2
NDC,82182077305,Other Outpatient Services,1465.56,952.61,,,0
NDC,87541030091,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IX SYRG",10974.18,7133.215,665.53,14761.0,11
NDC,87651076026,D-MANNOSE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,87701042595,OMEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
NDC,87701043152,CARBAMIDE PEROXIDE 6.5 % OT DROP,,,13270.0,14761.0,2
NDC,90011003011,"LACTOBAC NO.33-B.LACTIS,LONGUM 3.4 BILLION CELLS PO CAPS",1465.56,952.61,13270.0,14761.0,2
NDC,90011015039,GLUTATHIONE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
NDC,90011023006,BROMELAINS 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
NDC,96295012985,Other Outpatient Services,1465.56,952.61,,,0
NDC,96974000002,MAGNESIUM OXIDE-MG AA CHELATE 133 MG PO TABS,,,13270.0,14761.0,2
NDC,99999000002,HELP,,,13270.0,14761.0,2
NDC,99999000004,PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999000026,LIRAGLUTIDE 6 MG/ML INJ PEN,1465.56,952.61,13270.0,14761.0,2
NDC,99999000046,GI COCKTAIL 1-3-1,1465.56,952.61,,,0
NDC,99999000048,GLUTARALDEHYDE (GLUTARALD) SOLUTION 3%,1465.56,952.61,13270.0,14761.0,4
NDC,99999000881,MAGNESIUM SULFATE L&D LOADING DOSE 6 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
NDC,99999000898,MORPHINE (PF) 1 MG/ML IJ SOLN,504.0,327.6,,,0
NDC,99999000965,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999000980,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) PO ELIX,290.0,188.5,13270.0,14761.0,2
NDC,99999000985,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999001020,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,4
NDC,99999001021,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,4
NDC,99999001127,CHLORTHALIDONE 25 HALF-TAB = 12.5 MG,,,13270.0,14761.0,4
NDC,99999001128,COLCHICINE 0.6 HALF-TAB = 0.3 MG,,,13270.0,14761.0,4
NDC,99999001129,HYDROXYCHLOROQUINE 200 HALF-TAB = 100 MG,,,13270.0,14761.0,4
NDC,99999001149,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY BLUE TRAY,,,,,0
NDC,99999001150,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY WHITE TRAY,,,,,0
NDC,99999001192,URSODIOL ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
NDC,99999001194,HYDROMORPHONE 1 MG/ML PO LIQUID (DOSE >= 4 MG),290.0,188.5,13270.0,14761.0,4
NDC,99999001229,HYDROMORPHONE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
NDC,99999001238,HYDROMORPHONE 1MG/ML PED 20-50KG CONTIN PCA,1465.56,952.61,13270.0,14761.0,4
NDC,99999001239,METHADONE 5 MG/5 ML PO SOLN (2.5MG<DOSE<=10MG),290.0,188.5,13270.0,14761.0,4
NDC,99999001240,MORPHINE 10 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999001308,ACETYLCHOLINE 18.2 MCG/ML (ACH 10-4) INJECTION FOR INTRAPROCEDURE,,,13270.0,14761.0,2
NDC,99999001340,CLONIDINE ORAL SUSPENSION 10 MCG/ML,10974.18,7133.215,13270.0,14761.0,4
NDC,99999001466,VANILLA TPN WITH HEPARIN NICU,1465.56,952.61,13270.0,14761.0,4
NDC,99999001468,HEPARIN (PORCINE) IN NACL 500 UNITS/500ML NS FOR CONGENITAL HEART ECMO FLUSH FROM BAG,1160.0,754.0,13270.0,14761.0,2
NDC,99999001469,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP BOLUS FROM BAG,290.0,188.5,13270.0,14761.0,4
NDC,99999001534,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),20482.8,13313.82,13270.0,14761.0,2
NDC,99999001668,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999001668,Other Outpatient Services,387.29,251.74,,,0
NDC,99999001709,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML PO LIQD,,,13270.0,14761.0,4
NDC,99999001752,KETAMINE 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999001764,POTASSIUM CHLORIDE 10 MEQ/100ML IN 0.9% NACL PGBK,290.0,188.5,13270.0,14761.0,2
NDC,99999001765,POTASSIUM CHLORIDE 10 MEQ/100ML IN D5W PGBK,290.0,188.5,13270.0,14761.0,2
NDC,99999001809,PHENOBARBITAL ORAL SOLUTION 8 MG/2 ML FOR NICU,1465.56,952.61,13270.0,14761.0,2
NDC,99999001819,HB TELEHEALTH ORIGINATING SITE FACILITY FEE,485.73,315.72,,,0
NDC,99999001847,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999001971,EPINEPHRINE IN D5W 3 MG/100 ML (0.03 MG/ML) IV PREMIX,372.8,242.32,,,0
NDC,99999002032,SODIUM CHLORIDE 0.9% FOR ECMO FLUSH IV SOL BOLUS FROM BAG,,,13270.0,14761.0,2
NDC,99999002113,KETAMINE 10 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
NDC,99999002117,HB MISCELLANEOUS PHARMACY,1465.56,952.61,220.25,253.29,8
NDC,99999002117,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002164,"IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",1.01,0.65,1284.27,14761.0,13
NDC,99999002173,CANNABIDIOL CBD OIL,1465.56,952.61,13270.0,14761.0,2
NDC,99999002193,LOPERAMIDE 1 MG/7.5 ML PO LIQD,,,13270.0,14761.0,2
NDC,99999002213,TESTOSTERONE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002214,GABAPENTIN-KETAMINE-KETOPROFEN-LIDOCAINE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002216,PROGESTERONE ORAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002218,NALTREXONE ORAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002221,ESTROGEN TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002222,PROGESTERONE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
NDC,99999002327,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999002327,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002388,HB MISCELLANEOUS PHARMACY,1465.56,952.61,107.39,123.5,8
NDC,99999002388,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002391,AZITHROMYCIN 200 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
NDC,99999002393,HB TELEHEALTH ORIGINATING SITE FACILITY FEE,485.73,315.72,,,0
NDC,99999002403,FENTANYL BOLUS FROM PUMP FOR END OF LIFE/COMFORT PRL,,,13270.0,14761.0,2
NDC,99999002507,HB MISCELLANEOUS PHARMACY,10974.18,7133.215,81.08,93.25,16
NDC,99999002507,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002642,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999002642,Other Outpatient Services,387.29,251.74,,,0
NDC,99999002643,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999002643,Other Outpatient Services,387.29,251.74,,,0
NDC,99999002654,FLAVORING AGENT (CSMC) PO PACK,,,13270.0,14761.0,2
NDC,99999002736,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999002736,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002764,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999002764,Other Outpatient Services,387.29,251.74,,,0
NDC,99999002786,SACUBITRIL-VALSARTAN 24-26 MG HALF-TAB = 12-13 MG,290.0,188.5,13270.0,14761.0,2
NDC,99999002830,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE,290.0,188.5,13270.0,14761.0,4
NDC,99999002831,CALCIUM CHLORIDE 10% SYRINGE,290.0,188.5,13270.0,14761.0,4
NDC,99999002832,EPINEPHRINE 0.1 MG/ML SYRINGE,290.0,188.5,13270.0,14761.0,2
NDC,99999002843,METHYLPREDNISOLONE 32MG OR PLACEBO CAPSULES (C928-011 STUDY DRUG) IRB#1360,1465.56,952.61,13270.0,14761.0,2
NDC,99999002879,NIROGACESTAT (STUDY DRUG) 50 MG TABLET (IRB# STUDY00001749),1465.56,952.61,,,0
NDC,99999002896,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999002896,Other Outpatient Services,387.29,251.74,,,0
NDC,99999002899,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999002899,Other Outpatient Services,387.29,251.74,,,0
NDC,99999002900,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999002900,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002901,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999002901,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999002910,REMDESIVIR (VEKLURY) IN 0.9% NACL 100 MG/250 ML IV PGBK PREMIX,9144.0,5943.6,7.91,14761.0,3
NDC,99999002914,PUREFLOW RFP-404 BGK 4/2.5 CA SOLUTION,,,13270.0,14761.0,2
NDC,99999002920,AMINOPHYLLINE 500 MG/20 ML IV SOLN,10974.18,7133.215,13270.0,14761.0,4
NDC,99999002921,POTASSIUM IODIDE 1 G/ML PO SOLN,,,13270.0,14761.0,2
NDC,99999002933,PUREFLOW RFP-402 BGK 0/3 CA SOLUTION,,,13270.0,14761.0,2
NDC,99999002938,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999002938,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999003000,VANCOMYCIN PER PHARMACY PROTOCOL,,,13270.0,14761.0,2
NDC,99999003022,HB MISCELLANEOUS PHARMACY,387.29,251.74,,,0
NDC,99999003022,Other Outpatient Services,387.29,251.74,,,0
NDC,99999003024,HB MISCELLANEOUS PHARMACY,387.29,251.74,13270.0,14761.0,2
NDC,99999003024,Other Outpatient Services,387.29,251.74,,,0
NDC,99999003027,HB MISCELLANEOUS PHARMACY,1465.56,952.61,72.49,83.36,8
NDC,99999003027,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999003094,SELUMETINIB (STUDY DRUG) 10 MG CAPSULE (PRL: COG ACNS1833),1465.56,952.61,13270.0,14761.0,2
NDC,99999003117,HB MISCELLANEOUS PHARMACY,1465.56,952.61,107.39,123.5,8
NDC,99999003117,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999003196,BELANTAMAB MAFODOTIN-BLMF (STUDY DRUG) VIAL (PRL: COMPASSIONATE USE: SINGLE IND 165677),1465.56,952.61,,,0
NDC,99999003243,VALSARTAN 40 MG HALF-TAB = 20 MG,290.0,188.5,13270.0,14761.0,4
NDC,99999003249,GLUCOSE (TOLERANCE TEST) 100 GRAM/296 ML PO LIQD,,,13270.0,14761.0,2
NDC,99999003257,MAGROLIMAB (STUDY DRUG) VIAL (PRL: SINGLE IND 167485),1465.56,952.61,13270.0,14761.0,2
NDC,99999003415,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999012199,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999900036,FORTIFIED TOBRAMYCIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
NDC,99999900037,FORTIFIED GENTAMICIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
NDC,99999900038,FORTIFIED VANCOMYCIN 50 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
NDC,99999900040,NITROGLYCERIN OINTMENT 0.2% (IP ORDERING ONLY),,,13270.0,14761.0,2
NDC,99999900050,MODIFIED STANFORD'S STOMATITIS ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
NDC,99999900052,ATENOLOL ORAL SUSPENSION 2 MG/ML,290.0,188.5,13270.0,14761.0,2
NDC,99999900053,CAPTOPRIL ORAL SUSPENSION 1 MG/ML,1465.56,952.61,13270.0,14761.0,4
NDC,99999900055,HYDROCORTISONE ORAL SUSPENSION 2 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,99999900056,ENALAPRIL ORAL SUSPENSION 1 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
NDC,99999900057,METOLAZONE ORAL SUSPENSION 1 MG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,99999900058,METRONIDAZOLE ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,99999900063,CHLOROTHIAZIDE 250 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,99999900065,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,99999900066,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,99999900078,SILDENAFIL 2.5 MG/ML ORAL SUSPENSION (DOSE > 10 MG) (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
NDC,99999900079,RIFAMPIN ORAL SUSPENSION 25 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
NDC,99999900082,SODIUM CHLORIDE ORAL SOLUTION 4 MEQ/ML,290.0,188.5,13270.0,14761.0,2
NDC,99999900083,SODIUM CHLORIDE ORAL SOLUTION 4 MEQ/ML,290.0,188.5,13270.0,14761.0,2
NDC,99999900089,MODIFIED DANIELS SOLUTION,1958.4,1272.96,13270.0,14761.0,2
NDC,99999900090,ARGININE ORAL SOLUTION 10 % (0.475 MEQ/ML),290.0,188.5,13270.0,14761.0,2
NDC,99999900093,GLYCOPYRROLATE ORAL SOLUTION 0.2 MG/ML,,,13270.0,14761.0,2
NDC,99999900095,MAGNESIUM SULFATE ORAL SOLUTION 4.06 MEQ/ML,,,13270.0,14761.0,2
NDC,99999900097,SODIUM PHOSPHATE ORAL SOLUTION 4 MEQ/ML (3 MMOL/ML),290.0,188.5,13270.0,14761.0,2
NDC,99999900100,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,290.0,188.5,13270.0,14761.0,4
NDC,99999900102,MORPHINE ORAL SOLUTION 1 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900106,ALLOPURINOL ORAL SUSPENSION 20 MG/ML,,,13270.0,14761.0,2
NDC,99999900107,AMIODARONE ORAL SUSPENSION 5 MG/ML,290.0,188.5,13270.0,14761.0,2
NDC,99999900108,LABETALOL ORAL SUSPENSION 10 MG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,99999900112,FERROUS SULFATE 15 MG/ML PO DROP,,,13270.0,14761.0,2
NDC,99999900114,HYDROCORTISONE 50 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900133,CAFFEINE CITRATE 20 MG/ML ORAL SOLUTION PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900135,HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) PO SYRP,290.0,188.5,13270.0,14761.0,2
NDC,99999900137,OXYBUTYNIN CHLORIDE 5 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,99999900139,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) PO ELIX,290.0,188.5,13270.0,14761.0,2
NDC,99999900142,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML PO DROP,,,13270.0,14761.0,2
NDC,99999900143,PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML PO DROP,,,13270.0,14761.0,2
NDC,99999900145,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML PO ELIX,1465.56,952.61,13270.0,14761.0,4
NDC,99999900152,GENTAMICIN 4 % NEBULIZER SOLUTION,290.0,188.5,13270.0,14761.0,2
NDC,99999900155,MEDICINAL LEECH,290.0,188.5,13270.0,14761.0,4
NDC,99999900161,MORPHINE INJECTION - PEDS < 1 YEAR,10974.18,7133.215,13270.0,14761.0,2
NDC,99999900163,FLUCONAZOLE 2 MG/ML IN NS IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900164,METRONIDAZOLE 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900165,LINEZOLID 2 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900166,LEVOFLOXACIN 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
NDC,99999900167,ENOXAPARIN 100 MG/ML IV CUSTOM,290.0,188.5,13270.0,14761.0,2
NDC,99999900168,REMOVE PATCH,,,13270.0,14761.0,2
NDC,99999900169,HIV POST EXPOSURE PROPHYLAXIS KIT,4758.34,3092.92,,,0
NDC,99999900171,MD TO DOSE WARFARIN,,,13270.0,14761.0,2
NDC,99999900172,FAT EMULSION 20 % IV PEDS,290.0,188.5,13270.0,14761.0,4
NDC,99999900173,CLONAZEPAM 0.1 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
NDC,99999900174,LORAZEPAM 1 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,4
NDC,99999900175,LET TOPICAL SOLUTION,,,13270.0,14761.0,2
NDC,99999900180,AQUAPHOR OINTMENT,,,13270.0,14761.0,2
NDC,99999900181,OPIUM TINCTURE 10 MG/ML (MORPHINE) PO TINC,290.0,188.5,13270.0,14761.0,4
NDC,99999900192,MISOPROSTOL 100MCG QUARTER-TAB = 25MCG,,,13270.0,14761.0,2
NDC,99999900197,LIDOCAINE 1% (BUFFERED) INJ. SOLUTION,290.0,188.5,13270.0,14761.0,4
NDC,99999900201,KETOROLAC 30 MG/ML IV PEDIATRIC,290.0,188.5,0.85,14761.0,11
NDC,99999900203,SODIUM CHLORIDE 3% IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900218,"HEPARIN, PORCINE (PF) 1 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
NDC,99999900226,HEPARIN PER PHARMACY PROTOCOL,,,13270.0,14761.0,2
NDC,99999900253,FENTANYL 10 MCG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
NDC,99999900259,MORPHINE 5 MG/ML HIGH DOSE PCA CONTINUOUS DOSE(BASAL),,,13270.0,14761.0,2
NDC,99999900268,MAGNESIUM SULFATE LOADING DOSE FROM BAG/PUMP ANES-INTRAOP,,,13270.0,14761.0,2
NDC,99999900270,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,4
NDC,99999900301,ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,4
NDC,99999900302,ACYCLOVIR 200 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,99999900305,BISMUTH SUBSALICYLATE 262 MG/15 ML PO SUSP,,,13270.0,14761.0,2
NDC,99999900308,HYDROXYUREA ORAL SUSPENSION 100 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,99999900310,LANSOPRAZOLE ORAL SUSPENSION 3MG/ML,,,13270.0,14761.0,2
NDC,99999900311,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900312,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900313,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900316,FUROSEMIDE 10 MG/ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900319,HYDROXYZINE HCL 10 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900320,LORATADINE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999900321,METHADONE 1 MG/ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999900324,MIDAZOLAM 2 MG/ML PO SYRP,290.0,188.5,13270.0,14761.0,4
NDC,99999900325,MINERAL OIL-CHONDRUS 2.5 ML/5 ML PO EMUL,,,13270.0,14761.0,2
NDC,99999900326,NIFEDIPINE ORAL SUSPENSION 4 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
NDC,99999900327,NITROFURANTOIN 25 MG/5 ML PO SUSP,589.76,383.34,13270.0,14761.0,2
NDC,99999900333,SENNOSIDES 8.8 MG/5 ML PO SYRP,,,13270.0,14761.0,2
NDC,99999900335,VANCOMYCIN ORAL SOLUTION 25 MG/ML,290.0,188.5,13270.0,14761.0,4
NDC,99999900336,SPIRONOLACTONE 5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,99999900338,DIGOXIN 50 MCG/ML (0.05 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,99999900339,DIGOXIN 50 MCG/ML (0.05 MG/ML) PO SOLN,,,13270.0,14761.0,2
NDC,99999900341,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO LIQD,,,13270.0,14761.0,2
NDC,99999900342,LACOSAMIDE 10 MG/ML PO SOLN,326.4,212.16,13270.0,14761.0,4
NDC,99999900343,ESCITALOPRAM OXALATE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999900345,PAROXETINE HCL 10 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,2
NDC,99999900347,METHYLPHENIDATE HCL 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999900350,LEVOTHYROXINE (SYNTHROID) ORAL SUSPENSION 25 MCG/ML,1465.56,952.61,13270.0,14761.0,2
NDC,99999900351,TOPIRAMATE (TOPAMAX) ORAL SUSPENSION PEDIATRIC 6 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
NDC,99999900353,LORAZEPAM 0.5 HALF-TAB = 0.25 MG,290.0,188.5,13270.0,14761.0,4
NDC,99999900355,QUETIAPINE 25MG HALF-TAB = 12.5MG,290.0,188.5,13270.0,14761.0,4
NDC,99999900364,PHENOBARBITAL 10 MG/ML IV IN NS PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900366,VANCOMYCIN 750 MG/250 ML IVPB,290.0,188.5,13270.0,14761.0,2
NDC,99999900367,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,290.0,188.5,13270.0,14761.0,2
NDC,99999900367,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900370,VANCOMYCIN ENEMA,26272.0,17076.8,13270.0,14761.0,2
NDC,99999900373,LACTULOSE ENEMA,,,13270.0,14761.0,4
NDC,99999900375,MMX ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
NDC,99999900376,MAGIC MOUTHWASH (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
NDC,99999900380,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,99999900383,HYDROMORPHONE 10 MG/ML PCA HIGH DOSE,290.0,188.5,13270.0,14761.0,2
NDC,99999900386,ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900387,DESMOPRESSIN 0.1 MG PO HALF-TAB = 0.05 MG,,,13270.0,14761.0,2
NDC,99999900388,DRUG LEVEL REMINDER,,,13270.0,14761.0,2
NDC,99999900390,VANCOMYCIN ORAL SOLUTION 25 MG/ML,290.0,188.5,13270.0,14761.0,4
NDC,99999900393,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,4
NDC,99999900394,"HEPARIN 20,000 UNITS/20 ML SYRINGE FOR CRRT DIALYSIS",290.0,188.5,13270.0,14761.0,2
NDC,99999900395,EPINEPHRINE HCL IN 5% DEXTROSE 8 MG/250 ML (32 MCG/ML) IV SOLN,920.0,598.0,13270.0,14761.0,4
NDC,99999900397,SILVER NITRATE APPLICATORS 75-25 % TP STCK,,,13270.0,14761.0,2
NDC,99999900403,MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML PO OIL,,,13270.0,14761.0,2
NDC,99999900407,HYDROMORPHONE 1 MG/ML PO LIQD,290.0,188.5,13270.0,14761.0,4
NDC,99999900408,OXYCODONE 20 MG/ML PO CONC,290.0,188.5,13270.0,14761.0,4
NDC,99999900409,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) PO SOLN,290.0,188.5,13270.0,14761.0,4
NDC,99999900411,PATIENT'S OWN PUMP,,,13270.0,14761.0,2
NDC,99999900412,LABETALOL 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
NDC,99999900420,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN FOR INTRACATHETER",290.0,188.5,13270.0,14761.0,2
NDC,99999900425,MODIFIED HOPP'S STOMATITIS ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
NDC,99999900426,LOSARTAN 25 MG HALF-TAB = 12.5 MG,290.0,188.5,13270.0,14761.0,4
NDC,99999900427,TRAMADOL 50 MG HALF-TAB = 25 MG,,,13270.0,14761.0,2
NDC,99999900428,CYCLOSPORINE 0.05 % OP DPET,290.0,188.5,13270.0,14761.0,4
NDC,99999900432,ALUMINUM HYDROXIDE GEL 320 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,99999900433,SODIUM BICARBONATE (STRAIGHT DRUG) IV INFUSION,290.0,188.5,13270.0,14761.0,4
NDC,99999900434,PANTOPRAZOLE ORAL SUSPENSION 2 MG/ML,1465.56,952.61,13270.0,14761.0,4
NDC,99999900436,PANTOPRAZOLE ORAL SUSPENSION 2 MG/ML,290.0,188.5,13270.0,14761.0,4
NDC,99999900437,CARVEDILOL (COREG) ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
NDC,99999900440,METOPROLOL (LOPRESSOR) ORAL SUSPENSION 10MG/ML,290.0,188.5,13270.0,14761.0,2
NDC,99999900446,"CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) PO SUSP",,,13270.0,14761.0,2
NDC,99999900472,MIDAZOLAM PF 50 MG/50 ML (1MG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900473,FENTANYL 2500 MCG/50 ML (50 MCG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900476,FEXOFENADINE 30 MG/5 ML PO SUSP,,,13270.0,14761.0,2
NDC,99999900478,DIETHYLENE TRIAMINE PENTAACETIC ACID (TC-99M DTPA) ISOTOPE (NUC MED) N,1.01,0.65,13270.0,14761.0,4
NDC,99999900479,SODIUM IODIDE I-131 CAPSULE,,,28.8,14761.0,18
NDC,99999900480,SODIUM PERTECHNETATE (TC-99M O4) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
NDC,99999900481,MICROSPHERES (Y-90 GLASS) (THERA-SPHERES) ISOTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
NDC,99999900482,MICROSPHERES (Y-90 RESIN) (SIR-SPHERES) ISOPTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
NDC,99999900483,PENICILLIN G POTASSIUM 3 MILLION UNITS IN 0.9% NACL 50ML,352.0,228.8,13270.0,14761.0,2
NDC,99999900484,CHLORHEXIDINE GLUCONATE 0.12% ORAL RINSE,,,13270.0,14761.0,2
NDC,99999900513,ETHIODIZED OIL 48% IJ OIL,10974.18,7133.215,13270.0,14761.0,2
NDC,99999900544,ADENOSINE IN 0.9% NACL 90 MG/90 ML INFUSION (CATH LAB USE),691.2,449.28,13270.0,14761.0,2
NDC,99999900548,AMINOCAPROIC ACID 5G/20 ML (0.25 G/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900549,ACETIC ACID 4% TOPICAL SOLN INTRAPROCEDURE,10974.18,7133.215,,,0
NDC,99999900564,DAPSONE ORAL SUSPENSION 2 MG/ML PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
NDC,99999900565,HYDRALAZINE ORAL SUSPENSION 4 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,4
NDC,99999900568,ZONISAMIDE (ZONEGRAN) ORAL SUSPENSION 10 MG/ML PEDIATRIC (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
NDC,99999900569,FINASTERIDE (PROSCAR) ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,4
NDC,99999900577,HEPARIN FLUSH INFUSION FOR THROMBOLYSIS (5 UNITS/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
NDC,99999900578,ANTITHYMOCYTE GLOBULIN (EQUINE) (ATGAM) SKIN TEST,290.0,188.5,4941.46,14761.0,3
NDC,99999900579,CLOPIDOGREL ORAL SUSPENSION 5 MG/ML PEDIATRIC (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
NDC,99999900598,CETIRIZINE 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
NDC,99999900600,BECLOMETHASONE DIPROPIONATE ORAL EMULSION,290.0,188.5,13270.0,14761.0,2
NDC,99999900611,TACROLIMUS ORAL SUSPENSION 1 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
NDC,99999900755,TACROLIMUS CHANGE BAG REMINDER,,,13270.0,14761.0,2
NDC,99999911111,LU-177 DOTATATE (LUTATHERA) ISOTOPE (NUC MED),1.01,0.65,368.89,14761.0,10
NDC,99999977700,BARICITINIB 1 MG PO TABS,40233.12,26151.53,13270.0,14761.0,4
NDC,99999977799,ENOXAPARIN PER PHARMACY (FOR TRAUMA PROPHYLAXIS),,,13270.0,14761.0,2
NDC,99999977850,Other Outpatient Services,1465.56,952.61,,,0
NDC,99999999102,PRISMASATE BK 4/0 CA+,,,13270.0,14761.0,4
NDC,99999999103,PRISMASATE BK 4/2.5 CA+,,,13270.0,14761.0,4
NDC,99999999105,PRISMASATE BK 0/3.5 CA+,,,13270.0,14761.0,2
NDC,99999999107,FENTANYL HIGH DOSE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
NDC,99999999108,HYDROMORPHONE HIGH DOSE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
NDC,99999999998,FENTANYL CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
NDC,S0040051901,Other Outpatient Services,,,,,0
RC,100,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,100,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,100,Maternity û C-Section,,,19659.11,30797.0,15
RC,100,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,100,Medical,,,1550.0,1550.0,1
RC,100,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,100,Medical Care,,,9437.77,10629.2,2
RC,100,Medical/Surgical,,,1095.0,1095.0,1
RC,100,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,100,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,100,OB (mother and baby),,,1350.0,1350.0,1
RC,100,OB (mother only),,,1000.0,1000.0,1
RC,100,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,6
RC,100,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,100,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,100,Surgical,,,1550.0,1550.0,8
RC,100,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,100,Surgical Care,,,26962.95,29220.56,16
RC,101,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,101,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,101,Maternity û C-Section,,,19659.11,30797.0,15
RC,101,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,101,Medical,,,1550.0,1550.0,1
RC,101,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,101,Medical Care,,,9437.77,10629.2,2
RC,101,Medical/Surgical,,,1095.0,1095.0,1
RC,101,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,101,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,101,OB (mother and baby),,,1350.0,1350.0,1
RC,101,OB (mother only),,,1000.0,1000.0,1
RC,101,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,101,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,101,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,101,Surgical,,,1550.0,1550.0,8
RC,101,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,101,Surgical Care,,,26962.95,29220.56,16
RC,102,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,103,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,105,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,106,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,110,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,110,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,110,Maternity û C-Section,,,19659.11,30797.0,15
RC,110,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,110,Medical,,,1550.0,1550.0,1
RC,110,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,110,Medical Care,,,9437.77,10629.2,2
RC,110,Medical/Surgical,,,1095.0,1095.0,1
RC,110,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,110,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,110,OB (mother and baby),,,1350.0,1350.0,1
RC,110,OB (mother only),,,1000.0,1000.0,1
RC,110,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,110,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,110,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,110,Surgical,,,1550.0,1550.0,8
RC,110,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,110,Surgical Care,,,26962.95,29220.56,16
RC,111,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,111,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,111,Maternity û C-Section,,,19659.11,30797.0,15
RC,111,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,111,Medical,,,1550.0,1550.0,1
RC,111,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,111,Medical Care,,,9437.77,10629.2,2
RC,111,Medical/Surgical,,,1095.0,1095.0,1
RC,111,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,111,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,111,OB (mother and baby),,,1350.0,1350.0,1
RC,111,OB (mother only),,,1000.0,1000.0,1
RC,111,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,111,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,111,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,111,Surgical,,,1550.0,1550.0,8
RC,111,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,111,Surgical Care,,,26962.95,29220.56,16
RC,112,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,112,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,112,Maternity û C-Section,,,19659.11,30797.0,15
RC,112,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,112,Medical,,,1550.0,1550.0,1
RC,112,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,112,Medical Care,,,9437.77,10629.2,2
RC,112,Medical/Surgical,,,1095.0,1095.0,1
RC,112,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,112,OB (mother and baby),,,1350.0,1350.0,1
RC,112,OB (mother only),,,1000.0,1000.0,1
RC,112,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,112,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,112,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,112,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,113,Medical,,,1550.0,1550.0,1
RC,113,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,113,Medical Care,,,9437.77,10629.2,2
RC,113,Medical/Surgical,,,1095.0,1095.0,1
RC,113,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,113,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,113,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,113,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,113,Surgical,,,1550.0,1550.0,8
RC,113,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,113,Surgical Care,,,26962.95,29220.56,16
RC,114,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,114,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,114,PSYCH LEVEL 3 INPATIENT CARE - VIVITY,,,1474.0,1659.0,2
RC,114,Psychiatric,,,1200.0,1200.0,1
RC,114,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,115,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,115,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,115,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,116,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,116,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,116,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,117,Medical,,,1550.0,1550.0,1
RC,117,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,117,Medical Care,,,9437.77,10629.2,2
RC,117,Medical/Surgical,,,1095.0,1095.0,1
RC,117,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,117,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,117,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,117,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,117,Surgical,,,1550.0,1550.0,8
RC,117,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,117,Surgical Care,,,26962.95,29220.56,16
RC,118,ACUTE REHABILITATION UNIT (ARU),,,3817.0,7759.0,4
RC,118,Acute Rehab I,,,5396.17,5396.17,2
RC,118,Acute Rehabilitation,,,2000.0,6710.78,6
RC,118,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,118,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,118,Rehabilitation Unit,,,9156.17,13104.36,2
RC,118,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,119,Medical,,,1550.0,1550.0,1
RC,119,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,119,Medical Care,,,9437.77,10629.2,2
RC,119,Medical/Surgical,,,1095.0,1095.0,1
RC,119,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,119,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,119,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,119,Surgical,,,1550.0,1550.0,8
RC,119,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,119,Surgical Care,,,26962.95,29220.56,16
RC,120,General,12964.0,8426.6,,,0
RC,120,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,6
RC,120,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),12964.0,8426.6,8266.34,9759.83,14
RC,120,Maternity û C-Section,12964.0,8426.6,19659.11,30797.0,15
RC,120,Maternity û Normal Delivery,12964.0,8426.6,13179.27,20644.74,35
RC,120,Medical,12964.0,8426.6,1550.0,1550.0,1
RC,120,Medical - Adult and Pediatric,12964.0,8426.6,13278.41,18894.57,2
RC,120,Medical Care,12964.0,8426.6,9437.77,10629.2,2
RC,120,Medical/Surgical,12964.0,8426.6,1095.0,1095.0,1
RC,120,Medical/Surgical - Adult and Pediatric,12964.0,8426.6,4050.0,4050.0,1
RC,120,Medical/Surgical/Pediatrics,12964.0,8426.6,7065.44,11067.79,5
RC,120,OB (mother and baby),12964.0,8426.6,1350.0,1350.0,1
RC,120,OB (mother only),12964.0,8426.6,1000.0,1000.0,1
RC,120,Obstetrics -Vaginal or C-section,12964.0,8426.6,1350.0,1350.0,10
RC,120,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,12964.0,8426.6,,,0
RC,120,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,12964.0,8426.6,6800.0,6800.0,1
RC,120,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,12964.0,8426.6,6753.0,6753.0,1
RC,120,Surgical,12964.0,8426.6,1550.0,1550.0,8
RC,120,Surgical - Adult and Pediatric,12964.0,8426.6,36489.99,49761.15,16
RC,120,Surgical Care,12964.0,8426.6,26962.95,29220.56,16
RC,121,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,121,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,121,Maternity û C-Section,,,19659.11,30797.0,15
RC,121,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,121,Medical,,,1550.0,1550.0,1
RC,121,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,121,Medical Care,,,9437.77,10629.2,2
RC,121,Medical/Surgical,,,1095.0,1095.0,1
RC,121,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,121,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,121,OB (mother and baby),,,1350.0,1350.0,1
RC,121,OB (mother only),,,1000.0,1000.0,1
RC,121,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,121,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,121,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,121,Surgical,,,1550.0,1550.0,8
RC,121,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,121,Surgical Care,,,26962.95,29220.56,16
RC,122,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,122,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,122,Maternity û C-Section,,,19659.11,30797.0,15
RC,122,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,122,Medical,,,1550.0,1550.0,1
RC,122,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,122,Medical Care,,,9437.77,10629.2,2
RC,122,Medical/Surgical,,,1095.0,1095.0,1
RC,122,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,122,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,122,OB,,,,,0
RC,122,OB (mother and baby),,,1350.0,1350.0,1
RC,122,OB (mother only),,,1000.0,1000.0,1
RC,122,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,122,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,122,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,122,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,123,Medical,19263.0,12520.95,1550.0,1550.0,1
RC,123,Medical - Adult and Pediatric,19263.0,12520.95,13278.41,18894.57,2
RC,123,Medical Care,19263.0,12520.95,9437.77,10629.2,2
RC,123,Medical/Surgical,19263.0,12520.95,1095.0,1095.0,1
RC,123,Medical/Surgical - Adult and Pediatric,19263.0,12520.95,4050.0,4050.0,1
RC,123,Medical/Surgical/Pediatrics,19263.0,12520.95,7065.44,11067.79,5
RC,123,Pediatric,19263.0,12520.95,,,0
RC,123,Pediatric and Neonatal Services: Medical/Surgical,19263.0,12520.95,4360.0,4360.0,1
RC,123,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,19263.0,12520.95,,,0
RC,123,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,19263.0,12520.95,6800.0,6800.0,1
RC,123,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,19263.0,12520.95,6753.0,6753.0,1
RC,123,Surgical,19263.0,12520.95,1550.0,1550.0,8
RC,123,Surgical - Adult and Pediatric,19263.0,12520.95,36489.99,49761.15,16
RC,123,Surgical Care,19263.0,12520.95,26962.95,29220.56,16
RC,124,Medical - Adult and Pediatric,10611.0,6897.15,13278.41,18894.57,2
RC,124,Medical/Surgical - Adult and Pediatric,10611.0,6897.15,4050.0,4050.0,1
RC,124,PSYCH LEVEL 3 INPATIENT CARE - VIVITY,10611.0,6897.15,1474.0,1659.0,2
RC,124,Psychiatric,10611.0,6897.15,1200.0,1200.0,1
RC,124,Psychiatry,10611.0,6897.15,450.0,450.0,1
RC,124,Surgical - Adult and Pediatric,10611.0,6897.15,36489.99,49761.15,16
RC,125,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,125,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,125,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,126,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,126,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,127,Medical,29980.5,19487.33,1550.0,1550.0,1
RC,127,Medical - Adult and Pediatric,29980.5,19487.33,13278.41,18894.57,2
RC,127,Medical Care,29980.5,19487.33,9437.77,10629.2,2
RC,127,Medical/Surgical,29980.5,19487.33,1095.0,1095.0,1
RC,127,Medical/Surgical/Pediatrics,29980.5,19487.33,7065.44,11067.79,5
RC,127,Oncology,29980.5,19487.33,,,0
RC,127,Pediatric and Neonatal Services: Hematology/Oncology,29980.5,19487.33,4580.0,4580.0,1
RC,127,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,29980.5,19487.33,,,0
RC,127,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,29980.5,19487.33,6800.0,6800.0,1
RC,127,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,29980.5,19487.33,6753.0,6753.0,1
RC,127,Surgical,29980.5,19487.33,1550.0,1550.0,8
RC,127,Surgical - Adult and Pediatric,29980.5,19487.33,36489.99,49761.15,16
RC,127,Surgical Care,29980.5,19487.33,26962.95,29220.56,16
RC,128,ACUTE REHABILITATION UNIT (ARU),,,3817.0,7759.0,4
RC,128,Acute Rehab,,,3150.0,3150.0,1
RC,128,Acute Rehab I,,,5396.17,5396.17,2
RC,128,Acute Rehabilitation,,,2000.0,6710.78,6
RC,128,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,128,Pediatric and Neonatal Services: Acute Rehab,,,3070.0,3070.0,1
RC,128,Rehabilitation Unit,,,9156.17,13104.36,2
RC,128,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,129,Medical,18430.0,11979.5,1550.0,1550.0,1
RC,129,Medical - Adult and Pediatric,18430.0,11979.5,13278.41,18894.57,2
RC,129,Medical Care,18430.0,11979.5,9437.77,10629.2,2
RC,129,Medical/Surgical,18430.0,11979.5,1095.0,1095.0,1
RC,129,Medical/Surgical - Adult and Pediatric,18430.0,11979.5,4050.0,4050.0,1
RC,129,Medical/Surgical/Pediatrics,18430.0,11979.5,7065.44,11067.79,5
RC,129,Other,18430.0,11979.5,,,0
RC,129,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,18430.0,11979.5,,,0
RC,129,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,18430.0,11979.5,6800.0,6800.0,1
RC,129,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,18430.0,11979.5,6753.0,6753.0,1
RC,129,Surgical,18430.0,11979.5,1550.0,1550.0,8
RC,129,Surgical - Adult and Pediatric,18430.0,11979.5,36489.99,49761.15,16
RC,129,Surgical Care,18430.0,11979.5,26962.95,29220.56,16
RC,130,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,130,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,130,Maternity û C-Section,,,19659.11,30797.0,15
RC,130,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,130,Medical,,,1550.0,1550.0,1
RC,130,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,130,Medical Care,,,9437.77,10629.2,2
RC,130,Medical/Surgical,,,1095.0,1095.0,1
RC,130,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,130,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,130,OB (mother and baby),,,1350.0,1350.0,1
RC,130,OB (mother only),,,1000.0,1000.0,1
RC,130,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,130,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,130,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,130,Surgical,,,1550.0,1550.0,8
RC,130,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,130,Surgical Care,,,26962.95,29220.56,16
RC,131,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,131,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,131,Maternity û C-Section,,,19659.11,30797.0,15
RC,131,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,131,Medical,,,1550.0,1550.0,1
RC,131,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,131,Medical Care,,,9437.77,10629.2,2
RC,131,Medical/Surgical,,,1095.0,1095.0,1
RC,131,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,131,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,131,OB (mother and baby),,,1350.0,1350.0,1
RC,131,OB (mother only),,,1000.0,1000.0,1
RC,131,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,131,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,131,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,131,Surgical,,,1550.0,1550.0,8
RC,131,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,131,Surgical Care,,,26962.95,29220.56,16
RC,132,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,132,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,132,Maternity û C-Section,,,19659.11,30797.0,15
RC,132,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,132,Medical,,,1550.0,1550.0,1
RC,132,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,132,Medical Care,,,9437.77,10629.2,2
RC,132,Medical/Surgical,,,1095.0,1095.0,1
RC,132,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,132,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,132,OB (mother and baby),,,1350.0,1350.0,1
RC,132,OB (mother only),,,1000.0,1000.0,1
RC,132,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,132,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,132,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,132,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,133,Medical,,,1550.0,1550.0,1
RC,133,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,133,Medical Care,,,9437.77,10629.2,2
RC,133,Medical/Surgical,,,1095.0,1095.0,1
RC,133,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,133,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,133,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,133,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,133,Surgical,,,1550.0,1550.0,8
RC,133,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,133,Surgical Care,,,26962.95,29220.56,16
RC,134,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,134,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,134,PSYCH LEVEL 3 INPATIENT CARE - VIVITY,,,1474.0,1659.0,2
RC,134,Psychiatric,,,1200.0,1200.0,1
RC,134,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,135,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,135,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,135,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,136,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,136,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,136,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,137,Medical,,,1550.0,1550.0,1
RC,137,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,137,Medical Care,,,9437.77,10629.2,2
RC,137,Medical/Surgical,,,1095.0,1095.0,1
RC,137,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,137,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,137,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,137,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,137,Surgical,,,1550.0,1550.0,8
RC,137,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,137,Surgical Care,,,26962.95,29220.56,16
RC,138,ACUTE REHABILITATION UNIT (ARU),,,3817.0,7759.0,4
RC,138,Acute Rehab I,,,5396.17,5396.17,2
RC,138,Acute Rehabilitation,,,2000.0,6710.78,6
RC,138,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,138,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,138,Rehabilitation Unit,,,9156.17,13104.36,2
RC,138,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,139,Medical,,,1550.0,1550.0,1
RC,139,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,139,Medical Care,,,9437.77,10629.2,2
RC,139,Medical/Surgical,,,1095.0,1095.0,1
RC,139,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,139,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,139,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,139,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,139,Surgical,,,1550.0,1550.0,8
RC,139,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,139,Surgical Care,,,26962.95,29220.56,16
RC,140,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,140,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,140,Maternity û C-Section,,,19659.11,30797.0,15
RC,140,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,140,Medical,,,1550.0,1550.0,1
RC,140,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,140,Medical Care,,,9437.77,10629.2,2
RC,140,Medical/Surgical,,,1095.0,1095.0,1
RC,140,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,140,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,140,OB (mother and baby),,,1350.0,1350.0,1
RC,140,OB (mother only),,,1000.0,1000.0,1
RC,140,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,140,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,140,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,140,Surgical,,,1550.0,1550.0,8
RC,140,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,140,Surgical Care,,,26962.95,29220.56,16
RC,141,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,141,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,141,Maternity û C-Section,,,19659.11,30797.0,15
RC,141,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,141,Medical,,,1550.0,1550.0,1
RC,141,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,141,Medical Care,,,9437.77,10629.2,2
RC,141,Medical/Surgical,,,1095.0,1095.0,1
RC,141,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,141,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,141,OB (mother and baby),,,1350.0,1350.0,1
RC,141,OB (mother only),,,1000.0,1000.0,1
RC,141,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,141,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,141,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,141,Surgical,,,1550.0,1550.0,8
RC,141,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,141,Surgical Care,,,26962.95,29220.56,16
RC,142,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,142,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,142,Maternity û C-Section,,,19659.11,30797.0,15
RC,142,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,142,Medical,,,1550.0,1550.0,1
RC,142,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,142,Medical Care,,,9437.77,10629.2,2
RC,142,Medical/Surgical,,,1095.0,1095.0,1
RC,142,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,142,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,142,OB (mother and baby),,,1350.0,1350.0,1
RC,142,OB (mother only),,,1000.0,1000.0,1
RC,142,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,142,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,142,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,142,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,143,Medical,,,1550.0,1550.0,1
RC,143,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,143,Medical Care,,,9437.77,10629.2,2
RC,143,Medical/Surgical,,,1095.0,1095.0,1
RC,143,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,143,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,143,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,143,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,143,Surgical,,,1550.0,1550.0,8
RC,143,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,143,Surgical Care,,,26962.95,29220.56,16
RC,144,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,144,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,144,PSYCH LEVEL 3 INPATIENT CARE - VIVITY,,,1474.0,1659.0,2
RC,144,Psychiatric,,,1200.0,1200.0,1
RC,144,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,145,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,145,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,145,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,146,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,146,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,146,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,147,Medical,,,1550.0,1550.0,1
RC,147,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,147,Medical Care,,,9437.77,10629.2,2
RC,147,Medical/Surgical,,,1095.0,1095.0,1
RC,147,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,147,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,147,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,147,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,147,Surgical,,,1550.0,1550.0,8
RC,147,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,147,Surgical Care,,,26962.95,29220.56,16
RC,148,ACUTE REHABILITATION UNIT (ARU),,,3817.0,7759.0,4
RC,148,Acute Rehab I,,,5396.17,5396.17,2
RC,148,Acute Rehabilitation,,,2000.0,6710.78,6
RC,148,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,148,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,148,Rehabilitation Unit,,,9156.17,13104.36,2
RC,148,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,149,Medical,,,1550.0,1550.0,1
RC,149,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,149,Medical Care,,,9437.77,10629.2,2
RC,149,Medical/Surgical,,,1095.0,1095.0,1
RC,149,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,149,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,149,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,149,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,149,Surgical,,,1550.0,1550.0,8
RC,149,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,149,Surgical Care,,,26962.95,29220.56,16
RC,150,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,150,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,150,Maternity û C-Section,,,19659.11,30797.0,15
RC,150,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,150,Medical,,,1550.0,1550.0,1
RC,150,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,150,Medical Care,,,9437.77,10629.2,2
RC,150,Medical/Surgical,,,1095.0,1095.0,1
RC,150,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,150,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,150,OB (mother and baby),,,1350.0,1350.0,1
RC,150,OB (mother only),,,1000.0,1000.0,1
RC,150,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,150,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,150,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,150,Surgical,,,1550.0,1550.0,8
RC,150,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,150,Surgical Care,,,26962.95,29220.56,16
RC,151,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,151,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,151,Maternity û C-Section,,,19659.11,30797.0,15
RC,151,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,151,Medical,,,1550.0,1550.0,1
RC,151,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,151,Medical Care,,,9437.77,10629.2,2
RC,151,Medical/Surgical,,,1095.0,1095.0,1
RC,151,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,151,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,151,OB (mother and baby),,,1350.0,1350.0,1
RC,151,OB (mother only),,,1000.0,1000.0,1
RC,151,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,151,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,151,Surgical,,,1550.0,1550.0,8
RC,151,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,151,Surgical Care,,,26962.95,29220.56,16
RC,152,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,152,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,152,Maternity û C-Section,,,19659.11,30797.0,15
RC,152,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,152,Medical,,,1550.0,1550.0,1
RC,152,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,152,Medical Care,,,9437.77,10629.2,2
RC,152,Medical/Surgical,,,1095.0,1095.0,1
RC,152,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,152,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,152,OB (mother and baby),,,1350.0,1350.0,1
RC,152,OB (mother only),,,1000.0,1000.0,1
RC,152,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,152,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,152,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,152,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,153,Medical,,,1550.0,1550.0,1
RC,153,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,153,Medical Care,,,9437.77,10629.2,2
RC,153,Medical/Surgical,,,1095.0,1095.0,1
RC,153,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,153,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,153,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,153,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,153,Surgical,,,1550.0,1550.0,8
RC,153,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,153,Surgical Care,,,26962.95,29220.56,16
RC,154,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,154,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,154,PSYCH LEVEL 3 INPATIENT CARE - VIVITY,,,1474.0,1659.0,2
RC,154,Psychiatric,,,1200.0,1200.0,1
RC,154,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,155,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,155,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,155,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,156,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,156,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,156,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,157,Medical,,,1550.0,1550.0,1
RC,157,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,157,Medical Care,,,9437.77,10629.2,2
RC,157,Medical/Surgical,,,1095.0,1095.0,1
RC,157,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,157,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,157,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,157,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,157,Surgical,,,1550.0,1550.0,8
RC,157,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,157,Surgical Care,,,26962.95,29220.56,16
RC,158,ACUTE REHABILITATION UNIT (ARU),,,3817.0,7759.0,4
RC,158,Acute Rehab I,,,5396.17,5396.17,2
RC,158,Acute Rehabilitation,,,2000.0,6710.78,6
RC,158,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,158,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,158,Rehabilitation Unit,,,9156.17,13104.36,2
RC,158,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,159,Medical,,,1550.0,1550.0,1
RC,159,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,159,Medical Care,,,9437.77,10629.2,2
RC,159,Medical/Surgical,,,1095.0,1095.0,1
RC,159,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,159,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,159,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,159,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,159,Surgical,,,1550.0,1550.0,8
RC,159,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,159,Surgical Care,,,26962.95,29220.56,16
RC,160,Maternity Care: C-Section delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,6
RC,160,Maternity Care: Vaginal delivery incl newborn charges for Nursery Lev. 1 (Includes normal newborn),,,8266.34,9759.83,14
RC,160,Maternity û C-Section,,,19659.11,30797.0,15
RC,160,Maternity û Normal Delivery,,,13179.27,20644.74,35
RC,160,Medical,,,1550.0,1550.0,1
RC,160,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,160,Medical Care,,,9437.77,10629.2,2
RC,160,Medical/Surgical,,,1095.0,1095.0,1
RC,160,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,160,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,160,OB (mother and baby),,,1350.0,1350.0,1
RC,160,OB (mother only),,,1000.0,1000.0,1
RC,160,Obstetrics -Vaginal or C-section,,,1350.0,1350.0,10
RC,160,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,160,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,160,Surgical,,,1550.0,1550.0,8
RC,160,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,160,Surgical Care,,,26962.95,29220.56,16
RC,161,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,161,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,161,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,162,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,163,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,164,Medical,,,1550.0,1550.0,1
RC,164,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,164,Medical Care,,,9437.77,10629.2,2
RC,164,Medical/Surgical,,,1095.0,1095.0,1
RC,164,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,164,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,164,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,164,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,164,Surgical,,,1550.0,1550.0,8
RC,164,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,164,Surgical Care,,,26962.95,29220.56,16
RC,165,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,166,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,167,Medical,,,1550.0,1550.0,1
RC,167,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,167,Medical Care,,,9437.77,10629.2,2
RC,167,Medical/Surgical,,,1095.0,1095.0,1
RC,167,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,167,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,167,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,167,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,167,Surgical,,,1550.0,1550.0,8
RC,167,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,167,Surgical Care,,,26962.95,29220.56,16
RC,168,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,169,Medical,,,1550.0,1550.0,1
RC,169,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,169,Medical Care,,,9437.77,10629.2,2
RC,169,Medical/Surgical,,,1095.0,1095.0,1
RC,169,Medical/Surgical - Adult and Pediatric,,,4050.0,4050.0,1
RC,169,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,169,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,169,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,169,Surgical,,,1550.0,1550.0,8
RC,169,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,169,Surgical Care,,,26962.95,29220.56,16
RC,170,BOARDER BABY LEVEL I,,,1218.0,2052.0,4
RC,170,Boarder Baby,,,400.0,400.0,1
RC,170,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,170,Level I Newboard (Normal/Boarder),,,2811.7,3981.35,2
RC,170,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,170,NICU,,,1775.0,1775.0,1
RC,170,NICU/Newborn - Level I,,,1141.32,1787.75,5
RC,170,"Newborn-Level I (Newborn, Boarder)",,,650.0,650.0,1
RC,170,Nursery,,,292.0,292.0,1
RC,170,Nursery 1,,,2416.13,2683.8,3
RC,170,Nursery: Level I,,,1355.62,1448.24,2
RC,170,Pediatric and Neonatal Services: Neonatal Intensive Care Unit: LEVEL I,,,1200.0,1200.0,1
RC,170,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,171,BOARDER BABY LEVEL I,5235.0,3402.75,1218.0,2052.0,4
RC,171,Boarder Baby,5235.0,3402.75,400.0,400.0,1
RC,171,Intensive Care Unit (ICU/CCU/NICU),5235.0,3402.75,1980.0,1980.0,1
RC,171,Level I Newboard (Normal/Boarder),5235.0,3402.75,2811.7,3981.35,2
RC,171,Medical - Adult and Pediatric,5235.0,3402.75,13278.41,18894.57,2
RC,171,NICU,5235.0,3402.75,1775.0,1775.0,1
RC,171,NICU/Newborn - Level I,5235.0,3402.75,1141.32,1787.75,5
RC,171,Newborn Level I,5235.0,3402.75,,,0
RC,171,"Newborn-Level I (Newborn, Boarder)",5235.0,3402.75,650.0,650.0,1
RC,171,Nursery,5235.0,3402.75,292.0,292.0,1
RC,171,Nursery 1,5235.0,3402.75,2416.13,2683.8,3
RC,171,Nursery: Level I,5235.0,3402.75,1355.62,1448.24,2
RC,171,Pediatric and Neonatal Services: Neonatal Intensive Care Unit: LEVEL I,5235.0,3402.75,1200.0,1200.0,1
RC,171,Surgical - Adult and Pediatric,5235.0,3402.75,36489.99,49761.15,16
RC,172,Boarder Baby,16849.5,10952.18,400.0,400.0,1
RC,172,CONTINUING CARE FOR LOW BIRTH-WEIGHT NEONATES,16849.5,10952.18,4256.0,8051.0,4
RC,172,Intensive Care Unit (ICU/CCU/NICU),16849.5,10952.18,1980.0,1980.0,1
RC,172,Level II Newborn (Premature),16849.5,10952.18,13278.41,18894.57,2
RC,172,Medical - Adult and Pediatric,16849.5,10952.18,13278.41,18894.57,2
RC,172,NICU,16849.5,10952.18,1775.0,1775.0,1
RC,172,NICU/Newborn - Level II,16849.5,10952.18,7065.44,11067.79,5
RC,172,Newborn Level II,16849.5,10952.18,,,0
RC,172,Newborn-Level II (Premature),16849.5,10952.18,3025.0,3025.0,1
RC,172,Nursery,16849.5,10952.18,292.0,292.0,1
RC,172,Nursery 2,16849.5,10952.18,9581.63,13054.77,3
RC,172,Nursery: Level II and III,16849.5,10952.18,9572.49,10259.77,2
RC,172,Pediatric and Neonatal Services: Neonatal Intensive Care Unit: LEVEL II,16849.5,10952.18,2300.0,2300.0,1
RC,172,Surgical - Adult and Pediatric,16849.5,10952.18,36489.99,49761.15,16
RC,173,Boarder Baby,32225.0,20946.25,400.0,400.0,1
RC,173,INTERMEDIATE CARE FOR SICK NEONATES,32225.0,20946.25,5692.0,10980.0,4
RC,173,Intensive Care Unit (ICU/CCU/NICU),32225.0,20946.25,1980.0,1980.0,1
RC,173,Level III Newborn (Sick Neonate),32225.0,20946.25,13278.41,18894.57,2
RC,173,Medical - Adult and Pediatric,32225.0,20946.25,13278.41,18894.57,2
RC,173,NICU,32225.0,20946.25,1775.0,1775.0,1
RC,173,NICU/Newborn - Level III,32225.0,20946.25,7065.44,11067.79,5
RC,173,Newborn Level III,32225.0,20946.25,,,0
RC,173,Newborn-Level Ill (Sick Neonate),32225.0,20946.25,3380.0,3380.0,1
RC,173,Nursery,32225.0,20946.25,292.0,292.0,1
RC,173,Nursery 3,32225.0,20946.25,9581.63,13054.77,3
RC,173,Nursery: Level II and III,32225.0,20946.25,9572.49,10259.77,2
RC,173,Pediatric and Neonatal Services: Newborn and Infant Critical Care Unit: LEVEL III & IV,32225.0,20946.25,6780.0,6780.0,1
RC,173,Surgical - Adult and Pediatric,32225.0,20946.25,36489.99,49761.15,16
RC,174,Intensive Care Unit (ICU/CCU/NICU),56768.0,36899.2,1980.0,1980.0,1
RC,174,Level IV Newborn (NICU),56768.0,36899.2,13278.41,18894.57,2
RC,174,Medical - Adult and Pediatric,56768.0,36899.2,13278.41,18894.57,2
RC,174,NEONATAL INTENSIVE CRITICAL CARE,56768.0,36899.2,7770.0,14761.0,4
RC,174,NICU,56768.0,36899.2,1775.0,1775.0,1
RC,174,NICU/Newborn - Level IV,56768.0,36899.2,7065.44,11067.79,5
RC,174,Newborn LeveláIV,56768.0,36899.2,,,0
RC,174,Newborn-Level IV NICU,56768.0,36899.2,5250.0,5250.0,1
RC,174,Nursery,56768.0,36899.2,292.0,292.0,1
RC,174,Nursery 4,56768.0,36899.2,9581.63,13054.77,3
RC,174,Nursery: Level IV,56768.0,36899.2,9572.49,10259.77,2
RC,174,Pediatric and Neonatal Services: Newborn and Infant Critical Care Unit: LEVEL III & IV,56768.0,36899.2,6780.0,6780.0,1
RC,174,Surgical - Adult and Pediatric,56768.0,36899.2,36489.99,49761.15,16
RC,179,BOARDER BABY LEVEL I,,,1218.0,2052.0,4
RC,179,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,179,Level I Newboard (Normal/Boarder),,,2811.7,3981.35,2
RC,179,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,179,NICU,,,1775.0,1775.0,1
RC,179,NICU/Newborn - Level I,,,1141.32,1787.75,5
RC,179,Nursery,,,292.0,292.0,1
RC,179,Nursery 1,,,2416.13,2683.8,3
RC,179,Nursery: Level I,,,1355.62,1448.24,2
RC,179,Pediatric and Neonatal Services: Neonatal Intensive Care Unit: LEVEL I,,,1200.0,1200.0,1
RC,179,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,180,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,180,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,182,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,182,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,183,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,183,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,185,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,185,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,189,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,189,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,190,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,190,Psychiatry,,,450.0,450.0,1
RC,190,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,191,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,191,SNF LEVEL 1,,,1259.0,1416.0,2
RC,191,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,192,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,192,SNF LEVEL 2,,,1259.0,1416.0,2
RC,192,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,193,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,193,SNF LEVEL 3,,,1259.0,1416.0,2
RC,193,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,194,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,194,SNF LEVEL 3,,,1259.0,1416.0,2
RC,194,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,199,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,199,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,200,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",52033.0,33821.45,5250.0,5250.0,1
RC,200,General,52033.0,33821.45,,,0
RC,200,ICU/CCU,52033.0,33821.45,2225.0,11067.79,6
RC,200,ICU/CCU/PICU,52033.0,33821.45,35062.5,37516.76,3
RC,200,Intensive Care Unit (ICU/CCU/NICU),52033.0,33821.45,1980.0,1980.0,1
RC,200,Intensive Care: MICU/SICU/PICU/CCU,52033.0,33821.45,9437.77,10629.2,2
RC,200,Medical - Adult and Pediatric,52033.0,33821.45,13278.41,18894.57,2
RC,200,Medical/Surgical,52033.0,33821.45,1095.0,1095.0,1
RC,200,Medical/Surgical/Pediatrics,52033.0,33821.45,7065.44,11067.79,5
RC,200,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,52033.0,33821.45,,,0
RC,200,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,52033.0,33821.45,6800.0,6800.0,1
RC,200,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,52033.0,33821.45,6753.0,6753.0,1
RC,200,Surgical,52033.0,33821.45,1550.0,1550.0,8
RC,200,Surgical - Adult and Pediatric,52033.0,33821.45,36489.99,49761.15,16
RC,200,Surgical Care,52033.0,33821.45,26962.95,29220.56,16
RC,201,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,201,ICU/CCU,,,2225.0,11067.79,6
RC,201,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,201,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,201,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,201,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,201,Medical/Surgical,,,1095.0,1095.0,1
RC,201,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,201,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,201,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,201,Surgical,,,1550.0,1550.0,8
RC,201,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,201,Surgical Care,,,26962.95,29220.56,16
RC,202,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,202,ICU/CCU,,,2225.0,11067.79,6
RC,202,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,202,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,202,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,202,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,202,Medical/Surgical,,,1095.0,1095.0,1
RC,202,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,202,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,202,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,202,Surgical,,,1550.0,1550.0,8
RC,202,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,202,Surgical Care,,,26962.95,29220.56,16
RC,203,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",15292.0,9939.8,5250.0,5250.0,1
RC,203,ICU/CCU,15292.0,9939.8,2225.0,11067.79,6
RC,203,ICU/CCU/PICU,15292.0,9939.8,35062.5,37516.76,3
RC,203,Intensive Care Unit (ICU/CCU/NICU),15292.0,9939.8,1980.0,1980.0,1
RC,203,Intensive Care: MICU/SICU/PICU/CCU,15292.0,9939.8,9437.77,10629.2,2
RC,203,Medical - Adult and Pediatric,15292.0,9939.8,13278.41,18894.57,2
RC,203,Medical/Surgical,15292.0,9939.8,1095.0,1095.0,1
RC,203,Medical/Surgical/Pediatrics,15292.0,9939.8,7065.44,11067.79,5
RC,203,Pediatric,15292.0,9939.8,,,0
RC,203,Pediatric and Neonatal Services: Pediatric Intensive Care Unit,15292.0,9939.8,7810.0,7810.0,1
RC,203,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,15292.0,9939.8,,,0
RC,203,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,15292.0,9939.8,6800.0,6800.0,1
RC,203,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,15292.0,9939.8,6753.0,6753.0,1
RC,203,Surgical,15292.0,9939.8,1550.0,1550.0,8
RC,203,Surgical - Adult and Pediatric,15292.0,9939.8,36489.99,49761.15,16
RC,203,Surgical Care,15292.0,9939.8,26962.95,29220.56,16
RC,204,ICU/CCU,,,2225.0,11067.79,6
RC,204,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,204,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,204,PSYCHE ICU,,,1474.0,1659.0,2
RC,204,Psychiatric,,,1200.0,1200.0,1
RC,204,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,206,ICU-Intermediate/CCU-Intermediate,15998.0,10398.7,19021.94,20353.22,3
RC,206,Intermediate Care: (Step Down or Telemetry),15998.0,10398.7,9437.77,10629.2,2
RC,206,"Intermediate Intensive Care Unit, Intermediate Cardiac Care Unit",15998.0,10398.7,5250.0,5250.0,1
RC,206,IntermediateáICU,15998.0,10398.7,,,0
RC,206,Medical - Adult and Pediatric,15998.0,10398.7,13278.41,18894.57,2
RC,206,Medical/Surgical,15998.0,10398.7,1095.0,1095.0,1
RC,206,Medical/Surgical/Pediatrics,15998.0,10398.7,7065.44,11067.79,5
RC,206,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,15998.0,10398.7,,,0
RC,206,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,15998.0,10398.7,6800.0,6800.0,1
RC,206,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,15998.0,10398.7,6753.0,6753.0,1
RC,206,Surgical,15998.0,10398.7,1550.0,1550.0,8
RC,206,Surgical - Adult and Pediatric,15998.0,10398.7,36489.99,49761.15,16
RC,206,Surgical Care,15998.0,10398.7,26962.95,29220.56,16
RC,207,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,207,ICU/CCU,,,2225.0,11067.79,6
RC,207,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,207,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,207,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,207,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,207,Medical/Surgical,,,1095.0,1095.0,1
RC,207,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,207,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,207,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,207,Surgical,,,1550.0,1550.0,8
RC,207,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,207,Surgical Care,,,26962.95,29220.56,16
RC,208,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",76644.0,49818.6,5250.0,5250.0,1
RC,208,ICU/CCU,76644.0,49818.6,2225.0,11067.79,6
RC,208,ICU/CCU/PICU,76644.0,49818.6,35062.5,37516.76,3
RC,208,Intensive Care Unit (ICU/CCU/NICU),76644.0,49818.6,1980.0,1980.0,1
RC,208,Intensive Care: MICU/SICU/PICU/CCU,76644.0,49818.6,9437.77,10629.2,2
RC,208,Medical - Adult and Pediatric,76644.0,49818.6,13278.41,18894.57,2
RC,208,Medical/Surgical,76644.0,49818.6,1095.0,1095.0,1
RC,208,Medical/Surgical/Pediatrics,76644.0,49818.6,7065.44,11067.79,5
RC,208,Pediatric and Neonatal Services: Unlisted Abulatory Surgery procedures,76644.0,49818.6,,,0
RC,208,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,76644.0,49818.6,6800.0,6800.0,1
RC,208,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,76644.0,49818.6,6753.0,6753.0,1
RC,208,Surgical,76644.0,49818.6,1550.0,1550.0,8
RC,208,Surgical - Adult and Pediatric,76644.0,49818.6,36489.99,49761.15,16
RC,208,Surgical Care,76644.0,49818.6,26962.95,29220.56,16
RC,208,Trauma,76644.0,49818.6,43171.45,43211.44,2
RC,209,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,209,ICU/CCU,,,2225.0,11067.79,6
RC,209,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,209,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,209,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,209,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,209,Medical/Surgical,,,1095.0,1095.0,1
RC,209,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,209,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,209,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,209,Surgical,,,1550.0,1550.0,8
RC,209,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,209,Surgical Care,,,26962.95,29220.56,16
RC,210,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,210,General,,,,,0
RC,210,ICU/CCU,,,2225.0,11067.79,6
RC,210,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,210,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,210,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,210,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,210,Medical/Surgical,,,1095.0,1095.0,1
RC,210,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,210,Pediatric and Neonatal Services: Cardiothoracic Intensive Care Unit,,,8620.0,8620.0,1
RC,210,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,210,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,210,Surgical,,,1550.0,1550.0,8
RC,210,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,210,Surgical Care,,,26962.95,29220.56,16
RC,211,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,211,ICU/CCU,,,2225.0,11067.79,6
RC,211,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,211,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,211,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,211,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,211,Medical/Surgical,,,1095.0,1095.0,1
RC,211,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,211,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,211,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,211,Surgical,,,1550.0,1550.0,8
RC,211,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,211,Surgical Care,,,26962.95,29220.56,16
RC,212,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,212,ICU/CCU,,,2225.0,11067.79,6
RC,212,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,212,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,212,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,212,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,212,Medical/Surgical,,,1095.0,1095.0,1
RC,212,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,212,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,212,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,212,Surgical,,,1550.0,1550.0,8
RC,212,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,212,Surgical Care,,,26962.95,29220.56,16
RC,213,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,213,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,213,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,213,Medical/Surgical,,,1095.0,1095.0,1
RC,213,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,213,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,213,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,213,Surgical,,,1550.0,1550.0,8
RC,213,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,213,Surgical Care,,,26962.95,29220.56,16
RC,214,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,214,ICU-Intermediate/CCU-Intermediate,,,19021.94,20353.22,3
RC,214,Intermediate Care: (Step Down or Telemetry),,,9437.77,10629.2,2
RC,214,"Intermediate Intensive Care Unit, Intermediate Cardiac Care Unit",,,5250.0,5250.0,1
RC,214,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,214,Medical/Surgical,,,1095.0,1095.0,1
RC,214,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,214,Pediatric and Neonatal Services: Cardiothoracic Intensive Care Unit,,,8620.0,8620.0,1
RC,214,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,214,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,214,Surgical,,,1550.0,1550.0,8
RC,214,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,214,Surgical Care,,,26962.95,29220.56,16
RC,215,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,215,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,216,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,216,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,217,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,217,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,218,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,218,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,219,"All Intensive Care Unit (ICU) Including medical, surgical, Cardiac and pediatric",,,5250.0,5250.0,1
RC,219,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,219,ICU/CCU,,,2225.0,11067.79,6
RC,219,ICU/CCU/PICU,,,35062.5,37516.76,3
RC,219,Intensive Care Unit (ICU/CCU/NICU),,,1980.0,1980.0,1
RC,219,Intensive Care: MICU/SICU/PICU/CCU,,,9437.77,10629.2,2
RC,219,Medical - Adult and Pediatric,,,13278.41,18894.57,2
RC,219,Medical/Surgical,,,1095.0,1095.0,1
RC,219,Medical/Surgical/Pediatrics,,,7065.44,11067.79,5
RC,219,Pre-Transplant Inpatient Services and Pre-Evaluation (included but not limited to per lung donor) up to 1 day prior to transplant,,,6800.0,6800.0,1
RC,219,Pre-Transplant Inpatient Services and Pre-Evaluation - Bone Marrow Translpant up to 1 day prior to transplant,,,6753.0,6753.0,1
RC,219,Surgical,,,1550.0,1550.0,8
RC,219,Surgical - Adult and Pediatric,,,36489.99,49761.15,16
RC,219,Surgical Care,,,26962.95,29220.56,16
RC,220,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,220,General,,,,,0
RC,221,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,228,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,229,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,23,Neurosurgery,,,30000.0,30000.0,1
RC,230,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,231,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,232,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,233,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,234,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,235,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,236,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,24,Neurosurgery,,,30000.0,30000.0,1
RC,25,Neurosurgery,,,30000.0,30000.0,1
RC,250,5-HYDROXYTRYPTOPHAN (5-HTP) 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,5-HYDROXYTRYPTOPHAN (5-HTP) 200 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,ABACAVIR 20 MG/ML PO SOLN,2188.8,1422.72,13270.0,14761.0,2
RC,250,ABACAVIR 300 MG PO TABS,2083.0,1353.95,13270.0,14761.0,8
RC,250,ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"ABALOPARATIDE 80 MCG (3,120 MCG/1.56 ML) SC PNIJ",1465.56,952.61,13270.0,14761.0,6
RC,250,ABATACEPT (WITH MALTOSE) 250 MG IV SOLR,11987.465,7791.8550000000005,54.09,14761.0,3
RC,250,ABEMACICLIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ABEMACICLIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ABIRATERONE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
RC,250,ACALABRUTINIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ACALABRUTINIB MALEATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ACARBOSE 100 MG PO TABS,580.8,377.52,13270.0,14761.0,2
RC,250,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",1465.56,952.61,13270.0,14761.0,2
RC,250,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,ACETAMINOPHEN 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,ACETAMINOPHEN-CAFF-PYRILAMINE 500-60-15 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ACETAMINOPHEN-CAFFEINE 500-65 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,ACETAMINOPHEN-CODEINE 300-30 MG PO TABS,383.4,249.21,13270.0,14761.0,6
RC,250,ACETAMINOPHEN-CODEINE 300-60 MG PO TABS,665.6,432.64,13270.0,14761.0,6
RC,250,ACETAZOLAMIDE 125 MG PO TABS,391.2,254.28,13270.0,14761.0,4
RC,250,ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,4
RC,250,ACETAZOLAMIDE 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,14
RC,250,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,400.64,260.41499999999996,13270.0,14761.0,8
RC,250,ACETIC ACID (BULK) 5 % MISC LIQD,312.0,202.8,13270.0,14761.0,2
RC,250,ACETIC ACID 0.25 % IR SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,ACETIC ACID 2 % OT SOLN,417.36,271.28,13270.0,14761.0,2
RC,250,ACETIC ACID 4% TOPICAL SOLN INTRAPROCEDURE,1465.56,952.61,,,0
RC,250,ACETYLCYSTEINE 20% INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
RC,250,ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN,1944.7199999999998,1264.07,13270.0,14761.0,4
RC,250,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,13270.0,14761.0,16
RC,250,ACETYLCYSTEINE 200 MG/ML (20 %) ORAL/INHALATION SOLN,338.91999999999996,220.3,13270.0,14761.0,8
RC,250,ACITRETIN 10 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ACYCLOVIR 200 MG PO CAPS,585.0,380.25,13270.0,14761.0,8
RC,250,ACYCLOVIR 200 MG/5 ML PO SUSP,938.43,609.98,13270.0,14761.0,20
RC,250,ACYCLOVIR 800 MG PO TABS,869.0,564.85,13270.0,14761.0,8
RC,250,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,ADAGRASIB 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ADALIMUMAB 40 MG/0.4 ML SC PNKT,1465.56,952.61,13270.0,14761.0,2
RC,250,ADALIMUMAB 40 MG/0.4 ML SC SYKT,1465.56,952.61,,,0
RC,250,ADALIMUMAB 40 MG/0.8 ML SC SYKT,58048.29,37731.39,13270.0,14761.0,2
RC,250,ADALIMUMAB 80 MG/0.8 ML SC PNKT,1465.56,952.61,,,0
RC,250,ADALIMUMAB 80 MG/0.8 ML SC SYKT,1465.56,952.61,,,0
RC,250,ADEFOVIR 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ADENOSINE (ADENOCARD) 100 MCG/ML INJECTION FOR INTRAPROCEDURE,1465.56,952.61,13270.0,14761.0,2
RC,250,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,ADENOSINE 3 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,ADENOSINE IN 0.9% NACL 90 MG/90 ML INFUSION (CATH LAB USE),691.2,449.28,13270.0,14761.0,2
RC,250,ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR,35906.67,23339.34,50.36,14761.0,3
RC,250,ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR,57450.6,37342.89,50.36,14761.0,3
RC,250,AFATINIB 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AFLIBERCEPT 2 MG/0.05 ML IAV SYRG,1465.56,952.61,1023.52,14761.0,3
RC,250,ALBENDAZOLE 200 MG PO TABS,1192.48,775.11,13270.0,14761.0,8
RC,250,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",1008.8,655.72,13270.0,14761.0,26
RC,250,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",786.0,510.9,66.09,14761.0,58
RC,250,ALBUTEROL 90 MCG/ACTUATION IN AERO - PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
RC,250,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,13270.0,14761.0,10
RC,250,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,13270.0,14761.0,6
RC,250,ALBUTEROL SULFATE 5 MG/ML IN NEBU,715.52,465.09,13270.0,14761.0,2
RC,250,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,ALECTINIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ALEMTUZUMAB 30 MG/ML IV SOLN,1465.56,952.61,2910.87,14761.0,11
RC,250,ALFENTANIL 500 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,ALIROCUMAB 150 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,ALIROCUMAB 75 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,ALISKIREN 150 MG PO TABS,5957.76,3872.54,13270.0,14761.0,2
RC,250,ALISKIREN 300 MG PO TABS,4810.5599999999995,3126.865,13270.0,14761.0,4
RC,250,ALPELISIB 300 MG/DAY (150 MG X 2) PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPHA LIPOIC ACID 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPHA LIPOIC ACID 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPHA LIPOIC ACID 300 MG PO CAPS,1465.56,952.61,,,0
RC,250,ALPHA LIPOIC ACID 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPHA LIPOIC ACID 600 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,ALPRAZOLAM 0.25 MG HALF-TAB = 0.125 MG,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPRAZOLAM 0.25 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,ALPRAZOLAM 0.5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,ALPRAZOLAM 0.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,ALPROSTADIL 500 MCG/ML IJ SOLN,1698.6999999999998,1104.155,13270.0,14761.0,14
RC,250,ALTEPLASE 2 MG CATH SOLR,2760.32,1794.21,113.9,14761.0,3
RC,250,ALTEPLASE 2 MG CATH SOLR (PEDIATRIC),73793.7,47965.9,113.9,14761.0,3
RC,250,ALTEPLASE 50 MG IV SOLR,36896.85,23982.95,113.9,14761.0,6
RC,250,ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG PO CHEW,290.0,188.5,13270.0,14761.0,2
RC,250,AMANTADINE HCL 100 MG PO CAPS,1110.6,721.89,13270.0,14761.0,6
RC,250,AMANTADINE HCL 137 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
RC,250,AMANTADINE HCL 50 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,AMANTADINE HCL 68.5 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
RC,250,AMBRISENTAN 10 MG PO TABS,13671.599999999999,8886.539999999999,13270.0,14761.0,12
RC,250,AMBRISENTAN 5 MG PO TABS,5609.099999999999,3645.915,13270.0,14761.0,4
RC,250,AMIFAMPRIDINE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMIFAMPRIDINE PHOSPHATE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMIKACIN 500 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,14
RC,250,AMINO AC 8 %-D14W-ELECTROLYTES 8-14 % IV SOLP,640.0,416.0,13270.0,14761.0,6
RC,250,AMINO ACID (PREMASOL) 10% NO.7 IV SOLP,988.78,642.705,,,0
RC,250,AMINO ACID (TROPHAMINE) INFUSION 10 % IV SOLP,568.0,369.2,,,0
RC,250,AMINOCAPROIC ACID 250 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,AMINOCAPROIC ACID 500 MG PO TABS,2053.74,1334.93,13270.0,14761.0,8
RC,250,AMINOCAPROIC ACID 5G/20 ML (0.25 G/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,AMINOPHYLLINE 250 MG/10 ML IV SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,AMINOPHYLLINE 500 MG/20 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,AMIODARONE 150MG-D5W 150ML CSHS,290.0,188.5,13270.0,14761.0,2
RC,250,AMIODARONE 50 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,AMIODARONE IV INFUSION (1 MG/ML),290.0,188.5,13270.0,14761.0,2
RC,250,AMIODARONE ORAL SUSPENSION 5 MG/ML,290.0,188.5,13270.0,14761.0,2
RC,250,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,32817.14,21331.14,,,0
RC,250,AMLODIPINE BENZOATE 1 MG/ML PO SUSP,8748.0,5686.2,13270.0,14761.0,4
RC,250,AMLODIPINE-BENAZEPRIL 10-20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMLODIPINE-OLMESARTAN 10-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMLODIPINE-OLMESARTAN 5-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMMONIUM LACTATE 12 % TP LOTN,290.0,188.5,13270.0,14761.0,4
RC,250,AMOXICILLIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
RC,250,AMOXICILLIN 250 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
RC,250,AMOXICILLIN 500 MG PO CAPS,457.0,297.05,13270.0,14761.0,8
RC,250,AMOXICILLIN 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMOXICILLIN 875 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AMOXICILLIN-POT CLAVULANATE 250-125 MG PO TABS,969.12,629.93,13270.0,14761.0,2
RC,250,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,4
RC,250,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,420.48,273.31,13270.0,14761.0,12
RC,250,AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML PO SUSR,290.0,188.5,13270.0,14761.0,4
RC,250,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,894.4,581.36,13270.0,14761.0,32
RC,250,AMPHETAMINE-DEXTROAMPHETAMINE 5 MG PO HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,2
RC,250,AMPHOTERICIN B 50 MG IJ SOLR,562.72,365.77,13270.0,14761.0,2
RC,250,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,1540.48,1001.31,29.04,14761.0,3
RC,250,AMPICILLIN 500 MG PO CAPS,745.6,484.64,13270.0,14761.0,2
RC,250,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,10
RC,250,AMPICILLIN SODIUM 2 GRAM IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,AMPICILLIN SODIUM 500 MG IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,2
RC,250,AMPICILLIN-SULBACTAM 1.5 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,22
RC,250,ANAKINRA 100 MG/0.67 ML SC SYRG,3370.95,2191.12,13270.0,14761.0,8
RC,250,ANASTROZOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,ANGIOTENSIN II 2.5 MG/ML IV SOLN,15884.55,10324.96,13270.0,14761.0,2
RC,250,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",80800.0,52520.0,2.92,14761.0,3
RC,250,"ANTI-INHIBITOR COAGULANT CMPLX 700-1,300 UNIT IV SOLR",32320.0,21008.0,2.92,14761.0,3
RC,250,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,12538.08,8149.75,1191.32,14761.0,5
RC,250,"ANTIHEMOPHIL FVIII,FULL LENGTH 500 (+/-) UNIT IV SOLR",9520.0,6188.0,13270.0,14761.0,2
RC,250,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT IV SOLR,35241.28,22906.83,4.8,14761.0,3
RC,250,ANTITHYMOCYTE GLOBULIN (EQUINE) (ATGAM) SKIN TEST,290.0,188.5,4941.46,14761.0,3
RC,250,APALUTAMIDE 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,APIXABAN 2.5 MG PO TABS,1789.44,1163.135,13270.0,14761.0,8
RC,250,APIXABAN 5 MG PO TABS,1789.44,1163.135,13270.0,14761.0,8
RC,250,APOMORPHINE 10 MG/ML SC CRTG,1465.56,952.61,13270.0,14761.0,2
RC,250,APRACLONIDINE 0.5 % OP DROP,695.2,451.88,,,0
RC,250,APRACLONIDINE 1 % OP DPET,1465.56,952.61,,,0
RC,250,APREMILAST 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,APREPITANT 125 MG PO CAPS,3008.96,1955.82,13270.0,14761.0,2
RC,250,APREPITANT 80 MG PO CAPS,2050.56,1332.86,13270.0,14761.0,6
RC,250,ARFORMOTEROL 15 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,4
RC,250,ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN,1445.98,939.885,13270.0,14761.0,4
RC,250,ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLN,1445.98,939.885,1.57,14761.0,15
RC,250,ARGININE (L-ARGININE) PO POWD,1465.56,952.61,,,0
RC,250,ARGININE HCL (L-ARGININE) 10 % IV SOLP,624.0,405.6,13270.0,14761.0,2
RC,250,ARGININE ORAL SOLUTION 10 % (0.475 MEQ/ML),290.0,188.5,13270.0,14761.0,2
RC,250,ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,ARIPIPRAZOLE 1 MG/ML PO SOLN,2596.38,1687.645,13270.0,14761.0,4
RC,250,ARIPIPRAZOLE 10 MG PO TABS,360.72,234.465,13270.0,14761.0,14
RC,250,ARIPIPRAZOLE 15 MG PO TABS,4496.44,2922.685,13270.0,14761.0,14
RC,250,ARIPIPRAZOLE 2 MG PO TABS,2287.74,1487.03,13270.0,14761.0,18
RC,250,ARIPIPRAZOLE 5 MG PO TABS,3264.2,2121.73,13270.0,14761.0,8
RC,250,ARMODAFINIL 150 MG PO TABS,16302.72,10596.77,13270.0,14761.0,2
RC,250,ARMODAFINIL 250 MG PO TABS,8686.08,5645.955,13270.0,14761.0,4
RC,250,ARSENIC TRIOXIDE 1 MG/ML IV SOLN,4654.88,3025.67,8.96,14761.0,3
RC,250,ARTEMETHER-LUMEFANTRINE 20-120 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ARTESUNATE 110 MG IV SOLR,48406.5,31464.23,13270.0,14761.0,2
RC,250,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OP DROP,941.22,611.79,13270.0,14761.0,8
RC,250,ASCIMINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"ASCORBATE CALCIUM-BIOFLAVONOID 1,000-200 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
RC,250,ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN,4033.6,2621.84,13270.0,14761.0,2
RC,250,ASCORBIC ACID-MULTIVIT-MIN 1000 MG PO PWEP,1465.56,952.61,13270.0,14761.0,2
RC,250,ASENAPINE 3.8 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,ASENAPINE MALEATE 10 MG SL SUBL,1465.56,952.61,13270.0,14761.0,2
RC,250,ASENAPINE MALEATE 5 MG SL SUBL,895.04,581.78,13270.0,14761.0,2
RC,250,ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN,1465.56,952.61,65.73,14761.0,3
RC,250,ASPIRIN ORAL SUSPENSION 1 MG/ML PEDIATRIC,1465.56,952.61,13270.0,14761.0,4
RC,250,ASPIRIN-DIPYRIDAMOLE 25-200 MG PO CM12,776.64,504.82,13270.0,14761.0,4
RC,250,ATAZANAVIR 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ATAZANAVIR 300 MG PO CAPS,15179.52,9866.69,13270.0,14761.0,2
RC,250,ATENOLOL ORAL SUSPENSION 2 MG/ML,290.0,188.5,13270.0,14761.0,2
RC,250,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,70886.47,46076.21,107.39,14761.0,3
RC,250,ATOGEPANT 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ATOMOXETINE 10 MG PO CAPS,5894.4,3831.36,13270.0,14761.0,2
RC,250,ATOMOXETINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,ATOMOXETINE 60 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,ATOMOXETINE 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ATORVASTATIN 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,ATORVASTATIN 20 MG PO TABS,302.4,196.56,13270.0,14761.0,14
RC,250,ATORVASTATIN 40 MG PO TABS,905.5799999999999,588.625,13270.0,14761.0,10
RC,250,ATORVASTATIN 80 MG PO TABS,1148.78,746.7049999999999,13270.0,14761.0,20
RC,250,ATOVAQUONE 750 MG/5 ML PO SUSP,446.08,289.95,13270.0,14761.0,20
RC,250,ATOVAQUONE-PROGUANIL 250-100 MG PO TABS,2456.83,1596.94,13270.0,14761.0,2
RC,250,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,8
RC,250,ATROPINE 1 % OP DROP,652.8,424.32,13270.0,14761.0,6
RC,250,ATROPINE 1 % OP OINT,290.0,188.5,13270.0,14761.0,2
RC,250,AVATROMBOPAG 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AVELUMAB 20 MG/ML IV SOLN,30976.64,20134.82,118.51,14761.0,3
RC,250,AZACITIDINE 100 MG IJ SOLR,588.96,382.82500000000005,13270.0,14761.0,8
RC,250,AZATHIOPRINE 50 MG HALF-TAB = 25 MG,1465.56,952.61,13270.0,14761.0,4
RC,250,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,AZATHIOPRINE ORAL SUSPENSION 50 MG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,AZELASTINE 0.05 % OP DROP,1105.5,718.575,13270.0,14761.0,6
RC,250,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,13270.0,14761.0,8
RC,250,AZELASTINE 205.5 MCG (0.15 %) NA SPRY,1465.56,952.61,13270.0,14761.0,4
RC,250,AZELASTINE-FLUTICASONE 137-50 MCG/SPRAY NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,AZILSARTAN MED-CHLORTHALIDONE 40-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AZILSARTAN MED-CHLORTHALIDONE 40-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AZILSARTAN MEDOXOMIL 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AZILSARTAN MEDOXOMIL 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,AZITHROMYCIN 200 MG/5 ML PO SUSR,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,AZITHROMYCIN 250 MG PO TABS,950.4,617.76,13270.0,14761.0,22
RC,250,AZITHROMYCIN 500 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,AZITHROMYCIN 600 MG PO TABS,1762.62,1145.7,13270.0,14761.0,8
RC,250,AZTREONAM 1 GRAM IJ SOLR,368.51,239.53,13270.0,14761.0,24
RC,250,AZTREONAM 2 GRAM IJ SOLR,779.0550000000001,506.39,13270.0,14761.0,18
RC,250,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,877.78,570.5550000000001,,,0
RC,250,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",877.78,570.5550000000001,13270.0,14761.0,18
RC,250,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OIPK",529.92,344.45,13270.0,14761.0,2
RC,250,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OP OINT",290.0,188.5,13270.0,14761.0,4
RC,250,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM TP PACK",529.92,344.45,13270.0,14761.0,2
RC,250,BACLOFEN (LIORESAL) ORAL SUSPENSION 5 MG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,BACLOFEN 2000 MCG/ML IT SOLN,3835.3500000000004,2492.975,13270.0,14761.0,4
RC,250,BACLOFEN 25 MG/5 ML (5 MG/ML) PO SUSP,10821.12,7033.73,13270.0,14761.0,4
RC,250,BALOXAVIR MARBOXIL 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BALSAM PERU-CASTOR OIL TP OINT,440.9,286.58,13270.0,14761.0,2
RC,250,BARICITINIB 1 MG PO TABS,41923.68,27250.394999999997,13270.0,14761.0,6
RC,250,BARICITINIB 2 MG PO TABS,43614.24,28349.26,13270.0,14761.0,6
RC,250,BASILIXIMAB 20 MG IV SOLR,38230.02,24849.51,5713.88,14761.0,3
RC,250,BEBTELOVIMAB 175 MG/2 ML (87.5 MG/ML) IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,BECAPLERMIN 0.01 % TP GEL,1465.56,952.61,13270.0,14761.0,2
RC,250,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION IN HFAB,1631.98,1060.79,13270.0,14761.0,4
RC,250,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION IN HFAB,1465.56,952.61,13270.0,14761.0,2
RC,250,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION NA HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,BECLOMETHASONE DIPROPIONATE ORAL EMULSION,290.0,188.5,13270.0,14761.0,2
RC,250,BEDAQUILINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BELANTAMAB MAFODOTIN-BLMF (STUDY DRUG) VIAL (PRL: COMPASSIONATE USE: SINGLE IND 165677),1465.56,952.61,,,0
RC,250,BELATACEPT 250 MG IV SOLR,14744.0,9583.6,4.75,14761.0,3
RC,250,BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG PR SUPP,1465.56,952.61,13270.0,14761.0,6
RC,250,BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG PR SUPP,1465.56,952.61,13270.0,14761.0,6
RC,250,BELUMOSUDIL 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,BENDAMUSTINE 25 MG/ML IV SOLN,12446.1,8089.97,16.12,14761.0,3
RC,250,BENRALIZUMAB 30 MG/ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
RC,250,BENZOCAINE 20 % MM SPRA,647.975,421.18000000000006,13270.0,14761.0,6
RC,250,BENZOCAINE-MENTHOL 20-0.5 % TP AERO,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MM GEL,290.0,188.5,13270.0,14761.0,4
RC,250,BENZOYL PEROXIDE 5 % TP GEL,290.0,188.5,13270.0,14761.0,2
RC,250,BENZTROPINE 1 MG/ML IJ SOLN,372.67,242.24,13270.0,14761.0,4
RC,250,BEPOTASTINE BESILATE 1.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,BESIFLOXACIN 0.6 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,BETAHISTINE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",552.3199999999999,359.01,13270.0,14761.0,4
RC,250,"BETAMETHASONE, AUGMENTED 0.05 % TP CREA",1465.56,952.61,13270.0,14761.0,2
RC,250,BEVACIZUMAB 25 MG/ML IV SOLN,12751.04,8288.18,90.53,14761.0,3
RC,250,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,25482.69,16563.75,33.1,14761.0,6
RC,250,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,18926.08,12301.949999999999,29.37,14761.0,6
RC,250,BICALUTAMIDE 50 MG PO TABS,683.28,444.13,13270.0,14761.0,6
RC,250,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HD SOLN,720.0,468.0,13270.0,14761.0,2
RC,250,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG PO TABS,62850.24,40852.66,13270.0,14761.0,4
RC,250,BIMATOPROST 0.01 % OP DROP,1465.56,952.61,13270.0,14761.0,8
RC,250,BIMATOPROST 0.03 % LASH DRPA,1465.56,952.61,13270.0,14761.0,2
RC,250,BIMATOPROST 0.03 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,BINIMETINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BIOTIN 10000 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,BIOTIN 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,BIOTIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BIOTIN 5000 MCG PO TBDL,1465.56,952.61,13270.0,14761.0,2
RC,250,BISOPROLOL FUMARATE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,BIVALIRUDIN 250 MG IV SOLR,920.52,598.335,13270.0,14761.0,6
RC,250,BLEOMYCIN 15 UNITS IJ SOLR,298.56,194.06,13270.0,14761.0,6
RC,250,BLINATUMOMAB 35 MCG IV KIT,46301.85,30096.2,189.49,14761.0,6
RC,250,BLINATUMOMAB 35 MCG IV SOLR,46301.85,30096.2,13270.0,14761.0,2
RC,250,BORTEZOMIB 3.5 MG IJ SOLR,520.96,338.62,13270.0,14761.0,10
RC,250,BOSENTAN 62.5 MG PO TABS,128456.64000000001,83496.81499999999,13270.0,14761.0,4
RC,250,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,109800.0,71370.0,298.67,14761.0,3
RC,250,BREXPIPRAZOLE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BREXPIPRAZOLE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BREXPIPRAZOLE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BREXPIPRAZOLE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BREXPIPRAZOLE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BRIGATINIB 180 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,BRIMONIDINE 0.025 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,BRIMONIDINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,6
RC,250,BRIMONIDINE 0.15 % OP DROP,1465.56,952.61,13270.0,14761.0,8
RC,250,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,13270.0,14761.0,8
RC,250,BRIMONIDINE-TIMOLOL 0.2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,8
RC,250,BRINZOLAMIDE 1 % OP DRPS,2915.26,1894.915,13270.0,14761.0,12
RC,250,BRINZOLAMIDE-BRIMONIDINE 1-0.2 % OP DRPS,1465.56,952.61,13270.0,14761.0,4
RC,250,BRIVARACETAM 10 MG/ML PO SOLN,21960.0,14274.0,13270.0,14761.0,4
RC,250,BRIVARACETAM 100 MG PO TABS,29277.440000000002,19030.335,13270.0,14761.0,4
RC,250,BRIVARACETAM 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,BRIVARACETAM 50 MG PO TABS,21958.08,14272.75,13270.0,14761.0,2
RC,250,BRIVARACETAM 75 MG PO TABS,21958.08,14272.75,13270.0,14761.0,2
RC,250,BROMELAINS 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,BROMFENAC 0.07 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,BROMFENAC 0.075 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,BROMFENAC 0.09 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,BUDESONIDE 0.25 MG IN NBSP,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,BUDESONIDE 0.5 MG IN NBSP,877.78,570.5550000000001,13270.0,14761.0,22
RC,250,BUDESONIDE 180 MCG/ACTUATION IN AEPB,1465.56,952.61,13270.0,14761.0,2
RC,250,BUDESONIDE 3 MG PO CECX,3268.8,2124.72,13270.0,14761.0,10
RC,250,BUDESONIDE 9 MG PO TADE,1465.56,952.61,13270.0,14761.0,2
RC,250,BUDESONIDE 90 MCG/ACTUATION IN AEPB,1472.8,957.32,13270.0,14761.0,2
RC,250,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,8
RC,250,BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION IN HFAA,1248.57,811.5699999999999,13270.0,14761.0,6
RC,250,BUDESONIDE-GLYCOPYR-FORMOTEROL 160-9-4.8 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,8
RC,250,BUMETANIDE (BUMEX) 25MG IN 100ML (STRAIGHT DRUG) INFUSION,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,BUMETANIDE 0.25 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,54
RC,250,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,16
RC,250,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,34
RC,250,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,13270.0,14761.0,30
RC,250,BUPIVACAINE 0.25% INFUSION (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,4
RC,250,BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,10
RC,250,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,6
RC,250,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
RC,250,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,2
RC,250,BUPRENORPHINE 10 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,4
RC,250,BUPRENORPHINE 15 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,4
RC,250,BUPRENORPHINE 20 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,4
RC,250,BUPRENORPHINE 5 MCG/HR TD PTWK,1465.56,952.61,13270.0,14761.0,4
RC,250,BUPRENORPHINE HCL 0.3 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,BUPRENORPHINE HCL 2 MG SL SUBL,306.52,199.24,13270.0,14761.0,16
RC,250,BUPRENORPHINE HCL 300 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
RC,250,BUPRENORPHINE HCL 450 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
RC,250,BUPRENORPHINE HCL 600 MCG BU FILM,1465.56,952.61,13270.0,14761.0,6
RC,250,BUPRENORPHINE HCL 750 MCG BU FILM,1465.56,952.61,13270.0,14761.0,2
RC,250,BUPRENORPHINE HCL 8 MG SL SUBL,491.56,319.515,13270.0,14761.0,10
RC,250,BUPRENORPHINE-NALOXONE 0.7-0.18 MG SL SUBL,2372.16,1541.9,13270.0,14761.0,2
RC,250,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,13270.0,14761.0,6
RC,250,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,496.8,322.92,13270.0,14761.0,14
RC,250,BUPRENORPHINE-NALOXONE 4-1 MG SL FILM,1465.56,952.61,13270.0,14761.0,2
RC,250,BUPRENORPHINE-NALOXONE 8-2 MG SL FILM,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,506.64,329.315,13270.0,14761.0,10
RC,250,BUPROPION HBR 522 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,BUPROPION HCL 150 MG PO TB24,340.32,221.21,13270.0,14761.0,14
RC,250,BUPROPION HCL 300 MG PO TB24,1090.56,708.86,13270.0,14761.0,10
RC,250,BUTALBITAL-ACETAMINOP-CAF-COD 50-300-40-30 MG PO CAPS,8800.8,5720.52,13270.0,14761.0,4
RC,250,BUTALBITAL-ACETAMINOPHEN 50-325 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,BUTALBITAL-ACETAMINOPHEN-CAFF 50-300-40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,995.2,646.88,13270.0,14761.0,16
RC,250,BUTORPHANOL 10 MG/ML NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT,16695.27,10851.925000000001,85.12,14761.0,6
RC,250,CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN,129228.48,83998.51,269.53,14761.0,6
RC,250,CABERGOLINE 0.5 MG PO TABS,1023.275,665.125,13270.0,14761.0,6
RC,250,CABOZANTINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CABOZANTINIB 60 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CAFFEINE CITRATE 20 MG/ML ORAL SOLUTION PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) IJ SOLN,447.36,290.78,13270.0,14761.0,4
RC,250,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,232056.99,150837.04,13270.0,14761.0,2
RC,250,CALCIFEDIOL 30 MCG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCITONIN (SALMON) 200 UNIT/ACTUATION NA SPRY,421.07500000000005,273.695,13270.0,14761.0,6
RC,250,CALCITONIN (SALMON) 200 UNITS/ML IJ SOLN,5506.65,3579.32,1460.68,14761.0,9
RC,250,CALCITRIOL 1 MCG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCIUM CARBONATE-VIT D3-MIN 600 MG CALCIUM- 400 UNIT PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCIUM CARBONATE-VITAMIN D3 600 MG-5 MCG (200 UNIT) PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCIUM CHLORIDE 10% SYRINGE,290.0,188.5,13270.0,14761.0,4
RC,250,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,13270.0,14761.0,12
RC,250,CALCIUM CITRATE-VITAMIN D3 200 MG-6.25 MCG (250 UNIT) PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,13270.0,14761.0,12
RC,250,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,13270.0,14761.0,8
RC,250,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,572.8,372.32,13270.0,14761.0,24
RC,250,CALCIUM-MAGNESIUM-ZINC 333-133-8.3 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCIUM-MAGNESIUM-ZINC PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CALCIUM-VITAMIN D3-VITAMIN K 650 MG-12.5 MCG-40 MCG PO CHEW,1465.56,952.61,13270.0,14761.0,4
RC,250,CANAKINUMAB (PF) 150 MG/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,CANDESARTAN 16 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CANDESARTAN-HYDROCHLOROTHIAZID 32-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,23.44,14761.0,10
RC,250,CANNABIDIOL 100 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,CANNABIDIOL CBD OIL,1465.56,952.61,13270.0,14761.0,2
RC,250,CAPECITABINE 500 MG PO TABS,1224.3,795.7950000000001,13270.0,14761.0,4
RC,250,CAPLACIZUMAB-YHDP 11 MG IJ KIT,1465.56,952.61,13270.0,14761.0,2
RC,250,CAPMATINIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CAPMATINIB 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CAPSAICIN 0.1 % TP CREA,290.0,188.5,13270.0,14761.0,4
RC,250,CAPTOPRIL ORAL SUSPENSION 1 MG/ML,1465.56,952.61,13270.0,14761.0,4
RC,250,CARBAMAZEPINE 200 MG PO CM12,1465.56,952.61,13270.0,14761.0,6
RC,250,CARBAMAZEPINE 300 MG PO CM12,1465.56,952.61,13270.0,14761.0,4
RC,250,CARBAMIDE PEROXIDE 10 % MM SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,CARBIDOPA-LEVODOPA 23.75-95 MG PO CPSR,3829.58,2489.225,13270.0,14761.0,4
RC,250,CARBIDOPA-LEVODOPA 36.25-145 MG PO CPSR,3829.58,2489.225,13270.0,14761.0,4
RC,250,CARBIDOPA-LEVODOPA 48.75-195 MG PO CPSR,6193.6,4025.84,13270.0,14761.0,2
RC,250,CARBIDOPA-LEVODOPA 61.25-245 MG PO CPSR,7782.4,5058.56,13270.0,14761.0,2
RC,250,CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG PO TABS,1465.56,952.61,,,0
RC,250,CARBIDOPA-LEVODOPA-ENTACAPONE 37.5-150-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CARBOPLATIN 10 MG/ML IV SOLN,621.6,404.04,13270.0,14761.0,22
RC,250,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,592.86,385.36,13270.0,14761.0,8
RC,250,CARBOXYMETHYL-GLY-POLY80-PF 0.5-1-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,CARBOXYMETHYLCELLULOSE SODIUM 0.25 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DPET,290.0,188.5,13270.0,14761.0,2
RC,250,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PF SOLN,1072.0,696.8,13270.0,14761.0,4
RC,250,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PF SOLN",1465.56,952.61,13270.0,14761.0,4
RC,250,CARFILZOMIB 10 MG IV SOLR,8732.96,5676.42,61.73,14761.0,3
RC,250,CARFILZOMIB 60 MG IV SOLR,29473.65,19157.87,61.73,14761.0,3
RC,250,CARIPRAZINE 1.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,CARIPRAZINE 3 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,CARIPRAZINE 4.5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CARIPRAZINE 6 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CARISOPRODOL 250 MG PO TABS,2236.8,1453.92,13270.0,14761.0,2
RC,250,CARMUSTINE 100 MG IV SOLR,2798.0,1818.6999999999998,412.0,14761.0,9
RC,250,CARTEOLOL 1 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,CARVEDILOL (COREG) ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
RC,250,CARVEDILOL PHOSPHATE 10 MG PO CM24,1465.56,952.61,13270.0,14761.0,4
RC,250,CARVEDILOL PHOSPHATE 20 MG PO CM24,1465.56,952.61,13270.0,14761.0,4
RC,250,CARVEDILOL PHOSPHATE 40 MG PO CM24,1465.56,952.61,13270.0,14761.0,4
RC,250,CEFADROXIL 500 MG PO CAPS,443.2,288.08,13270.0,14761.0,2
RC,250,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,10
RC,250,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,CEFAZOLIN 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,CEFAZOLIN IN DEXTROSE (ISO-OS) 1 GRAM/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
RC,250,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,1465.56,952.61,13270.0,14761.0,2
RC,250,CEFDINIR 125 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
RC,250,CEFDINIR 300 MG PO CAPS,745.92,484.85,13270.0,14761.0,10
RC,250,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,18
RC,250,CEFEPIME 2 GRAM IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,CEFEPIME IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
RC,250,CEFIDEROCOL 1 GRAM IV SOLR,3470.99,2256.14,2.84,14761.0,5
RC,250,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,6
RC,250,CEFOXITIN 2 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,CEFOXITIN 95 MG/ML IV PUSH,1465.56,952.61,13270.0,14761.0,2
RC,250,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,4.9,14761.0,10
RC,250,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,14
RC,250,CEFTAZIDIME 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR,5882.34,3823.52,125.24,14761.0,3
RC,250,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR,2364.96,1537.22,10.25,14761.0,5
RC,250,CEFTRIAXONE 1 GRAM IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,CEFTRIAXONE 1 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,14
RC,250,CEFTRIAXONE IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
RC,250,CEFUROXIME AXETIL 250 MG PO TABS,527.0799999999999,342.6,13270.0,14761.0,4
RC,250,CEFUROXIME AXETIL 500 MG PO TABS,1302.72,846.77,13270.0,14761.0,4
RC,250,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,13270.0,14761.0,8
RC,250,CEFUROXIME SODIUM 750 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,CENOBAMATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,13270.0,14761.0,10
RC,250,CEPHALEXIN 250 MG/5 ML PO SUSR,903.98,587.585,13270.0,14761.0,6
RC,250,CEPHALEXIN 500 MG PO CAPS,1064.0,691.6,13270.0,14761.0,12
RC,250,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SC KIT,53994.87,35096.67,5.79,14761.0,3
RC,250,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SC SYKT,49552.47,32209.11,5.79,14761.0,3
RC,250,CEVIMELINE 30 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,CHLORAMBUCIL 2 MG PO TABS,1465.56,952.61,,,0
RC,250,CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG PO CAPS,633.6,411.84,13270.0,14761.0,4
RC,250,CHLOROPROCAINE (PF) 20 MG/ML (2 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,13270.0,14761.0,6
RC,250,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,552.4,359.05999999999995,13270.0,14761.0,8
RC,250,CHLORPROMAZINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CHLORPROMAZINE 25 MG/ML IJ SOLN,338.72,220.17,13270.0,14761.0,8
RC,250,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/DROP (400 UNIT/DROP) PO DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,"CHOLECALCIFEROL (VITAMIN D3) 250 MCG (10,000 UNIT) PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,"CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,CICLESONIDE 160 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,4
RC,250,CICLESONIDE 37 MCG/ACTUATION NA HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,CICLESONIDE 80 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,CICLOPIROX 0.77 % TP CREA,1465.56,952.61,13270.0,14761.0,8
RC,250,CICLOPIROX 1 % TP SHAM,1465.56,952.61,13270.0,14761.0,2
RC,250,CICLOPIROX 8 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,CIDOFOVIR 75 MG/ML IV SOLN,9689.76,6298.34,657.46,14761.0,3
RC,250,CILGAVIMAB 150 MG/1.5 ML IM SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,CINACALCET 30 MG PO TABS,4053.4,2634.71,13270.0,14761.0,12
RC,250,CINACALCET 60 MG PO TABS,2712.96,1763.4250000000002,13270.0,14761.0,6
RC,250,CINACALCET 90 MG PO TABS,581.28,377.83,13270.0,14761.0,8
RC,250,CIPROFLOXACIN 250 MG/5 ML PO SUMC,1944.0,1263.6,13270.0,14761.0,2
RC,250,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,13270.0,14761.0,12
RC,250,CIPROFLOXACIN HCL 0.3 % OP OINT,4052.5,2634.13,13270.0,14761.0,2
RC,250,CIPROFLOXACIN HCL 250 MG PO TABS,4382.4,2848.56,13270.0,14761.0,4
RC,250,CIPROFLOXACIN HCL 500 MG PO TABS,459.2,298.48,13270.0,14761.0,16
RC,250,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
RC,250,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,13270.0,14761.0,10
RC,250,CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OT DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CISATRACURIUM 10 MG/ML CONC. IV SOLN,1200.6399999999999,780.4150000000001,13270.0,14761.0,10
RC,250,CISATRACURIUM 2 MG/ML IV SOLN,350.03999999999996,227.525,13270.0,14761.0,32
RC,250,CISPLATIN 1 MG/ML IV SOLN,457.6,297.44,13270.0,14761.0,18
RC,250,CITALOPRAM 10 MG/5 ML PO SOLN,994.56,646.46,13270.0,14761.0,2
RC,250,CLADRIBINE 10 MG/10 ML IV SOLN,1337.92,869.65,17.74,14761.0,12
RC,250,CLARITHROMYCIN 250 MG PO TABS,564.52,366.94,13270.0,14761.0,4
RC,250,CLARITHROMYCIN 250 MG/5 ML PO SUSR,1125.6,731.64,13270.0,14761.0,2
RC,250,CLARITHROMYCIN 500 MG PO TABS,1104.96,718.225,13270.0,14761.0,8
RC,250,CLINDAMYCIN HCL 150 MG PO CAPS,313.8,203.97,13270.0,14761.0,12
RC,250,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,16
RC,250,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,CLINDAMYCIN PALMITATE HCL 75 MG/5 ML PO SOLR,406.4,264.16,13270.0,14761.0,4
RC,250,CLINDAMYCIN PHOSPHATE 1 % TP SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,18
RC,250,CLINDAMYCIN PHOSPHATE 2 % VA CREA,1295.36,841.98,13270.0,14761.0,2
RC,250,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,6
RC,250,CLOBAZAM 10 MG PO TABS,708.8,460.72,13270.0,14761.0,6
RC,250,CLOBAZAM 2.5 MG/ML PO SUSP,23352.96,15179.42,13270.0,14761.0,4
RC,250,CLOBAZAM 5 MG PO FILM,1465.56,952.61,13270.0,14761.0,2
RC,250,CLOBETASOL 0.05 % TP FOAM,1465.56,952.61,13270.0,14761.0,2
RC,250,CLOMIPRAMINE 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,CLONAZEPAM 0.1 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
RC,250,CLONAZEPAM 0.125 MG PO TBDL,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,CLONAZEPAM 0.25 MG PO TBDL,826.56,537.26,13270.0,14761.0,12
RC,250,CLONAZEPAM 0.5 MG PO TABS,553.0,359.45,13270.0,14761.0,10
RC,250,CLONAZEPAM 1 MG PO TABS,595.2,386.88,13270.0,14761.0,8
RC,250,CLONAZEPAM 1 MG PO TBDL,1465.56,952.61,13270.0,14761.0,2
RC,250,CLONAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,13270.0,14761.0,6
RC,250,CLONIDINE (PF) 5000 MCG/10 ML EP SOLN,729.76,474.34,13270.0,14761.0,2
RC,250,CLONIDINE 0.1 MG/24 HR TD PTWK,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,CLONIDINE 0.2 MG/24 HR TD PTWK,392.8,255.32,13270.0,14761.0,4
RC,250,CLONIDINE 0.3 MG/24 HR TD PTWK,1465.56,952.61,13270.0,14761.0,8
RC,250,CLONIDINE HCL 0.1 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
RC,250,CLONIDINE ORAL SUSPENSION 10 MCG/ML,1465.56,952.61,13270.0,14761.0,4
RC,250,CLOPIDOGREL 300 MG PO TABS,3287.04,2136.58,13270.0,14761.0,16
RC,250,CLOPIDOGREL 75 MG PO TABS,429.0,278.85,13270.0,14761.0,12
RC,250,CLOPIDOGREL ORAL SUSPENSION 5 MG/ML PEDIATRIC (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
RC,250,CLORAZEPATE DIPOTASSIUM 15 MG PO TABS,1465.56,952.61,,,0
RC,250,CLORAZEPATE DIPOTASSIUM 3.75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CLOTRIMAZOLE 1 % TP CREA,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,CLOTRIMAZOLE 1 % TP SOLN,375.32,243.96,13270.0,14761.0,4
RC,250,CLOTRIMAZOLE 10 MG MM TROC,3077.76,2000.54,13270.0,14761.0,12
RC,250,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,13270.0,14761.0,6
RC,250,COBICISTAT 150 MG PO TABS,4691.52,3049.49,13270.0,14761.0,4
RC,250,COCAINE 4 % NA SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,CODEINE SULFATE 15 MG PO TABS,1072.0,696.8,13270.0,14761.0,2
RC,250,CODEINE SULFATE 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,13270.0,14761.0,14
RC,250,COENZYME Q10 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,COENZYME Q10 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,COENZYME Q10 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,COFFEE XT-PHOSPHATIDYL SERINE 100-100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,COLCHICINE 0.6 MG PO TABS,1465.56,952.61,13270.0,14761.0,22
RC,250,COLESTIPOL 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,COLISTIN (COLISTIMETHATE NA) 150 MG IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TP OINT,4211.52,2737.49,13270.0,14761.0,2
RC,250,CONJ ESTROG-MEDROXYPROGEST ACE 0.3-1.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CONJ ESTROG-MEDROXYPROGEST ACE 0.45-1.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CONJ ESTROG-MEDROXYPROGEST ACE 0.625-2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CONJUGATED ESTROGENS 0.625 MG/GRAM VA CREA,6869.76,4465.34,13270.0,14761.0,4
RC,250,CONJUGATED ESTROGENS 25 MG IJ SOLR,5618.24,3651.86,476.64,14761.0,3
RC,250,COPPER 380 SQUARE MM IU IUD,9765.0,6347.25,13270.0,14761.0,4
RC,250,COPPER GLUCONATE 2 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,COQ10 (LIPOSOMAL UBIQUINOL) 80 MG/10 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
RC,250,COQ10 (UBIQUINOL) 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CORTICOTROPIN 80 UNITS/ML IJ GEL,1465.56,952.61,13270.0,14761.0,4
RC,250,COSYNTROPIN 0.25 MG IJ SOLR,386.47,251.20499999999998,13270.0,14761.0,4
RC,250,"COVID-19 VAC, BV (PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",1465.56,952.61,13270.0,14761.0,2
RC,250,"COVID-19 VAC, TRIS(PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",1465.56,952.61,13270.0,14761.0,4
RC,250,CRANBERRY CONC-C-BACILLUS COAG 450-30-50 MG-MG-MILLION PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,CRANBERRY EXTRACT 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN,1465.56,952.61,160.05,184.06,8
RC,250,CROFELEMER 125 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
RC,250,CROMOLYN 100 MG/5 ML PO CONC,1465.56,952.61,13270.0,14761.0,14
RC,250,CROMOLYN 20 MG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
RC,250,CROMOLYN 4 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,CROMOLYN 5.2 MG/SPRAY (4 %) NA SPRY,290.0,188.5,13270.0,14761.0,2
RC,250,CSHS PARENTERAL NUTRITITION ORDER ADULT,1116.78,725.905,13270.0,14761.0,4
RC,250,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,CYANOCOBALAMIN (VITAMIN B-12) 200 MCG/SPRAY SL SPSN,1465.56,952.61,13270.0,14761.0,2
RC,250,CYANOCOBALAMIN (VITAMIN B-12) 5000 MCG SL SUBL,1465.56,952.61,13270.0,14761.0,2
RC,250,CYCLOPENTOLATE 1 % OP DROP,290.0,188.5,13270.0,14761.0,6
RC,250,CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OP DROP,476.0,309.4,13270.0,14761.0,4
RC,250,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1733.2800000000002,1126.63,13270.0,14761.0,8
RC,250,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,3638.88,2365.2749999999996,13270.0,14761.0,8
RC,250,CYCLOPHOSPHAMIDE 25 MG PO CAPS,4248.0,2761.2,13270.0,14761.0,4
RC,250,CYCLOPHOSPHAMIDE 50 MG PO CAPS,13226.4,8597.16,13270.0,14761.0,6
RC,250,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1127.84,733.1,13270.0,14761.0,10
RC,250,CYCLOSERINE 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,CYCLOSPORINE 0.05 % OP DPET,4809.6,3126.24,13270.0,14761.0,10
RC,250,CYCLOSPORINE 0.09 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,CYCLOSPORINE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,CYCLOSPORINE 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,CYCLOSPORINE 250 MG/5 ML IV SOLN,1019.84,662.9,13270.0,14761.0,12
RC,250,CYCLOSPORINE MODIFIED 100 MG PO CAPS,1675.2,1088.88,13270.0,14761.0,8
RC,250,CYCLOSPORINE MODIFIED 100 MG/ML PO SOLN,8693.6,5650.84,13270.0,14761.0,4
RC,250,CYCLOSPORINE MODIFIED 25 MG PO CAPS,450.24,292.655,13270.0,14761.0,18
RC,250,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,CYTARABINE (PF) 20 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,D-MANNOSE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,DABIGATRAN ETEXILATE 110 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,DABIGATRAN ETEXILATE 150 MG PO CAPS,2809.92,1826.45,13270.0,14761.0,4
RC,250,DABIGATRAN ETEXILATE 75 MG PO CAPS,2809.92,1826.45,13270.0,14761.0,2
RC,250,DABRAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,DACARBAZINE 200 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,DACTINOMYCIN 0.5 MG IV SOLR,5634.88,3662.67,351.31,14761.0,9
RC,250,DALFAMPRIDINE (BULK) MISC POWD,1465.56,952.61,,,0
RC,250,DALFAMPRIDINE 10 MG PO TB12,1465.56,952.61,13270.0,14761.0,12
RC,250,DANTROLENE 20 MG IV SOLR,1040.0,676.0,13270.0,14761.0,6
RC,250,"DAPAGLIFLOZ PROPANED-METFORMIN 10-1,000 MG PO TBPH",1465.56,952.61,13270.0,14761.0,2
RC,250,DAPAGLIFLOZIN PROPANEDIOL 10 MG PO TABS,8940.0,5811.0,13270.0,14761.0,4
RC,250,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,8940.0,5811.0,13270.0,14761.0,4
RC,250,DAPSONE ORAL SUSPENSION 2 MG/ML PEDIATRIC,1465.56,952.61,13270.0,14761.0,2
RC,250,DAPTOMYCIN 350 MG IV SOLR,462.08,300.35,13270.0,14761.0,12
RC,250,DAPTOMYCIN 500 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,DARATUMUMAB 20 MG/ML IV SOLN,17451.675,11343.59,81.08,14761.0,6
RC,250,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SC SOLN",89752.73,58339.27,64.02,14761.0,3
RC,250,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML IJ SYRG,32418.63,21072.11,3.78,14761.0,3
RC,250,DAROLUTAMIDE 300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DARUNAVIR 100 MG/ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
RC,250,DARUNAVIR 600 MG PO TABS,32172.48,20912.11,13270.0,14761.0,2
RC,250,DARUNAVIR 800 MG PO TABS,32172.0,20911.8,13270.0,14761.0,4
RC,250,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG PO TABS,70316.16,45705.5,13270.0,14761.0,4
RC,250,DARUNAVIR-COBICISTAT 800-150 MG-MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,DASATINIB 100 MG PO TABS,272001.6,176801.04,13270.0,14761.0,2
RC,250,DASATINIB 140 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DASATINIB 20 MG PO TABS,150916.8,98095.92,13270.0,14761.0,2
RC,250,DASATINIB 50 MG PO TABS,301833.6,196191.84,13270.0,14761.0,2
RC,250,DAUNORUBICIN 5 MG/ML IV SOLN,1132.075,735.845,30.43,14761.0,6
RC,250,DECITABINE 50 MG IV SOLR,1465.56,952.61,13270.0,14761.0,6
RC,250,DEFERASIROX 180 MG PO TABS,447.36,290.78,13270.0,14761.0,2
RC,250,DEFERASIROX 250 MG PO TBDP,1465.56,952.61,13270.0,14761.0,4
RC,250,DEFERASIROX 360 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,DEFERASIROX 500 MG PO TBDP,1465.56,952.61,13270.0,14761.0,8
RC,250,DEFERASIROX 90 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DEFEROXAMINE 2 GRAM IJ SOLR,576.48,374.71,13270.0,14761.0,8
RC,250,DEFEROXAMINE 500 MG IJ SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,DEGARELIX 120 MG SC SOLR,17040.96,11076.625,5.2,14761.0,6
RC,250,DEGARELIX 80 MG SC SOLR,7281.44,4732.94,5.2,14761.0,3
RC,250,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SC SOLN,26016.46,16910.7,33.57,14761.0,3
RC,250,DENOSUMAB 60 MG/ML SC SYRG,14145.105,9194.32,33.57,14761.0,3
RC,250,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NA SPRP,849.92,552.45,13270.0,14761.0,2
RC,250,DESMOPRESSIN 4 MCG/ML IJ SOLN,2489.44,1618.14,6.75,14761.0,31
RC,250,DESOG-E.ESTRADIOL/E.ESTRADIOL 0.15-0.02 MGX21 /0.01 MG X 5 PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,DESOGESTREL-ETHINYL ESTRADIOL 0.15-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,DESVENLAFAXINE 100 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,DESVENLAFAXINE SUCCINATE 100 MG PO TB24,386.88,251.47500000000002,13270.0,14761.0,10
RC,250,DESVENLAFAXINE SUCCINATE 25 MG PO TB24,950.9399999999999,618.11,13270.0,14761.0,4
RC,250,DESVENLAFAXINE SUCCINATE 50 MG PO TB24,460.8,299.52,13270.0,14761.0,12
RC,250,DEUTETRABENAZINE 12 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DEXAMETHASONE 1 MG/ML PO DROP,354.72,230.57,13270.0,14761.0,2
RC,250,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,10
RC,250,DEXAMETHASONE 4 MG/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,4
RC,250,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP DROP,803.36,522.18,13270.0,14761.0,4
RC,250,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,DEXLANSOPRAZOLE 30 MG PO CPDM,1465.56,952.61,13270.0,14761.0,2
RC,250,DEXLANSOPRAZOLE 60 MG PO CPDM,1465.56,952.61,13270.0,14761.0,6
RC,250,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,364.2,236.73,13270.0,14761.0,10
RC,250,DEXRAZOXANE HCL 250 MG IV SOLR,1465.56,952.61,108.95,14761.0,5
RC,250,DEXRAZOXANE HCL 500 MG IV SOLR,5480.959999999999,3562.625,108.95,14761.0,10
RC,250,DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP,528.0,343.2,13270.0,14761.0,4
RC,250,DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP,440.0,286.0,13270.0,14761.0,4
RC,250,DEXTROAMPHETAMINE SULFATE 10 MG PO CPSR,1465.56,952.61,13270.0,14761.0,4
RC,250,DEXTROAMPHETAMINE SULFATE 15 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
RC,250,DEXTROAMPHETAMINE SULFATE 5 MG PO CPSR,1465.56,952.61,13270.0,14761.0,4
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,916.8,595.92,13270.0,14761.0,24
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG PO CP24,1465.56,952.61,13270.0,14761.0,6
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 30 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO CP24,1552.78,1009.3050000000001,13270.0,14761.0,4
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG PO TABS,415.4,270.01,13270.0,14761.0,6
RC,250,DEXTROAMPHETAMINE-AMPHETAMINE 7.5 MG PO TABS,1378.38,895.9449999999999,13270.0,14761.0,6
RC,250,DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML PO SU12,1465.56,952.61,13270.0,14761.0,2
RC,250,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,13270.0,14761.0,12
RC,250,DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG PO TB12,290.0,188.5,13270.0,14761.0,2
RC,250,"DEXTROMETHORPHAN-GUAIFENESIN 60-1,200 MG PO TB12",1465.56,952.61,13270.0,14761.0,4
RC,250,DEXTROMETHORPHAN-QUINIDINE 20-10 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,13270.0,14761.0,26
RC,250,DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML MISC SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,DIAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,DIAZEPAM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) PO SOLN",290.0,188.5,13270.0,14761.0,4
RC,250,DIAZEPAM 5 MG/ML IJ SYRG,354.78,230.61,13270.0,14761.0,4
RC,250,DIAZOXIDE 50 MG/ML PO SUSP,6891.36,4479.38,13270.0,14761.0,4
RC,250,DIBUCAINE 1 % TP OINT,290.0,188.5,13270.0,14761.0,8
RC,250,DICLOFENAC SODIUM 1 % TP GEL,297.6,193.44,13270.0,14761.0,12
RC,250,DICLOFENAC-MISOPROSTOL 50-200 MG-MCG PO TBID,1465.56,952.61,13270.0,14761.0,4
RC,250,DICLOXACILLIN 250 MG PO CAPS,1017.6,661.44,13270.0,14761.0,2
RC,250,DICYCLOMINE 10 MG/ML IM SOLN,771.53,501.495,13270.0,14761.0,6
RC,250,DIFLUPREDNATE 0.05 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,DIGOXIN IMMUNE FAB 40 MG IV SOLR,40106.88,26069.47,6086.61,14761.0,6
RC,250,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,1267.12,823.63,13270.0,14761.0,6
RC,250,DILTIAZEM HCL 120 MG PO CP24,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,DILTIAZEM HCL 180 MG PO CP24,406.08,263.95,13270.0,14761.0,12
RC,250,DILTIAZEM HCL 240 MG PO CP24,889.92,578.45,13270.0,14761.0,14
RC,250,DILTIAZEM HCL 300 MG PO CP24,973.26,632.615,13270.0,14761.0,8
RC,250,DILTIAZEM HCL 360 MG PO CP24,532.8,346.32,13270.0,14761.0,4
RC,250,DILTIAZEM HCL 5 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,DILTIAZEM ORAL SUSPENSION 12 MG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,DIMENHYDRINATE 25 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,DIMETHYL FUMARATE 240 MG PO CPDR,1465.56,952.61,13270.0,14761.0,6
RC,250,DIMETHYL SULFOXIDE 50 % IS SOLN,10360.0,6734.0,891.43,14761.0,3
RC,250,DINOPROSTONE 10 MG VA INSR,7811.04,5077.18,13270.0,14761.0,8
RC,250,"DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG",1465.56,952.61,13270.0,14761.0,2
RC,250,"DIPHEN-LIDOCAINE-MAG,AL-SIMETH 25-200-400-40 MG/30ML MM MWSH",1465.56,952.61,13270.0,14761.0,4
RC,250,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,868.0,564.2,13270.0,14761.0,20
RC,250,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,6
RC,250,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",560.37,364.24,13270.0,14761.0,4
RC,250,DIPYRIDAMOLE 5 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,DIROXIMEL FUMARATE 231 MG PO CPDR,1465.56,952.61,13270.0,14761.0,4
RC,250,DIVALPROEX 125 MG PO CDRS,875.1999999999999,568.88,13270.0,14761.0,14
RC,250,DIVALPROEX 125 MG PO TBEC,290.0,188.5,13270.0,14761.0,6
RC,250,DIVALPROEX 250 MG PO TB24,1635.1799999999998,1062.865,13270.0,14761.0,8
RC,250,DIVALPROEX 250 MG PO TBEC,597.0,388.05,13270.0,14761.0,16
RC,250,DIVALPROEX 500 MG PO TB24,1465.56,952.61,13270.0,14761.0,4
RC,250,DIVALPROEX 500 MG PO TBEC,769.0,499.85,13270.0,14761.0,16
RC,250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",290.0,188.5,13270.0,14761.0,2
RC,250,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",877.78,570.5550000000001,13270.0,14761.0,6
RC,250,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,526.1099999999999,341.97,13270.0,14761.0,8
RC,250,DOCOSAHEXAENOIC ACID 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,DOCUSATE SODIUM-BENZOCAINE 283-20 MG/5 ML PR ENEM,1465.56,952.61,13270.0,14761.0,2
RC,250,DOFETILIDE 125 MCG PO CAPS,4803.84,3122.5,13270.0,14761.0,2
RC,250,DOFETILIDE 250 MCG PO CAPS,4885.44,3175.54,13270.0,14761.0,6
RC,250,DOFETILIDE 500 MCG PO CAPS,1431.36,930.38,13270.0,14761.0,10
RC,250,DOLUTEGRAVIR 50 MG PO TABS,34661.76,22530.14,13270.0,14761.0,4
RC,250,DOLUTEGRAVIR-LAMIVUDINE 50-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DOLUTEGRAVIR-RILPIVIRINE 50-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,DONEPEZIL 23 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,6
RC,250,DORAVIRINE 100 MG PO TABS,1653.63,1074.86,13270.0,14761.0,2
RC,250,DORNASE ALFA 1 MG/ML IN SOLN,1994.2,1296.23,13270.0,14761.0,4
RC,250,DORZOLAMIDE 2 % OP DROP,439.6,285.74,13270.0,14761.0,16
RC,250,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,6
RC,250,DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OP DROP,1465.56,952.61,13270.0,14761.0,14
RC,250,DOXORUBICIN 2 MG/ML IV SOLN,338.8,220.22,13270.0,14761.0,18
RC,250,DOXORUBICIN 50 MG IV SOLR (FOR CHEMOEMBOLIZATION),2607.2,1694.68,13270.0,14761.0,2
RC,250,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",2512.48,1633.11,165.71,14761.0,9
RC,250,DOXYCYCLINE (VIBRAMYCIN) 100 MG/100 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
RC,250,DOXYCYCLINE (VIBRAMYCIN) 100 MG/250 ML D5W VIAL-TO-BAG IVPB,1465.56,952.61,13270.0,14761.0,4
RC,250,DOXYCYCLINE HYCLATE 100 MG IV SOLR,290.0,188.5,13270.0,14761.0,12
RC,250,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1493.98,971.085,13270.0,14761.0,16
RC,250,DOXYCYCLINE HYCLATE 50 MG PO CAPS,301.6,196.04,13270.0,14761.0,4
RC,250,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML PO SUSR,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,DOXYCYCLINE MONOHYDRATE 40 MG PO CPID,1465.56,952.61,13270.0,14761.0,4
RC,250,DRONABINOL 2.5 MG PO CAPS,1533.0,996.45,13270.0,14761.0,8
RC,250,DRONABINOL 5 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,DRONEDARONE 400 MG PO TABS,6561.9,4265.235,13270.0,14761.0,4
RC,250,DROSPIRENONE (CONTRACEPTIVE) 4 MG (28) PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.02 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,DROXIDOPA 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,14
RC,250,DROXIDOPA 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,8
RC,250,DROXIDOPA 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,DULAGLUTIDE 0.75 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,DULAGLUTIDE 1.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,DULAGLUTIDE 3 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,DULAGLUTIDE 4.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,DULOXETINE 20 MG PO CPDR,1019.3399999999999,662.5699999999999,13270.0,14761.0,12
RC,250,DULOXETINE 30 MG PO CPDR,1465.56,952.61,13270.0,14761.0,18
RC,250,DULOXETINE 60 MG PO CPDR,1292.78,840.3050000000001,13270.0,14761.0,12
RC,250,DUPILUMAB 300 MG/2 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,DUPILUMAB 300 MG/2 ML SC SYRG,9104.155,5917.700000000001,13270.0,14761.0,2
RC,250,DURVALUMAB 50 MG/ML IV SOLN,67367.2,43788.68,101.88,14761.0,3
RC,250,DUTASTERIDE-TAMSULOSIN 0.5-0.4 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
RC,250,ECULIZUMAB 300 MG/30 ML IV SOLN,58706.91,38159.49,279.71,14761.0,3
RC,250,EDARAVONE 105 MG/5 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
RC,250,EDARAVONE 30 MG/100 ML IV SOLN,1465.56,952.61,27.57,14761.0,3
RC,250,EDOXABAN 30 MG PO TABS,1465.56,952.61,,,0
RC,250,EFAVIRENZ 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG PO TABS,3577.92,2325.65,13270.0,14761.0,4
RC,250,ELAGOLIX 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ELECTROLYTE-A IV SOLP,290.0,188.5,13270.0,14761.0,6
RC,250,ELETRIPTAN 40 MG PO TABS,4344.875,2824.165,13270.0,14761.0,4
RC,250,ELEXACAFTOR-TEZACAFTOR-IVACAFT 100-50-75 MG(D) /150 MG (N) PO TBSQ,1465.56,952.61,,,0
RC,250,ELOTUZUMAB 300 MG IV SOLR,20480.94,13312.61,9.44,14761.0,3
RC,250,ELTROMBOPAG OLAMINE 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ELTROMBOPAG OLAMINE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ELTROMBOPAG OLAMINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ELUXADOLINE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ELUXADOLINE 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG PO TABS,62850.24,40852.66,13270.0,14761.0,4
RC,250,ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG PO TABS,65929.92,42854.45,13270.0,14761.0,2
RC,250,EMPAGLIFLOZIN 10 MG PO TABS,4472.16,2906.9,13270.0,14761.0,4
RC,250,EMPAGLIFLOZIN 25 MG PO TABS,4472.16,2906.9,13270.0,14761.0,4
RC,250,"EMPAGLIFLOZIN-METFORMIN 12.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,4
RC,250,EMTRICITAB-RILPIVIR-TENOFO ALA 200-25-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,EMTRICITABINE 200 MG PO CAPS,6909.6,4491.24,13270.0,14761.0,2
RC,250,EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG PO TABS,1465.56,952.61,13270.0,14761.0,12
RC,250,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG PO TABS,32830.08,21339.55,13270.0,14761.0,4
RC,250,ENALAPRIL MALEATE 10 MG PO TABS,1113.58,723.825,13270.0,14761.0,8
RC,250,ENALAPRIL MALEATE 2.5 MG PO TABS,509.0,330.85,13270.0,14761.0,6
RC,250,ENALAPRIL MALEATE 20 MG PO TABS,868.8,564.72,13270.0,14761.0,8
RC,250,ENALAPRIL MALEATE 5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,ENALAPRIL ORAL SUSPENSION 1 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
RC,250,ENALAPRILAT 1.25 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,ENASIDENIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ENCORAFENIB 75 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,ENOXAPARIN 100 MG/ML IV CUSTOM,290.0,188.5,13270.0,14761.0,2
RC,250,ENOXAPARIN 100 MG/ML SC SYRG,370.24,240.66,13270.0,14761.0,6
RC,250,ENOXAPARIN 120 MG/0.8 ML SC SYRG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,ENOXAPARIN 150 MG/ML SC SYRG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,13270.0,14761.0,8
RC,250,ENOXAPARIN 40 MG/0.4 ML SC SYRG,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,13270.0,14761.0,6
RC,250,ENOXAPARIN 80 MG/0.8 ML SC SYRG,290.0,188.5,13270.0,14761.0,2
RC,250,ENTACAPONE 200 MG PO TABS,894.4,581.36,13270.0,14761.0,4
RC,250,ENTECAVIR 0.05 MG/ML PO SOLN,14320.32,9308.21,13270.0,14761.0,4
RC,250,ENTECAVIR 0.5 MG PO TABS,1214.94,789.71,13270.0,14761.0,14
RC,250,ENZALUTAMIDE 40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ENZALUTAMIDE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ENZALUTAMIDE 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,EPHEDRINE SULFATE 50 MG/ML IV SOLN,890.74,578.98,13270.0,14761.0,30
RC,250,EPINEPHRINE 0.1 MG/ML IJ SYRG,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,EPINEPHRINE 0.1 MG/ML SYRINGE,290.0,188.5,13270.0,14761.0,2
RC,250,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,1465.56,952.61,13270.0,14761.0,8
RC,250,EPINEPHRINE 1 MG/ML IJ SOLN,1844.64,1199.02,13270.0,14761.0,2
RC,250,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,EPINEPHRINE HCL 1 MG/ML NA SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,EPINEPHRINE HCL IN 5% DEXTROSE 8 MG/250 ML (32 MCG/ML) IV SOLN,920.0,598.0,13270.0,14761.0,4
RC,250,EPINEPHRINE IN D5W 3 MG/100 ML (0.03 MG/ML) IV PREMIX,372.8,242.32,,,0
RC,250,EPINEPHRINE IN D5W 8 MG/250ML (0.032 MG/ML)IV PREMIX,1465.56,952.61,13270.0,14761.0,4
RC,250,EPLERENONE 25 MG PO TABS,896.22,582.54,13270.0,14761.0,6
RC,250,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,1082.135,703.3900000000001,0.95,14761.0,12
RC,250,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,0.95,14761.0,12
RC,250,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,344.775,224.105,0.95,14761.0,12
RC,250,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,432.85,281.34999999999997,0.95,14761.0,12
RC,250,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,4328.545,2813.5550000000003,0.95,14761.0,6
RC,250,EPOPROSTENOL 0.5 MG IV SOLR,405.72,263.72,13270.0,14761.0,8
RC,250,EPOPROSTENOL 1.5 MG IV SOLR,1967.3600000000001,1278.7849999999999,13270.0,14761.0,6
RC,250,EPTIFIBATIDE 2 MG/ML IV SOLN,309.92,201.45,13270.0,14761.0,2
RC,250,ERENUMAB-AOOE 140 MG/ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
RC,250,ERGOTAMINE-CAFFEINE 2-100 MG PR SUPP,36743.81,23883.48,13270.0,14761.0,2
RC,250,ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN,12690.0,8248.5,169.08,14761.0,3
RC,250,ERTAPENEM 1 GRAM IJ SOLR,447.22,290.69,13270.0,14761.0,20
RC,250,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,462.12,300.375,13270.0,14761.0,4
RC,250,ERYTHROMYCIN 250 MG PO TBEC,2307.3599999999997,1499.7849999999999,13270.0,14761.0,4
RC,250,ERYTHROMYCIN 333 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
RC,250,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,ERYTHROMYCIN 500 MG PO TABS,4459.2,2898.48,13270.0,14761.0,6
RC,250,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML PO SUSR,3640.0,2366.0,13270.0,14761.0,4
RC,250,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,970.99,631.145,13270.0,14761.0,6
RC,250,ESCITALOPRAM OXALATE 20 MG PO TABS,892.0,579.8,13270.0,14761.0,18
RC,250,ESCITALOPRAM OXALATE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
RC,250,ESCITALOPRAM OXALATE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,ESLICARBAZEPINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ESLICARBAZEPINE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ESLICARBAZEPINE 800 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,"ESMOLOL IN STERILE WATER 2,000 MG/100 ML (20 MG/ML) IV SOLP",1513.6,983.84,13270.0,14761.0,4
RC,250,"ESMOLOL IN STERILE WATER 2,500 MG/250 ML (10 MG/ML) IV SOLP",1504.0,977.6,13270.0,14761.0,2
RC,250,ESTAZOLAM 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL 0.025 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,6
RC,250,ESTRADIOL 0.025 MG/24 HR TD PTWK,648.2950000000001,421.39,13270.0,14761.0,10
RC,250,ESTRADIOL 0.0375 MG/24 HR TD PTSW,1465.56,952.61,,,0
RC,250,ESTRADIOL 0.0375 MG/24 HR TD PTWK,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL 0.05 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,10
RC,250,ESTRADIOL 0.05 MG/24 HR TD PTWK,647.015,420.56,13270.0,14761.0,6
RC,250,ESTRADIOL 0.075 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,6
RC,250,ESTRADIOL 0.1 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,12
RC,250,ESTRADIOL 0.1 MG/24 HR TD PTWK,647.72,421.02,13270.0,14761.0,8
RC,250,ESTRADIOL 1 MG/GRAM (0.1 %) TD GLPK,1465.56,952.61,13270.0,14761.0,4
RC,250,ESTRADIOL 1.25 GRAM/ACTUATION TD GLPM,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL 10 MCG VA INST,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL 4 MCG VA INST,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TD PTSW,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTRADIOL-NORETHINDRONE ACET 1-0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ESTROGEN TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,ESZOPICLONE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ESZOPICLONE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ETANERCEPT 25 MG/0.5 ML SC SOLN,14206.4,9234.16,984.67,14761.0,3
RC,250,ETANERCEPT 50 MG/ML (1 ML) SC SYRG,1465.56,952.61,984.67,14761.0,3
RC,250,ETHACRYNATE SODIUM 50 MG IV SOLR,13949.44,9067.14,13270.0,14761.0,2
RC,250,ETHACRYNIC ACID 25 MG PO TABS,19896.0,12932.4,13270.0,14761.0,4
RC,250,ETHAMBUTOL 100 MG PO TABS,675.2,438.88,13270.0,14761.0,2
RC,250,ETHAMBUTOL 400 MG PO TABS,908.8,590.72,13270.0,14761.0,12
RC,250,ETHIODIZED OIL 48% IJ OIL,1465.56,952.61,13270.0,14761.0,2
RC,250,ETHYL ALCOHOL 99 % IA SOLN,12223.92,7945.55,13270.0,14761.0,2
RC,250,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,22
RC,250,ETONOGESTREL 68 MG SD IMPL,5936.04,3858.4249999999997,13270.0,14761.0,4
RC,250,ETOPOSIDE (STRAIGHT DRUG) IVPB,1465.56,952.61,13270.0,14761.0,2
RC,250,ETOPOSIDE 20 MG/ML IV SOLN,509.0,330.85,13270.0,14761.0,6
RC,250,ETRAVIRINE 100 MG PO TABS,18425.28,11976.43,13270.0,14761.0,6
RC,250,ETRAVIRINE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,4858.6,3158.09,13270.0,14761.0,14
RC,250,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,314.22,204.24,13270.0,14761.0,12
RC,250,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,19168.149999999998,12459.3,13270.0,14761.0,8
RC,250,EVOLOCUMAB 140 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,EVOLOCUMAB 140 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,EXEMESTANE 25 MG PO TABS,1478.22,960.84,13270.0,14761.0,8
RC,250,EXENATIDE 10 MCG/DOSE(250 MCG/ML) 2.4 ML SC PNIJ,12670.39,8235.75,13270.0,14761.0,2
RC,250,EXENATIDE 5 MCG/DOSE (250 MCG/ML) 1.2 ML SC PNIJ,12670.41,8235.77,13270.0,14761.0,2
RC,250,EXENATIDE MICROSPHERES 2 MG/0.65 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,EZETIMIBE 10 MG PO TABS,1816.78,1180.905,13270.0,14761.0,18
RC,250,EZETIMIBE-SIMVASTATIN 10-40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"FACTOR IX CPLX(PCC)NO4,3FACTOR 500 (+/-) UNIT IV SOLR",6092.78,3960.305,2.06,14761.0,5
RC,250,"FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR",22500.0,14625.0,164.36,14761.0,5
RC,250,FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR,26412.75,17168.29,34.63,14761.0,3
RC,250,FAMCICLOVIR 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,13270.0,14761.0,16
RC,250,FAMOTIDINE 40 MG/5 ML (8 MG/ML) PO SUSR,447.2,290.68,13270.0,14761.0,4
RC,250,FAMOTIDINE-CA CARB-MAG HYDROX 10-800-165 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,FAT EMULSION 20 % IV EMUL,684.0,444.6,13270.0,14761.0,12
RC,250,FAT EMULSION 20 % IV PEDS,664.0,431.6,13270.0,14761.0,8
RC,250,FAT EMULSION 20% (SMOFLIPID) ADULT,432.0,280.8,13270.0,14761.0,18
RC,250,FAT EMULSION 20% (SMOFLIPID) IV PEDS,1140.78,741.505,13270.0,14761.0,4
RC,250,FAT EMULSION WITH FISH OIL (OMEGAVEN) (NEO-PEDS) 10% IV SYRINGE,894.4,581.36,13270.0,14761.0,2
RC,250,FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL,894.4,581.36,13270.0,14761.0,2
RC,250,FEBUXOSTAT 40 MG PO TABS,2605.0,1693.25,13270.0,14761.0,8
RC,250,FEBUXOSTAT 80 MG PO TABS,303.36,197.18,13270.0,14761.0,6
RC,250,FELBAMATE 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,FELODIPINE 2.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,FELODIPINE 5 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,FENOFIBRATE 160 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,FENOFIBRATE MICRONIZED 134 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,FENOFIBRATE MICRONIZED 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,FENOFIBRATE MICRONIZED 67 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,298.08,193.75,13270.0,14761.0,12
RC,250,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,323.56,210.315,13270.0,14761.0,10
RC,250,FENTANYL 10 MCG/ML IV PEDIATRIC,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,FENTANYL 100 MCG/HR TD PT72,410.82,267.03,13270.0,14761.0,16
RC,250,FENTANYL 12 MCG/HR TD PT72,1106.24,719.06,13270.0,14761.0,14
RC,250,FENTANYL 150 MCG/3 ML (50 MCG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,FENTANYL 25 MCG/HR TD PT72,531.52,345.49,13270.0,14761.0,18
RC,250,FENTANYL 2500 MCG/50 ML (50 MCG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,FENTANYL 50 MCG/HR TD PT72,617.0,401.05,13270.0,14761.0,10
RC,250,FENTANYL 75 MCG/HR TD PT72,1465.56,952.61,13270.0,14761.0,10
RC,250,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,26
RC,250,FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML IV SOLN,884.0,574.6,13270.0,14761.0,2
RC,250,FENTANYL PCA,1465.56,952.61,13270.0,14761.0,10
RC,250,FENTANYL PCA HIGH DOSE,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,FERRIC CARBOXYMALTOSE 50 IRON MG/ML IV SOLN,12366.119999999999,8037.98,1.37,14761.0,3
RC,250,FERRIC CITRATE 210 MG IRON PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,FERRIC SUBSULFATE 259 MG/G TP SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,FERROUS SULFATE 140 MG (45 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,FERROUS SULFATE 142 MG (45 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,FERROUS SULFATE 250 MG (50 MG IRON) PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,2238.63,1455.105,0.42,14761.0,6
RC,250,FESOTERODINE 4 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,FESOTERODINE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,6
RC,250,"FIBRINOGEN 1 GRAM (700 MG- 1,300 MG) IV SOLR",290.0,188.5,1.38,14761.0,3
RC,250,FIDAXOMICIN 200 MG PO TABS,74248.96,48261.82,13270.0,14761.0,4
RC,250,FILGRASTIM-SNDZ 300 MCG IJ SYRG,2126.84,1382.4450000000002,0.45,14761.0,6
RC,250,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.875,2211.87,0.45,14761.0,6
RC,250,FINASTERIDE (PROSCAR) ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,4
RC,250,FINASTERIDE 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
RC,250,FINERENONE 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,FINERENONE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,FLU VAC QS 2022(6 MS UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,FLU VAC QS2022-23 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUCONAZOLE 10 MG/ML PO SUSR,290.0,188.5,13270.0,14761.0,4
RC,250,FLUCONAZOLE 100 MG PO TABS,988.0,642.2,13270.0,14761.0,12
RC,250,FLUCONAZOLE 2 MG/ML IN NS IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,FLUCONAZOLE 200 MG PO TABS,2477.6,1610.44,13270.0,14761.0,8
RC,250,FLUCONAZOLE 50 MG PO TABS,310.08,201.55,13270.0,14761.0,4
RC,250,FLUCONAZOLE CUSTOM IVPB IN NACL,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,FLUCONAZOLE CUSTOM IVPB IN NACL DOSES <=800 MG (CSMC),1465.56,952.61,13270.0,14761.0,2
RC,250,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,FLUCYTOSINE 250 MG PO CAPS,13416.48,8720.71,13270.0,14761.0,6
RC,250,FLUCYTOSINE 500 MG PO CAPS,25344.96,16474.225,13270.0,14761.0,8
RC,250,FLUDARABINE 50 MG IV SOLR,1394.72,906.57,167.05,14761.0,3
RC,250,FLUDARABINE 50 MG/2 ML IV SOLN,616.0,400.4,167.05,14761.0,3
RC,250,FLUMAZENIL 0.1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,FLUNISOLIDE 25 MCG (0.025 %) NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUOCINONIDE 0.05 % TP GEL,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUOCINONIDE 0.05 % TP OINT,290.0,188.5,13270.0,14761.0,4
RC,250,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,1121.5,728.975,13270.0,14761.0,6
RC,250,FLUOROMETHOLONE 0.1 % OP DRPS,1154.4,750.36,13270.0,14761.0,2
RC,250,FLUOROURACIL 1 GRAM/20 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,FLUOROURACIL 5 % TP CREA,1528.6399999999999,993.615,13270.0,14761.0,2
RC,250,FLUOROURACIL 5 G/100 ML IV SOLN,822.4,534.56,13270.0,14761.0,6
RC,250,FLUOROURACIL 500 MG/10 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,FLUOXETINE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUPHENAZINE HCL 2.5 MG/ML IJ SOLN,1635.2,1062.88,13270.0,14761.0,2
RC,250,FLUTICASONE FUROATE 100 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE FUROATE 27.5 MCG/ACTUATION NA SPSN,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,4
RC,250,FLUTICASONE FUROATE-VILANTEROL 200-25 MCG/DOSE IN DSDV,475.33,308.96,13270.0,14761.0,4
RC,250,FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE IN DSDV,339.25,220.51,13270.0,14761.0,4
RC,250,FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE PROPION-SALMETEROL 232-14 MCG/ACTUATION IN AEPB,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,8
RC,250,FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE IN DSDV,1465.56,952.61,13270.0,14761.0,8
RC,250,FLUTICASONE PROPIONATE 110 MCG/ACTUATION IN HFAA,1396.09,907.4549999999999,13270.0,14761.0,8
RC,250,FLUTICASONE PROPIONATE 220 MCG/ACTUATION IN HFAA,2615.425,1700.03,13270.0,14761.0,8
RC,250,FLUTICASONE PROPIONATE 250 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE PROPIONATE 44 MCG/ACTUATION IN HFAA,1228.2649999999999,798.37,13270.0,14761.0,8
RC,250,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,FLUTICASONE PROPIONATE 93 MCG/ACTUATION NA AERB,1465.56,952.61,13270.0,14761.0,2
RC,250,FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,4
RC,250,FLUTICASONE-UMECLIDIN-VILANTER 200-62.5-25 MCG IN DSDV,1465.56,952.61,13270.0,14761.0,6
RC,250,FLUVOXAMINE 100 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
RC,250,FLUVOXAMINE 150 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
RC,250,FOLIC ACID 5 MG/ML IJ SOLN,395.36,256.985,13270.0,14761.0,4
RC,250,FOMEPIZOLE 1 G/ML IV SOLN,8398.08,5458.75,8.02,14761.0,3
RC,250,FONDAPARINUX 10 MG/0.8 ML SC SYRG,557.185,362.17,13270.0,14761.0,4
RC,250,FONDAPARINUX 2.5 MG/0.5 ML SC SYRG,290.0,188.5,13270.0,14761.0,8
RC,250,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,549.88,357.42,13270.0,14761.0,8
RC,250,FORMOTEROL FUMARATE 20 MCG/2 ML IN NEBU,1465.56,952.61,13270.0,14761.0,8
RC,250,FORTIFIED GENTAMICIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,2
RC,250,FORTIFIED TOBRAMYCIN 14 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,4
RC,250,FORTIFIED VANCOMYCIN 50 MG/ML OP DROPS,290.0,188.5,13270.0,14761.0,4
RC,250,FOSAPREPITANT 150 MG IV SOLR,402.79999999999995,261.82,13270.0,14761.0,16
RC,250,FOSCARNET 24 MG/ML IV SOLN,5042.0,3277.3,62.65,14761.0,9
RC,250,FOSFOMYCIN TROMETHAMINE 3 GRAM PO PACK,1256.62,816.8,13270.0,14761.0,8
RC,250,FOSPHENYTOIN 100 MG PE/2 ML IJ SOLN,361.63,235.06,13270.0,14761.0,4
RC,250,FOSPHENYTOIN 500 MG PE/10 ML IJ SOLN,1808.16,1175.3,13270.0,14761.0,6
RC,250,FOSTAMATINIB 100 MG PO TABS,1465.56,952.61,,,0
RC,250,FOSTAMATINIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,FOSTEMSAVIR 600 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
RC,250,FREMANEZUMAB-VFRM 225 MG/1.5 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,FULVESTRANT 250 MG/5 ML IM SYRG,1129.52,734.19,9.35,14761.0,9
RC,250,FUROSEMIDE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,22
RC,250,GABAPENTIN 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,GABAPENTIN 600 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,GABAPENTIN ENACARBIL 300 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,GABAPENTIN ENACARBIL 600 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,GABAPENTIN-KETAMINE-KETOPROFEN-LIDOCAINE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,GALCANEZUMAB-GNLM 120 MG/ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,GALCANEZUMAB-GNLM 120 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,GANCICLOVIR 0.15 % OP GEL,1465.56,952.61,13270.0,14761.0,2
RC,250,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,GANCICLOVIR SODIUM 500 MG IV SOLR,609.48,396.16,13270.0,14761.0,20
RC,250,GATIFLOXACIN 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,GEFITINIB 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TP SPGE",1465.56,952.61,13270.0,14761.0,6
RC,250,GEMCITABINE 1 GRAM IV SOLR,510.28,331.68,13270.0,14761.0,6
RC,250,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,361.71000000000004,235.11,13270.0,14761.0,4
RC,250,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN,591.65,384.57500000000005,13270.0,14761.0,2
RC,250,GEMCITABINE 200 MG IV SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,90405.0,58763.25,285.99,14761.0,3
RC,250,GENTAMICIN 0.1 % TP CREA,1025.7,666.705,13270.0,14761.0,6
RC,250,GENTAMICIN 0.1 % TP OINT,588.72,382.67,13270.0,14761.0,4
RC,250,GENTAMICIN 0.3 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,GENTAMICIN 4 % NEBULIZER SOLUTION,290.0,188.5,13270.0,14761.0,2
RC,250,GENTAMICIN 40 MG/ML IJ SOLN,330.91999999999996,215.1,13270.0,14761.0,10
RC,250,GENTAMICIN IN NACL (ISO-OSM) 100 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,GENTAMICIN IN NACL (ISO-OSM) 120 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,GENTAMICIN IN NACL (ISO-OSM) 60 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,GI COCKTAIL 1-3-1,1465.56,952.61,,,0
RC,250,GILTERITINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,GLATIRAMER 40 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,4
RC,250,GLECAPREVIR-PIBRENTASVIR 100-40 MG PO TABS,101901.36,66235.885,13270.0,14761.0,4
RC,250,GLUCAGON 1 MG IJ SOLR,4174.08,2713.15,239.45,14761.0,6
RC,250,GLUCAGON 1 MG/ML IJ SOLR,1465.56,952.61,239.45,14761.0,6
RC,250,GLUCAGON HCL 1 MG/ML IJ SOLR,1465.56,952.61,239.45,14761.0,3
RC,250,GLUCARPIDASE 1000 UNITS IV SOLR,1465.56,952.61,13270.0,14761.0,2
RC,250,GLUTAMINE (BULK) MISC POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,GLUTAMINE (SICKLE CELL) 5 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,4
RC,250,GLUTARALDEHYDE (GLUTARALD) SOLUTION 3%,1465.56,952.61,13270.0,14761.0,4
RC,250,GLUTATHIONE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,40
RC,250,GLYCOPYRROLATE-FORMOTEROL 9-4.8 MCG IN HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,GLYCOPYRRONIUM TOSYLATE 2.4 % TP TOWL,1465.56,952.61,13270.0,14761.0,2
RC,250,GOSERELIN 3.6 MG SC IMPL,16822.4,10934.56,840.22,14761.0,3
RC,250,GRANISETRON 3.1 MG/24 HOUR TD PTWK,1465.56,952.61,13270.0,14761.0,2
RC,250,GRANISETRON HCL 1 MG PO TABS,681.64,443.065,13270.0,14761.0,4
RC,250,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,GUANFACINE 3 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,General,1465.56,952.61,,,0
RC,250,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,735.68,478.19,13270.0,14761.0,2
RC,250,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,HB MISCELLANEOUS PHARMACY,1465.56,952.61,195.58,14761.0,10
RC,250,HEPARIN (PORCINE) 1000 UNITS/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,26
RC,250,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",1465.56,952.61,13270.0,14761.0,2
RC,250,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,290.0,188.5,13270.0,14761.0,6
RC,250,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP,290.0,188.5,13270.0,14761.0,8
RC,250,HEPARIN (PORCINE) IN NACL (PF) 1000 UNITS/500ML FOR ECMO FLUSH IV SOLP BOLUS FROM BAG,290.0,188.5,13270.0,14761.0,4
RC,250,HEPARIN (PORCINE) IN NACL 1000 UNITS/500ML NS FOR CONGENITAL HEART ECMO FLUSH FROM BAG,1465.56,952.61,13270.0,14761.0,2
RC,250,HEPARIN (PORCINE) IN NACL 500 UNITS/500ML NS FOR CONGENITAL HEART ECMO FLUSH FROM BAG,1160.0,754.0,13270.0,14761.0,2
RC,250,"HEPARIN 20,000 UNITS/20 ML SYRINGE FOR CRRT DIALYSIS",290.0,188.5,13270.0,14761.0,2
RC,250,HEPARIN BOLUS FOR ACS PROTOCOL,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,HEPARIN BOLUS INJECTION-PEDIATRIC,1465.56,952.61,13270.0,14761.0,4
RC,250,HEPARIN FLUSH INFUSION FOR THROMBOLYSIS (5 UNITS/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,HEPARIN IN D5W 25000 UNIT/250 ML FOR CRRT NX STAGE PUMP,290.0,188.5,13270.0,14761.0,8
RC,250,HEPARIN SOLUTION 2 UNITS/ML FOR FLUSH INTRAPROCEDURE (CATH LAB ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,13270.0,14761.0,8
RC,250,"HEPARIN, PORCINE (PF) 1 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,2
RC,250,"HEPARIN, PORCINE (PF) 10 UNITS/ML IV SYRG",290.0,188.5,13270.0,14761.0,4
RC,250,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",877.78,570.5550000000001,13270.0,14761.0,8
RC,250,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN FOR INTRACATHETER",290.0,188.5,13270.0,14761.0,2
RC,250,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",877.78,570.5550000000001,13270.0,14761.0,10
RC,250,"HEPARIN, PORCINE (PF) 5000 UNIT/0.5 ML IJ SYRG",290.0,188.5,13270.0,14761.0,2
RC,250,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",5088.62,3307.6,174.24,14761.0,9
RC,250,HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN,1917.42,1246.32,174.24,14761.0,6
RC,250,HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG,1948.67,1266.64,13270.0,14761.0,2
RC,250,HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG,296.96,193.02,13270.0,14761.0,2
RC,250,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP,684.02,444.61,13270.0,14761.0,2
RC,250,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,13270.0,14761.0,2
RC,250,HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN,357.0,232.05,13270.0,14761.0,8
RC,250,HIV POST EXPOSURE PROPHYLAXIS KIT,4758.34,3092.92,,,0
RC,250,HOMEOPATHIC PRODUCTS TP OINT,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) IV SOLR",28800.0,18720.0,2.79,14761.0,6
RC,250,HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) IV SOLR,14400.0,9360.0,2.79,14761.0,6
RC,250,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1465.56,952.61,,,0
RC,250,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IX SYRG",1465.56,952.61,665.53,14761.0,3
RC,250,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,13270.0,14761.0,6
RC,250,HYDRALAZINE 20 MG/ML IJ SOLN,566.48,368.21,13270.0,14761.0,8
RC,250,HYDRALAZINE ORAL SUSPENSION 4 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROCHLOROTHIAZIDE 10 MG/ML PO SUSP PEDIATRICS,1465.56,952.61,13270.0,14761.0,2
RC,250,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,596.8,387.92,13270.0,14761.0,12
RC,250,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,609.6,396.24,13270.0,14761.0,16
RC,250,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,453.0,294.45,13270.0,14761.0,8
RC,250,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) PO SYRP,290.0,188.5,13270.0,14761.0,6
RC,250,HYDROCORTISONE 1 % TP CREA,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,HYDROCORTISONE 1 % TP LOTN,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROCORTISONE 1 % TP OINT,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROCORTISONE 10 MG PO TABS,832.0,540.8,13270.0,14761.0,12
RC,250,HYDROCORTISONE 100 MG/60 ML PR ENEM,319.68,207.79,13270.0,14761.0,2
RC,250,HYDROCORTISONE 2.5 % TP CREA,290.0,188.5,13270.0,14761.0,8
RC,250,HYDROCORTISONE 2.5 % TP OINT,1465.56,952.61,13270.0,14761.0,2
RC,250,HYDROCORTISONE 20 MG PO TABS,718.4,466.96,13270.0,14761.0,4
RC,250,HYDROCORTISONE 5 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,HYDROCORTISONE 50 MG/ML IV PUSH PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROCORTISONE ACETATE 25 MG PR SUPP,465.64,302.66499999999996,13270.0,14761.0,8
RC,250,HYDROCORTISONE ORAL SUSPENSION 2 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML IJ SOLR,337.92,219.65,13270.0,14761.0,4
RC,250,HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML IJ SOLR,1237.76,804.54,13270.0,14761.0,2
RC,250,HYDROCORTISONE-ACETIC ACID 1-2 % OT DROP,1618.88,1052.27,13270.0,14761.0,4
RC,250,HYDROCORTISONE-PRAMOXINE 1-1 % PR FOAM,2759.68,1793.79,13270.0,14761.0,4
RC,250,HYDROMORPHONE (PF) 1 MG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,16
RC,250,HYDROMORPHONE (PF) 2 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROMORPHONE (PF)-0.9 % NACL 1 MG/ML IV SPCA,1465.56,952.61,13270.0,14761.0,2
RC,250,HYDROMORPHONE 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,HYDROMORPHONE 1 MG/ML PO LIQD,290.0,188.5,13270.0,14761.0,4
RC,250,HYDROMORPHONE 1 MG/ML PO LIQUID (DOSE >= 4 MG),290.0,188.5,13270.0,14761.0,4
RC,250,HYDROMORPHONE 10 MG/ML PCA HIGH DOSE,290.0,188.5,13270.0,14761.0,2
RC,250,HYDROMORPHONE 1MG/ML PED 20-50KG CONTIN PCA,1465.56,952.61,13270.0,14761.0,4
RC,250,HYDROMORPHONE 2 MG PO TABS,321.8,209.17000000000002,13270.0,14761.0,14
RC,250,HYDROMORPHONE 2 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,HYDROMORPHONE 3 MG PR SUPP,873.31,567.65,13270.0,14761.0,2
RC,250,HYDROMORPHONE 4 MG PO TABS,350.4,227.76,13270.0,14761.0,10
RC,250,HYDROMORPHONE 8 MG PO TABS,931.2,605.28,13270.0,14761.0,8
RC,250,HYDROXOCOBALAMIN 5 GRAM IV SOLR,8171.5,5311.475,13270.0,14761.0,6
RC,250,HYDROXYCHLOROQUINE 200 MG/8 ML ORAL SUSPENSION,1465.56,952.61,13270.0,14761.0,4
RC,250,HYDROXYUREA (SICKLE CELL) 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,HYDROXYUREA 500 MG PO CAPS,562.6,365.69,13270.0,14761.0,8
RC,250,HYDROXYUREA ORAL SUSPENSION 100 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,HYPOCHLOROUS ACID-SODIUM CHLOR 0.01 % TP SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,HYPROMELLOSE 2.5 % OP DROP,1465.56,952.61,,,0
RC,250,IBRUTINIB 140 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBRUTINIB 140 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBRUTINIB 280 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBRUTINIB 420 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBRUTINIB 560 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBUPROFEN 100 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,IBUPROFEN 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,3969.06,2579.89,13270.0,14761.0,2
RC,250,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1312.8,853.32,300.59,14761.0,3
RC,250,ICATIBANT 30 MG/3 ML SC SYRG,14446.755000000001,9390.39,188.82,14761.0,6
RC,250,ICOSAPENT ETHYL 0.5 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ICOSAPENT ETHYL 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,8
RC,250,IDARUBICIN 1 MG/ML IV SOLN,743.2,483.08,13270.0,14761.0,8
RC,250,IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN,22846.05,14849.93,13270.0,14761.0,2
RC,250,IFOSFAMIDE 1 GRAM IV SOLR,648.88,421.775,13270.0,14761.0,6
RC,250,IFOSFAMIDE 3 GRAM IV SOLR,1282.08,833.35,13270.0,14761.0,4
RC,250,ILOPERIDONE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IMATINIB 100 MG PO TABS,1627.2,1057.68,13270.0,14761.0,10
RC,250,IMATINIB 400 MG PO TABS,1315.2,854.88,13270.0,14761.0,4
RC,250,IMIPENEM-CILASTATIN 500 MG IV SOLR,388.37,252.44,13270.0,14761.0,8
RC,250,IMIPENEM-CILASTATIN 500 MG/100 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
RC,250,IMIQUIMOD 5 % TP CRPK,703.87,457.52,13270.0,14761.0,6
RC,250,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,6896.0,4482.4,60.49,14761.0,12
RC,250,IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SC SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR,11977.2,7785.18,61.88,14761.0,6
RC,250,IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 GRAM IV SOLR,9731.54,6325.5,13270.0,14761.0,2
RC,250,IMMUNE GLOB-PLASMA FRA BOVINE 5 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
RC,250,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,14554.8,9460.619999999999,60.77,14761.0,6
RC,250,INCLISIRAN 284 MG/1.5 ML SC SYRG,30426.75,19777.39,15.17,17.45,8
RC,250,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,5068.48,3294.51,13270.0,14761.0,2
RC,250,INDOCYANINE GREEN 25 MG IJ SOLR,1918.08,1246.755,10.63,14761.0,16
RC,250,INDOMETHACIN 50 MG PR SUPP,96896.64,62982.82,13270.0,14761.0,4
RC,250,INDOMETHACIN SODIUM 1 MG IV SOLR,4322.88,2809.87,13270.0,14761.0,2
RC,250,INFLIXIMAB 100 MG IV SOLR,9243.92,6008.545,40.12,14761.0,3
RC,250,INFLIXIMAB-AXXQ 100 MG IV SOLR,6335.52,4118.09,26.51,14761.0,5
RC,250,INFLIXIMAB-DYYB 100 MG IV SOLR,6708.32,4360.41,16.96,14761.0,3
RC,250,"INHALAT. SPACING DEV,SM. MASK MISC SPCR",731.04,475.18,13270.0,14761.0,2
RC,250,INHALATIONAL SPACING DEVICE MISC SPCR,542.24,352.46,13270.0,14761.0,2
RC,250,INOSITOL 650 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,206172.0,134011.8,3260.96,14761.0,3
RC,250,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN ASPART (NIACINAMIDE) 100 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN ASPART U-100 100 UNITS/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN DEGLUDEC 100 UNIT/ML (3 ML) SC INPN,1515.84,985.3,13270.0,14761.0,2
RC,250,INSULIN DEGLUDEC 100 UNITS/ML SC SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN DEGLUDEC 200 UNIT/ML (3 ML) SC INPN,3031.68,1970.59,13270.0,14761.0,2
RC,250,INSULIN DEGLUDEC-LIRAGLUTIDE 100 UNIT-3.6 MG /ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN GLARGINE 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,6
RC,250,INSULIN GLARGINE 100 UNITS/ML SC SOLN,914.24,594.26,13270.0,14761.0,2
RC,250,INSULIN GLARGINE U-300 CONC 300 UNIT/ML (1.5 ML) SC INPN,1465.56,952.61,,,0
RC,250,INSULIN GLARGINE U-300 CONC 300 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN GLARGINE-LIXISENATIDE 100 UNIT-33 MCG/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN GLULISINE U-100 100 UNITS/ML SC SOLN,1257.28,817.23,13270.0,14761.0,2
RC,250,INSULIN LISPRO 100 UNITS/ML SC CRTG,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN LISPRO 100 UNITS/ML SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN LISPRO 100 UNITS/ML SC SOLN,577.565,375.42,13270.0,14761.0,16
RC,250,INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) SC SUSP,767.84,499.1,13270.0,14761.0,2
RC,250,INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SC SUSP,290.0,188.5,13270.0,14761.0,4
RC,250,INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,2
RC,250,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,INSULIN OTHER PATIENT SUPPLIED PUMP BOLUS,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SC INPN,1465.56,952.61,13270.0,14761.0,4
RC,250,INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN (PRL 1772 & 2600 ONLY),290.0,188.5,13270.0,14761.0,2
RC,250,INSULIN REGULAR HUMAN 100 UNITS/ML IJ SOLN,405.88,263.82,13270.0,14761.0,6
RC,250,INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) IV SOLN,297.6,193.44,13270.0,14761.0,2
RC,250,IODINE 150 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IODINE STRONG (LUGOLS) 5 % PO SOLN,504.9,328.19,13270.0,14761.0,2
RC,250,IOHEXOL 300 MG IODINE/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,IOHEXOL 300 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,1465.56,952.61,13270.0,14761.0,2
RC,250,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,1465.56,952.61,13270.0,14761.0,4
RC,250,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,319578.48,207726.01,220.25,14761.0,3
RC,250,IPRATROPIUM BROMIDE 0.02 % IN SOLN,877.78,570.5550000000001,13270.0,14761.0,32
RC,250,IPRATROPIUM BROMIDE 17 MCG/ACTUATION IN HFAA,2287.02,1486.56,13270.0,14761.0,4
RC,250,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NA SPRY,1465.56,952.61,13270.0,14761.0,6
RC,250,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NA SPRY,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,13270.0,14761.0,8
RC,250,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
RC,250,IRBESARTAN 300 MG PO TABS,486.72,316.37,13270.0,14761.0,12
RC,250,IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IRINOTECAN 100 MG/5 ML IV SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,26154.0,17000.1,80.64,14761.0,3
RC,250,IRON 18 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IRON DEXTRAN 50 MG/ML IJ SOLN,529.06,343.89,22.0,14761.0,6
RC,250,"IRON FUM, POLY #1-VITC-L.CASEI 130 MG IRON-25 MG-30 MG PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,596.5899999999999,387.78499999999997,13270.0,14761.0,6
RC,250,IRON SUCROSE 200 MG IRON/10 ML IV SOLN,863.2,561.0799999999999,13270.0,14761.0,2
RC,250,ISAVUCONAZONIUM SULFATE 186 MG PO CAPS,12455.595000000001,8096.135,13270.0,14761.0,8
RC,250,ISAVUCONAZONIUM SULFATE 372 MG IV SOLR,3582.9399999999996,2328.91,1.22,14761.0,10
RC,250,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,1440.8400000000001,936.545,13270.0,14761.0,6
RC,250,ISOSORBIDE MONONITRATE 20 MG PO TABS,1465.56,952.61,,,0
RC,250,ISOSULFAN BLUE 1 % SC SOLN,1465.56,952.61,10.63,14761.0,3
RC,250,ISRADIPINE 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ISTRADEFYLLINE 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ISTRADEFYLLINE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ITRACONAZOLE 10 MG/ML PO SOLN,5212.8,3388.32,13270.0,14761.0,4
RC,250,ITRACONAZOLE 100 MG PO CAPS,2243.04,1457.975,13270.0,14761.0,6
RC,250,IVABRADINE 5 MG PO TABS,8885.76,5775.74,13270.0,14761.0,4
RC,250,IVABRADINE 7.5 MG PO TABS,8885.76,5775.74,13270.0,14761.0,2
RC,250,IVACAFTOR 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,IVERMECTIN 3 MG PO TABS,1307.52,849.89,13270.0,14761.0,8
RC,250,IVOSIDENIB 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,IXEKIZUMAB 80 MG/ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,Inpatient Services,1465.56,952.61,,,0
RC,250,KETAMINE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,4
RC,250,KETAMINE 10 MG/ML IJ SOLN,295.04,191.78,13270.0,14761.0,2
RC,250,KETAMINE 10 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,KETAMINE 50 MG/ML (1 ML) IV SYRG,290.0,188.5,13270.0,14761.0,2
RC,250,KETAMINE 50 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,KETOCONAZOLE 2 % TP CREA,906.3,589.095,13270.0,14761.0,4
RC,250,KETOCONAZOLE 2 % TP SHAM,1465.56,952.61,13270.0,14761.0,4
RC,250,KETOCONAZOLE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,KETOROLAC 0.4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,KETOROLAC 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
RC,250,KETOROLAC 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,877.78,570.5550000000001,0.85,14761.0,9
RC,250,KETOROLAC 30 MG/ML IV PEDIATRIC,877.78,570.5550000000001,0.85,14761.0,18
RC,250,KETOTIFEN FUMARATE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,6
RC,250,KETOTIFEN FUMARATE 0.025 % (0.035 %) OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,L NORGEST/E.ESTRADIOL-E.ESTRAD 0.1 MG-20 MCG (84)/10 MCG (7) PO 3MPK,1465.56,952.61,13270.0,14761.0,4
RC,250,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,LABETALOL 5 MG/ML IV SOLN,338.88,220.27,13270.0,14761.0,40
RC,250,LABETALOL ORAL SUSPENSION 10 MG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,LACOSAMIDE 10 MG/ML PO SOLN,561.44,364.94,13270.0,14761.0,10
RC,250,LACOSAMIDE 200 MG PO TABS,1833.42,1191.72,13270.0,14761.0,14
RC,250,LACOSAMIDE 200 MG/20 ML IV SOLN,356.32,231.60500000000002,13270.0,14761.0,10
RC,250,LACOSAMIDE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,16
RC,250,LACTASE 9000 UNITS PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,LACTO NO.76-BIFIDO-FOS-LARCH 25B CELL-25B CELL-50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,"LACTOBAC NO.33-B.LACTIS,LONGUM 3.4 BILLION CELLS PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,LACTOBAC-BIFIDOBAC-GLOB PR CON 15 BILLION CELL-170 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LAMIVUDINE 10 MG/ML PO SOLN,1651.2,1073.28,13270.0,14761.0,4
RC,250,LAMIVUDINE 100 MG PO TABS,8218.56,5342.06,13270.0,14761.0,2
RC,250,LAMIVUDINE 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
RC,250,LAMOTRIGINE 100 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,24
RC,250,LAMOTRIGINE 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,14
RC,250,LAMOTRIGINE 200 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,LAMOTRIGINE 25 MG PO TABS,8069.8,5245.37,13270.0,14761.0,10
RC,250,LAMOTRIGINE 250 MG PO TR24,1465.56,952.61,13270.0,14761.0,8
RC,250,LAMOTRIGINE 300 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,LANREOTIDE 120 MG/0.5 ML SC SYRG,86058.0,55937.7,62.22,14761.0,3
RC,250,LANSOPRAZOLE 30 MG PO TBLD,11046.380000000001,7180.145,13270.0,14761.0,4
RC,250,LANTHANUM 1000 MG PO CHEW,1355.04,880.78,13270.0,14761.0,6
RC,250,LANTHANUM 500 MG PO CHEW,7241.04,4706.68,13270.0,14761.0,12
RC,250,LANTHANUM 750 MG PO CHEW,1242.24,807.46,13270.0,14761.0,2
RC,250,LATANOPROST 0.005 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,LATANOPROSTENE BUNOD 0.024 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,LENALIDOMIDE 10 MG PO CAPS,399414.4,259619.36,13270.0,14761.0,2
RC,250,LENALIDOMIDE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,LENALIDOMIDE 25 MG PO CAPS,299561.14,194714.74,13270.0,14761.0,2
RC,250,LENVATINIB 10 MG/DAY (10 MG X 1) PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LENVATINIB 12 MG/DAY (4 MG X 3) PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LENVATINIB 20 MG/DAY (10 MG X 2) PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,LENVATINIB 4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LETERMOVIR 480 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,LETROZOLE 2.5 MG PO TABS,6068.68,3944.64,13270.0,14761.0,18
RC,250,LEUCOVORIN CALCIUM 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEUCOVORIN CALCIUM 350 MG IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,LEUCOVORIN CALCIUM 5 MG PO TABS,1398.0,908.7,13270.0,14761.0,2
RC,250,LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT,53991.9,35094.74,219.79,14761.0,3
RC,250,LEUPROLIDE 3.75 MG IM SYKT,15102.81,9816.83,2014.27,14761.0,3
RC,250,LEUPROLIDE 7.5 MG (1 MONTH) SC SYRG,1401.28,910.83,219.79,14761.0,3
RC,250,LEVALBUTEROL HCL 0.31 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,13270.0,14761.0,8
RC,250,LEVALBUTEROL HCL 1.25 MG IN NEBU,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,LEVALBUTEROL TARTRATE 45 MCG/ACTUATION IN HFAA,486.72,316.37,13270.0,14761.0,4
RC,250,LEVETIRACETAM 1000 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,LEVETIRACETAM 500 MG/5 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,6
RC,250,LEVOCARNITINE 200 MG/ML IV SOLN,579.52,376.69,13270.0,14761.0,2
RC,250,LEVOCARNITINE 330 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,LEVOCETIRIZINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,LEVODOPA 42 MG IN CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOFLOXACIN 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,LEVOFLOXACIN 250 MG PO TABS,308.2,200.32999999999998,13270.0,14761.0,10
RC,250,LEVOFLOXACIN 250 MG/10 ML PO SOLN,7188.48,4672.51,13270.0,14761.0,4
RC,250,LEVOFLOXACIN 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,6
RC,250,LEVOFLOXACIN 500 MG PO TABS,325.0,211.25,13270.0,14761.0,10
RC,250,LEVOFLOXACIN 750 MG PO TABS,472.2,306.93,13270.0,14761.0,10
RC,250,LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,8
RC,250,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,13270.0,14761.0,10
RC,250,LEVOMEFOL-B6-MEB12-ALGAL OIL 3 MG-35 MG-2 MG -90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,LEVOMEFOLATE CALCIUM 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMEFOLATE-ALGAL OIL 15-90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMEFOLATE-ALGAL OIL 7.5-90.314 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMEFOLATE-B12-HERB 236 1-1-500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMILNACIPRAN 120 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMILNACIPRAN 20 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMILNACIPRAN 40 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOMILNACIPRAN 80 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVONORGESTREL 1.5 MG PO TABS,290.0,188.5,,,0
RC,250,LEVONORGESTREL 20.4 MCG/24 HR (8 YRS) 52 MG IU IUD,14907.68,9689.99,13270.0,14761.0,2
RC,250,LEVONORGESTREL-ETHINYL ESTRAD 0.15 MG-30 MCG (91) PO 3MPK,1465.56,952.61,13270.0,14761.0,4
RC,250,LEVONORGESTREL-ETHINYL ESTRAD 0.15-0.03 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVORPHANOL TARTRATE 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE (SYNTHROID) ORAL SUSPENSION 25 MCG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 100 MCG IV SOLR,1359.42,883.62,13270.0,14761.0,12
RC,250,LEVOTHYROXINE 125 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 20 MCG/ML PO SOLN,1976.0,1284.4,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 25 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 50 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 75 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LEVOTHYROXINE 88 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,32
RC,250,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),877.78,570.5550000000001,13270.0,14761.0,22
RC,250,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,13270.0,14761.0,8
RC,250,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE (PF) 40 MG/ML (4 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE 1% (BUFFERED) INJ. SOLUTION,290.0,188.5,13270.0,14761.0,4
RC,250,LIDOCAINE 1.8 % TP PTMD,1465.56,952.61,13270.0,14761.0,2
RC,250,LIDOCAINE 10 MG/ML (1 %) IJ SOLN (CC),290.0,188.5,13270.0,14761.0,4
RC,250,LIDOCAINE 4 % TP CREA,396.96,258.02,13270.0,14761.0,14
RC,250,LIDOCAINE 4 % TP CREA CC,877.78,570.5550000000001,13270.0,14761.0,2
RC,250,LIDOCAINE 4 % TP PTMD,486.72,316.37,13270.0,14761.0,16
RC,250,LIDOCAINE 5 % TP CREA,1465.56,952.61,13270.0,14761.0,2
RC,250,LIDOCAINE 5 % TP OINT,894.67,581.535,13270.0,14761.0,14
RC,250,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE HCL 2 % MM JELL,1465.56,952.61,13270.0,14761.0,6
RC,250,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,13270.0,14761.0,8
RC,250,LIDOCAINE HCL 2 % MM SOLN,1465.56,952.61,13270.0,14761.0,8
RC,250,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,596.0,387.4,13270.0,14761.0,14
RC,250,LIDOCAINE HCL 4 % LATR SOLN,944.3,613.7950000000001,13270.0,14761.0,8
RC,250,LIDOCAINE HCL 4 % TP GEL,1465.56,952.61,13270.0,14761.0,2
RC,250,LIDOCAINE HCL 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,LIDOCAINE IN 5 % DEXTROSE (PF) 4 MG/ML (0.4 %) IV SOLP,290.0,188.5,13270.0,14761.0,2
RC,250,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
RC,250,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 IJ SOLN",290.91999999999996,189.1,13270.0,14761.0,14
RC,250,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,13270.0,14761.0,4
RC,250,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,38
RC,250,"LIDOCAINE-EPINEPHRINE 2 %-1:100,000 IJ SOLN",290.0,188.5,13270.0,14761.0,10
RC,250,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,455.04,295.78,13270.0,14761.0,14
RC,250,LIFITEGRAST 5 % OP DPET,1465.56,952.61,13270.0,14761.0,4
RC,250,LIGHT MINERAL OIL-MIN OIL (PF) 0.5-0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,LINACLOTIDE 145 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,4
RC,250,LINACLOTIDE 290 MCG PO CAPS,8059.68,5238.79,13270.0,14761.0,4
RC,250,LINACLOTIDE 72 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,8
RC,250,LINAGLIPTIN 5 MG PO TABS,13228.8,8598.72,13270.0,14761.0,6
RC,250,"LINAGLIPTIN-METFORMIN 2.5-1,000 MG PO TABS",1465.56,952.61,13270.0,14761.0,4
RC,250,LINAGLIPTIN-METFORMIN 2.5-850 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LINEZOLID 2 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,LINEZOLID 600 MG PO TABS,927.64,602.9649999999999,13270.0,14761.0,8
RC,250,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,374.4,243.36,13270.0,14761.0,26
RC,250,LIOTHYRONINE 10 MCG/ML IV SOLN,5143.04,3342.98,13270.0,14761.0,2
RC,250,"LIPASE-PROTEASE-AMYLASE 20,000-63,000- 84,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
RC,250,"LIPASE-PROTEASE-AMYLASE 3,000-10,000 -14,000-UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,4
RC,250,"LIPASE-PROTEASE-AMYLASE 3,000-9,500- 15,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,2
RC,250,"LIPASE-PROTEASE-AMYLASE 36,000-114,000- 180,000 UNIT PO CPDR",19249.6,12512.24,13270.0,14761.0,4
RC,250,"LIPASE-PROTEASE-AMYLASE 40,000-126,000- 168,000 UNIT PO CPDR",1465.56,952.61,13270.0,14761.0,4
RC,250,LIRAGLUTIDE (WEIGHT LOSS) 3 MG/0.5 ML (18 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,LIRAGLUTIDE 6 MG/ML INJ PEN,1465.56,952.61,13270.0,14761.0,2
RC,250,LISDEXAMFETAMINE 20 MG PO CAPS,19268.8,12524.72,13270.0,14761.0,2
RC,250,LISDEXAMFETAMINE 20 MG PO CHEW,1465.56,952.61,,,0
RC,250,LISDEXAMFETAMINE 40 MG PO CAPS,19268.8,12524.72,13270.0,14761.0,2
RC,250,LOFEXIDINE 0.18 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LOPINAVIR-RITONAVIR 200-50 MG PO TABS,8366.7,5438.3550000000005,13270.0,14761.0,4
RC,250,LORATADINE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,LORAZEPAM 0.5 HALF-TAB = 0.25 MG,290.0,188.5,13270.0,14761.0,4
RC,250,LORAZEPAM 0.5 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,LORAZEPAM 1 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,LORAZEPAM 1 MG/ML ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,4
RC,250,LORAZEPAM 2 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,LORAZEPAM 2 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,LORLATINIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LORLATINIB 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,LOSARTAN 25 MG HALF-TAB = 12.5 MG,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,LOSARTAN 25 MG PO TABS,731.2,475.28,13270.0,14761.0,22
RC,250,LOSARTAN 50 MG PO TABS,1123.98,730.585,13270.0,14761.0,28
RC,250,LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,LOTEPREDNOL ETABONATE 0.2 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,LOTEPREDNOL ETABONATE 0.38 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
RC,250,LOTEPREDNOL ETABONATE 0.5 % OP DRPG,1465.56,952.61,13270.0,14761.0,4
RC,250,LOTEPREDNOL ETABONATE 0.5 % OP DRPS,3103.8199999999997,2017.48,13270.0,14761.0,6
RC,250,LOTEPREDNOL ETABONATE 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,"LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",1465.56,952.61,300.39,345.45,8
RC,250,LUBIPROSTONE 24 MCG PO CAPS,3187.68,2071.9900000000002,13270.0,14761.0,6
RC,250,LUBIPROSTONE 8 MCG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,LULICONAZOLE 1 % TP CREA,1465.56,952.61,13270.0,14761.0,2
RC,250,LUMATEPERONE 42 MG PO CAPS,1465.56,952.61,13270.0,14761.0,6
RC,250,LURASIDONE 120 MG PO TABS,30622.08,19904.35,13270.0,14761.0,4
RC,250,LURASIDONE 20 MG PO TABS,20514.24,13334.26,13270.0,14761.0,2
RC,250,LURASIDONE 40 MG PO TABS,20514.24,13334.26,13270.0,14761.0,4
RC,250,LURASIDONE 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN",41429.705,26929.309999999998,4941.46,14761.0,6
RC,250,MACITENTAN 10 MG PO TABS,57338.94,37270.31,13270.0,14761.0,4
RC,250,MAFENIDE ACETATE 50 GRAM TP PACK,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGIC MOUTHWASH (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,MAGNESIUM 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM 250 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM AMINO ACID CHELATE 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM CHLORIDE 71.5 MG PO TBEC,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM CITRATE 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM CITRATE 125 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,"MAGNESIUM CITRATE,MAG OXIDE 250 MG PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM GLYCINATE (BULK) 10 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM GLYCINATE-MAG OXIDE 120 MG MAGNESIUM PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM HYDROXIDE 1200 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,"MAGNESIUM MALATE, CHELATE 125 MG MAGNESIUM PO CAPS",1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM OXIDE 500 MG MAGNESIUM PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM OXIDE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,10
RC,250,MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP,290.0,188.5,13270.0,14761.0,4
RC,250,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK,1465.56,952.61,13270.0,14761.0,2
RC,250,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,13270.0,14761.0,8
RC,250,MAGNESIUM SULFATE L&D LOADING DOSE 6 GRAM/100 ML,290.0,188.5,13270.0,14761.0,2
RC,250,MAGROLIMAB (STUDY DRUG) VIAL (PRL: SINGLE IND 167485),1465.56,952.61,13270.0,14761.0,2
RC,250,MANNITOL 20 % 20 % IV SOLP,360.0,234.0,13270.0,14761.0,12
RC,250,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,MARAVIROC 150 MG PO TABS,25790.4,16763.76,13270.0,14761.0,2
RC,250,MARAVIROC 300 MG PO TABS,25790.4,16763.76,13270.0,14761.0,2
RC,250,MARIBAVIR 200 MG PO TABS,149399.04,97109.375,13270.0,14761.0,8
RC,250,"MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR",1352.35,879.03,13270.0,14761.0,4
RC,250,MECOBAL-LEVOMEFOLAT CA-B6 PHOS 3-35-2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MEDICINAL LEECH,290.0,188.5,13270.0,14761.0,4
RC,250,MEDROXYPROGESTERONE 150 MG/ML IM SUSP,919.0999999999999,597.415,13270.0,14761.0,4
RC,250,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,MELATONIN 1 MG PO CHEW,1465.56,952.61,13270.0,14761.0,4
RC,250,MELATONIN 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MELOXICAM 7.5 MG/5 ML PO SUSP,1465.56,952.61,,,0
RC,250,MELPHALAN HCL-BETADEX SBES 50 MG IV SOLR,9643.14,6268.04,21.61,14761.0,5
RC,250,MEMANTINE 10 MG PO TABS,598.4,388.96,13270.0,14761.0,14
RC,250,MEMANTINE 28 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
RC,250,MEMANTINE 5 MG PO TABS,600.0,390.0,13270.0,14761.0,16
RC,250,MEMANTINE-DONEPEZIL 28-10 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
RC,250,MEMANTINE-DONEPEZIL 7-10 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
RC,250,"MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR",1650.59,1072.88,13270.0,14761.0,2
RC,250,"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG",2556.08,1661.45,13270.0,14761.0,4
RC,250,MENTHOL 16 % TP LIQD,1465.56,952.61,13270.0,14761.0,2
RC,250,MENTHOL-ZINC OXIDE 0.15-1 % TP POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,MEPERIDINE (PF) 25 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
RC,250,MEPIVACAINE (PF) 20 MG/ML (2 %) IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,MERCAPTOPURINE (PURINETHOL) ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
RC,250,MERCAPTOPURINE 20 MG/ML PO SUSP,11737.58,7629.425,13270.0,14761.0,4
RC,250,MERCAPTOPURINE 50 MG PO TABS,1181.6,768.04,13270.0,14761.0,4
RC,250,MEROPENEM 1 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,MEROPENEM 500 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,MEROPENEM-VABORBACTAM 2 GRAM IV SOLR,3110.4,2021.76,2.61,14761.0,6
RC,250,MESALAMINE 0.375 GRAM PO CP24,1465.56,952.61,13270.0,14761.0,10
RC,250,MESALAMINE 1000 MG PR SUPP,1993.74,1295.93,13270.0,14761.0,12
RC,250,MESALAMINE 4 GRAM/60 ML PR ENEM,290.0,188.5,13270.0,14761.0,4
RC,250,MESALAMINE 400 MG PO CDTI,8994.24,5846.26,13270.0,14761.0,6
RC,250,MESALAMINE 500 MG PO CPSR,1465.56,952.61,13270.0,14761.0,2
RC,250,MESALAMINE 800 MG PO TBEC,1465.56,952.61,13270.0,14761.0,4
RC,250,MESNA 100 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,METAXALONE 800 MG PO TABS,1963.26,1276.115,13270.0,14761.0,4
RC,250,METHACHOLINE 50 MG IN 0.9% NACL WITH 0.4% PHENOL 2 ML (25 MG/ML) (TEST SOLUTION A),1237.31,804.25,,,0
RC,250,METHADONE 1 MG/ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,METHADONE 10 MG PO TABS,334.6,217.49,13270.0,14761.0,12
RC,250,METHADONE 10 MG/ML IJ SOLN,5475.04,3558.7749999999996,13270.0,14761.0,4
RC,250,METHADONE 10 MG/ML PO CONC,294.24,191.26,13270.0,14761.0,4
RC,250,METHADONE 5 MG PO TABS,310.4,201.76,13270.0,14761.0,16
RC,250,METHADONE 5 MG/5 ML PO SOLN (2.5MG<DOSE<=10MG),290.0,188.5,13270.0,14761.0,6
RC,250,METHAMPHETAMINE 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,METHEN-M.BLUE-S.PHOS-PHSAL-HYO 118-10-40.8-36 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,METHOCARBAMOL 100 MG/ML IJ SOLN,353.72,229.92,13270.0,14761.0,12
RC,250,METHOCARBAMOL 500 MG PO HALF-TAB = 250 MG,1465.56,952.61,13270.0,14761.0,4
RC,250,METHOCARBAMOL 500 MG PO TABS,327.4,212.81,13270.0,14761.0,16
RC,250,METHOCARBAMOL 750 MG PO TABS,413.6,268.84000000000003,13270.0,14761.0,22
RC,250,METHOTREXATE (PF) 20 MG/0.4 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
RC,250,METHOTREXATE SODIUM (PF) 1 GRAM IJ SOLR,938.56,610.06,13270.0,14761.0,6
RC,250,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,309.12,200.93,13270.0,14761.0,34
RC,250,METHOTREXATE SODIUM 2.5 MG PO TABS,2416.2,1570.53,13270.0,14761.0,6
RC,250,METHOTREXATE SODIUM 25 MG/ML IJ SOLN,385.12,250.33,13270.0,14761.0,2
RC,250,METHOXSALEN 20 MCG/ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,METHYL SALICYLATE-MENTHOL 10-3 % TP PTMD,1465.56,952.61,13270.0,14761.0,4
RC,250,METHYLCELLULOSE (LAXATIVE) 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,1465.56,952.61,10.63,14761.0,5
RC,250,METHYLERGONOVINE 0.2 MG PO TABS,4919.360000000001,3197.585,13270.0,14761.0,8
RC,250,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,304.255,197.765,13270.0,14761.0,6
RC,250,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.6800000000003,1553.29,13270.0,14761.0,6
RC,250,METHYLNALTREXONE 150 MG PO TABS,37625.76,24456.74,13270.0,14761.0,2
RC,250,METHYLNALTREXONE 8 MG/0.4 ML SC SYRG,2389.76,1553.34,13270.0,14761.0,4
RC,250,METHYLPHENIDATE 5 MG HALF-TAB = 2.5 MG,294.4,191.36,13270.0,14761.0,2
RC,250,METHYLPHENIDATE HCL 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,METHYLPHENIDATE HCL 20 MG PO TBSR,1465.56,952.61,13270.0,14761.0,4
RC,250,METHYLPHENIDATE HCL 27 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,METHYLPHENIDATE HCL 36 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,METHYLPHENIDATE HCL 5 MG PO TABS,294.4,191.36,13270.0,14761.0,12
RC,250,METHYLPHENIDATE HCL 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,METHYLPREDNISOLONE 32MG OR PLACEBO CAPSULES (C928-011 STUDY DRUG) IRB#1360,1465.56,952.61,13270.0,14761.0,2
RC,250,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
RC,250,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
RC,250,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML IJ SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML IJ SOLR,290.0,188.5,13270.0,14761.0,4
RC,250,METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML IV SOLR,690.88,449.07,13270.0,14761.0,2
RC,250,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,509.92,331.45,13270.0,14761.0,8
RC,250,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,13270.0,14761.0,6
RC,250,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,325.0,211.25,13270.0,14761.0,6
RC,250,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,METOLAZONE ORAL SUSPENSION 1 MG/ML,1465.56,952.61,13270.0,14761.0,2
RC,250,METOPROLOL (LOPRESSOR) ORAL SUSPENSION 10MG/ML,290.0,188.5,13270.0,14761.0,2
RC,250,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,METRONIDAZOLE 0.75 % TP GEL,637.2,414.18,13270.0,14761.0,2
RC,250,METRONIDAZOLE 0.75 % TP LOTN,1465.56,952.61,13270.0,14761.0,2
RC,250,METRONIDAZOLE 250 MG PO TABS,525.6,341.64,13270.0,14761.0,16
RC,250,METRONIDAZOLE 5 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,METRONIDAZOLE 500 MG PO TABS,920.0,598.0,13270.0,14761.0,12
RC,250,METRONIDAZOLE IN NACL (ISO-OS) 250 MG/50 ML IVPB,290.0,188.5,,,0
RC,250,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,34
RC,250,METRONIDAZOLE ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,MICAFUNGIN 100 MG IV SOLR,432.32,281.01,13270.0,14761.0,10
RC,250,MICAFUNGIN 100 MG/100 ML D5W VIAL-TO-BAG IVPB,2787.68,1811.99,13270.0,14761.0,2
RC,250,MICONAZOLE NITRATE 100 MG VA SUPP,1465.56,952.61,13270.0,14761.0,4
RC,250,MICONAZOLE NITRATE 2 % VA CREA,290.0,188.5,13270.0,14761.0,12
RC,250,MICONAZOLE NITRATE 200 MG VA SUPP,595.82,387.28,13270.0,14761.0,2
RC,250,MIDAZOLAM (PF) 1 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,MIDAZOLAM (PF) 5 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,MIDAZOLAM 1 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,MIDAZOLAM 2 MG/ML PO SYRP,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,MIDAZOLAM 250 MG/50 ML (5 MG/ML) ADULT STRAIGHT DRUG IV SOLUTION,1465.56,952.61,13270.0,14761.0,2
RC,250,MIDAZOLAM 250 MG/50 ML (5 MG/ML) PEDS STRAIGHT DRUG IV SOLUTION,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,MIDAZOLAM 5 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,MIDAZOLAM 5 MG/SPRAY (0.1 ML) NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,"MIDAZOLAM IN NACL,ISO-OSMO(PF) 1 MG/ML IV SOLN",1465.56,952.61,13270.0,14761.0,2
RC,250,MIDAZOLAM PF 50 MG/50 ML (1MG/ML) STRAIGHT DRUG IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,MIDOSTAURIN 25 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MIFEPRISTONE 200 MG PO TABS,688.0,447.2,13270.0,14761.0,2
RC,250,MILNACIPRAN 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MILNACIPRAN 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MILNACIPRAN 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,MILRINONE 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,MILRINONE IN 0.9% NACL 20 MG/50 ML (0.4 MG/ML) INHALATION SOLUTION,1465.56,952.61,13270.0,14761.0,2
RC,250,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,MINOCYCLINE 100 MG IV SOLR,4008.0,2605.2,3.22,14761.0,6
RC,250,MINOCYCLINE 100 MG PO CAPS,410.4,266.76,13270.0,14761.0,12
RC,250,MINOXIDIL 2 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,MIRABEGRON 25 MG PO TB24,6861.6,4460.04,13270.0,14761.0,2
RC,250,MIRABEGRON 50 MG PO TB24,4163.58,2706.325,13270.0,14761.0,4
RC,250,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
RC,250,MITOMYCIN 20 MG IV SOLR,1465.56,952.61,52.93,14761.0,9
RC,250,MITOMYCIN 5 MG IV SOLR,1997.8400000000001,1298.6,52.93,14761.0,6
RC,250,MITOXANTRONE 2 MG/ML IV CONC,1669.28,1085.03,68.05,14761.0,9
RC,250,MMX ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,MODAFINIL 100 MG PO TABS,4169.28,2710.03,13270.0,14761.0,6
RC,250,MODIFIED DANIELS SOLUTION,1958.4,1272.96,13270.0,14761.0,2
RC,250,MODIFIED HOPP'S STOMATITIS ORAL SUSPENSION,290.0,188.5,13270.0,14761.0,2
RC,250,MODIFIED STANFORD'S STOMATITIS ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
RC,250,MOLNUPIRAVIR 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,MOMETASONE 0.1 % TP SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,MOMETASONE 200 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,2
RC,250,MOMETASONE 50 MCG/ACTUATION NA SPRY,822.87,534.865,13270.0,14761.0,4
RC,250,MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION IN HFAA,1465.56,952.61,13270.0,14761.0,4
RC,250,MONTELUKAST 10 MG PO TABS,377.0,245.05,13270.0,14761.0,20
RC,250,MONTELUKAST 4 MG PO CHEW,290.0,188.5,13270.0,14761.0,4
RC,250,MONTELUKAST 5 MG PO CHEW,290.0,188.5,13270.0,14761.0,4
RC,250,MORPHINE (PF) 0.5 MG/ML IJ SOLN,360.68,234.44,13270.0,14761.0,8
RC,250,MORPHINE (PF) 1 MG/ML IJ SOLN,360.68,234.44,13270.0,14761.0,10
RC,250,MORPHINE (PF) 25 MG/ML IJ SOLN,5219.2,3392.48,13270.0,14761.0,2
RC,250,MORPHINE (PF) 30 MG/30 ML (1 MG/ML) IV PCAS,290.0,188.5,13270.0,14761.0,4
RC,250,MORPHINE 10 MG/5 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,MORPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,MORPHINE 10 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,MORPHINE 100 MG PO TBSR,290.0,188.5,13270.0,14761.0,4
RC,250,MORPHINE 15 MG PO TABS,1124.8,731.12,13270.0,14761.0,4
RC,250,MORPHINE 15 MG PO TBSR,752.0,488.8,13270.0,14761.0,12
RC,250,MORPHINE 2 MG/ML IV SYRG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,MORPHINE 25 MG/ML IV SOLN,4774.4,3103.36,13270.0,14761.0,6
RC,250,MORPHINE 30 MG PO CM24,1465.56,952.61,13270.0,14761.0,2
RC,250,MORPHINE 30 MG PO TBSR,1566.38,1018.145,13270.0,14761.0,14
RC,250,MORPHINE 4 MG/ML IJ SYRG,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,MORPHINE 4 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,MORPHINE 50 MG PO CSRP,1465.56,952.61,13270.0,14761.0,2
RC,250,MORPHINE 50 MG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,MORPHINE 60 MG PO TBSR,3123.2,2030.08,13270.0,14761.0,12
RC,250,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) PO SOLN,290.0,188.5,13270.0,14761.0,10
RC,250,MORPHINE INJECTION - PEDS < 1 YEAR,1465.56,952.61,13270.0,14761.0,2
RC,250,MORPHINE ORAL SOLUTION 1 MG/ML PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,299642.4,194767.56,13270.0,14761.0,4
RC,250,MOXIFLOXACIN 0.5 % OP DROP,459.90999999999997,298.94,13270.0,14761.0,14
RC,250,MOXIFLOXACIN 400 MG PO TABS,1312.08,852.85,13270.0,14761.0,6
RC,250,MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML IV PGBK,656.0,426.4,13270.0,14761.0,2
RC,250,MULTIVIT-MIN-IRON-FA-VIT K-LUT 8 MG IRON-400 MCG-50 MCG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,MUPIROCIN 2 % TP OINT,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,MV-MN-OM3-DHA-EPA-FISH-LUT-ZEA 250 MG (90 MG-160 MG) PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN",290.0,188.5,13270.0,14761.0,4
RC,250,MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR,1091.92,709.75,13270.0,14761.0,24
RC,250,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,11400.96,7410.625,13270.0,14761.0,6
RC,250,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,610.4,396.76,13270.0,14761.0,24
RC,250,MYCOPHENOLATE MOFETIL 500 MG PO TABS,1485.8,965.77,13270.0,14761.0,12
RC,250,MYCOPHENOLATE SODIUM 180 MG PO TBEC,896.9399999999999,583.01,13270.0,14761.0,12
RC,250,MYCOPHENOLATE SODIUM 360 MG PO TBEC,8009.58,5206.225,13270.0,14761.0,16
RC,250,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",1465.56,952.61,,,0
RC,250,NALBUPHINE 10 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,NALDEMEDINE 0.2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,NALOXEGOL 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,NALOXEGOL 25 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,NALOXONE 0.4 MG/ML IJ SYRG,290.0,188.5,13270.0,14761.0,2
RC,250,NALOXONE 1 MG/ML IJ SYRG,301.15999999999997,195.755,13270.0,14761.0,8
RC,250,NALTREXONE (BULK) 100 % MISC POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,NALTREXONE ORAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP DROP,290.0,188.5,13270.0,14761.0,4
RC,250,NATAMYCIN 5 % OP DRPS,1465.56,952.61,13270.0,14761.0,4
RC,250,NEBIVOLOL 10 MG PO TABS,305.28,198.43,13270.0,14761.0,14
RC,250,NEBIVOLOL 2.5 MG PO TABS,1004.64,653.0150000000001,13270.0,14761.0,10
RC,250,NEBIVOLOL 5 MG PO TABS,1358.94,883.31,13270.0,14761.0,14
RC,250,NELARABINE 250 MG/50 ML IV SOLN,3922.4,2549.56,90.31,14761.0,3
RC,250,NELARABINE 250 MG/50 ML IVPB,10626.4,6907.16,90.31,14761.0,3
RC,250,NELFINAVIR 625 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,NEOMYCIN 500 MG PO TABS,1736.8000000000002,1128.92,13270.0,14761.0,6
RC,250,"NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TP OINT",290.0,188.5,13270.0,14761.0,2
RC,250,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OP OINT",290.0,188.5,13270.0,14761.0,4
RC,250,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OP DRPS",877.78,570.5550000000001,13270.0,14761.0,8
RC,250,"NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75 MG-10,000 UNIT-0.025MG/ML OP DROP",708.0,460.2,13270.0,14761.0,2
RC,250,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT DRPS",1187.36,771.78,13270.0,14761.0,4
RC,250,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT SOLN",1465.56,952.61,13270.0,14761.0,4
RC,250,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,NEPAFENAC 0.1 % OP DRPS,1465.56,952.61,13270.0,14761.0,4
RC,250,NETARSUDIL 0.02 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,NETARSUDIL-LATANOPROST 0.02-0.005 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,NEVIRAPINE 200 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,NIACIN 1000 MG PO TB24,744.48,483.91,13270.0,14761.0,2
RC,250,NIACIN 500 MG PO TB24,473.76,307.945,13270.0,14761.0,4
RC,250,NIACIN 750 MG PO TB24,819.36,532.58,13270.0,14761.0,2
RC,250,NIACINAMIDE 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,NICARDIPINE 25 MG/10 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,NICOTINE (POLACRILEX) 2 MG BU LOZG,1465.56,952.61,13270.0,14761.0,2
RC,250,NIFEDIPINE ORAL SUSPENSION 4 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,NILOTINIB 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,NIMODIPINE 30 MG PO CAPS,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,NIMODIPINE 30 MG/5 ML PO SYRG,854.64,555.52,13270.0,14761.0,8
RC,250,NINTEDANIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,NINTEDANIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,NIRAPARIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,NIRMATRELVIR-RITONAVIR 150-100 MG PO DSPK,1465.56,952.61,13270.0,14761.0,4
RC,250,NIROGACESTAT (STUDY DRUG) 50 MG TABLET (IRB# STUDY00001749),1465.56,952.61,,,0
RC,250,NITAZOXANIDE 100 MG/5 ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
RC,250,NITAZOXANIDE 500 MG PO TABS,24609.025,15995.865,13270.0,14761.0,6
RC,250,NITROFURANTOIN 100 MG PO CAPS,1687.98,1097.185,13270.0,14761.0,12
RC,250,NITROFURANTOIN 25 MG/5 ML PO SUSP,589.76,383.34,13270.0,14761.0,2
RC,250,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,NITROGLYCERIN 0.3 MG/HR TD PT24,789.95,513.47,13270.0,14761.0,2
RC,250,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,2788.45,1812.49,13270.0,14761.0,6
RC,250,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,NITROGLYCERIN IN D5W 50 MG/250 ML (0.2 MG/ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,NIVOLUMAB 100 MG/10 ML IV SOLN,29202.39,18981.55,39.53,14761.0,3
RC,250,NIVOLUMAB 240 MG/24 ML IV SOLN,70085.95,45555.87,39.53,14761.0,3
RC,250,NIVOLUMAB 40 MG/4 ML IV SOLN,11681.03,7592.67,39.53,14761.0,3
RC,250,NOREPINEPHRINE (LEVOPHED)(0.032MG/ML) 8 MG IN D5W 250 ML,380.0,247.0,13270.0,14761.0,4
RC,250,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,22
RC,250,NORETH-ETHINYL ESTRADIOL-IRON 0.8MG-25MCG(24) AND 75 MG (4) PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,NORETHINDRONE AC-ETH ESTRADIOL 1-5 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-10 MCG (24)/10 MCG (2) PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,NORETHINDRONE-E.ESTRADIOL-IRON 1 MG-20 MCG(24) /75 MG (4) PO CHEW,1465.56,952.61,13270.0,14761.0,4
RC,250,NORETHINDRONE-E.ESTRADIOL-IRON 1.5 MG-30 MCG (21)/75 MG (7) PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,NORFLURANE-PENTAFLUOROPROPANE TP SPRA,3435.9249999999997,2233.35,13270.0,14761.0,2
RC,250,NYSTATIN 100000 UNIT/GRAM TP CREA,290.0,188.5,13270.0,14761.0,6
RC,250,NYSTATIN 100000 UNIT/GRAM TP OINT,301.48,195.95999999999998,13270.0,14761.0,8
RC,250,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,13270.0,14761.0,18
RC,250,NYSTATIN 100000 UNITS/ML PO SUSP,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TP CREA",1465.56,952.61,13270.0,14761.0,4
RC,250,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TP OINT",877.78,570.5550000000001,13270.0,14761.0,2
RC,250,OBINUTUZUMAB 1000 MG/40 ML IV SOLN,77514.48,50384.41,92.88,14761.0,3
RC,250,OCRELIZUMAB 30 MG/ML IV SOLN,185768.64,120749.62,74.46,14761.0,3
RC,250,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,22
RC,250,OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN,330.08000000000004,214.555,13270.0,14761.0,4
RC,250,OCTREOTIDE ACETATE 50 MCG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,"OCTREOTIDE,MICROSPHERES 20 MG IM SSRR",34064.0,22141.6,267.57,14761.0,6
RC,250,"OCTREOTIDE,MICROSPHERES 30 MG IM SSRR",54196.17,35227.51,267.57,14761.0,3
RC,250,OFATUMUMAB 20 MG/0.4 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,OFLOXACIN 0.3 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,OFLOXACIN 0.3 % OP DROP FOR EAR,290.0,188.5,13270.0,14761.0,2
RC,250,OLANZAPINE 10 MG IM SOLR,514.72,334.57,13270.0,14761.0,8
RC,250,OLANZAPINE 10 MG PO TBDL,5670.28,3685.68,13270.0,14761.0,8
RC,250,OLANZAPINE 5 MG PO TBDL,1442.38,937.5450000000001,13270.0,14761.0,24
RC,250,OLAPARIB 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,OLMESARTAN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OLMESARTAN 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,OLMESARTAN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OLOPATADINE 0.1 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,OLOPATADINE 0.2 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,OLOPATADINE 0.6 % NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,OMALIZUMAB 150 MG SC SOLR,12037.02,7824.0599999999995,47.68,14761.0,3
RC,250,OMALIZUMAB 150 MG/ML SC SYRG,12037.02,7824.0599999999995,47.68,14761.0,3
RC,250,OMALIZUMAB 75 MG/0.5 ML SC SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,OMEGA-3 ACID ETHYL ESTERS 1 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,OMEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,4
RC,250,OMEPRAZOLE COMPOUNDING KIT 2 MG/ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
RC,250,OMEPRAZOLE-SODIUM BICARBONATE 20-1.1 MG-GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ONABOTULINUMTOXINA 100 UNITS IJ SOLR,8398.0,5458.7,7.98,14761.0,3
RC,250,ONDANSETRON 4 MG PO TBDL,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,ONDANSETRON HCL 2 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,ONDANSETRON HCL 4 MG PO TABS,514.6,334.49,13270.0,14761.0,18
RC,250,ONDANSETRON HCL 4 MG/5 ML PO SOLN,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,ONDANSETRON HCL 8 MG PO TABS,939.2,610.48,13270.0,14761.0,12
RC,250,OPICAPONE 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,OPIUM TINCTURE 10 MG/ML (MORPHINE) PO TINC,290.0,188.5,13270.0,14761.0,4
RC,250,OSELTAMIVIR 30 MG PO CAPS,891.36,579.385,13270.0,14761.0,18
RC,250,OSELTAMIVIR 6 MG/ML PO SUSR,2264.64,1472.02,13270.0,14761.0,4
RC,250,OSELTAMIVIR 75 MG PO CAPS,1277.08,830.1,13270.0,14761.0,8
RC,250,OSIMERTINIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OSIMERTINIB 80 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OXACILLIN 1 GRAM IJ SOLR,290.0,188.5,13270.0,14761.0,6
RC,250,OXACILLIN 2 GRAM IJ SOLR,316.0,205.4,13270.0,14761.0,10
RC,250,OXACILLIN IVPB VIAL 1 G/50 ML NS VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,2
RC,250,OXALIPLATIN 100 MG/20 ML IV SOLN,365.28,237.435,13270.0,14761.0,14
RC,250,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,OXANDROLONE 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,OXCARBAZEPINE 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,OXCARBAZEPINE 600 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYBUTYNIN CHLORIDE 10 MG PO TR24,518.4,336.96,13270.0,14761.0,16
RC,250,OXYBUTYNIN CHLORIDE 5 MG PO TR24,449.6,292.24,13270.0,14761.0,10
RC,250,OXYCODONE 10 MG PO TR12,3928.4799999999996,2553.51,13270.0,14761.0,6
RC,250,OXYCODONE 15 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,OXYCODONE 15 MG PO TR12,1465.56,952.61,13270.0,14761.0,6
RC,250,OXYCODONE 20 MG PO TR12,7325.12,4761.33,13270.0,14761.0,8
RC,250,OXYCODONE 20 MG/ML PO CONC,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,OXYCODONE 30 MG PO TABS,421.8,274.16999999999996,13270.0,14761.0,8
RC,250,OXYCODONE 40 MG PO TR12,1465.56,952.61,13270.0,14761.0,4
RC,250,OXYCODONE 5 MG PO TABS,539.2,350.48,13270.0,14761.0,20
RC,250,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,13270.0,14761.0,16
RC,250,OXYCODONE 80 MG PO TR12,21889.28,14228.029999999999,13270.0,14761.0,4
RC,250,OXYCODONE MYRISTATE 18 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYCODONE MYRISTATE 27 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYCODONE MYRISTATE 36 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYCODONE MYRISTATE 9 MG PO CSPT,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1625.58,1056.625,13270.0,14761.0,24
RC,250,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,1947.98,1266.185,13270.0,14761.0,10
RC,250,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,446.6,290.28999999999996,13270.0,14761.0,8
RC,250,OXYCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,1340.2,871.13,13270.0,14761.0,6
RC,250,OXYMORPHONE 40 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
RC,250,OXYTOCIN 10 UNITS/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,Other Outpatient Services,745.92,484.85,,,0
RC,250,PACLITAXEL 6 MG/ML IV CONC,454.245,295.26,13270.0,14761.0,16
RC,250,PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR,13249.26,8612.02,16.62,14761.0,3
RC,250,PACRITINIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PALBOCICLIB 100 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PALBOCICLIB 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PALBOCICLIB 125 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PALBOCICLIB 125 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,PALIPERIDONE 1.5 MG PO TR24,1465.56,952.61,13270.0,14761.0,2
RC,250,PALIPERIDONE 3 MG PO TR24,1217.34,791.27,13270.0,14761.0,4
RC,250,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,1465.56,952.61,18.38,14761.0,3
RC,250,PALIVIZUMAB 50 MG/0.5 ML IM SOLN,23663.61,15381.345000000001,896.37,14761.0,6
RC,250,PALONOSETRON 0.25 MG/5 ML IV SOLN,309.0,200.85,13270.0,14761.0,10
RC,250,PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN,488.0,317.2,13270.0,14761.0,4
RC,250,PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN,15189.75,9873.34,198.39,14761.0,3
RC,250,PANTOPRAZOLE (PROTONIX) 40 MG/50 ML NS VIAL-TO-BAG IV INFUSION,877.78,570.5550000000001,13270.0,14761.0,6
RC,250,PANTOPRAZOLE 20 MG PO TBEC,299.2,194.48,13270.0,14761.0,20
RC,250,PANTOPRAZOLE 40 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,30
RC,250,PANTOPRAZOLE 40 MG PO TBEC,364.8,237.12,13270.0,14761.0,24
RC,250,PANTOPRAZOLE ORAL SUSPENSION 2 MG/ML,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,PANTOTHENIC ACID (VIT B5) 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,12
RC,250,PARICALCITOL 1 MCG PO CAPS,555.12,360.82500000000005,13270.0,14761.0,8
RC,250,PARICALCITOL 2 MCG/ML IV SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,PAROMOMYCIN 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PAROXETINE HCL 10 MG/5 ML PO SUSP,290.0,188.5,13270.0,14761.0,2
RC,250,PAROXETINE HCL 25 MG PO TB24,1465.56,952.61,13270.0,14761.0,6
RC,250,PAROXETINE HCL 37.5 MG PO TB24,1465.56,952.61,13270.0,14761.0,4
RC,250,PASIREOTIDE PAMOATE 60 MG IM SUSR,171609.21,111545.99,597.49,687.12,8
RC,250,PATIROMER CALCIUM SORBITEX 16.8 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
RC,250,PATIROMER CALCIUM SORBITEX 25.2 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
RC,250,PATIROMER CALCIUM SORBITEX 8.4 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,2
RC,250,PEDI MV NO.193-L.RHAMNOSUS GG 5 BILLION CELLS PO CHEW,1465.56,952.61,,,0
RC,250,PEDIATRIC MULTIVIT NO.36-IRON 10 MG IRON PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,352.0,228.8,13270.0,14761.0,10
RC,250,PEG 400-PROPYLENE GLYCOL (PF) 0.4-0.3 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OP DRPG,1465.56,952.61,13270.0,14761.0,2
RC,250,PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM PO PWPK,1876.32,1219.61,,,0
RC,250,PEGASPARGASE 750 UNITS/ML IJ SOLN,229844.16,149398.7,13270.0,33707.9,3
RC,250,PEGFILGRASTIM 6 MG/0.6 ML SC OBISYRINGE,38865.87,25262.82,38.78,14761.0,3
RC,250,PEGFILGRASTIM 6 MG/0.6 ML SC SYRG,38865.87,25262.82,38.78,14761.0,3
RC,250,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,9031.74,5870.63,13270.0,14761.0,4
RC,250,PEMBROLIZUMAB 25 MG/ML IV SOLN,26752.14,17388.89,72.49,14761.0,6
RC,250,PEMETREXED DISODIUM 100 MG IV SOLR,6780.08,4407.055,5.21,14761.0,6
RC,250,PEMETREXED DISODIUM 500 MG IV SOLR,1639.84,1065.9,5.21,14761.0,15
RC,250,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,5000.8,3250.52,30.34,14761.0,3
RC,250,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,10760.285,6994.1900000000005,30.34,14761.0,6
RC,250,PENICILLIN G BENZATHINE 600000 UNITS/ML IM SYRG,3176.0,2064.4,30.34,14761.0,3
RC,250,PENICILLIN G POTASSIUM 3 MILLION UNITS IN 0.9% NACL 50ML,908.78,590.705,13270.0,14761.0,4
RC,250,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,PENICILLIN G SODIUM 5 MILLION UNITS IJ SOLR,584.56,379.96,13270.0,14761.0,8
RC,250,PENICILLIN V POTASSIUM 250 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,PENICILLIN V POTASSIUM 250 MG/5 ML PO SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,PENTAMIDINE 300 MG IJ SOLR,1133.51,736.78,13270.0,14761.0,4
RC,250,PENTAMIDINE 300 MG IN SOLR,2013.6,1308.84,13270.0,14761.0,4
RC,250,PENTOBARBITAL SODIUM 50 MG/ML IJ SOLN,14973.6,9732.84,13270.0,14761.0,6
RC,250,PENTOSAN POLYSULFATE SODIUM 100 MG PO CAPS,17852.8,11604.32,13270.0,14761.0,2
RC,250,PENTOXIFYLLINE 20 MG/ML ORAL SOLUTION,1465.56,952.61,13270.0,14761.0,4
RC,250,PERAMPANEL 2 MG PO TABS,9257.28,6017.23,13270.0,14761.0,4
RC,250,PERAMPANEL 4 MG PO TABS,18295.2,11891.88,13270.0,14761.0,2
RC,250,PERAMPANEL 6 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PERAMPANEL 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,736.0,478.4,13270.0,14761.0,8
RC,250,PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,800.0,520.0,13270.0,14761.0,4
RC,250,PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN,656.0,426.4,13270.0,14761.0,4
RC,250,PERMETHRIN 5 % TP CREA,421.44,273.93499999999995,13270.0,14761.0,12
RC,250,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,61384.43,39899.88,20.07,14761.0,3
RC,250,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG PO TABS,10666.4,6933.16,13270.0,14761.0,4
RC,250,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML PO ELIX,1465.56,952.61,13270.0,14761.0,4
RC,250,PHENOBARBITAL 10 MG/ML IV IN NS PEDIATRIC,290.0,188.5,13270.0,14761.0,4
RC,250,PHENOBARBITAL 16.2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) PO ELIX,290.0,188.5,13270.0,14761.0,4
RC,250,PHENOBARBITAL 32.4 MG PO TABS,794.4,516.36,13270.0,14761.0,6
RC,250,PHENOBARBITAL 60 MG PO TABS,1465.56,952.61,,,0
RC,250,PHENOBARBITAL 97.2 MG PO TABS,895.98,582.385,13270.0,14761.0,4
RC,250,PHENOBARBITAL ORAL SOLUTION 8 MG/2 ML FOR NICU,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENOBARBITAL SODIUM 130 MG/ML IJ SOLN,584.37,379.84,13270.0,14761.0,4
RC,250,PHENOBARBITAL SODIUM 65 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,PHENOXYBENZAMINE 10 MG PO CAPS,40995.2,26646.88,,,0
RC,250,PHENTOLAMINE 5 MG IJ SOLR,5847.12,3800.625,457.13,14761.0,6
RC,250,PHENYLEPHRINE HCL 0.125 % NA DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENYLEPHRINE HCL 0.25 % NA SPRY,290.0,188.5,13270.0,14761.0,4
RC,250,PHENYLEPHRINE HCL 0.5 % NA SPRY,290.0,188.5,13270.0,14761.0,4
RC,250,PHENYLEPHRINE HCL 10 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,328.64,213.62,13270.0,14761.0,12
RC,250,PHENYLEPHRINE HCL 2.5 % OP DROP,1341.6,872.04,13270.0,14761.0,10
RC,250,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENYLEPHRINE-ACETAMINOPHEN-GG 5-325-200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PHENYTOIN 50 MG/ML IV PEDIATRIC,290.0,188.5,13270.0,14761.0,2
RC,250,PHENYTOIN SODIUM 50 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML IJ SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,PHYTONADIONE (VITAMIN K1) 10 MG/ML IJ SOLN,335.89,218.32999999999998,13270.0,14761.0,4
RC,250,PHYTONADIONE (VITAMIN K1) 100 MCG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PHYTONADIONE (VITAMIN K1) 5 MG PO TABS,11485.869999999999,7465.8150000000005,13270.0,14761.0,8
RC,250,PHYTONADIONE 5 MG HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,4
RC,250,PILOCARPINE HCL 1 % OP DROP,1317.54,856.4000000000001,13270.0,14761.0,4
RC,250,PILOCARPINE HCL 2 % OP DROP,1330.98,865.135,13270.0,14761.0,4
RC,250,PILOCARPINE HCL 4 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,PIMAVANSERIN 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PIMAVANSERIN 34 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PIMECROLIMUS 1 % TP CREA,1465.56,952.61,13270.0,14761.0,4
RC,250,PIOGLITAZONE 15 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,PIOGLITAZONE 30 MG PO TABS,321.12,208.73,13270.0,14761.0,10
RC,250,PIOGLITAZONE 45 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,36
RC,250,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,877.78,570.5550000000001,13270.0,14761.0,24
RC,250,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,13270.0,14761.0,8
RC,250,PIRFENIDONE 267 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PIRFENIDONE 267 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PIRFENIDONE 801 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,PITAVASTATIN CALCIUM 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PITAVASTATIN CALCIUM 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PITAVASTATIN CALCIUM 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PLECANATIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,PN - PEDS,1465.56,952.61,13270.0,14761.0,4
RC,250,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3342.62,2172.7,13270.0,14761.0,2
RC,250,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3861.76,2510.14,13270.0,14761.0,2
RC,250,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,"PNV,CALCIUM 72-IRON-FOLIC ACID 27 MG IRON- 1 MG PO TABS",1465.56,952.61,13270.0,14761.0,2
RC,250,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP,1465.56,952.61,13270.0,14761.0,2
RC,250,POLYETHYLENE GLYCOL 400 0.25 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",877.78,570.5550000000001,13270.0,14761.0,6
RC,250,POLYMYXIN B SULFATE 500000 UNITS IJ SOLR,290.0,188.5,13270.0,14761.0,2
RC,250,POLYSACCHARIDE IRON COMPLEX 150 MG IRON PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,POMALIDOMIDE 3 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,POMALIDOMIDE 4 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PONATINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PONATINIB 30 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PONATINIB 45 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PORACTANT ALFA 240 MG/3 ML ITL SUSP,12262.08,7970.35,13270.0,14761.0,12
RC,250,PORFIMER 75 MG IV SOLR,209907.0,136439.55,13270.0,29722.81,3
RC,250,POSACONAZOLE 100 MG PO TBEC,12622.08,8204.35,13270.0,14761.0,10
RC,250,POSACONAZOLE 200 MG/5 ML (40 MG/ML) PO SUSP,21458.64,13948.12,13270.0,14761.0,2
RC,250,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,14
RC,250,POTASSIUM ALUM (BULK) MISC POWD,1465.56,952.61,13270.0,14761.0,2
RC,250,POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
RC,250,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,8
RC,250,POTASSIUM CHLORIDE 10 MEQ/100ML IN 0.9% NACL PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,POTASSIUM CHLORIDE 10 MEQ/100ML IN D5W PGBK,290.0,188.5,13270.0,14761.0,2
RC,250,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,13270.0,14761.0,36
RC,250,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION,290.0,188.5,13270.0,14761.0,4
RC,250,POTASSIUM CHLORIDE 20 MEQ/15 ML PO LIQD,338.88,220.27,13270.0,14761.0,18
RC,250,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,4
RC,250,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,8
RC,250,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,521.6,339.04,13270.0,14761.0,16
RC,250,POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML IV PGBK,322.2,209.43,13270.0,14761.0,6
RC,250,POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK,290.0,188.5,13270.0,14761.0,4
RC,250,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,354.4,230.36,13270.0,14761.0,12
RC,250,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,6
RC,250,POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP,290.0,188.5,13270.0,14761.0,8
RC,250,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,877.78,570.5550000000001,13270.0,14761.0,16
RC,250,POTASSIUM CITRATE 15 MEQ PO TBSR,1465.56,952.61,13270.0,14761.0,4
RC,250,POTASSIUM CITRATE 99 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN,777.36,505.28499999999997,13270.0,14761.0,22
RC,250,POVIDONE-IODINE 10 % TP SOLN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,POVIDONE-IODINE 5 % OP SOLN,290.0,188.5,13270.0,14761.0,2
RC,250,PRALATREXATE 40 MG/2 ML (20 MG/ML) IV SOLN,133376.22,86694.54,465.41,14761.0,3
RC,250,PRAMIPEXOLE 0.125 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,PRAMIPEXOLE 0.25 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,PRAMIPEXOLE 0.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,PRAMIPEXOLE 0.75 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,PRAMIPEXOLE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,PRAMIPEXOLE 1.5 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,PRAMIPEXOLE 3.75 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,PRAMOXINE 1 % TP FOAM,990.0,643.5,13270.0,14761.0,6
RC,250,PRASUGREL 10 MG PO TABS,396.0,257.4,13270.0,14761.0,12
RC,250,PRASUGREL 5 MG PO TABS,343.0,222.95,13270.0,14761.0,4
RC,250,PRAVASTATIN 10 MG PO TABS,360.0,234.0,13270.0,14761.0,18
RC,250,PRAVASTATIN 20 MG PO TABS,334.8,217.62,13270.0,14761.0,18
RC,250,PRAVASTATIN 40 MG PO TABS,1222.4,794.56,13270.0,14761.0,12
RC,250,PRAVASTATIN 80 MG PO TABS,1685.04,1095.275,13270.0,14761.0,6
RC,250,PREDNISOLONE 5 MG PO TABS,12246.380000000001,7960.145,13270.0,14761.0,4
RC,250,PREDNISOLONE ACET-GATIFLOXACIN 1-0.5 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PREDNISOLONE ACETATE (PF) 1 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PREDNISOLONE ACETATE 0.12 % OP DRPS,2391.04,1554.18,13270.0,14761.0,2
RC,250,PREDNISOLONE ACETATE 1 % OP DRPS,1062.62,690.7,13270.0,14761.0,10
RC,250,PREDNISOLONE ACETATE-BROMFENAC 1-0.075 % OP DRPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PREGABALIN 100 MG PO CAPS,771.4,501.41,13270.0,14761.0,8
RC,250,PREGABALIN 20 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,PREGABALIN 25 MG PO CAPS,872.56,567.165,13270.0,14761.0,12
RC,250,PREGABALIN 50 MG PO CAPS,1124.8,731.12,13270.0,14761.0,12
RC,250,PREGABALIN 75 MG PO CAPS,1145.6,744.64,13270.0,14761.0,12
RC,250,"PRENAT.VITS,CAL,MIN-IRON-FOLIC PO TABS",1465.56,952.61,13270.0,14761.0,2
RC,250,PRENATAL 105-IRON-FOLIC AC-DHA 30 MG IRON- 1.4 MG-300 MG PO CMPK,1465.56,952.61,13270.0,14761.0,2
RC,250,PRENATAL 25-IRON-FOLATE 6-DHA 30 MG IRON-1MG -200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,PRENATAL71-IRON-FOLIC ACID-DHA 30-1.4-200 MG PO CPID,1465.56,952.61,13270.0,14761.0,2
RC,250,PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,PRETOMANID 200 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,PROCAINAMIDE 100 MG/ML IJ SOLN,965.92,627.85,679.95,14761.0,6
RC,250,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,13270.0,14761.0,14
RC,250,PROGESTERONE MICRONIZED 200 MG PO CAPS,1465.56,952.61,,,0
RC,250,PROGESTERONE ORAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,PROGESTERONE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,PROMETHAZINE 12.5 MG PR SUPP,290.0,188.5,13270.0,14761.0,2
RC,250,PROMETHAZINE 25 MG PR SUPP,1465.56,952.61,13270.0,14761.0,4
RC,250,PROMETHAZINE-CODEINE 6.25-10 MG/5 ML PO SYRP,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPAFENONE 225 MG PO CP12,1465.56,952.61,13270.0,14761.0,8
RC,250,PROPAFENONE 325 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPAFENONE 425 MG PO CP12,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPARACAINE 0.5 % OP DROP,523.2,340.08,13270.0,14761.0,12
RC,250,PROPOFOL 10 MG/ML BOLUS,290.0,188.5,13270.0,14761.0,2
RC,250,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,13270.0,14761.0,40
RC,250,PROPRANOLOL 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,PROPRANOLOL 120 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPRANOLOL 160 MG PO CS24,1465.56,952.61,13270.0,14761.0,4
RC,250,PROPRANOLOL 80 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPRANOLOL 80 MG PO CS24,1465.56,952.61,13270.0,14761.0,2
RC,250,PROPYLENE GLYCOL 0.6 % OP DROP,1465.56,952.61,13270.0,14761.0,4
RC,250,PROPYLENE GLYCOL-GLYCERIN 0.6-0.6 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,PROTAMINE 10 MG/ML IV SOLN,389.0,252.85,13270.0,14761.0,4
RC,250,PRUCALOPRIDE 1 MG PO TABS,8306.4,5399.16,13270.0,14761.0,4
RC,250,PRUCALOPRIDE 2 MG PO TABS,8306.4,5399.16,13270.0,14761.0,4
RC,250,PSEUDOEPHEDRINE HCL 15 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
RC,250,PSYLLIUM HUSK 0.4 GRAM PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,PYRIDOSTIGMINE BROMIDE 180 MG PO TBSR,2966.4,1928.16,13270.0,14761.0,2
RC,250,PYRIDOSTIGMINE BROMIDE 5 MG/ML IJ SOLN,448.8,291.72,13270.0,14761.0,6
RC,250,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,QUETIAPINE 100 MG PO TABS,1022.4,664.56,13270.0,14761.0,20
RC,250,QUETIAPINE 200 MG PO TABS,963.2,626.08,13270.0,14761.0,16
RC,250,QUETIAPINE 200 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,QUETIAPINE 25 MG PO TABS,350.6,227.89,13270.0,14761.0,16
RC,250,QUETIAPINE 25MG HALF-TAB = 12.5MG,290.0,188.5,13270.0,14761.0,4
RC,250,QUETIAPINE 300 MG PO TABS,376.0,244.4,13270.0,14761.0,12
RC,250,QUETIAPINE 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,4
RC,250,QUETIAPINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,QUETIAPINE 50 MG PO TABS,797.6,518.44,13270.0,14761.0,20
RC,250,QUETIAPINE 50 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,RABEPRAZOLE 20 MG PO TBEC,1465.56,952.61,13270.0,14761.0,4
RC,250,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,25843.18,16798.065,358.25,14761.0,6
RC,250,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",4835.6,3143.1400000000003,435.99,14761.0,6
RC,250,RACEPINEPHRINE 2.25 % IN NEBU,290.0,188.5,13270.0,14761.0,4
RC,250,RALOXIFENE 60 MG PO TABS,1420.12,923.08,13270.0,14761.0,4
RC,250,RALTEGRAVIR 400 MG PO TABS,29766.72,19348.37,13270.0,14761.0,2
RC,250,RAMELTEON 8 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,RAMUCIRUMAB 10 MG/ML IV SOLN,39726.72,25822.37,88.5,14761.0,6
RC,250,RANOLAZINE 500 MG PO TB12,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,RASAGILINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,RASAGILINE 1 MG PO TABS,3444.48,2238.91,13270.0,14761.0,6
RC,250,RASBURICASE 1.5 MG IV SOLR,9457.845000000001,6147.595,462.33,14761.0,11
RC,250,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,58788.72,38212.67,274.88,316.11,8
RC,250,REGADENOSON 0.4 MG/5 ML IV SYRG,2653.98,1725.085,13270.0,14761.0,4
RC,250,REGORAFENIB 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,RELUGOLIX 120 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,REMDESIVIR (VEKLURY) IN 0.9% NACL 100 MG/250 ML IV PGBK PREMIX,9144.0,5943.6,7.91,14761.0,3
RC,250,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,7.91,14761.0,10
RC,250,REMIFENTANIL 2 MG IV SOLR,1917.22,1246.19,13270.0,14761.0,2
RC,250,REPAGLINIDE 0.5 MG PO TABS,363.2,236.08,13270.0,14761.0,4
RC,250,REPAGLINIDE 1 MG PO TABS,377519.4,245387.61,13270.0,14761.0,8
RC,250,REPAGLINIDE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,REVEFENACIN 175 MCG/3 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
RC,250,RIBAVIRIN 200 MG PO CAPS,1568.0749999999998,1019.2450000000001,13270.0,14761.0,6
RC,250,RIBOCICLIB 600 MG/DAY (200 MG X 3) PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,RIFABUTIN 150 MG PO CAPS,18777.6,12205.44,13270.0,14761.0,8
RC,250,RIFAMPIN 150 MG PO CAPS,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,RIFAMPIN 300 MG PO CAPS,753.5999999999999,489.84000000000003,13270.0,14761.0,22
RC,250,RIFAMPIN 600 MG IV SOLR,1933.12,1256.53,13270.0,14761.0,6
RC,250,RIFAMPIN ORAL SUSPENSION 25 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,2
RC,250,RIFAPENTINE 150 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,RIFAXIMIN 200 MG PO TABS,4736.16,3078.5,13270.0,14761.0,4
RC,250,RIFAXIMIN 550 MG PO TABS,48705.6,31658.64,13270.0,14761.0,8
RC,250,RILONACEPT 220 MG SC SOLR,1465.56,952.61,13270.0,14761.0,4
RC,250,RILPIVIRINE HCL 25 MG PO TABS,22112.64,14373.22,13270.0,14761.0,4
RC,250,RILUZOLE 50 MG PO TABS,1030.38,669.745,13270.0,14761.0,6
RC,250,RILUZOLE 50 MG/10 ML PO SUSP,1465.56,952.61,13270.0,14761.0,2
RC,250,RIMEGEPANT 75 MG PO TBDL,1465.56,952.61,13270.0,14761.0,2
RC,250,RIOCIGUAT 0.5 MG PO TABS,11799.900000000001,7669.935,13270.0,14761.0,4
RC,250,RIOCIGUAT 1 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,RIOCIGUAT 2.5 MG PO TABS,11799.900000000001,7669.935,13270.0,14761.0,4
RC,250,RISANKIZUMAB-RZAA 360 MG/2.4 ML (150 MG/ML) SC INJT,1465.56,952.61,,,0
RC,250,RISANKIZUMAB-RZAA 60 MG/ML IV SOLN,86978.16,56535.8,,,0
RC,250,RISEDRONATE 35 MG PO TABS,372.48,242.11,13270.0,14761.0,2
RC,250,RISEDRONATE 5 MG PO TABS,1104.48,717.91,13270.0,14761.0,2
RC,250,RISPERIDONE 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,RISPERIDONE 0.5 MG PO TABS,3582.3999999999996,2328.56,13270.0,14761.0,6
RC,250,RISPERIDONE 0.5 MG PO TBDL,874.57,568.47,13270.0,14761.0,6
RC,250,RISPERIDONE 1 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,RISPERIDONE 1 MG PO TBDL,394.53499999999997,256.45,13270.0,14761.0,8
RC,250,RISPERIDONE 1 MG/ML PO SOLN,1815.36,1179.98,13270.0,14761.0,2
RC,250,RISPERIDONE 2 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,RISPERIDONE 2 MG PO TBDL,474.88,308.67,13270.0,14761.0,12
RC,250,RISPERIDONE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,RITONAVIR 100 MG PO TABS,2415.84,1570.295,13270.0,14761.0,6
RC,250,RITONAVIR 80 MG/ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,RITUXIMAB 10 MG/ML IV CONC,26306.56,17099.265,96.27,14761.0,6
RC,250,RITUXIMAB-PVVR 10 MG/ML IV SOLN,24362.88,15835.869999999999,27.94,14761.0,6
RC,250,RIVAROXABAN 10 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,RIVAROXABAN 15 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,RIVAROXABAN 2.5 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,RIVAROXABAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,12
RC,250,RIVASTIGMINE 13.3 MG/24 HOUR TD PT24,3167.56,2058.915,13270.0,14761.0,4
RC,250,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,5258.2,3417.83,13270.0,14761.0,6
RC,250,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,340.88,221.57,13270.0,14761.0,8
RC,250,RIVASTIGMINE TARTRATE 1.5 MG PO CAPS,408.48,265.515,13270.0,14761.0,4
RC,250,RIVASTIGMINE TARTRATE 3 MG PO CAPS,522.24,339.46,13270.0,14761.0,2
RC,250,ROCURONIUM 10 MG/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,30
RC,250,ROFLUMILAST 250 MCG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ROFLUMILAST 500 MCG PO TABS,6132.96,3986.42,13270.0,14761.0,2
RC,250,ROMIPLOSTIM 125 MCG SC SOLR,20973.6,13632.84,13270.0,14761.0,2
RC,250,ROMIPLOSTIM 250 MCG SC SOLR,23594.94,15336.71,13270.0,14761.0,2
RC,250,ROMIPLOSTIM 500 MCG SC SOLR,47189.79,30673.36,13270.0,14761.0,2
RC,250,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SC SYRG,11830.14,7689.59,13.91,14761.0,3
RC,250,ROPINIROLE 12 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROPINIROLE 2 MG PO TB24,1465.56,952.61,13270.0,14761.0,6
RC,250,ROPINIROLE 4 MG PO TB24,1465.56,952.61,,,0
RC,250,ROPINIROLE 8 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,ROPIVACAINE 0.2 % EPIDURAL (L&D),290.0,188.5,13270.0,14761.0,2
RC,250,ROPIVACAINE 0.2 % PERIPHERAL NERVE BLOCK INFUSION,454.4,295.36,13270.0,14761.0,4
RC,250,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,13270.0,14761.0,6
RC,250,ROPIVACAINE 0.2% IN 0.9% NACL 500 ML FOR PERIPHERAL NERVE CATETHER,686.4,446.16,13270.0,14761.0,4
RC,250,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.15 % EP SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % EP SOLN,2048.0,1331.2,13270.0,14761.0,2
RC,250,ROSUVASTATIN 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,18
RC,250,ROSUVASTATIN 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,20
RC,250,ROSUVASTATIN 40 MG PO TABS,1036.2,673.53,13270.0,14761.0,26
RC,250,ROSUVASTATIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,16
RC,250,ROTIGOTINE 1 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROTIGOTINE 2 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,4
RC,250,ROTIGOTINE 3 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROTIGOTINE 4 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROTIGOTINE 6 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,ROTIGOTINE 8 MG/24 HOUR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,RUFINAMIDE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,RUXOLITINIB 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,RUXOLITINIB 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,RUXOLITINIB 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,RUXOLITINIB 5 MG PO TABS,274399.68,178359.79,13270.0,14761.0,4
RC,250,S-ADENOSYLMETHIONINE 400 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,22619.16,14702.45,43.17,14761.0,3
RC,250,SACUBITRIL-VALSARTAN 24-26 MG HALF-TAB = 12-13 MG,290.0,188.5,13270.0,14761.0,2
RC,250,SACUBITRIL-VALSARTAN 24-26 MG PO TABS,10153.92,6600.05,13270.0,14761.0,4
RC,250,SACUBITRIL-VALSARTAN 49-51 MG PO TABS,10153.92,6600.05,13270.0,14761.0,4
RC,250,SACUBITRIL-VALSARTAN 97-103 MG PO TABS,20307.84,13200.095,13270.0,14761.0,6
RC,250,SALIVA STIMULANT COMB. NO.3 MM SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,SALIVA SUBSTITUTE COMBO NO.9 MM MWSH,1465.56,952.61,13270.0,14761.0,2
RC,250,SALMETEROL 50 MCG/DOSE IN DSDV,3156.48,2051.71,13270.0,14761.0,6
RC,250,SAXAGLIPTIN 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,SAXAGLIPTIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,"SAXAGLIPTIN-METFORMIN 2.5-1,000 MG PO TM24",1465.56,952.61,13270.0,14761.0,2
RC,250,"SAXAGLIPTIN-METFORMIN 5-1,000 MG PO TM24",1465.56,952.61,13270.0,14761.0,2
RC,250,SAXAGLIPTIN-METFORMIN 5-500 MG PO TM24,1465.56,952.61,13270.0,14761.0,2
RC,250,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,963.71,626.41,13270.0,14761.0,20
RC,250,SECRETIN (HUMAN) 16 MCG IV SOLR,10281.6,6683.04,53.01,14761.0,3
RC,250,SELEGILINE 12 MG/24 HR TD PT24,1465.56,952.61,13270.0,14761.0,4
RC,250,SELENIUM 200 MCG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,SELEXIPAG 1600 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
RC,250,SELEXIPAG 200 MCG PO TABS,130403.81999999999,84762.48,13270.0,14761.0,6
RC,250,SELEXIPAG 400 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
RC,250,SELEXIPAG 600 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,2
RC,250,SELEXIPAG 800 MCG PO TABS,403319.04,262157.38,13270.0,14761.0,4
RC,250,SELPERCATINIB 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,SELUMETINIB (STUDY DRUG) 10 MG CAPSULE (PRL: COG ACNS1833),1465.56,952.61,13270.0,14761.0,2
RC,250,SEMAGLUTIDE (WEIGHT LOSS) 2.4 MG/0.75 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SEMAGLUTIDE 0.25 MG OR 0.5 MG(2 MG/1.5 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SEMAGLUTIDE 1 MG/DOSE (2 MG/1.5 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SEMAGLUTIDE 1 MG/DOSE (4 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SEMAGLUTIDE 14 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,SEMAGLUTIDE 2 MG/DOSE (8 MG/3 ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,SEMAGLUTIDE 3 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,SEMAGLUTIDE 7 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,SENNA-PSYLL-CASC-L.ACID-HRB279 545 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,1465.56,952.61,13270.0,14761.0,12
RC,250,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,12117.88,7876.62,13270.0,14761.0,14
RC,250,SEVELAMER CARBONATE 800 MG PO TABS,1563.84,1016.5,13270.0,14761.0,36
RC,250,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,1807.6,1174.94,13270.0,14761.0,2
RC,250,SILDENAFIL (PULM.HYPERTENSION) 10 MG/ML PO SUSR,1465.56,952.61,13270.0,14761.0,2
RC,250,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,340.8,221.52,13270.0,14761.0,20
RC,250,SILDENAFIL 2.5 MG/ML ORAL SUSPENSION (DOSE > 10 MG) (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
RC,250,SILDENAFIL 2.5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,SILODOSIN 4 MG PO CAPS,956.46,621.6949999999999,13270.0,14761.0,20
RC,250,SILODOSIN 8 MG PO CAPS,397.20000000000005,258.18,13270.0,14761.0,12
RC,250,SILTUXIMAB 400 MG IV SOLR,1465.56,952.61,195.58,224.92,8
RC,250,SILVER SULFADIAZINE 1 % TP CREA,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,SINCALIDE 5 MCG IJ SOLR,1983.73,1289.42,13270.0,14761.0,2
RC,250,SIROLIMUS 0.5 MG PO TABS,16135.2,10487.880000000001,13270.0,14761.0,6
RC,250,SIROLIMUS 1 MG PO TABS,25765.8,16747.77,13270.0,14761.0,10
RC,250,SIROLIMUS 1 MG/ML PO SOLN,29280.96,19032.62,13270.0,14761.0,2
RC,250,SIROLIMUS 2 MG PO TABS,15702.4,10206.56,13270.0,14761.0,4
RC,250,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,14757.12,9592.13,13270.0,14761.0,10
RC,250,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,14757.12,9592.13,13270.0,14761.0,10
RC,250,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,14757.12,9592.13,13270.0,14761.0,12
RC,250,"SMALLPOX,MPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8 UNIT/0.5 SC SUSP",4190.4,2723.76,,,0
RC,250,SOD BIC-GINGER-FENNEL-CHAMOM 14-2.5-2-13 MG/5 ML PO LIQD,1465.56,952.61,13270.0,14761.0,2
RC,250,SOD BORATE-BORIC AC-NACL-WATER OP IRSL,290.0,188.5,13270.0,14761.0,2
RC,250,SOD PICOSULF-MAG OX-CITRIC AC 10 MG-3.5 GRAM- 12 GRAM/160 ML PO SOLN,1465.56,952.61,13270.0,14761.0,4
RC,250,SOD SULF-POT CHLORIDE-MAG SULF 1.479-0.188- 0.225 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,"SOD,POT CHLOR-MAG-SOD,POT PHOS 800-40-20-8.75- 6.25 MG/100 ML IR IRSL",1465.56,952.61,13270.0,14761.0,4
RC,250,SODIUM ACETATE 2 MEQ/ML IV SOLN,290.4,188.76,13270.0,14761.0,22
RC,250,SODIUM BICARBONATE (STRAIGHT DRUG) IV INFUSION,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM BICARBONATE 325 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG,880.38,572.245,13270.0,14761.0,8
RC,250,SODIUM BICARBONATE 4.2 % IV SOLN,320.32,208.20999999999998,13270.0,14761.0,6
RC,250,SODIUM BICARBONATE 650 MG PO TABS,696.0,452.4,13270.0,14761.0,20
RC,250,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM BICARBONATE 8.4 % IV SOLN,370.4,240.76,13270.0,14761.0,22
RC,250,"SODIUM BICARBONATE-CITRIC ACID 1,940-1,000 MG PO TBEF",1465.56,952.61,13270.0,14761.0,2
RC,250,SODIUM CHLORIDE 0.65 % NA SPRA,290.0,188.5,13270.0,14761.0,8
RC,250,SODIUM CHLORIDE 0.9 % IN NEBU,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM CHLORIDE 1 GRAM PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,SODIUM CHLORIDE 3 % IN NEBU,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,SODIUM CHLORIDE 3% IV PEDIATRIC,290.0,188.5,13270.0,14761.0,6
RC,250,SODIUM CHLORIDE 3% IVPB,290.0,188.5,13270.0,14761.0,12
RC,250,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,13270.0,14761.0,6
RC,250,SODIUM CHLORIDE 5 % OP OINT,1465.56,952.61,13270.0,14761.0,2
RC,250,SODIUM CHLORIDE 5% FOR APHERESIS ONLY,290.0,188.5,13270.0,14761.0,2
RC,250,SODIUM CHLORIDE 7 % IN NEBU,1465.56,952.61,13270.0,14761.0,4
RC,250,SODIUM CHLORIDE ORAL SOLUTION 4 MEQ/ML,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM CITRATE 230 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,SODIUM HYALURONATE 10 MG/ML IO SYRG,1465.56,952.61,13270.0,14761.0,2
RC,250,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,SODIUM PHENYLBUTYRATE 500 MG PO TABS,1465.56,952.61,,,0
RC,250,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,344.15999999999997,223.70499999999998,13270.0,14761.0,22
RC,250,SODIUM PHOSPHATE ORAL SOLUTION 4 MEQ/ML (3 MMOL/ML),290.0,188.5,13270.0,14761.0,2
RC,250,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN,1102.5900000000001,716.685,13270.0,14761.0,2
RC,250,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IVPB,1584.0,1029.6,13270.0,14761.0,4
RC,250,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,921.95,599.27,13270.0,14761.0,8
RC,250,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM PO PWPK,921.95,599.27,13270.0,14761.0,8
RC,250,"SODIUM,POTASSIUM,MAG SULFATES 17.5-3.13-1.6 GRAM PO SOLR",1465.56,952.61,13270.0,14761.0,2
RC,250,SOFOSBUVIR-VELPATASVIR 400-100 MG PO TABS,60361.58,39235.025,13270.0,14761.0,6
RC,250,SOLIFENACIN 10 MG PO TABS,5747.04,3735.58,13270.0,14761.0,2
RC,250,SOLIFENACIN 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,SOLRIAMFETOL 150 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,SOMATROPIN 10 MG/2 ML (5 MG/ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SOMATROPIN 12 MG (36 UNIT) IJ CRTG,1465.56,952.61,13270.0,14761.0,2
RC,250,SOMATROPIN 20 MG/2 ML (10 MG/ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,SPIRONOLACTONE 5 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,ST. JOHN'S WORT 300 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,STERILE TALC 4 GRAM PL SUSR,2092.7799999999997,1360.305,13270.0,14761.0,8
RC,250,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,SUCROFERRIC OXYHYDROXIDE 500 MG PO CHEW,1465.56,952.61,13270.0,14761.0,2
RC,250,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,1465.56,952.61,13270.0,14761.0,8
RC,250,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,13270.0,14761.0,8
RC,250,SULFACETAMIDE SODIUM 10 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,635.71,413.21,13270.0,14761.0,36
RC,250,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,400.8,260.52,13270.0,14761.0,20
RC,250,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,SULFASALAZINE 500 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,10
RC,250,SULFASALAZINE 500 MG PO TBEC,944.78,614.105,13270.0,14761.0,4
RC,250,SUMATRIPTAN 10 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,2
RC,250,SUMATRIPTAN 20 MG/ACTUATION NA SPRY,1465.56,952.61,13270.0,14761.0,6
RC,250,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,323.88,210.51999999999998,13270.0,14761.0,16
RC,250,SUVOREXANT 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,SUVOREXANT 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,SUVOREXANT 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TACROLIMUS 0.1 % TP OINT,1465.56,952.61,13270.0,14761.0,4
RC,250,TACROLIMUS 0.5 MG PO CAPS,1772.8000000000002,1152.32,13270.0,14761.0,8
RC,250,TACROLIMUS 0.5 MG PO CP24,501.6,326.04,13270.0,14761.0,2
RC,250,TACROLIMUS 0.75 MG PO TB24,4337.84,2819.5950000000003,13270.0,14761.0,4
RC,250,TACROLIMUS 1 MG PO CAPS,1465.56,952.61,13270.0,14761.0,24
RC,250,TACROLIMUS 1 MG PO CP24,1003.2,652.08,13270.0,14761.0,2
RC,250,TACROLIMUS 1 MG PO TB24,2067.66,1343.975,13270.0,14761.0,8
RC,250,TACROLIMUS 4 MG PO TB24,4449.6,2892.24,13270.0,14761.0,4
RC,250,TACROLIMUS 5 MG PO CAPS,14574.4,9473.36,13270.0,14761.0,14
RC,250,TACROLIMUS 5 MG PO CP24,5016.48,3260.71,13270.0,14761.0,2
RC,250,TACROLIMUS 5 MG/ML IV SOLN,1476.42,959.67,317.24,14761.0,3
RC,250,TACROLIMUS ORAL SUSPENSION 1 MG/ML (IP ORDERING ONLY),1465.56,952.61,13270.0,14761.0,4
RC,250,TADALAFIL (PULM. HYPERTENSION) 20 MG PO TABS,745.2,484.38,13270.0,14761.0,14
RC,250,TADALAFIL 2.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,TADALAFIL 5 MG PO TABS,1465.56,952.61,13270.0,14761.0,14
RC,250,TAFAMIDIS 61 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,TAFAMIDIS MEGLUMINE 20 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,TAFLUPROST (PF) 0.0015 % OP DPET,1465.56,952.61,13270.0,14761.0,8
RC,250,TAMOXIFEN 10 MG PO TABS,702.4,456.56,13270.0,14761.0,10
RC,250,TAMOXIFEN 20 MG/10 ML PO SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,TAMSULOSIN 0.4 MG PO CAPS,419.2,272.48,13270.0,14761.0,30
RC,250,TAPENTADOL 100 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
RC,250,TAPENTADOL 150 MG PO TB12,1465.56,952.61,13270.0,14761.0,2
RC,250,TAPENTADOL 50 MG PO TABS,18145.6,11794.64,13270.0,14761.0,2
RC,250,TAURINE 1000 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,TBO-FILGRASTIM 300 MCG SC SYRG,2234.88,1452.67,0.48,14761.0,10
RC,250,TBO-FILGRASTIM 480 MCG SC SYRG,3576.64,2324.82,0.48,14761.0,6
RC,250,TEBENTAFUSP-TEBN 100 MCG/0.5 ML IV SOLN,184320.0,119808.0,267.41,14761.0,10
RC,250,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,13270.0,14761.0,8
RC,250,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,39.82,14761.0,11
RC,250,TECOVIRIMAT 200 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,TELMISARTAN 20 MG PO TABS,290.0,188.5,13270.0,14761.0,4
RC,250,TELMISARTAN 40 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,TELMISARTAN 80 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,13270.0,14761.0,12
RC,250,TEMAZEPAM 7.5 MG PO CAPS,1566.72,1018.37,13270.0,14761.0,4
RC,250,TEMOZOLOMIDE 100 MG PO CAPS,350.45,227.79,13270.0,14761.0,2
RC,250,TEMOZOLOMIDE 140 MG PO CAPS,536.94,349.01,13270.0,14761.0,4
RC,250,TEMOZOLOMIDE 20 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
RC,250,TEMOZOLOMIDE 5 MG PO CAPS,290.0,188.5,13270.0,14761.0,4
RC,250,TENAPANOR 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TENECTEPLASE 50 MG IV SOLR,69575.04,45223.78,196.4,14761.0,10
RC,250,TENOFOVIR ALAFENAMIDE 25 MG PO TABS,22758.24,14792.86,13270.0,14761.0,4
RC,250,TENOFOVIR DISOPROXIL FUMARATE 300 MG PO TABS,10232.880000000001,6651.37,13270.0,14761.0,6
RC,250,TERBINAFINE HCL 250 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,250,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,13270.0,14761.0,8
RC,250,TERCONAZOLE 0.8 % VA CREA,386.56,251.26,13270.0,14761.0,2
RC,250,TERIPARATIDE 20 MCG/DOSE (600MCG/2.4ML) SC PNIJ,1465.56,952.61,13270.0,14761.0,4
RC,250,TERIPARATIDE 20 MCG/DOSE (620MCG/2.48ML) SC PNIJ,10574.035,6873.12,13270.0,14761.0,4
RC,250,TESAMORELIN 2 MG SC SOLR,1465.56,952.61,13270.0,14761.0,2
RC,250,TESTOSTERONE 1 % (50 MG/5 GRAM) TD GLPK,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,TESTOSTERONE 20.25 MG/1.25 GRAM (1.62 %) TD GLPM,1465.56,952.61,13270.0,14761.0,4
RC,250,TESTOSTERONE 4 MG/24 HR TD PT24,1465.56,952.61,13270.0,14761.0,2
RC,250,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,13270.0,14761.0,4
RC,250,TESTOSTERONE ENANTHATE 100 MG/0.5 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
RC,250,TESTOSTERONE ENANTHATE 75 MG/0.5 ML SC ATIN,1465.56,952.61,13270.0,14761.0,2
RC,250,TESTOSTERONE TOPICAL COMPOUNDED PRESCRIPTION,1465.56,952.61,13270.0,14761.0,2
RC,250,TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG,602.32,391.51,13270.0,14761.0,2
RC,250,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,724.42,14761.0,7
RC,250,TETRABENAZINE 12.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TETRACAINE HCL (PF) 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,4
RC,250,TETRACYCLINE 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,TETRACYCLINE 500 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,TETRAHYDROZOLINE 0.05 % OP DROP,290.0,188.5,13270.0,14761.0,4
RC,250,THALIDOMIDE 100 MG PO CAPS,124278.78,80781.21,13270.0,14761.0,2
RC,250,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,13270.0,14761.0,20
RC,250,THIOGUANINE 40 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,THIOTEPA 15 MG IJ SOLR,2720.56,1768.365,260.26,14761.0,6
RC,250,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,13270.0,14761.0,10
RC,250,THROMBIN (RECOMBINANT) 5000 UNITS TP SOLR,924.32,600.81,13270.0,14761.0,2
RC,250,THYROID (PORK) 97.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,THYROTROPIN ALFA 0.9 MG IM SOLR,1465.56,952.61,2581.7,14761.0,6
RC,250,TIAGABINE 2 MG PO TABS,1465.56,952.61,,,0
RC,250,TIAGABINE 4 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TICAGRELOR 60 MG PO TABS,6928.32,4503.41,13270.0,14761.0,4
RC,250,TICAGRELOR 90 MG PO TABS,11547.2,7505.68,13270.0,14761.0,4
RC,250,TIGECYCLINE 50 MG IV SOLR,455.08000000000004,295.79999999999995,13270.0,14761.0,8
RC,250,TIMOLOL 0.25 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,TIMOLOL 0.5 % OP DROP,1465.56,952.61,13270.0,14761.0,2
RC,250,TIMOLOL MALEATE (PF) 0.5 % OP DPET,1465.56,952.61,13270.0,14761.0,2
RC,250,TIMOLOL MALEATE 0.25 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,TIMOLOL MALEATE 0.5 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,TINIDAZOLE 500 MG PO TABS,735.04,477.78,13270.0,14761.0,4
RC,250,TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
RC,250,TIOTROPIUM BROMIDE 18 MCG IN CPDV,1465.56,952.61,13270.0,14761.0,2
RC,250,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,1913.93,1244.055,13270.0,14761.0,6
RC,250,TIOTROPIUM-OLODATEROL 2.5-2.5 MCG/ACTUATION IN MIST,1465.56,952.61,13270.0,14761.0,2
RC,250,TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN,1804.0,1172.6,13270.0,14761.0,2
RC,250,TIRZEPATIDE 5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,TIRZEPATIDE 7.5 MG/0.5 ML SC PNIJ,1465.56,952.61,13270.0,14761.0,2
RC,250,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,64107.0,41669.55,226.12,14761.0,10
RC,250,TIXAGEVIMAB 150 MG/1.5 ML IM SOLN,1465.56,952.61,13270.0,14761.0,2
RC,250,TOBRAMYCIN 0.3 % OP DROP,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,TOBRAMYCIN 0.3 % OP OINT,1465.56,952.61,13270.0,14761.0,2
RC,250,TOBRAMYCIN 1.2 G SOLN FOR MIXTURE (INTRAPROCEDURE),959.04,623.38,13270.0,14761.0,2
RC,250,TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML IN NEBU,1465.56,952.61,13270.0,14761.0,6
RC,250,TOBRAMYCIN NEBULIZER SOLUTION 40 MG/ML,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.44,188.785,13270.0,14761.0,8
RC,250,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,753.92,490.05,13270.0,14761.0,16
RC,250,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP OINT,1465.56,952.61,13270.0,14761.0,2
RC,250,TOBRAMYCIN-LOTEPRED 0.3-0.5 % OP DRPS,4934.56,3207.46,13270.0,14761.0,2
RC,250,TOCILIZUMAB 162 MG/0.9 ML SC SYRG,17513.12,11383.53,13270.0,14761.0,2
RC,250,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN,21246.56,13810.26,7.42,14761.0,3
RC,250,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,42493.12,27620.53,7.42,14761.0,3
RC,250,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,8498.56,5524.06,7.42,14761.0,3
RC,250,TOFACITINIB 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TOFACITINIB 11 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,TOLTERODINE 1 MG PO TABS,744.96,484.22,13270.0,14761.0,6
RC,250,TOLTERODINE 2 MG PO CP24,1465.56,952.61,13270.0,14761.0,6
RC,250,TOLTERODINE 2 MG PO TABS,4056.48,2636.71,13270.0,14761.0,4
RC,250,TOLTERODINE 4 MG PO CP24,1465.56,952.61,13270.0,14761.0,10
RC,250,TOLVAPTAN 15 MG PO TABS,1465.56,952.61,13270.0,14761.0,10
RC,250,TOLVAPTAN 30 MG PO TABS,36710.83,23862.04,13270.0,14761.0,8
RC,250,TOPIRAMATE (TOPAMAX) ORAL SUSPENSION PEDIATRIC 6 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,TOPIRAMATE 100 MG PO CSPX,1465.56,952.61,13270.0,14761.0,2
RC,250,TOPIRAMATE 100 MG PO TABS,720.0,468.0,13270.0,14761.0,8
RC,250,TOPIRAMATE 200 MG PO CP24,1465.56,952.61,13270.0,14761.0,2
RC,250,TOPIRAMATE 200 MG PO TABS,345.6,224.64,13270.0,14761.0,2
RC,250,TOPIRAMATE 25 MG PO CP24,1465.56,952.61,13270.0,14761.0,4
RC,250,TOPIRAMATE 25 MG PO TABS,386.4,251.16,13270.0,14761.0,12
RC,250,TOPOTECAN 4 MG IV SOLR,2086.88,1356.47,13270.0,14761.0,2
RC,250,TPN - NICU (WEIGHT BASED),1465.56,952.61,13270.0,14761.0,6
RC,250,TRAMADOL 100 MG PO TM24,1465.56,952.61,13270.0,14761.0,2
RC,250,TRAMADOL 300 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,TRAMETINIB 2 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,TRANEXAMIC ACID (CYCLOKAPRON) (100MG/ML) 5000MG IN 50ML (STRAIGHT DRU),1465.56,952.61,13270.0,14761.0,2
RC,250,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,13270.0,14761.0,30
RC,250,TRANEXAMIC ACID 650 MG PO TABS,705.64,458.665,13270.0,14761.0,6
RC,250,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",290.0,188.5,13270.0,14761.0,2
RC,250,TRASTUZUMAB-QYYP 420 MG IV SOLR,17962.56,11675.66,23.87,14761.0,6
RC,250,TRAVOPROST 0.004 % OP DROP,1465.56,952.61,13270.0,14761.0,8
RC,250,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) IN NEBU,51746.21,33635.04,13270.0,14761.0,2
RC,250,TREPROSTINIL 16 MCG (112)- 32 MCG (84) IN CTDV,1465.56,952.61,13270.0,14761.0,2
RC,250,TREPROSTINIL 16 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
RC,250,TREPROSTINIL 16(112)-32(112) -48(28) MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
RC,250,TREPROSTINIL 32 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,4
RC,250,TREPROSTINIL 48 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,4
RC,250,TREPROSTINIL 64 MCG IN CTDV,1465.56,952.61,13270.0,14761.0,2
RC,250,TREPROSTINIL DIOLAMINE 0.25 MG PO TBSR,1465.56,952.61,13270.0,14761.0,4
RC,250,TREPROSTINIL DIOLAMINE 1 MG PO TBSR,1465.56,952.61,13270.0,14761.0,4
RC,250,TREPROSTINIL DIOLAMINE 5 MG PO TBSR,1465.56,952.61,13270.0,14761.0,2
RC,250,TREPROSTINIL SODIUM 1 MG/ML IJ SOLN,3352.86,2179.36,69.5,14761.0,9
RC,250,TREPROSTINIL SODIUM 10 MG/ML IJ SOLN,39997.98,25998.69,69.5,14761.0,3
RC,250,TREPROSTINIL SODIUM 2.5 MG/ML IJ SOLN,1465.56,952.61,69.5,14761.0,3
RC,250,TREPROSTINIL SODIUM 5 MG/ML IJ SOLN,17416.35,11320.625,69.5,14761.0,6
RC,250,TREPROSTINIL-NEBULIZER-ACCESOR 1.74 MG/2.9 ML IN NEBU,1465.56,952.61,13270.0,14761.0,2
RC,250,TRETINOIN (ANTINEOPLASTIC) 10 MG PO CAPS,22124.184999999998,14380.72,13270.0,14761.0,4
RC,250,TRETINOIN 0.025 % TP CREA,1465.56,952.61,,,0
RC,250,TRIAMCINOLONE ACETONIDE 0.025 % TP OINT,290.0,188.5,13270.0,14761.0,2
RC,250,TRIAMCINOLONE ACETONIDE 0.1 % DT PSTE,785.12,510.33000000000004,13270.0,14761.0,4
RC,250,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,297.82,193.58,13270.0,14761.0,12
RC,250,TRIAMCINOLONE ACETONIDE 0.1 % TP LOTN,877.78,570.5550000000001,13270.0,14761.0,8
RC,250,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,13270.0,14761.0,12
RC,250,TRIAMCINOLONE ACETONIDE 10 MG/ML IJ SUSP,290.0,188.5,13270.0,14761.0,2
RC,250,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,1465.56,952.61,22.1,14761.0,3
RC,250,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,708.32,460.41,13270.0,14761.0,10
RC,250,TRIAMCINOLONE ACETONIDE 55 MCG NA SPRA,1465.56,952.61,13270.0,14761.0,2
RC,250,TRIAZOLAM 0.125 MG PO TABS,1291.98,839.7850000000001,13270.0,14761.0,4
RC,250,TRIAZOLAM 0.25 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,TRIFLURIDINE 1 % OP DROP,2921.88,1899.22,13270.0,14761.0,2
RC,250,TRIMETHOBENZAMIDE 100 MG/ML IM SOLN,722.24,469.46,13270.0,14761.0,4
RC,250,TRIMETHOPRIM 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,TROPICAMIDE 0.5 % OP DROP,290.0,188.5,13270.0,14761.0,6
RC,250,TROPICAMIDE 1 % OP DROP,385.0,250.25,13270.0,14761.0,12
RC,250,TROSPIUM 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,8
RC,250,TUBERCULIN PPD 5 TUB. UNIT /0.1 ML ID SOLN,1641.28,1066.83,13270.0,14761.0,8
RC,250,UBROGEPANT 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,UBROGEPANT 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,UMECLIDINIUM 62.5 MCG/ACTUATION IN DSDV,1465.56,952.61,13270.0,14761.0,4
RC,250,UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION IN DSDV,2071.945,1346.7649999999999,13270.0,14761.0,6
RC,250,UPADACITINIB 15 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,UPADACITINIB 30 MG PO TB24,1465.56,952.61,13270.0,14761.0,2
RC,250,UREA 20 % TP CREA,290.0,188.5,13270.0,14761.0,4
RC,250,URSODIOL 250 MG PO TABS,1329.6,864.24,13270.0,14761.0,12
RC,250,URSODIOL 500 MG PO TABS,1465.56,952.61,,,0
RC,250,URSODIOL ORAL SUSPENSION 50 MG/ML (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,4
RC,250,USTEKINUMAB 90 MG/ML SC SYRG,233470.62,151755.9,199.12,14761.0,3
RC,250,VALACYCLOVIR 1 GRAM PO TABS,890.6999999999999,578.955,13270.0,14761.0,8
RC,250,VALACYCLOVIR 500 MG PO TABS,989.8199999999999,643.38,13270.0,14761.0,14
RC,250,VALBENAZINE 40 MG PO CAPS,1465.56,952.61,13270.0,14761.0,4
RC,250,VALBENAZINE 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,VALGANCICLOVIR 450 MG PO TABS,8899.74,5784.83,13270.0,14761.0,24
RC,250,VALGANCICLOVIR 50 MG/ML PO SOLR,11929.98,7754.49,13270.0,14761.0,6
RC,250,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,877.78,570.5550000000001,13270.0,14761.0,20
RC,250,VALSARTAN 160 MG PO TABS,596.16,387.5,13270.0,14761.0,10
RC,250,VALSARTAN 40 MG HALF-TAB = 20 MG,290.0,188.5,13270.0,14761.0,4
RC,250,VALSARTAN 40 MG PO TABS,290.0,188.5,13270.0,14761.0,6
RC,250,VALSARTAN 80 MG PO TABS,424.8,276.12,13270.0,14761.0,10
RC,250,VANCOMYCIN 1.25 GRAM IV SOLR,290.69,188.95,13270.0,14761.0,2
RC,250,VANCOMYCIN 10 GRAM IV SOLR,417.6,271.44,13270.0,14761.0,2
RC,250,VANCOMYCIN 1000 MG IV SOLR,290.0,188.5,13270.0,14761.0,10
RC,250,VANCOMYCIN 125 MG PO CAPS,890.44,578.7850000000001,13270.0,14761.0,8
RC,250,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,VANCOMYCIN 25 MG/ML PO SOLR,1465.56,952.61,13270.0,14761.0,2
RC,250,VANCOMYCIN 250 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,VANCOMYCIN 5 GRAM IV SOLR,739.76,480.845,13270.0,14761.0,10
RC,250,VANCOMYCIN 500 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,13270.0,14761.0,8
RC,250,VANCOMYCIN 750 MG/250 ML IVPB,290.0,188.5,13270.0,14761.0,2
RC,250,VANCOMYCIN ENEMA,26272.0,17076.8,13270.0,14761.0,2
RC,250,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,VANCOMYCIN ORAL SOLUTION 25 MG/ML,290.0,188.5,13270.0,14761.0,8
RC,250,VANILLA TPN WITH HEPARIN NICU,1465.56,952.61,13270.0,14761.0,4
RC,250,VARENICLINE 0.03 MG/SPRAY NA SPRM,1465.56,952.61,13270.0,14761.0,2
RC,250,VARENICLINE 0.5 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SC SUSR,1465.56,952.61,,,0
RC,250,VASOPRESSIN 0.2 UNITS/ML IV SOLN,596.8,387.92,13270.0,14761.0,2
RC,250,VASOPRESSIN 0.4 UNITS/ML IV SOLN,1342.4,872.56,13270.0,14761.0,2
RC,250,VASOPRESSIN 20 UNITS/ML IV SOLN,1192.58,775.18,13270.0,14761.0,10
RC,250,VECURONIUM BROMIDE 10 MG IV SOLR,877.78,570.5550000000001,13270.0,14761.0,24
RC,250,VEDOLIZUMAB 300 MG IV SOLR,84239.19,54755.47,27.72,14761.0,3
RC,250,VENETOCLAX 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,VENETOCLAX 100 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,VENETOCLAX 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,VENLAFAXINE 150 MG PO CP24,493.92,321.05,13270.0,14761.0,14
RC,250,VENLAFAXINE 25 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,4
RC,250,VENLAFAXINE 37.5 MG PO CP24,424.8,276.12,13270.0,14761.0,10
RC,250,VENLAFAXINE 37.5 MG PO TABS,303.4,197.20999999999998,13270.0,14761.0,8
RC,250,VENLAFAXINE 50 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,VENLAFAXINE 75 MG PO CP24,437.04,284.08,13270.0,14761.0,26
RC,250,VENLAFAXINE 75 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,12
RC,250,VERAPAMIL 100 MG PO CPCT,1465.56,952.61,13270.0,14761.0,2
RC,250,VERAPAMIL 2.5 MG/ML IV SOLN,359.555,233.71,13270.0,14761.0,20
RC,250,VERICIGUAT 10 MG PO TABS,10034.88,6522.67,13270.0,14761.0,4
RC,250,VERICIGUAT 2.5 MG PO TABS,7358.69,4783.15,13270.0,14761.0,4
RC,250,VIBEGRON 75 MG PO TABS,1465.56,952.61,13270.0,14761.0,6
RC,250,VIGABATRIN 500 MG PO PWPK,1465.56,952.61,13270.0,14761.0,4
RC,250,VILAZODONE 10 MG PO TABS,5177.28,3365.23,13270.0,14761.0,2
RC,250,VILAZODONE 20 MG PO TABS,3242.16,2107.405,13270.0,14761.0,6
RC,250,VILAZODONE 40 MG PO TABS,3321.42,2158.92,13270.0,14761.0,6
RC,250,VINBLASTINE 1 MG/ML IV SOLN,793.28,515.63,13270.0,14761.0,2
RC,250,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,6
RC,250,VINORELBINE 50 MG/5 ML IV SOLN,506.88,329.47,13270.0,14761.0,2
RC,250,VISMODEGIB 150 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,"VITAMINS A,C,E-ZINC-COPPER 2,148 MCG-113 MG-45 MG-17.4MG PO TABS",1465.56,952.61,13270.0,14761.0,2
RC,250,VORICONAZOLE 200 MG IV SOLR,307.08000000000004,199.6,13270.0,14761.0,12
RC,250,VORICONAZOLE 200 MG PO TABS,5755.68,3741.195,13270.0,14761.0,8
RC,250,VORICONAZOLE 200 MG/5 ML (40 MG/ML) PO SUSR,6932.4,4506.06,13270.0,14761.0,4
RC,250,VORICONAZOLE 50 MG PO TABS,665.76,432.74,13270.0,14761.0,8
RC,250,VORTIOXETINE 10 MG PO TABS,7664.64,4982.02,13270.0,14761.0,2
RC,250,VORTIOXETINE 5 MG PO TABS,7664.64,4982.02,13270.0,14761.0,2
RC,250,VOXELOTOR 500 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,6133.8,14761.0,3
RC,250,WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OP OINT,1465.56,952.61,13270.0,14761.0,2
RC,250,XYLITOL 550 MG MM MABT,1465.56,952.61,13270.0,14761.0,2
RC,250,ZAFIRLUKAST 10 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ZAFIRLUKAST 20 MG PO TABS,1465.56,952.61,13270.0,14761.0,4
RC,250,ZALEPLON 5 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ZANUBRUTINIB 80 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,250,ZIDOVUDINE 10 MG/ML IV SOLN,435.2,282.88,13270.0,14761.0,2
RC,250,ZIDOVUDINE 100 MG PO CAPS,2257.6,1467.44,13270.0,14761.0,2
RC,250,ZIDOVUDINE 300 MG PO TABS,910.86,592.0550000000001,13270.0,14761.0,4
RC,250,ZILEUTON 600 MG PO TABS,1465.56,952.61,13270.0,14761.0,2
RC,250,ZINC CHLORIDE 1 MG/ML IV SOLN,290.0,188.5,13270.0,14761.0,4
RC,250,ZINC SULFATE 5 MG/ML IV SOLN,667.44,433.84,13270.0,14761.0,6
RC,250,ZIPRASIDONE HCL 20 MG PO CAPS,2654.72,1725.57,13270.0,14761.0,8
RC,250,ZIPRASIDONE HCL 40 MG PO CAPS,3289.6,2138.24,13270.0,14761.0,4
RC,250,ZIPRASIDONE HCL 60 MG PO CAPS,2595.84,1687.3,13270.0,14761.0,4
RC,250,ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR,625.225,406.395,13270.0,14761.0,4
RC,250,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,475.63,309.15999999999997,13270.0,14761.0,8
RC,250,ZOLPIDEM 10 MG PO TABS,877.78,570.5550000000001,13270.0,14761.0,14
RC,250,ZOLPIDEM 12.5 MG PO TBMP,1465.56,952.61,,,0
RC,250,ZOLPIDEM 3.5 MG SL SUBL,1465.56,952.61,13270.0,14761.0,6
RC,250,ZOLPIDEM 5 MG HALF-TAB = 2.5 MG,1465.56,952.61,13270.0,14761.0,2
RC,250,ZOLPIDEM 5 MG PO TABS,290.0,188.5,13270.0,14761.0,8
RC,250,ZOLPIDEM 6.25 MG PO TBMP,1465.56,952.61,13270.0,14761.0,2
RC,250,ZONISAMIDE (ZONEGRAN) ORAL SUSPENSION 10 MG/ML PEDIATRIC (IP ORDERING ONLY),290.0,188.5,13270.0,14761.0,2
RC,250,ZONISAMIDE 50 MG PO CAPS,1465.56,952.61,13270.0,14761.0,2
RC,255,DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % PO SOLN,290.0,188.5,13270.0,14761.0,2
RC,255,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),298.84000000000003,194.245,13270.0,14761.0,4
RC,255,DIATRIZOATE MEGLUMINE 30 % UR SOLN,,,13270.0,14761.0,2
RC,255,Drugs incident to radiology,,,,,0
RC,255,ETHIODIZED OIL 480 MG IODINE/ML IJ OIL,12321.0,8008.65,13270.0,14761.0,4
RC,255,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),2238.63,1455.105,13270.0,14761.0,6
RC,255,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,2
RC,255,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,2
RC,255,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,8
RC,255,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN,,,13270.0,14761.0,2
RC,255,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,,,13270.0,14761.0,6
RC,255,IODIXANOL 320 MG IODINE/ML IV SOLN,,,13270.0,14761.0,8
RC,255,IOHEXOL 12 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,2
RC,255,IOHEXOL 180 MG IODINE/ML IT SOLN,,,13270.0,14761.0,4
RC,255,IOHEXOL 240 MG IODINE/ML IV SOLN,,,13270.0,14761.0,4
RC,255,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),391.2,254.28,13270.0,14761.0,14
RC,255,IOHEXOL 350 MG IODINE/ML IV SOLN,,,13270.0,14761.0,10
RC,255,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,13270.0,14761.0,4
RC,255,IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN,,,13270.0,14761.0,2
RC,255,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,,,13270.0,14761.0,4
RC,255,PERFLUTREN PROTEIN-A MICROSPHR 0.22 MG/ML IV SUSP,,,13270.0,14761.0,2
RC,255,SULFUR HEXAFLUORIDE MICROSPHR 25 MG IV SUSR,,,13270.0,14761.0,2
RC,256,experimental drugs,387.29,251.74,,,0
RC,258,IVásolutions,0.01,0.01,,,0
RC,26,Neurosurgery,,,30000.0,30000.0,1
RC,260,General,991.58,644.53,,,0
RC,260,HYDRATION THEARPY,1764.97,1147.23,,,0
RC,260,IV Therapy,991.58,644.53,,,0
RC,260,Infusion Therapy,991.58,644.53,1594.96,2426.97,5
RC,261,HYDRATION THEARPY,1764.97,1147.23,,,0
RC,261,Infusion Therapy,,,1594.96,2426.97,5
RC,262,Infusion Therapy,,,1594.96,2426.97,5
RC,263,INFUSION THERAPY,,,2148.0,2209.0,2
RC,263,Infusion Therapy,,,1594.96,2426.97,5
RC,264,INFUSION THERAPY,,,2148.0,2209.0,2
RC,264,Infusion Therapy,,,1594.96,2426.97,5
RC,265,INFUSION THERAPY,,,2148.0,2209.0,2
RC,266,INFUSION THERAPY,,,2148.0,2209.0,2
RC,267,INFUSION THERAPY,,,2148.0,2209.0,2
RC,268,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,268,INFUSION THERAPY,,,2148.0,2209.0,2
RC,269,Cardiovascular Surgery,,,2520.0,2520.0,1
RC,269,INFUSION THERAPY,,,2148.0,2209.0,2
RC,269,Infusion Therapy,,,1594.96,2426.97,5
RC,27,Neurosurgery,,,30000.0,30000.0,1
RC,270,Cardiovascular Surgery,971.79,631.66,2520.0,2520.0,1
RC,270,General,971.79,631.66,,,0
RC,271,Cardiovascular Surgery,880.4,572.26,2520.0,2520.0,1
RC,271,Nonsterile,880.4,572.26,,,0
RC,272,Cardiovascular Surgery,2334.97,1517.73,2520.0,2520.0,1
RC,272,Sterile,2334.97,1517.73,,,0
RC,274,ALL OTHER IMPLANTS AND PROSTHESIS OUTPATIENT,999.0,649.35,,,0
RC,274,"Exclusions for: Outpatient Prosthesis, Orthotics, Pacemakers, Implants/IOLs - when charges per unit exceeds $5,000",999.0,649.35,,,0
RC,274,High Cost Implantables,999.0,649.35,,,0
RC,274,IMPLANTS INPATIENT CATCH ALL,999.0,649.35,,,0
RC,274,"Implants, Prosthetics and Orthotics",999.0,649.35,,,0
RC,274,NON-IMPLANTABLE PROSTHETICS/ORTHOTICS,999.0,649.35,,,0
RC,274,"Pediatric and Neonatal Services: Surgical Implants/Pacemaker, Prosthetics/Orthotics, Intra Ocular Lens when Billed Charges Exceed $5,000 per item per Admission",999.0,649.35,,,0
RC,274,Prosthetic/orthotic devices,999.0,649.35,,,0
RC,274,Prosthetics and Orthotics,999.0,649.35,,,0
RC,274,Prosthetics/Orthotics,999.0,649.35,,,0
RC,275,ALL OTHER IMPLANTS AND PROSTHESIS OUTPATIENT,64536.75,41948.89,,,0
RC,275,"Exclusions for: Outpatient Prosthesis, Orthotics, Pacemakers, Implants/IOLs - when charges per unit exceeds $5,000",64536.75,41948.89,,,0
RC,275,High Cost Implantables,64536.75,41948.89,,,0
RC,275,IMPLANTS,64536.75,41948.89,,,0
RC,275,IMPLANTS INPATIENT CATCH ALL,64536.75,41948.89,,,0
RC,275,"Implants, Prosthetics and Orthotics",64536.75,41948.89,,,0
RC,275,Pacemaker,64536.75,41948.89,,,0
RC,275,Pacemaker Supplies,64536.75,41948.89,,,0
RC,275,"Pediatric and Neonatal Services: Surgical Implants/Pacemaker, Prosthetics/Orthotics, Intra Ocular Lens when Billed Charges Exceed $5,000 per item per Admission",64536.75,41948.89,,,0
RC,276,ALL OTHER IMPLANTS AND PROSTHESIS OUTPATIENT,3217.9,2091.63,,,0
RC,276,"Exclusions for: Outpatient Prosthesis, Orthotics, Pacemakers, Implants/IOLs - when charges per unit exceeds $5,000",3217.9,2091.63,,,0
RC,276,High Cost Implantables,3217.9,2091.63,,,0
RC,276,IMPLANTS INPATIENT CATCH ALL,3217.9,2091.63,,,0
RC,276,"Implants, Prosthetics and Orthotics",3217.9,2091.63,,,0
RC,276,Intraocular Lens,3217.9,2091.63,,,0
RC,276,Intraocular lens,3217.9,2091.63,,,0
RC,276,"Pediatric and Neonatal Services: Surgical Implants/Pacemaker, Prosthetics/Orthotics, Intra Ocular Lens when Billed Charges Exceed $5,000 per item per Admission",3217.9,2091.63,,,0
RC,278,ALL OTHER IMPLANTS AND PROSTHESIS OUTPATIENT,19799.1,12869.41,,,0
RC,278,"Exclusions for: Outpatient Prosthesis, Orthotics, Pacemakers, Implants/IOLs - when charges per unit exceeds $5,000",19799.1,12869.41,,,0
RC,278,High Cost Implantables,19799.1,12869.41,,,0
RC,278,IMPLANTS,19799.1,12869.41,,,0
RC,278,IMPLANTS INPATIENT CATCH ALL,19799.1,12869.41,,,0
RC,278,Implants,19799.1,12869.41,,,0
RC,278,"Implants, Prosthetics and Orthotics",19799.1,12869.41,,,0
RC,278,MICROSPHERES (Y-90 GLASS) (THERA-SPHERES) ISOTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
RC,278,MICROSPHERES (Y-90 RESIN) (SIR-SPHERES) ISOPTOPE (NUC MED),1.0,0.65,21772.24,25038.07,8
RC,278,Other implants,19799.1,12869.41,,,0
RC,278,"Pediatric and Neonatal Services: Surgical Implants/Pacemaker, Prosthetics/Orthotics, Intra Ocular Lens when Billed Charges Exceed $5,000 per item per Admission",19799.1,12869.41,,,0
RC,28,Spine Surgery,,,25000.0,25000.0,1
RC,280,INFUSION THERAPY,,,2148.0,2148.0,1
RC,281,INFUSION THERAPY,,,2209.0,2209.0,1
RC,282,INFUSION THERAPY,,,2209.0,2209.0,1
RC,283,INFUSION THERAPY,,,2209.0,2209.0,1
RC,284,INFUSION THERAPY,,,2209.0,2209.0,1
RC,285,INFUSION THERAPY,,,2209.0,2209.0,1
RC,286,INFUSION THERAPY,,,2209.0,2209.0,1
RC,287,INFUSION THERAPY,,,2209.0,2209.0,1
RC,288,INFUSION THERAPY,,,2209.0,2209.0,1
RC,289,INFUSION THERAPY,,,2148.0,2209.0,2
RC,29,Spine Surgery,,,25000.0,25000.0,1
RC,292,OUTPATIENT DME,538.43,349.98,,,0
RC,292,Purchase of newáDME,538.43,349.98,,,0
RC,30,Spine Surgery,,,25000.0,25000.0,1
RC,300,Clinical Laboratory,868.53,564.54,,,0
RC,300,General,868.53,564.54,,,0
RC,300,Laboratory,868.53,564.54,,,0
RC,300,OUTPATIENT LAB,868.53,564.54,,,0
RC,300,Pediatric and Neonatal Services: Laboratory Services,868.53,564.54,,,0
RC,300,"Radiology, Pathology, and Diagnostic Tests",868.53,564.54,,,0
RC,301,Chemistry,668.37,434.44,,,0
RC,301,Clinical Laboratory,668.37,434.44,,,0
RC,301,Laboratory,668.37,434.44,,,0
RC,301,OUTPATIENT LAB,668.37,434.44,,,0
RC,301,Pediatric and Neonatal Services: Laboratory Services,668.37,434.44,,,0
RC,301,"Radiology, Pathology, and Diagnostic Tests",668.37,434.44,,,0
RC,302,Clinical Laboratory,1022.51,664.63,,,0
RC,302,Immunology,1022.51,664.63,,,0
RC,302,Laboratory,1022.51,664.63,,,0
RC,302,OUTPATIENT LAB,1022.51,664.63,,,0
RC,302,Pediatric and Neonatal Services: Laboratory Services,1022.51,664.63,,,0
RC,302,"Radiology, Pathology, and Diagnostic Tests",1022.51,664.63,,,0
RC,305,Clinical Laboratory,448.69,291.65,,,0
RC,305,Hematology,448.69,291.65,,,0
RC,305,Laboratory,448.69,291.65,,,0
RC,305,OUTPATIENT LAB,448.69,291.65,,,0
RC,305,Pediatric and Neonatal Services: Laboratory Services,448.69,291.65,,,0
RC,305,"Radiology, Pathology, and Diagnostic Tests",448.69,291.65,,,0
RC,306,Bacteriology and Microbiology,535.86,348.31,,,0
RC,306,Clinical Laboratory,535.86,348.31,,,0
RC,306,Laboratory,535.86,348.31,,,0
RC,306,OUTPATIENT LAB,535.86,348.31,,,0
RC,306,Pediatric and Neonatal Services: Laboratory Services,535.86,348.31,,,0
RC,306,"Radiology, Pathology, and Diagnostic Tests",535.86,348.31,,,0
RC,307,Clinical Laboratory,406.68,264.34,,,0
RC,307,Laboratory,406.68,264.34,,,0
RC,307,OUTPATIENT LAB,406.68,264.34,,,0
RC,307,Pediatric and Neonatal Services: Laboratory Services,406.68,264.34,,,0
RC,307,"Radiology, Pathology, and Diagnostic Tests",406.68,264.34,,,0
RC,307,Urology,406.68,264.34,,,0
RC,309,Clinical Laboratory,30.43,19.78,,,0
RC,309,Laboratory,30.43,19.78,,,0
RC,309,OUTPATIENT LAB,30.43,19.78,,,0
RC,309,Other,30.43,19.78,,,0
RC,309,Pediatric and Neonatal Services: Laboratory Services,30.43,19.78,,,0
RC,309,"Radiology, Pathology, and Diagnostic Tests",30.43,19.78,,,0
RC,310,Clinical Laboratory,1281.0,832.65,,,0
RC,310,General,1281.0,832.65,,,0
RC,310,OUTPATIENT LAB,1281.0,832.65,,,0
RC,310,Pathology,1281.0,832.65,,,0
RC,310,Pediatric and Neonatal Services: Laboratory Services,1281.0,832.65,,,0
RC,310,"Radiology, Pathology, and Diagnostic Tests",1281.0,832.65,,,0
RC,311,Clinical Laboratory,769.02,499.86,,,0
RC,311,Cytology,769.02,499.86,,,0
RC,311,OUTPATIENT LAB,769.02,499.86,,,0
RC,311,Pathology,769.02,499.86,,,0
RC,311,Pediatric and Neonatal Services: Laboratory Services,769.02,499.86,,,0
RC,311,"Radiology, Pathology, and Diagnostic Tests",769.02,499.86,,,0
RC,312,Clinical Laboratory,912.04,592.83,,,0
RC,312,Histology,912.04,592.83,,,0
RC,312,OUTPATIENT LAB,912.04,592.83,,,0
RC,312,Pathology,912.04,592.83,,,0
RC,312,Pediatric and Neonatal Services: Laboratory Services,912.04,592.83,,,0
RC,312,"Radiology, Pathology, and Diagnostic Tests",912.04,592.83,,,0
RC,320,General,2274.79,1478.61,,,0
RC,320,Other Diagnostic Radiology,2274.79,1478.61,546.13,593.21,3
RC,320,Pediatric and Neonatal Services: Routine X-rays,2274.79,1478.61,,,0
RC,320,"Radiology, Pathology, and Diagnostic Tests",2274.79,1478.61,,,0
RC,321,Other Diagnostic Radiology,,,546.13,593.21,3
RC,322,Arthrography,3834.59,2492.48,,,0
RC,322,Other Diagnostic Radiology,3834.59,2492.48,546.13,593.21,3
RC,322,Pediatric and Neonatal Services: Routine X-rays,3834.59,2492.48,,,0
RC,322,"Radiology, Pathology, and Diagnostic Tests",3834.59,2492.48,,,0
RC,323,Arteriography,18106.1,11768.97,,,0
RC,323,Other Diagnostic Radiology,18106.1,11768.97,546.13,593.21,3
RC,323,Pediatric and Neonatal Services: Routine X-rays,18106.1,11768.97,,,0
RC,323,"Radiology, Pathology, and Diagnostic Tests",18106.1,11768.97,,,0
RC,324,Chest X-ray,1606.76,1044.39,,,0
RC,324,Other Diagnostic Radiology,1606.76,1044.39,546.13,593.21,3
RC,324,Pediatric and Neonatal Services: Routine X-rays,1606.76,1044.39,,,0
RC,324,"Radiology, Pathology, and Diagnostic Tests",1606.76,1044.39,,,0
RC,329,Other,4288.93,2787.8,,,0
RC,329,Other Diagnostic Radiology,4288.93,2787.8,546.13,593.21,3
RC,329,Pediatric and Neonatal Services: Routine X-rays,4288.93,2787.8,,,0
RC,329,"Radiology, Pathology, and Diagnostic Tests",4288.93,2787.8,,,0
RC,331,Chemotherapy Administration,2053.07,1334.5,,,0
RC,331,Chemotherapy Administration Services,2053.07,1334.5,,,0
RC,331,INFUSION THERAPY,2053.07,1334.5,2148.0,2209.0,2
RC,332,INFUSION THERAPY,,,2148.0,2209.0,2
RC,333,Radiation Therapy,10318.6,6707.09,,,0
RC,333,Radiation therapy,10318.6,6707.09,,,0
RC,333,"Radiology, Pathology, and Diagnostic Tests",10318.6,6707.09,,,0
RC,333,Stereotactic Radiosurgery,102573.0,66672.45,54913.12,86027.67,5
RC,333,"Stereotactic Radiosurgery, Multisource or Linear based completed in one session",56445.8,36689.77,64417.25,69885.3,27
RC,333,"Stereotactic Radiosurgery, fractionated, entire course not to exceed 5 fractions",27427.7,17828.01,,,0
RC,335,Chemotherapy Administration,991.58,644.53,,,0
RC,335,Chemotherapy Administration Services,991.58,644.53,,,0
RC,335,INFUSION THERAPY,991.58,644.53,2148.0,2209.0,2
RC,335,Infusion Therapy,991.58,644.53,1594.96,2426.97,5
RC,340,General,7877.34,5120.27,,,0
RC,340,Nuclear Medicine,7877.34,5120.27,2571.25,2789.24,3
RC,340,"Radiology, Pathology, and Diagnostic Tests",7877.34,5120.27,,,0
RC,341,Diagnostic,6279.86,4081.91,,,0
RC,341,Nuclear Medicine,6279.86,4081.91,2571.25,2789.24,3
RC,341,"Radiology, Pathology, and Diagnostic Tests",6279.86,4081.91,,,0
RC,342,Nuclear Medicine,4075.18,2648.87,2571.25,2789.24,3
RC,342,"Radiology, Pathology, and Diagnostic Tests",4075.18,2648.87,,,0
RC,342,Therapeutic,4075.18,2648.87,,,0
RC,343,BICISATE DIHYDROCHLORIDE (TC-99M) (NEUROLITE) ISOTOPE (NUC ME),1.01,0.65,851.46,14761.0,10
RC,343,DIETHYLENE TRIAMINE PENTAACETIC ACID (TC-99M DTPA) ISOTOPE (NUC MED) N,1.01,0.65,13270.0,14761.0,2
RC,343,Diagnostic radiopharmaceuticals,1.01,0.65,,,0
RC,343,F-18 FLUCICLOVINE,1.01,0.65,334.23,384.37,8
RC,343,FLORBETAPIR F-18 10 MCI (370 MBQ) IV SOLN,1.01,0.65,2732.71,3142.62,8
RC,343,FLUORODEOXYGLUCOSE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,343,"FLUOROESTRADIOL F-18 148 MBQ/ML TO 3,700 MBQ/ML IV SOLN",1.01,0.65,620.94,714.08,8
RC,343,GALLIUM (GA-67) CITRATE ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,343,GALLIUM DOTATATE (GA-68)(NETSPOT) ISOTOPE (NUC MED),1.01,0.65,63.62,73.16,8
RC,343,High Cost Drugs,1.01,0.65,,,0
RC,343,"IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",1.01,0.65,1284.27,14761.0,10
RC,343,INDIUM 111-PENTETREOTIDE 3-10 MCI/ML-MCG IV KIT,1.01,0.65,2384.05,2741.66,8
RC,343,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN,1.01,0.65,2583.53,14761.0,10
RC,343,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,1.01,0.65,1728.35,1987.6,8
RC,343,KIT FOR PREP OF TC-99M-ALBUMIN 2.5 MG IV SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,KIT FOR TC 99M-SESTAMIBI NO.1 IV SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR,1.01,0.65,13270.0,14761.0,4
RC,343,KIT PREP OF TC-99M-SOD PYROPH 12 MG IV SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,KIT TC-99M-MERTIATIDE (BETIAT) 1 MG IV SOLR,1.01,0.65,13270.0,14761.0,2
RC,343,LABELED RED BLOOD CELLS (TC-99M RBC) (ULTRATAG) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,343,LU-177 DOTATATE (LUTATHERA) ISOTOPE (NUC MED),1.01,0.65,368.89,14761.0,26
RC,343,"LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",1.01,0.65,300.39,345.45,8
RC,343,MEDRONATE (TC-99M MDP) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,343,PENTETATE INDIUM DISOD. IN-111 1.5 MCI/1.5 ML IT SOLN,1.01,0.65,890.67,14761.0,10
RC,343,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML IV SOLN",1.01,0.65,413.95,476.04,8
RC,343,RUBIDIUM CHLORIDE RB-82,1.01,0.65,13270.0,14761.0,2
RC,343,"Radiology, Pathology, and Diagnostic Tests",1.01,0.65,,,0
RC,343,SODIUM FLOURIDE (F-18) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,343,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) PO CAPS,1.01,0.65,13270.0,14761.0,2
RC,343,SODIUM PERTECHNETATE (TC-99M O4) ISOTOPE (NUC MED),1.01,0.65,13270.0,14761.0,2
RC,344,High Cost Drugs,,,,,0
RC,344,"RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN",,,205.77,236.63,8
RC,344,"Radiology, Pathology, and Diagnostic Tests",,,,,0
RC,344,SODIUM IODIDE I-131 CAPSULE,,,28.8,14761.0,10
RC,349,BICISATE DIHYDROCHLORIDE (TC-99M) (NEUROLITE) ISOTOPE (NUC ME),,,851.46,14761.0,3
RC,349,DIETHYLENE TRIAMINE PENTAACETIC ACID (TC-99M DTPA) ISOTOPE (NUC MED) N,,,13270.0,14761.0,2
RC,349,FLUORODEOXYGLUCOSE (F-18) ISOTOPE (NUC MED),,,13270.0,14761.0,2
RC,349,GALLIUM (GA-67) CITRATE ISOTOPE (NUC MED),,,13270.0,14761.0,2
RC,349,GALLIUM DOTATATE (GA-68)(NETSPOT) ISOTOPE (NUC MED),,,63.62,73.16,8
RC,349,"IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",,,1284.27,14761.0,3
RC,349,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN,,,2583.53,14761.0,3
RC,349,KIT FOR PREP OF TC-99M-ALBUMIN 2.5 MG IV SOLR,,,13270.0,14761.0,2
RC,349,KIT FOR TC 99M-SESTAMIBI NO.1 IV SOLR,,,13270.0,14761.0,2
RC,349,KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC SOLR,,,13270.0,14761.0,2
RC,349,KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR,,,13270.0,14761.0,2
RC,349,KIT PREP OF TC-99M-SOD PYROPH 12 MG IV SOLR,,,13270.0,14761.0,2
RC,349,KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR,,,13270.0,14761.0,2
RC,349,KIT TC-99M-MERTIATIDE (BETIAT) 1 MG IV SOLR,,,13270.0,14761.0,2
RC,349,LABELED RED BLOOD CELLS (TC-99M RBC) (ULTRATAG) ISOTOPE (NUC MED),,,13270.0,14761.0,2
RC,349,MEDRONATE (TC-99M MDP) ISOTOPE (NUC MED),,,13270.0,14761.0,2
RC,349,Nuclear Medicine,,,2571.25,2789.24,3
RC,349,RUBIDIUM CHLORIDE RB-82,,,13270.0,14761.0,2
RC,349,SODIUM IODIDE I-131 CAPSULE,,,28.8,33.12,8
RC,349,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) PO CAPS,,,,,0
RC,350,CT/CTA Scan(s) includes contrast materials and other radiologic supplies,4948.41,3216.47,,,0
RC,350,Computerized Tomography (CT) Scan,4948.41,3216.47,3084.44,3346.23,3
RC,350,Pediatric and Neonatal Services: CT Scan with and/or without contrast,4948.41,3216.47,740.0,740.0,1
RC,350,"Radiology, Pathology, and Diagnostic Tests",4948.41,3216.47,,,0
RC,351,CT/CTA Scan(s) includes contrast materials and other radiologic supplies,8051.27,5233.33,,,0
RC,351,Computerized Tomography (CT) Scan,8051.27,5233.33,3084.44,3346.23,3
RC,351,Pediatric and Neonatal Services: CT Scan with and/or without contrast,8051.27,5233.33,740.0,740.0,1
RC,351,"Radiology, Pathology, and Diagnostic Tests",8051.27,5233.33,,,0
RC,352,CT/CTA Scan(s) includes contrast materials and other radiologic supplies,8051.27,5233.33,,,0
RC,352,Computerized Tomography (CT) Scan,8051.27,5233.33,3084.44,3346.23,3
RC,352,Pediatric and Neonatal Services: CT Scan with and/or without contrast,8051.27,5233.33,740.0,740.0,1
RC,352,"Radiology, Pathology, and Diagnostic Tests",8051.27,5233.33,,,0
RC,359,Computerized Tomography (CT) Scan,,,3084.44,3346.23,3
RC,359,Pediatric and Neonatal Services: CT Scan with and/or without contrast,,,740.0,740.0,1
RC,360,Ambulatory Surgery,8681.23,5642.8,,,0
RC,360,Ambulatory Surgery: Default Rate,8681.23,5642.8,,,0
RC,360,Inpatient Surgical Fee,12592.72,8185.27,10983.24,17205.33,5
RC,360,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,4065
RC,360,Outpatient Surgical Group 1,6838.045,4444.73,9088.3,13492.72,8800
RC,360,Outpatient Surgical Group 2,12682.9,8243.885,12162.28,18056.43,5215
RC,360,Outpatient Surgical Group 3,13383.7,8699.404999999999,13899.75,20635.92,4845
RC,360,Outpatient Surgical Group 4,25241.3,16406.85,17187.58,25517.11,2835
RC,360,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,1510
RC,360,Outpatient Surgical Group 6,20418.3,13271.895,22453.45,33334.94,535
RC,360,Outpatient Surgical Group 7,30218.4,19641.96,27131.25,40279.73,1485
RC,360,Outpatient Surgical Group 8,8681.23,5642.8,26436.26,39247.93,65
RC,360,Outpatient Surgical Group 9,33237.4,21604.315000000002,36513.58,54208.97,560
RC,360,Pediatric and Neonatal Services: Ambulatory Surgery,8681.23,5642.8,,,0
RC,361,Ambulatory Surgery,6099.75,3964.84,,,0
RC,361,Ambulatory Surgery: Default Rate,6099.75,3964.84,,,0
RC,361,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,4065
RC,361,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,361,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,361,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,361,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,361,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,1510
RC,361,Outpatient Surgical Group 6,20418.3,13271.895,22453.45,33334.94,535
RC,361,Outpatient Surgical Group 7,30218.4,19641.96,27131.25,40279.73,1485
RC,361,Outpatient Surgical Group 8,6099.75,3964.84,26436.26,39247.93,65
RC,361,Outpatient Surgical Group 9,33237.4,21604.315000000002,36513.58,54208.97,560
RC,361,Pediatric and Neonatal Services: Ambulatory Surgery,6099.75,3964.84,,,0
RC,362,Ambulatory Surgery: Default Rate,68377.59,44445.43,,,0
RC,362,Organ transplant - other than kidney,68377.59,44445.43,,,0
RC,369,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,369,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,369,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,369,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,369,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,369,Outpatient Surgical Group 5,54325.5,35311.58,19539.84,29009.34,1510
RC,369,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,535
RC,369,Outpatient Surgical Group 7,30306.95,19699.52,27131.25,40279.73,1485
RC,369,Outpatient Surgical Group 8,,,26436.26,39247.93,65
RC,369,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,560
RC,370,General,1011.67,657.59,,,0
RC,370,Pediatric and Neonatal Services: Ambulatory Surgery,1011.67,657.59,,,0
RC,390,BLOOD,860.02,559.01,,,0
RC,390,Blood and Blood Related Services,860.02,559.01,,,0
RC,390,General,860.02,559.01,,,0
RC,391,"Administration (e.g., transfusions)",4587.08,2981.6,,,0
RC,391,BLOOD,4587.08,2981.6,,,0
RC,391,Blood and Blood Related Services,4587.08,2981.6,,,0
RC,400,Imaging Services,,,269.88,292.88,3
RC,401,Diagnostic and Screening Mammography,1519.9,987.93,482.38,522.92,3
RC,401,Diagnostic mammography,1519.9,987.93,,,0
RC,401,"Radiology, Pathology, and Diagnostic Tests",1519.9,987.93,,,0
RC,402,Pediatric and Neonatal Services: Ultrasound,2215.88,1440.32,245.0,245.0,1
RC,402,"Radiology, Pathology, and Diagnostic Tests",2215.88,1440.32,,,0
RC,402,Ultrasound,2215.88,1440.32,,,0
RC,402,Ultrasound Imaging,2215.88,1440.32,702.31,761.48,3
RC,403,Diagnostic and Screening Mammography,1726.31,1122.1,482.38,522.92,3
RC,403,"Radiology, Pathology, and Diagnostic Tests",1726.31,1122.1,,,0
RC,403,Screening mammography,1726.31,1122.1,,,0
RC,404,"Pediatric and Neonatal Services: PET Scan, 1 scan per visit",14448.95,9391.82,1748.0,1748.0,1
RC,404,"Pediatric and Neonatal Services: PET Scan, 2 scans per visit",14448.95,9391.82,2342.0,2342.0,1
RC,404,Positron Emission Tomography,14448.95,9391.82,5783.19,6273.92,3
RC,404,"Radiology, Pathology, and Diagnostic Tests",14448.95,9391.82,,,0
RC,409,Imaging Services,,,269.88,292.88,3
RC,410,General,1250.4,812.76,,,0
RC,410,RESPIRATORY THERAPY - OUTPATIENT,1250.4,812.76,430.0,470.0,2
RC,410,Respiratory Services,1250.4,812.76,,,0
RC,411,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,412,Inhalation services,1249.46,812.15,,,0
RC,412,RESPIRATORY THERAPY - OUTPATIENT,1249.46,812.15,430.0,470.0,2
RC,412,Respiratory Services,1249.46,812.15,,,0
RC,413,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,414,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,415,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,416,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,417,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,418,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,419,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,420,General,565.69,367.7,,,0
RC,420,PHYSICAL THERAPY - OUTPATIENT,565.69,367.7,430.0,470.0,2
RC,420,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",565.69,367.7,200.0,200.0,1
RC,420,Physical Therapy,565.69,367.7,,,0
RC,421,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,421,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,422,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,422,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,423,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,423,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,424,Evaluation or reevaluation,1695.42,1102.02,,,0
RC,424,PHYSICAL THERAPY - OUTPATIENT,1695.42,1102.02,430.0,470.0,2
RC,424,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",1695.42,1102.02,200.0,200.0,1
RC,424,Physical Therapy,1695.42,1102.02,,,0
RC,425,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,427,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,428,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,429,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,429,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,430,General,561.64,365.07,,,0
RC,430,Occupational Therapy,561.64,365.07,,,0
RC,430,Outpatient Occupational Therapy,561.64,365.07,430.0,470.0,2
RC,430,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",561.64,365.07,200.0,200.0,1
RC,431,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,431,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,432,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,432,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,433,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,433,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,434,Evaluation or reevaluation,1131.36,735.38,,,0
RC,434,Occupational Therapy,1131.36,735.38,,,0
RC,434,Outpatient Occupational Therapy,1131.36,735.38,430.0,470.0,2
RC,434,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",1131.36,735.38,200.0,200.0,1
RC,435,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,436,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,437,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,438,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,439,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,439,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,440,General,1316.6,855.79,,,0
RC,440,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",1316.6,855.79,200.0,200.0,1
RC,440,SPEECH THERAPY - OUTPATIENT,1316.6,855.79,430.0,470.0,2
RC,440,Speech Therapy,1316.6,855.79,,,0
RC,441,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,441,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,442,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,442,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,443,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,443,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,444,Evaluation or reevaluation,1695.42,1102.02,,,0
RC,444,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",1695.42,1102.02,200.0,200.0,1
RC,444,SPEECH THERAPY - OUTPATIENT,1695.42,1102.02,430.0,470.0,2
RC,444,Speech Therapy,1695.42,1102.02,,,0
RC,445,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,446,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,447,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,448,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,449,"Pediatric and Neonatal Services: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST)",,,200.0,200.0,1
RC,449,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,450,Emergency Critical Care,16839.3,10945.55,13495.88,14640.56,3
RC,450,Emergency Level 1,6215.280000000001,4039.93,899.94,976.61,6
RC,450,Emergency Level 1: Limited,4686.045,3045.9300000000003,1148.08,2290.16,10
RC,450,Emergency Level 2,7209.275,4686.03,2055.94,2230.11,6
RC,450,Emergency Level 2: Intermediate,8738.51,5680.03,2710.42,5406.67,5
RC,450,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,6
RC,450,Emergency Level 3: Comprehensive,13212.150000000001,8587.895,5444.5,10860.55,10
RC,450,Emergency Level 4,10646.055,6919.9349999999995,8353.38,9063.15,6
RC,450,Emergency Level 4: Critical Care,16839.3,10945.55,8746.72,17447.72,5
RC,450,Emergency Level 5,11304.605,7347.99,9061.0,9829.95,6
RC,450,Emergency room,8738.51,5680.03,,,0
RC,450,General,8738.51,5680.03,,,0
RC,450,Outpatient Emergency and Trauma Services,8738.51,5680.03,,,0
RC,451,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,451,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,451,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,451,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,451,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,451,Emergency Critical Care,16839.3,10945.55,13495.88,14640.56,3
RC,451,Emergency Level 1,3692.05,2399.83,899.94,976.61,6
RC,451,Emergency Level 1: Limited,4686.045,3045.9300000000003,1148.08,2290.16,10
RC,451,Emergency Level 2,5680.04,3692.03,2055.94,2230.11,6
RC,451,Emergency Level 2: Intermediate,8738.51,5680.03,2710.42,5406.67,5
RC,451,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,6
RC,451,Emergency Level 3: Comprehensive,13212.150000000001,8587.895,5444.5,10860.55,10
RC,451,Emergency Level 4,12553.6,8159.84,8353.38,9063.15,6
RC,451,Emergency Level 4: Critical Care,16839.3,10945.55,8746.72,17447.72,5
RC,451,Emergency Level 5,13870.7,9015.95,9061.0,9829.95,6
RC,452,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,452,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,452,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,452,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,452,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,452,Emergency Critical Care,16839.3,10945.55,13495.88,14640.56,3
RC,452,Emergency Level 1,3692.05,2399.83,899.94,976.61,6
RC,452,Emergency Level 1: Limited,4686.045,3045.9300000000003,1148.08,2290.16,10
RC,452,Emergency Level 2,5680.04,3692.03,2055.94,2230.11,6
RC,452,Emergency Level 2: Intermediate,8738.51,5680.03,2710.42,5406.67,5
RC,452,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,6
RC,452,Emergency Level 3: Comprehensive,13212.150000000001,8587.895,5444.5,10860.55,10
RC,452,Emergency Level 4,12553.6,8159.84,8353.38,9063.15,6
RC,452,Emergency Level 4: Critical Care,16839.3,10945.55,8746.72,17447.72,5
RC,452,Emergency Level 5,13870.7,9015.95,9061.0,9829.95,6
RC,453,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,453,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,453,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,453,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,453,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,453,Spine Surgery,,,25000.0,25000.0,1
RC,454,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,454,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,454,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,454,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,454,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,454,Spine Surgery,,,25000.0,25000.0,1
RC,455,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,455,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,455,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,455,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,455,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,455,Spine Surgery,,,25000.0,25000.0,1
RC,456,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,456,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,456,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,456,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,456,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,456,Spine Surgery,,,25000.0,25000.0,1
RC,456,Urgent Care,,,473.44,944.4,5
RC,457,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,457,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,457,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,457,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,457,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,457,Spine Surgery,,,25000.0,25000.0,1
RC,458,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,458,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,458,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,458,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,458,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,458,Spine Surgery,,,25000.0,25000.0,1
RC,459,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,459,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,459,EMERGENCY CARE LEVEL 3,8738.51,5680.03,4518.0,4862.0,4
RC,459,EMERGENCY CARE LEVEL 4,12553.6,8159.84,9060.0,9859.0,4
RC,459,EMERGENCY CARE LEVEL 5,15355.0,9980.75,16899.0,18206.0,6
RC,459,Emergency Critical Care,16839.3,10945.55,13495.88,14640.56,3
RC,459,Emergency Level 1,3692.05,2399.83,899.94,976.61,6
RC,459,Emergency Level 1: Limited,4686.045,3045.9300000000003,1148.08,2290.16,10
RC,459,Emergency Level 2,5680.04,3692.03,2055.94,2230.11,6
RC,459,Emergency Level 2: Intermediate,8738.51,5680.03,2710.42,5406.67,5
RC,459,Emergency Level 3,8738.51,5680.03,4466.75,4845.75,6
RC,459,Emergency Level 3: Comprehensive,13212.150000000001,8587.895,5444.5,10860.55,10
RC,459,Emergency Level 4,12553.6,8159.84,8353.38,9063.15,6
RC,459,Emergency Level 4: Critical Care,16839.3,10945.55,8746.72,17447.72,5
RC,459,Emergency Level 5,13870.7,9015.95,9061.0,9829.95,6
RC,459,Spine Surgery,,,25000.0,25000.0,1
RC,460,General,3283.21,2134.09,,,0
RC,460,Pulmonary Function,3283.21,2134.09,,,0
RC,460,"Radiology, Pathology, and Diagnostic Tests",3283.21,2134.09,,,0
RC,460,Spine Surgery,1586.08,1030.95,25000.0,25000.0,1
RC,470,Audiology,3297.7,2143.5,,,0
RC,470,General,3297.7,2143.5,,,0
RC,470,"Radiology, Pathology, and Diagnostic Tests",3297.7,2143.5,,,0
RC,471,Audiology,3687.39,2396.8,,,0
RC,471,Diagnostic,3687.39,2396.8,,,0
RC,471,"Radiology, Pathology, and Diagnostic Tests",3687.39,2396.8,,,0
RC,471,Spine Surgery,4793.61,3115.84,25000.0,25000.0,1
RC,472,Spine Surgery,,,25000.0,25000.0,1
RC,473,Spine Surgery,,,25000.0,25000.0,1
RC,480,Ambulatory Surgery,1440.95,936.62,,,0
RC,480,Ambulatory Surgery: Default Rate,1440.95,936.62,,,0
RC,480,Cardiology,1440.95,936.62,,,0
RC,480,General,1440.95,936.62,,,0
RC,480,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,480,Outpatient Surgical Group 1,6773.325000000001,4402.66,9088.3,13492.72,8800
RC,480,Outpatient Surgical Group 2,12682.9,8243.885,12162.28,18056.43,5215
RC,480,Outpatient Surgical Group 3,13383.7,8699.404999999999,13899.75,20635.92,4845
RC,480,Outpatient Surgical Group 4,25241.3,16406.85,17187.58,25517.11,2835
RC,480,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,1510
RC,480,Outpatient Surgical Group 6,20418.3,13271.895,22453.45,33334.94,535
RC,480,Outpatient Surgical Group 7,30218.4,19641.96,27131.25,40279.73,1485
RC,480,Outpatient Surgical Group 8,1440.95,936.62,26436.26,39247.93,65
RC,480,Outpatient Surgical Group 9,33237.4,21604.315000000002,36513.58,54208.97,560
RC,480,Pediatric and Neonatal Services: Ambulatory Surgery,1440.95,936.62,,,0
RC,480,"Radiology, Pathology, and Diagnostic Tests",1440.95,936.62,,,0
RC,481,Ambulatory Surgery,37207.0,24184.55,,,0
RC,481,Ambulatory Surgery: Default Rate,3283.21,2134.09,,,0
RC,481,Cardiac CatheterizationLab Services,37207.0,24184.55,,,0
RC,481,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,4065
RC,481,Outpatient Surgical Group 1,6838.045,4444.73,9088.3,13492.72,8800
RC,481,Outpatient Surgical Group 2,13288.8,8637.720000000001,12162.28,18056.43,5215
RC,481,Outpatient Surgical Group 3,13708.900000000001,8910.785,13899.75,20635.92,4845
RC,481,Outpatient Surgical Group 4,25520.1,16588.06,17187.58,25517.11,2835
RC,481,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,1510
RC,481,Outpatient Surgical Group 6,31567.1,20518.614999999998,22453.45,33334.94,535
RC,481,Outpatient Surgical Group 7,30395.5,19757.08,27131.25,40279.73,1485
RC,481,Outpatient Surgical Group 8,37207.0,24184.55,26436.26,39247.93,65
RC,481,Outpatient Surgical Group 9,36619.25,23802.515,36513.58,54208.97,560
RC,481,Pediatric and Neonatal Services: Ambulatory Surgery,37207.0,24184.55,,,0
RC,481,"Radiology, Pathology, and Diagnostic Tests",37207.0,24184.55,,,0
RC,482,Cardiac Stress Test,3969.24,2580.01,,,0
RC,482,"Radiology, Pathology, and Diagnostic Tests",3969.24,2580.01,,,0
RC,482,Stress test,3969.24,2580.01,,,0
RC,483,Echocardiology,4755.58,3091.13,,,0
RC,483,"Radiology, Pathology, and Diagnostic Tests",4755.58,3091.13,,,0
RC,490,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,490,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,490,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,490,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,490,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,490,Outpatient Surgical Group 5,54325.5,35311.58,19539.84,29009.34,1510
RC,490,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,535
RC,490,Outpatient Surgical Group 7,30306.95,19699.52,27131.25,40279.73,1485
RC,490,Outpatient Surgical Group 8,,,26436.26,39247.93,65
RC,490,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,560
RC,499,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,499,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,499,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,499,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,499,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,499,Outpatient Surgical Group 5,54325.5,35311.58,19539.84,29009.34,1510
RC,499,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,535
RC,499,Outpatient Surgical Group 7,30306.95,19699.52,27131.25,40279.73,1485
RC,499,Outpatient Surgical Group 8,,,26436.26,39247.93,65
RC,499,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,560
RC,510,Ambulatory Surgery: Default Rate,1062.28,690.485,,,0
RC,510,Clinic Visit,1037.19,674.17,,,0
RC,510,Outpatient Clinic,1037.19,674.17,130.0,130.0,1
RC,511,Clinic Visit,,,,,0
RC,511,Outpatient Clinic,,,130.0,130.0,1
RC,512,Outpatient Clinic,,,130.0,130.0,1
RC,513,Outpatient Clinic,,,130.0,130.0,1
RC,514,Outpatient Clinic,,,130.0,130.0,1
RC,515,Outpatient Clinic,,,130.0,130.0,1
RC,516,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,516,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,516,Outpatient Clinic,,,130.0,130.0,1
RC,517,Outpatient Clinic,,,130.0,130.0,1
RC,518,Outpatient Clinic,,,130.0,130.0,1
RC,518,Spine Surgery,,,25000.0,25000.0,1
RC,519,Outpatient Clinic,,,130.0,130.0,1
RC,519,Spine Surgery,,,25000.0,25000.0,1
RC,520,Spine Surgery,,,25000.0,25000.0,1
RC,526,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,526,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,526,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,610,General,7500.04,4875.03,,,0
RC,610,MRI/MRA,7500.04,4875.03,3089.09,3116.45,2
RC,610,Magnetic Resonance Imaging,7500.04,4875.03,3084.44,3346.23,3
RC,610,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,7500.04,4875.03,900.0,900.0,1
RC,610,"Radiology, Pathology, and Diagnostic Tests",7500.04,4875.03,,,0
RC,611,Brain/brain stem,10167.2,6608.68,,,0
RC,611,MRI/MRA,10167.2,6608.68,3089.09,3116.45,2
RC,611,Magnetic Resonance Imaging,10167.2,6608.68,3084.44,3346.23,3
RC,611,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,10167.2,6608.68,900.0,900.0,1
RC,611,"Radiology, Pathology, and Diagnostic Tests",10167.2,6608.68,,,0
RC,612,MRI/MRA,10057.9,6537.64,3089.09,3116.45,2
RC,612,Magnetic Resonance Imaging,10057.9,6537.64,3084.44,3346.23,3
RC,612,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,10057.9,6537.64,900.0,900.0,1
RC,612,"Radiology, Pathology, and Diagnostic Tests",10057.9,6537.64,,,0
RC,612,Spinal cord/spine,10057.9,6537.64,,,0
RC,614,Magnetic Resonance Imaging,,,3084.44,3346.23,3
RC,614,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,,,900.0,900.0,1
RC,615,Head and neck,7912.54,5143.15,,,0
RC,615,MRI/MRA,7912.54,5143.15,3089.09,3116.45,2
RC,615,Magnetic Resonance Imaging,7912.54,5143.15,3084.44,3346.23,3
RC,615,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,7912.54,5143.15,900.0,900.0,1
RC,615,"Radiology, Pathology, and Diagnostic Tests",7912.54,5143.15,,,0
RC,616,Magnetic Resonance Imaging,,,3084.44,3346.23,3
RC,616,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,,,900.0,900.0,1
RC,618,MRI/MRA,9285.33,6035.46,3089.09,3116.45,2
RC,618,Magnetic Resonance Imaging,9285.33,6035.46,3084.44,3346.23,3
RC,618,Other MRA,9285.33,6035.46,,,0
RC,618,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,9285.33,6035.46,900.0,900.0,1
RC,618,"Radiology, Pathology, and Diagnostic Tests",9285.33,6035.46,,,0
RC,619,MRI/MRA,,,3089.09,3116.45,2
RC,619,Magnetic Resonance Imaging,,,3084.44,3346.23,3
RC,619,Pediatric and Neonatal Services: MRI and MRA with and/or without contrast agent,,,900.0,900.0,1
RC,624,FDAáinvestigational devices,1.0,0.65,,,0
RC,636,ABATACEPT (WITH MALTOSE) 250 MG IV SOLR,11282.32,7333.51,54.09,62.2,8
RC,636,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,20482.8,13313.82,10.75,12.36,8
RC,636,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,8590.0,5583.5,10.75,12.36,8
RC,636,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN",10386.4,6751.16,,,0
RC,636,ACETAMINOPHEN 10 MG/ML CUSTOM DOSE IV SOLN,10386.4,6751.16,,,0
RC,636,ACETAZOLAMIDE SODIUM 500 MG IJ SOLR,365.28,237.43,,,0
RC,636,ACETIC ACID (BULK) 5 % MISC LIQD,301.0,195.65,,,0
RC,636,ACETIC ACID 4% TOPICAL SOLN INTRAPROCEDURE,20482.8,13313.82,,,0
RC,636,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN INTRAPROCEDURE,3270.72,2125.97,,,0
RC,636,ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN,290.0,188.5,,,0
RC,636,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,ADALIMUMAB 40 MG/0.4 ML SC PNKT,20482.8,13313.82,,,0
RC,636,ADALIMUMAB 40 MG/0.8 ML SC PNKT,58048.29,37731.39,,,0
RC,636,ADENOSINE (ADENOCARD) 100 MCG/ML INJECTION FOR INTRAPROCEDURE,20482.8,13313.82,,,0
RC,636,ADENOSINE 3 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,ADENOSINE IN 0.9% NACL 90 MG/90 ML INFUSION (CATH LAB USE),691.2,449.28,,,0
RC,636,ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR,35906.67,23339.34,50.36,57.92,8
RC,636,ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR,57450.6,37342.89,50.36,57.92,8
RC,636,"ALBUMIN, HUMAN 25 % 25 % IV SOLP",932.8,606.32,,,0
RC,636,"ALBUMIN, HUMAN 5 % 5 % IV SOLP",1060.0,689.0,66.09,76.0,72
RC,636,ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) IN NEBU,290.0,188.5,,,0
RC,636,ALBUTEROL SULFATE 2.5 MG/0.5 ML IN NEBU,290.0,188.5,,,0
RC,636,ALBUTEROL SULFATE 5 MG/ML IN NEBU,715.52,465.09,,,0
RC,636,ALFENTANIL 500 MCG/ML IJ SOLN,20482.8,13313.82,,,0
RC,636,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG IV SOLR,5350.0,3477.5,6.15,7.07,16
RC,636,ALTEPLASE 2 MG CATH SOLR,2760.32,1794.21,113.9,130.98,8
RC,636,ALTEPLASE 50 MG IV SOLR,36896.85,23982.95,113.9,130.98,8
RC,636,AMINO AC 8 %-D14W-ELECTROLYTES 8-14 % IV SOLP,640.0,416.0,,,0
RC,636,AMINOPHYLLINE 500 MG/20 ML IV SOLN,10386.4,6751.16,,,0
RC,636,AMIODARONE 150MG-D5W 150ML CSHS,290.0,188.5,,,0
RC,636,AMIODARONE 50 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,AMIODARONE IV INFUSION (1 MG/ML),290.0,188.5,,,0
RC,636,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,32817.14,21331.14,25.74,29.6,8
RC,636,AMOBARBITAL 500 MG IJ SOLR,10927.68,7102.99,,,0
RC,636,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,1540.48,1001.31,29.04,33.4,8
RC,636,AMPICILLIN SODIUM 1 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,AMPICILLIN SODIUM 2 GRAM IJ SOLR,10386.4,6751.16,,,0
RC,636,AMPICILLIN SODIUM 500 MG IJ SOLR,10386.4,6751.16,,,0
RC,636,AMPICILLIN-SULBACTAM (UNASYN) 3 GRAM/100 ML NS VIAL-TO-BAG IVPB,10386.4,6751.16,,,0
RC,636,AMPICILLIN-SULBACTAM 1.5 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,AMPICILLIN-SULBACTAM 3 GRAM IJ SOLR,10386.4,6751.16,,,0
RC,636,"ANTIHEMOPHIL FVIII,FULL LENGTH 1,000 (+/-) UNIT IV SOLR",19040.0,12376.0,1.93,14761.0,12
RC,636,"ANTIHEMOPHIL FVIII,FULL LENGTH 2,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.93,2.22,8
RC,636,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV SOLR",32321.4,21008.91,1.74,14761.0,20
RC,636,ANTIHEMOPHILIC FACTOR-VWF 250-600 UNIT IV SOLR,11040.0,7176.0,1.74,14761.0,10
RC,636,"ANTIHEMOPHILIC FACTOR-VWF 500-1,200 UNIT IV SOLR",22080.0,14352.0,1.74,14761.0,20
RC,636,ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML IV SOLN,20482.8,13313.82,,,0
RC,636,ARSENIC TRIOXIDE 1 MG/ML IV SOLN,4654.88,3025.67,8.96,10.31,8
RC,636,ARSENIC TRIOXIDE 2 MG/ML IV SOLN,969.02,629.86,8.96,10.31,8
RC,636,ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN,4033.6,2621.84,,,0
RC,636,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",101266.38,65823.15,107.39,123.5,8
RC,636,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,70886.47,46076.21,107.39,123.5,8
RC,636,ATROPINE 0.1 MG/ML IJ SYRG,290.0,188.5,,,0
RC,636,ATROPINE 1 % OP DROP,605.92,393.85,13270.0,14761.0,4
RC,636,AVELUMAB 20 MG/ML IV SOLN,30976.64,20134.82,118.51,136.29,8
RC,636,AZACITIDINE 100 MG IJ SOLR,715.84,465.3,,,0
RC,636,AZITHROMYCIN 500 MG IV SOLR,10386.4,6751.16,,,0
RC,636,AZITHROMYCIN 500 MG/250 ML NS VIAL-TO-BAG,290.0,188.5,,,0
RC,636,AZTREONAM 1 GRAM IJ SOLR,329.01,213.86,,,0
RC,636,All Other Outpatient Services,20482.8,13313.82,,,0
RC,636,All Oupatient,20482.8,13313.82,,,0
RC,636,All Outpatient Hospital Services,20482.8,13313.82,,,0
RC,636,BACITRACIN ZINC 500 UNIT/GRAM TP OIPK,290.0,188.5,,,0
RC,636,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OIPK",529.92,344.45,13270.0,14761.0,2
RC,636,BACLOFEN 2000 MCG/ML IT SOLN,13343.97,8673.58,,,0
RC,636,BACLOFEN 50 MCG/ML IT SOLN,447.23,290.7,,,0
RC,636,BACLOFEN 500 MCG/ML IT SOLN,11721.4,7618.91,217.39,249.99,8
RC,636,BASILIXIMAB 20 MG IV SOLR,38230.02,24849.51,5713.88,6570.96,8
RC,636,BCG LIVE 50 MG IS SUSR,2632.96,1711.42,,,0
RC,636,BEBTELOVIMAB 175 MG/2 ML (87.5 MG/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,BELANTAMAB MAFODOTIN-BLMF 100 MG IV SOLR,20482.8,13313.82,58.25,66.99,8
RC,636,BELATACEPT 250 MG IV SOLR,14744.0,9583.6,4.75,5.46,8
RC,636,BELIMUMAB 120 MG IV SOLR,10156.0,6601.4,67.43,77.54,8
RC,636,BELIMUMAB 400 MG IV SOLR,19041.3,12376.84,67.43,77.54,8
RC,636,BENDAMUSTINE 25 MG/ML IV SOLN,12446.1,8089.97,16.12,18.54,8
RC,636,BENZTROPINE 1 MG/ML IJ SOLN,372.67,242.24,,,0
RC,636,"BETAMETHASONE ACET,SOD PHOS 6 MG/ML IJ SUSP",553.12,359.53,,,0
RC,636,BEVACIZUMAB (AVASTIN) INTRAVITREAL INJECTION,12751.04,8288.18,2.26,2.6,8
RC,636,BEVACIZUMAB 25 MG/ML IV SOLN,31877.600000000002,20720.44,90.53,104.11,16
RC,636,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,25482.69,16563.75,33.1,38.07,16
RC,636,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,18926.08,12301.949999999999,29.37,33.77,16
RC,636,BEZLOTOXUMAB 25 MG/ML IV SOLN,20482.8,13313.82,49.64,57.08,8
RC,636,BIVALIRUDIN 250 MG IV SOLR,722.99,469.94,,,0
RC,636,BLEOMYCIN 15 UNITS IJ SOLR,10390.68,6753.94,,,0
RC,636,BLEOMYCIN 30 UNITS IJ SOLR,737.44,479.34,,,0
RC,636,BLINATUMOMAB 35 MCG IV KIT,46301.85,30096.2,189.49,217.91,16
RC,636,BORTEZOMIB 3.5 MG IJ SOLR,520.96,338.62,,,0
RC,636,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,109800.0,71370.0,298.67,343.47,8
RC,636,BUDESONIDE 0.25 MG IN NBSP,290.0,188.5,,,0
RC,636,BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION IN HFAA,20482.8,13313.82,,,0
RC,636,BUMETANIDE 0.25 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) IJ SOLN,290.0,188.5,,,0
RC,636,BUPIVACAINE (PF) 0.5 % (5 MG/ML) IJ SOLN,10386.4,6751.16,,,0
RC,636,BUPIVACAINE (PF) 0.75 % IJ SOLN,290.0,188.5,,,0
RC,636,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM,290.0,188.5,,,0
RC,636,BUTORPHANOL 10 MG/ML NA SPRY,20482.8,13313.82,,,0
RC,636,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT,31924.98,20751.24,85.12,97.89,8
RC,636,CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN,129228.48,83998.51,269.53,309.96,8
RC,636,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) IJ SOLN,447.36,290.78,,,0
RC,636,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,232056.99,150837.04,,,0
RC,636,CALCITRIOL 1 MCG/ML IV SOLN,20482.8,13313.82,,,0
RC,636,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN,290.0,188.5,,,0
RC,636,CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRG,290.0,188.5,,,0
RC,636,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",290.0,188.5,,,0
RC,636,"CALCIUM GLUC IN NACL, ISO-OSM 2 G/100 ML IV SOLN",290.0,188.5,,,0
RC,636,CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN,10386.4,6751.16,,,0
RC,636,CANGRELOR 50 MG IV SOLR,13432.54,8731.15,23.44,26.96,16
RC,636,CARBOPLATIN 10 MG/ML IV SOLN,655.68,426.19,,,0
RC,636,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,578.4300000000001,375.98,,,0
RC,636,CARFILZOMIB 10 MG IV SOLR,8732.96,5676.42,61.73,70.99,8
RC,636,CARFILZOMIB 30 MG IV SOLR,14736.87,9578.97,61.73,70.99,8
RC,636,CARFILZOMIB 60 MG IV SOLR,29473.65,19157.87,61.73,70.99,8
RC,636,CARMUSTINE 100 MG IV SOLR,2892.0,1879.8,412.0,473.8,8
RC,636,CEFAZOLIN 1 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFAZOLIN 2 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,20482.8,13313.82,,,0
RC,636,CEFEPIME 1 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFEPIME 2 GRAM IJ SOLR,10386.4,6751.16,,,0
RC,636,CEFEPIME IVPB VIAL 1 GRAM/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
RC,636,CEFOXITIN 1 GRAM IV SOLR,290.0,188.5,,,0
RC,636,CEFOXITIN 2 GRAM IV SOLR,10386.4,6751.16,,,0
RC,636,CEFOXITIN 95 MG/ML IV PUSH,20482.8,13313.82,,,0
RC,636,CEFTAROLINE FOSAMIL 600 MG IV SOLR,3032.02,1970.81,4.9,5.63,8
RC,636,CEFTAZIDIME 1 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFTAZIDIME 2 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFTRIAXONE 1 GRAM IJ SOLR,10386.4,6751.16,,,0
RC,636,CEFTRIAXONE 1 GRAM IV SOLR,290.0,188.5,,,0
RC,636,CEFTRIAXONE 2 GRAM IJ SOLR,290.0,188.5,,,0
RC,636,CEFTRIAXONE 250 MG IJ SOLR,290.0,188.5,,,0
RC,636,CEFUROXIME SODIUM 1.5 GRAM IV SOLR,290.0,188.5,,,0
RC,636,CEFUROXIME SODIUM 750 MG IJ SOLR,290.0,188.5,,,0
RC,636,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,95460.81,62049.53,35.16,40.44,8
RC,636,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SC KIT,53994.87,35096.67,5.79,6.66,8
RC,636,CETUXIMAB 100 MG/50 ML IV SOLN,11986.4,7791.16,93.99,108.08,8
RC,636,CETUXIMAB 200 MG/100 ML IV SOLN,13484.7,8765.06,93.99,108.08,8
RC,636,CHLOROPROCAINE (PF) 30 MG/ML (3 %) IJ SOLN,313.6,203.84,,,0
RC,636,CHLOROPROCAINE 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
RC,636,CHLORPROMAZINE 100 MG PO TABS,20482.8,13313.82,,,0
RC,636,CHLORPROMAZINE 25 MG/ML IJ SOLN,349.56,227.215,,,0
RC,636,CIDOFOVIR 75 MG/ML IV SOLN,9689.76,6298.34,657.46,756.08,8
RC,636,CILGAVIMAB 150 MG/1.5 ML IM SOLN,20482.8,13313.82,,,0
RC,636,CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK,290.0,188.5,,,0
RC,636,CISATRACURIUM 2 MG/ML IV SOLN,350.03999999999996,227.525,,,0
RC,636,CISPLATIN 1 MG/ML IV SOLN,457.6,297.44,,,0
RC,636,CLADRIBINE 10 MG/10 ML IV SOLN,1609.92,1046.45,17.74,20.4,8
RC,636,CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK,290.0,188.5,,,0
RC,636,CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK,10386.4,6751.16,,,0
RC,636,CLINDAMYCIN PHOSPHATE 150 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,CLINDAMYCIN PHOSPHATE 600 MG/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
RC,636,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EP SOLN",290.0,188.5,,,0
RC,636,CLONIDINE ORAL SUSPENSION 10 MCG/ML,20482.8,13313.82,,,0
RC,636,"COAGULATION FACTOR IX 1,000 (+/-) UNIT IV SOLR",20482.8,13313.82,1.75,14761.0,3
RC,636,COAGULATION FACTOR VIIA RECOMB 1 MG IV SOLR,19846.785,12900.41,3.13,14761.0,20
RC,636,COAGULATION FACTOR VIIA RECOMB 2 MG IV SOLR,29452.17,19143.91,3.13,14761.0,13
RC,636,COAGULATION FACTOR VIIA RECOMB 5 MG IV SOLR,20482.8,13313.82,3.13,3.6,8
RC,636,COCAINE 4 % NA SOLN,20482.8,13313.82,,,0
RC,636,COLLAGENASE CLOSTRIDIUM HISTO. 0.9 MG IJ SOLR,20482.8,13313.82,88.61,101.9,8
RC,636,CONJUGATED ESTROGENS 25 MG IJ SOLR,5618.24,3651.86,476.64,548.14,8
RC,636,COPPER 380 SQUARE MM IU IUD,9765.0,6347.25,,,0
RC,636,COSYNTROPIN 0.25 MG IJ SOLR,386.47,251.20499999999998,,,0
RC,636,"COVID-19 VAC, BV (PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",20482.8,13313.82,,,0
RC,636,"COVID-19 VAC, TRIS(PFIZER)(PF) 30 MCG/0.3 ML IM SUSP",20482.8,13313.82,,,0
RC,636,CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN,20482.8,13313.82,160.05,184.06,8
RC,636,CSMC OPED,20482.8,13313.82,,,0
RC,636,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,CYCLOPHOSPHAMIDE 1 GRAM IV SOLR,1702.4,1106.56,,,0
RC,636,CYCLOPHOSPHAMIDE 2 GRAM IV SOLR,4771.84,3101.7,,,0
RC,636,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1075.1999999999998,698.88,,,0
RC,636,CYCLOSPORINE 100 MG PO CAPS,20482.8,13313.82,,,0
RC,636,CYCLOSPORINE 250 MG/5 ML IV SOLN,20482.8,13313.82,,,0
RC,636,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) IJ SOLN,290.0,188.5,,,0
RC,636,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IJ SOLN,290.0,188.5,,,0
RC,636,DACARBAZINE 200 MG IV SOLR,10386.4,6751.16,,,0
RC,636,DACTINOMYCIN 0.5 MG IV SOLR,6544.24,4253.755,351.31,404.0,40
RC,636,"DALTEPARIN (PORCINE) 10,000 ANTI-XA UNIT/ML SC SYRG",20482.8,13313.82,,,0
RC,636,DAPTOMYCIN 350 MG IV SOLR,372.64,242.22,,,0
RC,636,DAPTOMYCIN 500 MG IV SOLR,10386.4,6751.16,,,0
RC,636,DARATUMUMAB 20 MG/ML IV SOLN,17451.675,11343.59,81.08,93.25,16
RC,636,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SC SOLN",89752.73,58339.27,64.02,73.62,8
RC,636,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML IJ SYRG,12967.47,8428.86,3.78,4.35,8
RC,636,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML IJ SYRG,19451.25,12643.31,3.78,4.35,8
RC,636,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML IJ SYRG,32418.63,21072.11,3.78,4.35,8
RC,636,DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR,94095.0,61161.75,301.95,347.24,8
RC,636,DECITABINE 50 MG IV SOLR,1304.32,847.8050000000001,,,0
RC,636,DEFEROXAMINE 2 GRAM IJ SOLR,471.36,306.385,,,0
RC,636,DEGARELIX 120 MG SC SOLR,17040.96,11076.625,5.2,5.98,16
RC,636,DEGARELIX 80 MG SC SOLR,13882.119999999999,9023.38,5.2,5.98,16
RC,636,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SC SOLN,24486.08,15915.95,33.57,38.61,8
RC,636,DENOSUMAB 60 MG/ML SC SYRG,13313.04,8653.48,33.57,38.61,8
RC,636,DESMOPRESSIN 4 MCG/ML IJ SOLN,2500.32,1625.21,6.75,7.76,56
RC,636,DEXAMETHASONE 4 MG/ML IV PUSH PEDIATRIC,290.0,188.5,,,0
RC,636,DEXAMETHASONE 4 MG/ML ORAL SOLUTION,290.0,188.5,,,0
RC,636,DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN,397.96000000000004,258.675,,,0
RC,636,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,290.0,188.5,,,0
RC,636,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,290.0,188.5,,,0
RC,636,DEXRAZOXANE HCL 250 MG IV SOLR,1156.8,751.92,108.95,125.29,24
RC,636,DEXRAZOXANE HCL 500 MG IV SOLR,2017.6,1311.44,108.95,125.29,24
RC,636,DEXTROSE 50 % IN WATER (D50W) IV SYRG,290.0,188.5,,,0
RC,636,DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML MISC SOLN,20482.8,13313.82,,,0
RC,636,DIATRIZOATE MEGLUMINE 30 % UR SOLN,20482.8,13313.82,,,0
RC,636,DIAZEPAM 5 MG/ML IJ SYRG,354.78,230.61,,,0
RC,636,DICYCLOMINE 10 MG/ML IM SOLN,771.53,501.495,,,0
RC,636,DIGOXIN 250 MCG/ML (0.25 MG/ML) IJ SOLN,1086.825,706.435,,,0
RC,636,DIGOXIN IMMUNE FAB 40 MG IV SOLR,40106.88,26069.47,6086.61,6999.6,8
RC,636,DIHYDROERGOTAMINE 1 MG/ML IJ SOLN,650.7,422.96,,,0
RC,636,DILTIAZEM HCL 5 MG/ML IV SOLN,10386.4,6751.16,,,0
RC,636,"DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG",20482.8,13313.82,,,0
RC,636,DIPHENHYDRAMINE HCL 50 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,"DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",647.655,420.975,,,0
RC,636,DIPYRIDAMOLE 5 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,"DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP",10386.4,6751.16,,,0
RC,636,DOCETAXEL 20 MG/2 ML (10 MG/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN,1131.455,735.4449999999999,,,0
RC,636,"DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN",290.0,188.5,,,0
RC,636,DORNASE ALFA 1 MG/ML IN SOLN,1994.2,1296.23,,,0
RC,636,DORNASE ALFA 1 MG/ML VIA CHEST TUBE,1994.2,1296.23,,,0
RC,636,DOXORUBICIN 2 MG/ML IV SOLN,932.8,606.32,,,0
RC,636,DOXORUBICIN 50 MG IV SOLR (FOR CHEMOEMBOLIZATION),3166.08,2057.95,,,0
RC,636,"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP",4815.2,3129.88,165.71,190.57,64
RC,636,DOXYCYCLINE HYCLATE 100 MG IV SOLR,10386.4,6751.16,,,0
RC,636,DUPILUMAB 200 MG/1.14 ML SC SYRG,16742.74,10882.78,,,0
RC,636,DURVALUMAB 50 MG/ML IV SOLN,41767.685,27148.995,101.88,117.16,16
RC,636,Drugs requiring detailed coding,20482.8,13313.82,,,0
RC,636,ECULIZUMAB 300 MG/30 ML IV SOLN,58706.91,38159.49,279.71,321.67,8
RC,636,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,55713.42,36213.72,34.63,46.64,16
RC,636,ELECTROLYTE-A IV SOLP,290.0,188.5,,,0
RC,636,ELOTUZUMAB 300 MG IV SOLR,20480.94,13312.61,9.44,10.85,8
RC,636,ELOTUZUMAB 400 MG IV SOLR,27307.62,17749.95,9.44,10.85,8
RC,636,ENALAPRILAT 1.25 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,25281.0,16432.65,45.75,52.61,8
RC,636,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,37921.5,24648.98,45.75,52.61,8
RC,636,ENOXAPARIN 100 MG/ML SC SYRG,290.0,188.5,,,0
RC,636,ENOXAPARIN 120 MG/0.8 ML SC SYRG,290.0,188.5,,,0
RC,636,ENOXAPARIN 150 MG/ML SC SYRG,10386.4,6751.16,,,0
RC,636,ENOXAPARIN 30 MG/0.3 ML SC SYRG,290.0,188.5,,,0
RC,636,ENOXAPARIN 40 MG/0.4 ML SC SYRG,290.0,188.5,,,0
RC,636,ENOXAPARIN 60 MG/0.6 ML SC SYRG,290.0,188.5,,,0
RC,636,ENOXAPARIN 80 MG/0.8 ML SC SYRG,10386.4,6751.16,,,0
RC,636,EPHEDRINE SULFATE 50 MG/ML IV SOLN,315.92,205.35,,,0
RC,636,EPINEPHRINE 0.1 MG/ML IJ SYRG,20482.8,13313.82,,,0
RC,636,EPINEPHRINE 1 MG/ML (1 ML) IJ SOLN,2528.16,1643.3,,,0
RC,636,EPINEPHRINE 1 MG/ML IJ SOLN,1844.64,1199.02,,,0
RC,636,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) IJ SOLN,290.0,188.5,,,0
RC,636,EPINEPHRINE HCL 1 MG/ML NA SOLN,20482.8,13313.82,,,0
RC,636,EPINEPHRINE HCL IN 5% DEXTROSE 8 MG/250 ML (32 MCG/ML) IV SOLN,920.0,598.0,,,0
RC,636,EPINEPHRINE IN D5W 8 MG/250ML (0.032 MG/ML)IV PREMIX,20482.8,13313.82,,,0
RC,636,EPOETIN ALFA-EPBX 10000 UNITS IJ SOLN,832.41,541.07,0.95,10.91,24
RC,636,EPOETIN ALFA-EPBX 2000 UNITS/ML IJ SOLN,290.0,188.5,0.95,10.91,16
RC,636,EPOETIN ALFA-EPBX 3000 UNITS IJ SOLN,290.0,188.5,0.95,10.91,16
RC,636,EPOETIN ALFA-EPBX 4000 UNITS IJ SOLN,332.96,216.42,0.95,10.91,16
RC,636,EPOETIN ALFA-EPBX 40000 UNITS IJ SOLN,3329.65,2164.27,0.95,10.91,24
RC,636,EPOPROSTENOL 0.5 MG IV SOLR,405.72,263.72,,,0
RC,636,EPOPROSTENOL 1.5 MG IV SOLR,1042.72,677.77,,,0
RC,636,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,16993.35,11045.68,23.28,26.77,8
RC,636,ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN,12690.0,8248.5,169.08,194.44,8
RC,636,ERTAPENEM 1 GRAM IJ SOLR,430.365,279.735,,,0
RC,636,ERTAPENEM 1 GRAM IJ SOLR CSHS IV PUSH,745.36,484.48,,,0
RC,636,ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR,1043.52,678.29,,,0
RC,636,ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,"ESMOLOL IN STERILE WATER 2,500 MG/250 ML (10 MG/ML) IV SOLP",1504.0,977.6,,,0
RC,636,ETHIODIZED OIL 48% IJ OIL,20482.8,13313.82,,,0
RC,636,ETHIODIZED OIL 480 MG IODINE/ML IJ OIL,16401.9,10661.235,,,0
RC,636,ETHYL ALCOHOL 99 % IA SOLN,12223.92,7945.55,,,0
RC,636,ETOMIDATE 2 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,ETONOGESTREL 68 MG SD IMPL,15444.66,10039.029999999999,,,0
RC,636,ETOPOSIDE 20 MG/ML IV SOLN,515.4,335.01,,,0
RC,636,"Exclusions for Outpatient Chemotherapy High-Cost Drugs- when charges per code per visit exceeds $8,000",20482.8,13313.82,,,0
RC,636,"FACTOR IX CPLX(PCC)NO4,3FACTOR 1,000 (+/-) UNIT IV SOLR",21138.665,13740.130000000001,2.06,14761.0,9
RC,636,FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR,26412.75,17168.29,34.63,39.82,8
RC,636,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,290.0,188.5,,,0
RC,636,FAT EMULSION 20% (SMOFLIPID) ADULT,432.0,280.8,,,0
RC,636,FENTANYL CITRATE (PF) 50 MCG/ML IJ SOLN,290.0,188.5,,,0
RC,636,FERRIC CARBOXYMALTOSE 50 IRON MG/ML IV SOLN,9512.4,6183.06,1.37,1.58,8
RC,636,FERRIC SUBSULFATE 259 MG/G TP SOLN,290.0,188.5,,,0
RC,636,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,1827.16,1187.65,0.42,0.48,16
RC,636,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN (RADIANT USE),2282.76,1483.79,,,0
RC,636,FILGRASTIM-SNDZ 300 MCG IJ SYRG,2126.84,1382.4450000000002,0.45,0.52,16
RC,636,FILGRASTIM-SNDZ 480 MCG IJ SYRG,3402.875,2211.87,0.45,0.52,24
RC,636,FLOXURIDINE 0.5 GRAM IJ SOLR,27197.534999999996,17678.4,4803.97,5524.57,16
RC,636,FLU VAC QS 2022(6 MS UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,20482.8,13313.82,,,0
RC,636,FLU VAC QS2022-23 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,20482.8,13313.82,,,0
RC,636,FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG,20482.8,13313.82,,,0
RC,636,FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG,20482.8,13313.82,,,0
RC,636,FLUCONAZOLE CUSTOM IVPB IN NACL,290.0,188.5,,,0
RC,636,FLUCONAZOLE CUSTOM IVPB IN NACL DOSES <=800 MG (CSMC),20482.8,13313.82,,,0
RC,636,FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK,10386.4,6751.16,,,0
RC,636,FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK,290.0,188.5,,,0
RC,636,FLUDARABINE 50 MG IV SOLR,1394.72,906.57,167.05,192.1,8
RC,636,FLUDARABINE 50 MG/2 ML IV SOLN,10549.4,6857.11,167.05,192.1,16
RC,636,FLUMAZENIL 0.1 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,10630.119999999999,6909.58,,,0
RC,636,FLUOROURACIL 1 GRAM/20 ML IV SOLN,369.6,240.24,,,0
RC,636,FLUOROURACIL 2.5 GRAM/50 ML IV SOLN,366.2,238.03,,,0
RC,636,FLUOROURACIL 5 G/100 ML IV SOLN,822.4,534.56,,,0
RC,636,FLUOROURACIL 500 MG/10 ML IV SOLN,290.0,188.5,,,0
RC,636,FOLIC ACID 5 MG/ML IJ SOLN,395.36,256.985,,,0
RC,636,FONDAPARINUX 7.5 MG/0.6 ML SC SYRG,290.0,188.5,,,0
RC,636,FOSAPREPITANT 150 MG IV SOLR,532.0,345.8,,,0
RC,636,FULVESTRANT 250 MG/5 ML IM SYRG,1379.36,896.58,9.35,10.75,96
RC,636,FUROSEMIDE 10 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,GADODIAMIDE 5 MMOL/10 ML (287 MG/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN,20482.8,13313.82,,,0
RC,636,GEMCITABINE 1 GRAM IV SOLR,510.28,331.68,,,0
RC,636,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,361.71000000000004,235.11,,,0
RC,636,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN,591.65,384.57500000000005,,,0
RC,636,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN,10386.4,6751.16,,,0
RC,636,GENTAMICIN 40 MG/ML IJ SOLN,330.91999999999996,215.1,,,0
RC,636,GENTAMICIN IN NACL (ISO-OSM) 100 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,GENTAMICIN IN NACL (ISO-OSM) 120 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,GENTAMICIN IN NACL (ISO-OSM) 60 MG/50 ML IV PGBK,290.0,188.5,,,0
RC,636,GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML IV PGBK,290.0,188.5,,,0
RC,636,GLUCAGON 1 MG IJ SOLR,4380.48,2847.31,239.45,275.37,24
RC,636,GLUCAGON 1 MG/ML IJ SOLR,20482.8,13313.82,239.45,275.37,24
RC,636,GLYCOPYRROLATE 0.2 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,GOLIMUMAB 12.5 MG/ML IV SOLN,16755.41,10891.02,13.82,15.89,8
RC,636,GOSERELIN 10.8 MG SC IMPL,26280.18,17082.12,840.22,966.25,8
RC,636,GOSERELIN 3.6 MG SC IMPL,16822.4,10934.56,840.22,966.25,8
RC,636,GRANISETRON HCL 1 MG/ML (1 ML) IV SOLN,10386.4,6751.16,,,0
RC,636,HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR,10386.4,6751.16,,,0
RC,636,HALOPERIDOL LACTATE 5 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,HB MISCELLANEOUS PHARMACY,20482.8,13313.82,13270.0,14761.0,2
RC,636,HEPARIN (PORCINE) 1000 UNIT/ML IJ SOLN,290.0,188.5,,,0
RC,636,HEPARIN (PORCINE) 10000 UNITS/ML IJ SOLN,290.0,188.5,,,0
RC,636,HEPARIN (PORCINE) 5000 UNITS/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP",10386.4,6751.16,,,0
RC,636,HEPARIN BOLUS FOR ACS PROTOCOL,10386.4,6751.16,,,0
RC,636,HEPARIN SOLUTION 2 UNITS/ML FOR FLUSH INTRAPROCEDURE (CATH LAB ONLY),290.0,188.5,,,0
RC,636,HEPARIN SOLUTION 5 UNITS/ML FOR INSTRUMENT WASH/RINSE FOR INTRAPROCEDURE (IR ONLY),290.0,188.5,,,0
RC,636,HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML IV SOLP,290.0,188.5,,,0
RC,636,"HEPARIN, PORCINE (PF) 10 UNITS/ML IV SYRG",290.0,188.5,,,0
RC,636,"HEPARIN, PORCINE (PF) 100 UNITS/ML IV SYRG",10386.4,6751.16,,,0
RC,636,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN (ADULT FLUSH)",290.0,188.5,,,0
RC,636,"HEPARIN, PORCINE (PF) 1000 UNIT/ML IJ SOLN FOR INTRACATHETER",290.0,188.5,,,0
RC,636,"HEPARIN, PORCINE (PF) 1000 UNITS/ML IJ SOLN",10386.4,6751.16,,,0
RC,636,"HEPARIN, PORCINE (PF) 5000 UNIT/0.5 ML IJ SYRG",290.0,188.5,,,0
RC,636,"HEPARIN, PORCINE (PF) 5000 UNITS/ML IJ SYRG",20482.8,13313.82,,,0
RC,636,HEPATITIS A VIRUS VACCINE (PF) 1440 UNITS IM SUSP,1024.22,665.74,,,0
RC,636,"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN",14597.24,9488.205,174.24,200.38,16
RC,636,HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG,1948.67,1266.64,,,0
RC,636,HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG,296.96,193.02,,,0
RC,636,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP,684.02,444.61,,,0
RC,636,HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG,684.02,444.61,,,0
RC,636,HISTRELIN 50 MG (65 MCG/DAY) IL KIT,451634.58,293562.48,56469.54,64939.98,8
RC,636,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",12534.575,8147.475,,,0
RC,636,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IX SYRG",20482.8,13313.82,665.53,765.36,16
RC,636,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IX SYRG",20482.8,13313.82,850.67,978.27,8
RC,636,"HYALURONIDASE, HUMAN RECOMB. 150 UNITS/ML IJ SOLN",600.32,390.21,,,0
RC,636,HYDRALAZINE 20 MG/ML IJ SOLN,566.48,368.21,,,0
RC,636,HYDROCORTISONE ACETATE 25 MG PR SUPP,290.0,188.5,,,0
RC,636,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML IJ SOLR,337.92,219.65,,,0
RC,636,HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML IJ SOLR,1237.76,804.54,,,0
RC,636,HYDROMORPHONE (PF) 1 MG/ML IJ SOLN,20482.8,13313.82,,,0
RC,636,HYDROMORPHONE (PF) 10 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,HYDROMORPHONE (PF) 2 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,HYDROMORPHONE (PF)-0.9 % NACL 1 MG/ML IV SPCA,20482.8,13313.82,,,0
RC,636,HYDROMORPHONE 1 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,HYDROMORPHONE 2 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,HYLAN G-F 20 16 MG/2 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
RC,636,HYLAN G-F 20 48 MG/6 ML IX SYRG,20482.8,13313.82,11.4,13.11,8
RC,636,High Cost Drugs,20482.8,13313.82,,,0
RC,636,IBANDRONATE 3 MG/3 ML IV SYRG,3652.32,2374.01,,,0
RC,636,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1312.8,853.32,300.59,345.68,8
RC,636,IFOSFAMIDE 1 GRAM IV SOLR,648.88,421.775,,,0
RC,636,IFOSFAMIDE 3 GRAM IV SOLR,1282.08,833.35,,,0
RC,636,IMIGLUCERASE 400 UNITS IV SOLR,13873.04,9017.48,54.31,62.46,8
RC,636,IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN,10344.0,6723.599999999999,60.49,69.56,72
RC,636,IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR,16230.0,10549.5,61.88,71.16,16
RC,636,IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) IJ SOLN,22392.0,14554.8,60.77,69.89,32
RC,636,IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) IJ SOLN,22392.0,14554.8,60.77,69.89,8
RC,636,IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) IJ SOLN,44784.0,29109.6,60.77,69.89,8
RC,636,IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) IJ SOLN,13040.4,8476.26,60.77,69.89,16
RC,636,INCLISIRAN 284 MG/1.5 ML SC SYRG,30426.75,19777.39,15.17,17.45,8
RC,636,INCOBOTULINUMTOXINA 100 UNITS IM SOLR,5110.0,3321.5,6.65,7.64,8
RC,636,INCOBOTULINUMTOXINA 200 UNITS IM SOLR,10220.0,6643.0,6.65,7.64,8
RC,636,INCOBOTULINUMTOXINA 50 UNITS IM SOLR,2680.0,1742.0,6.65,7.64,8
RC,636,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IJ SOLN,20482.8,13313.82,,,0
RC,636,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,5068.48,3294.51,,,0
RC,636,INDOCYANINE GREEN 25 MG IJ SOLR,1918.08,1246.755,10.63,12.22,24
RC,636,INFLIXIMAB 100 MG IV SOLR,8700.16,5655.1,40.12,46.14,8
RC,636,INFLIXIMAB-ABDA 100 MG IV SOLR,20482.8,13313.82,33.85,38.92,16
RC,636,INFLIXIMAB-AXXQ 100 MG IV SOLR,6335.52,4118.09,26.51,30.49,8
RC,636,INFLIXIMAB-DYYB 100 MG IV SOLR,6708.32,4360.41,16.96,19.5,8
RC,636,INHALATIONAL SPACING DEVICE MISC SPCR,542.24,352.46,,,0
RC,636,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,206172.0,134011.8,3260.96,3750.1,8
RC,636,INSULIN LISPRO 100 UNITS/ML SC SOLN,387.29,251.74,,,0
RC,636,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,290.0,188.5,,,0
RC,636,INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) IV SOLN,297.6,193.44,,,0
RC,636,IODIXANOL 320 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
RC,636,IOHEXOL 12 MG IODINE/ML PO SOLN,290.0,188.5,,,0
RC,636,IOHEXOL 180 MG IODINE/ML IT SOLN,20482.8,13313.82,,,0
RC,636,IOHEXOL 240 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
RC,636,IOHEXOL 300 MG IODINE/ML IV SOLN,1342.2,872.43,,,0
RC,636,IOHEXOL 300 MG IODINE/ML IV SOLN (RADIANT USE),463.36,301.18,,,0
RC,636,IOHEXOL 300 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,20482.8,13313.82,,,0
RC,636,IOHEXOL 350 MG IODINE/ML IV SOLN,20482.8,13313.82,,,0
RC,636,IOHEXOL 350 MG IODINE/ML PO SOLN **FOR INPATIENT USE**,20482.8,13313.82,,,0
RC,636,IOHEXOL 9 MG IODINE/ML PO SOLN,290.0,188.5,,,0
RC,636,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,199736.63999999998,129828.815,220.25,253.29,16
RC,636,IPRATROPIUM BROMIDE 0.02 % IN SOLN,10386.4,6751.16,,,0
RC,636,IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML IN NEBU,290.0,188.5,,,0
RC,636,IRINOTECAN 100 MG/5 ML IV SOLN,290.68,188.94,,,0
RC,636,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,26154.0,17000.1,80.64,92.74,8
RC,636,IRON DEXTRAN 50 MG/ML IJ SOLN,529.06,343.89,22.0,25.3,16
RC,636,IRON SUCROSE 100 MG IRON/5 ML IV SOLN,663.9,431.54,,,0
RC,636,ISATUXIMAB-IRFC 20 MG/ML IV SOLN,20482.8,13313.82,97.19,111.76,16
RC,636,ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN,2012.48,1308.11,,,0
RC,636,ISOSULFAN BLUE 1 % SC SOLN,18069.76,11745.345000000001,10.63,12.22,24
RC,636,KETAMINE 50 MG/ML (1 ML) IV SYRG,290.0,188.5,,,0
RC,636,KETAMINE 50 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,KETOROLAC 15 MG/ML IJ SOLN,20482.8,13313.82,0.85,0.98,8
RC,636,KETOROLAC 30 MG/ML (1 ML) IJ SOLN,10386.4,6751.16,0.85,0.98,56
RC,636,KETOROLAC 30 MG/ML IV PEDIATRIC,10386.4,6751.16,0.85,0.98,32
RC,636,KETOROLAC 60 MG/2 ML IM SOLN,20482.8,13313.82,0.85,0.98,8
RC,636,LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG,10386.4,6751.16,,,0
RC,636,LABETALOL 5 MG/ML IV SOLN,338.88,220.27,,,0
RC,636,LACOSAMIDE 200 MG/20 ML IV SOLN,356.32,231.60500000000002,,,0
RC,636,LANREOTIDE 120 MG/0.5 ML SC SYRG,86058.0,55937.7,62.22,71.56,8
RC,636,LEUCOVORIN CALCIUM 350 MG IJ SOLR,361.44,234.94,,,0
RC,636,LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT,45308.88,29450.77,2014.27,2316.42,8
RC,636,LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT,53991.9,35094.74,219.79,252.76,8
RC,636,LEUPROLIDE (4 MONTH) 30 MG IM SYKT,71989.47,46793.16,219.79,252.76,8
RC,636,LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT,98955.63,64321.16,2014.27,2316.42,8
RC,636,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,108989.73,70843.32,2014.27,2316.42,8
RC,636,LEUPROLIDE 1 MG/0.2ML FOR PEDS STIM TEST,8312.46,5403.1,,,0
RC,636,LEUPROLIDE 3.75 MG IM SYKT,15102.81,9816.83,2014.27,2316.42,8
RC,636,LEUPROLIDE 7.5 MG (1 MONTH) SC SYRG,1401.28,910.83,219.79,252.76,8
RC,636,LEUPROLIDE 7.5 MG IM SYKT,17997.48,11698.36,219.79,252.76,8
RC,636,LEVALBUTEROL HCL 0.31 MG IN NEBU,290.0,188.5,,,0
RC,636,LEVALBUTEROL HCL 0.63 MG IN NEBU,290.0,188.5,,,0
RC,636,LEVALBUTEROL HCL 1.25 MG IN NEBU,290.0,188.5,,,0
RC,636,LEVETIRACETAM 500 MG/5 ML IV SOLN,10386.4,6751.16,,,0
RC,636,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK,290.0,188.5,,,0
RC,636,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,290.0,188.5,,,0
RC,636,LEVONORGESTREL 14 MCG/24 HR (3 YRS) 13.5 MG IU IUD,16182.08,10518.35,,,0
RC,636,LEVONORGESTREL 17.5 MCG/24 HR (5 YRS) 19.5 MG IU IUD,19434.08,12632.15,,,0
RC,636,LEVONORGESTREL 20 MCG/24 HOURS (8 YRS) 52 MG IU IUD,19434.08,12632.15,,,0
RC,636,LEVONORGESTREL 20.4 MCG/24 HR (8 YRS) 52 MG IU IUD,14907.68,9689.99,,,0
RC,636,LEVOTHYROXINE 100 MCG IV SOLR,848.96,551.82,,,0
RC,636,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN,10386.4,6751.16,,,0
RC,636,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN (30 CC),290.0,188.5,,,0
RC,636,LIDOCAINE (PF) 10 MG/ML (1 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,,,0
RC,636,LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRG,290.0,188.5,,,0
RC,636,LIDOCAINE (PF) 20 MG/ML (2 %) IJ SOLN,10386.4,6751.16,,,0
RC,636,LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN,290.0,188.5,,,0
RC,636,LIDOCAINE (PF) 40 MG/ML (4 %) IJ SOLN INTRAPROCEDURE,290.0,188.5,,,0
RC,636,LIDOCAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,,,0
RC,636,LIDOCAINE 10 MG/ML (1 %) IJ SOLN (CC),290.0,188.5,,,0
RC,636,LIDOCAINE HCL 10 MG/ML (1 %) IJ SOLN,10386.4,6751.16,,,0
RC,636,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,,,0
RC,636,LIDOCAINE HCL 2 % MM SOLN,20482.8,13313.82,,,0
RC,636,LIDOCAINE HCL 20 MG/ML (2 %) IJ SOLN,290.0,188.5,,,0
RC,636,LIDOCAINE HCL 4 % (40 MG/ML) MM SOLN,596.0,387.4,,,0
RC,636,LIDOCAINE HCL 4 % LATR SOLN,10452.92,6794.4,,,0
RC,636,LIDOCAINE HCL 5 MG/ML (0.5 %) IJ SOLN,290.0,188.5,,,0
RC,636,LIDOCAINE IN 5 % DEXTROSE (PF) 4 MG/ML (0.4 %) IV SOLP,290.0,188.5,,,0
RC,636,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 IJ SOLN",290.0,188.5,,,0
RC,636,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 IJ SOLN",290.0,188.5,,,0
RC,636,LINACLOTIDE 72 MCG PO CAPS,20482.8,13313.82,,,0
RC,636,LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK,332.2,215.93,,,0
RC,636,LORAZEPAM 2 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,"LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",20482.8,13313.82,300.39,345.45,8
RC,636,LURBINECTEDIN 4 MG IV SOLR,20482.8,13313.82,253.53,291.55,8
RC,636,LUSPATERCEPT-AAMT 25 MG SC SOLR,36292.41,23590.07,50.57,58.16,8
RC,636,LUSPATERCEPT-AAMT 75 MG SC SOLR,108876.78,70769.91,50.57,58.16,8
RC,636,MAGNESIUM SULFATE 50 % (4 MEQ/ML) IJ SOLN,10386.4,6751.16,,,0
RC,636,MAGNESIUM SULFATE 500 MG/ML (50 %) IJ SOLN,290.0,188.5,,,0
RC,636,MAGNESIUM SULFATE IN D5W 1 G/100 ML IV PGBK,290.0,188.5,,,0
RC,636,MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP,290.0,188.5,,,0
RC,636,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK,290.0,188.5,,,0
RC,636,MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML ANES-INTRAOP,290.0,188.5,,,0
RC,636,MAGNESIUM SULFATE L&D LOADING DOSE 4 GRAM/100 ML,290.0,188.5,,,0
RC,636,MANNITOL 20 % 20 % IV SOLP,290.0,188.5,,,0
RC,636,MANNITOL 25 % 25 % IV SOLN,290.0,188.5,,,0
RC,636,"MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR",1352.35,879.03,,,0
RC,636,MEDROXYPROGESTERONE 150 MG/ML IM SUSP,10427.72,6778.0199999999995,,,0
RC,636,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,819.2,532.48,,,0
RC,636,MELPHALAN HCL-BETADEX SBES 50 MG IV SOLR,9643.14,6268.04,21.61,24.85,8
RC,636,"MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR",1650.59,1072.88,,,0
RC,636,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",1650.59,1072.88,,,0
RC,636,"MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN",20482.8,13313.82,,,0
RC,636,"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG",2556.08,1661.45,,,0
RC,636,MEPERIDINE (PF) 25 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,MEPERIDINE (PF) 50 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,MEPIVACAINE (PF) 10 MG/ML (1 %) IJ SOLN,20482.8,13313.82,,,0
RC,636,MEPIVACAINE (PF) 20 MG/ML (2 %) IJ SOLN,20482.8,13313.82,,,0
RC,636,MEPOLIZUMAB 100 MG SC SOLR,27498.06,17873.74,37.9,43.58,8
RC,636,MEPOLIZUMAB 100 MG/ML SC SYRG,20482.8,13313.82,37.9,43.58,8
RC,636,MEROPENEM 1 GRAM IV SOLR,10386.4,6751.16,,,0
RC,636,MEROPENEM 500 MG IV SOLR,10386.4,6751.16,,,0
RC,636,MESNA 100 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,METHACHOLINE CHLORIDE 100 MG IN SOLR,1237.31,804.25,,,0
RC,636,METHADONE 10 MG/ML IJ SOLN,5475.04,3558.7749999999996,,,0
RC,636,METHOCARBAMOL 100 MG/ML IJ SOLN,353.72,229.92,,,0
RC,636,METHOHEXITAL 500 MG IJ SOLR,1372.96,892.42,,,0
RC,636,METHOTREXATE SODIUM (PF) 25 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,METHOTREXATE SODIUM 25 MG/ML IJ SOLN,10433.96,6782.075,,,0
RC,636,METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN,20482.8,13313.82,10.63,12.22,16
RC,636,METHYLERGONOVINE 0.2 MG/ML (1 ML) IJ SOLN,318.51,207.03,,,0
RC,636,METHYLNALTREXONE 12 MG/0.6 ML SC SYRG,2389.76,1553.34,,,0
RC,636,METHYLPREDNISOLONE ACETATE 40 MG/ML IJ SUSP,290.0,188.5,,,0
RC,636,METHYLPREDNISOLONE ACETATE 80 MG/ML IJ SUSP,290.0,188.5,,,0
RC,636,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML IJ SOLR,290.0,188.5,,,0
RC,636,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML IJ SOLR,290.0,188.5,,,0
RC,636,METHYLPREDNISOLONE SODIUM SUCC 1000 MG IV SOLR,509.92,331.45,,,0
RC,636,METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR,290.0,188.5,,,0
RC,636,METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR,325.0,211.25,,,0
RC,636,METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,METOPROLOL TARTRATE 5 MG/5 ML IV SOLN,10386.4,6751.16,,,0
RC,636,METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,290.0,188.5,,,0
RC,636,MICAFUNGIN 100 MG IV SOLR,357.78,232.56,,,0
RC,636,MIDAZOLAM (PF) 1 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,MIDAZOLAM 1 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,MIDAZOLAM 5 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK,290.0,188.5,,,0
RC,636,MIRABEGRON 50 MG PO TB24,6861.6,4460.04,,,0
RC,636,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,59698.08,38803.75,,,0
RC,636,MITOMYCIN 20 MG IV SOLR,2471.68,1606.59,52.93,60.87,32
RC,636,MITOMYCIN 5 MG IV SOLR,1997.8400000000001,1298.6,52.93,60.87,16
RC,636,MORPHINE (PF) 0.5 MG/ML IJ SOLN,360.68,234.44,,,0
RC,636,MORPHINE (PF) 1 MG/ML IJ SOLN,431.36,280.38,,,0
RC,636,MORPHINE (PF) 25 MG/ML IJ SOLN,4996.799999999999,3247.92,,,0
RC,636,MORPHINE (PF) 30 MG/30 ML (1 MG/ML) IV PCAS,290.0,188.5,,,0
RC,636,MORPHINE 10 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,MORPHINE 10 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,MORPHINE 2 MG/ML IV SYRG,10386.4,6751.16,,,0
RC,636,MORPHINE 4 MG/ML IJ SYRG,290.0,188.5,,,0
RC,636,MORPHINE 4 MG/ML IV SOLN,10386.4,6751.16,,,0
RC,636,MORPHINE INJECTION - PEDS < 1 YEAR,20482.8,13313.82,,,0
RC,636,MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN,154815.2,100629.88,791.27,909.96,8
RC,636,"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN",290.0,188.5,,,0
RC,636,NALOXONE 0.4 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,NALOXONE 0.4 MG/ML IJ SYRG,290.0,188.5,,,0
RC,636,NALOXONE 1 MG/ML IJ SYRG,301.15999999999997,195.755,,,0
RC,636,NATALIZUMAB 300 MG/15 ML IV SOLN,68301.72,44396.12,30.08,34.59,8
RC,636,NELARABINE 250 MG/50 ML IVPB,7274.4,4728.36,90.31,103.86,16
RC,636,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,10386.4,6751.16,,,0
RC,636,NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) IV SYRG,20482.8,13313.82,,,0
RC,636,NICARDIPINE 25 MG/10 ML IV SOLN,10386.4,6751.16,,,0
RC,636,NIFEDIPINE ORAL SUSPENSION 4 MG/ML (IP ORDERING ONLY),290.0,188.5,,,0
RC,636,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,NITROGLYCERIN IN D5W 50 MG/250 ML (0.2 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,NIVOLUMAB 100 MG/10 ML IV SOLN,29202.39,18981.55,39.53,45.46,8
RC,636,NIVOLUMAB 120 MG/12 ML IV SOLN,35042.98,22777.94,39.53,45.46,8
RC,636,NIVOLUMAB 240 MG/24 ML IV SOLN,70085.95,45555.87,39.53,45.46,8
RC,636,NIVOLUMAB 40 MG/4 ML IV SOLN,11681.03,7592.67,39.53,45.46,8
RC,636,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,20482.8,13313.82,237.16,272.73,8
RC,636,NOREPINEPHRINE (LEVOPHED)(0.032MG/ML) 8 MG IN D5W 250 ML,380.0,247.0,,,0
RC,636,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,10386.4,6751.16,,,0
RC,636,OBINUTUZUMAB 1000 MG/40 ML IV SOLN,77514.48,50384.41,92.88,106.81,8
RC,636,OCRELIZUMAB 30 MG/ML IV SOLN,185768.64,120749.62,74.46,85.63,8
RC,636,OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN,290.0,188.5,,,0
RC,636,OCTREOTIDE ACETATE 50 MCG/ML IJ SOLN,290.0,188.5,,,0
RC,636,"OCTREOTIDE,MICROSPHERES 10 MG IM SSRR",25999.68,16899.79,267.57,307.71,8
RC,636,"OCTREOTIDE,MICROSPHERES 20 MG IM SSRR",34064.0,22141.6,267.57,307.71,8
RC,636,"OCTREOTIDE,MICROSPHERES 30 MG IM SSRR",35745.48,23234.56,267.57,307.71,16
RC,636,OLANZAPINE 10 MG IM SOLR,519.64,337.765,,,0
RC,636,OMALIZUMAB 150 MG SC SOLR,11328.96,7363.82,47.68,54.83,8
RC,636,OMALIZUMAB 150 MG/ML SC SYRG,11328.96,7363.82,47.68,54.83,8
RC,636,ONABOTULINUMTOXINA 100 UNITS IJ SOLR,6460.0,4199.0,7.98,9.17,8
RC,636,ONABOTULINUMTOXINA 200 UNITS IJ SOLR,10336.0,6718.4,7.98,9.17,8
RC,636,ONDANSETRON 4 MG PO TBDL,10386.4,6751.16,,,0
RC,636,ONDANSETRON 8 MG PO TBDL,20482.8,13313.82,,,0
RC,636,ONDANSETRON HCL (PF) 4 MG/2 ML IJ SOLN,290.0,188.5,,,0
RC,636,ONDANSETRON HCL 2 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,ONDANSETRON HCL 4 MG PO TABS,514.6,334.49,,,0
RC,636,ONDANSETRON HCL 8 MG PO TABS,939.2,610.48,,,0
RC,636,ORITAVANCIN 400 MG IV SOLR,17269.65,11225.27,35.44,40.75,8
RC,636,OSELTAMIVIR 6 MG/ML PO SUSR,2264.64,1472.02,,,0
RC,636,OXALIPLATIN 100 MG/20 ML IV SOLN,432.32,281.01,,,0
RC,636,OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN,517.72,336.52,,,0
RC,636,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,290.0,188.5,13270.0,14761.0,2
RC,636,OXYTOCIN 10 UNITS/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,PACLITAXEL 6 MG/ML IV CONC,643.68,418.39,,,0
RC,636,PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR,13249.26,8612.02,16.62,19.11,8
RC,636,PALONOSETRON 0.25 MG/5 ML IV SOLN,309.0,200.85,,,0
RC,636,PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN,418.08,271.75,,,0
RC,636,PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN,37974.375,24683.345,198.39,228.15,16
RC,636,PANTOPRAZOLE 40 MG IV SOLR,10386.4,6751.16,,,0
RC,636,PARICALCITOL 2 MCG/ML IV SOLN,290.0,188.5,,,0
RC,636,PASIREOTIDE PAMOATE 60 MG IM SUSR,171609.21,111545.99,597.49,687.12,8
RC,636,PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN,88065.0,57242.25,123.12,141.59,8
RC,636,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,320.0,208.0,,,0
RC,636,PEGASPARGASE 750 UNITS/ML IJ SOLN,229844.16,149398.7,33707.9,38764.09,8
RC,636,PEGFILGRASTIM 6 MG/0.6 ML SC OBISYRINGE,38865.87,25262.82,38.78,44.6,8
RC,636,PEGFILGRASTIM 6 MG/0.6 ML SC SYRG,38865.87,25262.82,38.78,44.6,8
RC,636,PEGFILGRASTIM-BMEZ 6 MG/0.6 ML SC SYRG,20482.8,13313.82,431.78,496.54,8
RC,636,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SC SYRG,20482.8,13313.82,168.77,194.08,8
RC,636,PEGINTERFERON ALFA-2A 180 MCG/ML SC SOLN,18540.36,12051.235,,,0
RC,636,PEMBROLIZUMAB 25 MG/ML IV SOLN,36260.76,23569.495,72.49,83.36,24
RC,636,PEMETREXED DISODIUM 100 MG IV SOLR,1200.32,780.21,5.21,5.99,40
RC,636,PEMETREXED DISODIUM 500 MG IV SOLR,1798.32,1168.91,5.21,5.99,32
RC,636,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,5250.865,3413.06,30.34,34.89,16
RC,636,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,10760.285,6994.1900000000005,30.34,34.89,16
RC,636,PENICILLIN G POTASSIUM 3 MILLION UNITS IN 0.9% NACL 50ML,10417.4,6771.3099999999995,,,0
RC,636,PENICILLIN G POTASSIUM 5 MILLION UNITS IJ SOLR,290.0,188.5,,,0
RC,636,PENTAMIDINE 300 MG IJ SOLR,1133.51,736.78,,,0
RC,636,PENTAMIDINE 300 MG IN SOLR,2013.6,1308.84,,,0
RC,636,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,20482.8,13313.82,,,0
RC,636,PERFLUTREN PROTEIN-A MICROSPHR 0.22 MG/ML IV SUSP,20482.8,13313.82,,,0
RC,636,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,61384.43,39899.88,20.07,23.08,8
RC,636,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SC SOLN",125248.82,81411.73,80.41,92.47,8
RC,636,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SC SOLN,83495.88,54272.32,80.41,92.47,8
RC,636,PHENOBARBITAL SODIUM 130 MG/ML IJ SOLN,584.37,379.84,,,0
RC,636,PHENYLEPHRINE HCL 10 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,PHENYLEPHRINE HCL 2.5 % OP DROP,912.9599999999999,593.425,13270.0,14761.0,2
RC,636,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,20482.8,13313.82,,,0
RC,636,PHENYTOIN SODIUM 50 MG/ML IV SOLN,10386.4,6751.16,,,0
RC,636,PHYTONADIONE (VITAMIN K1) 10 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR,10386.4,6751.16,,,0
RC,636,PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR,10386.4,6751.16,,,0
RC,636,PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR,10386.4,6751.16,,,0
RC,636,PIPERACILLIN-TAZOBACTAM IVPB VIAL 2.25 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
RC,636,PIPERACILLIN-TAZOBACTAM VIAL 3.375 G/50 ML D5W VIAL-TO-BAG IVPB,10386.4,6751.16,,,0
RC,636,PIPERACILLIN-TAZOBACTAM VIAL 4.5 G/50 ML D5W VIAL-TO-BAG IVPB,290.0,188.5,,,0
RC,636,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SC SOLN,20482.8,13313.82,62.85,72.27,8
RC,636,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,11912.71,7743.26,,,0
RC,636,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,3861.76,2510.14,,,0
RC,636,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN,10677.72,6940.5199999999995,,,0
RC,636,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SYRG,1745.28,1134.43,,,0
RC,636,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP,20482.8,13313.82,,,0
RC,636,PORFIMER 75 MG IV SOLR,209907.0,136439.55,29722.81,34181.23,8
RC,636,POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP,10386.4,6751.16,,,0
RC,636,POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP,290.0,188.5,,,0
RC,636,POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP,10386.4,6751.16,,,0
RC,636,POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK,521.6,339.04,,,0
RC,636,POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP,290.0,188.5,,,0
RC,636,POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP,10386.4,6751.16,,,0
RC,636,POVIDONE-IODINE 10 % TP SOLN,10386.4,6751.16,,,0
RC,636,POVIDONE-IODINE 5 % OP SOLN,290.0,188.5,,,0
RC,636,PRALATREXATE 40 MG/2 ML (20 MG/ML) IV SOLN,133376.22,86694.54,465.41,535.22,8
RC,636,PROCAINAMIDE 100 MG/ML IJ SOLN,965.92,627.85,679.95,781.95,8
RC,636,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) IJ SOLN,290.0,188.5,,,0
RC,636,PROGESTERONE 50 MG/ML IM OIL,20482.8,13313.82,,,0
RC,636,PROPOFOL 10 MG/ML IV EMUL,290.0,188.5,,,0
RC,636,PROPRANOLOL 1 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,PROTAMINE 10 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,PYRIDOXINE (VITAMIN B6) 100 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,"Pediatric and Neonatal Services: High-Cost Drugs - Minerals, Solutions and Vitamins do not apply - when Billed Charges Exceed $5,000 per dose",20482.8,13313.82,,,0
RC,636,Pharmaceuticals,20482.8,13313.82,,,0
RC,636,RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN,20482.8,13313.82,358.25,411.99,24
RC,636,"RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR",4835.6,3143.1400000000003,435.99,501.39,24
RC,636,RACEPINEPHRINE 2.25 % IN NEBU,290.0,188.5,,,0
RC,636,RAMUCIRUMAB 10 MG/ML IV SOLN,39726.72,25822.37,88.5,101.77,16
RC,636,RASBURICASE 1.5 MG IV SOLR,17450.13,11342.58,462.33,531.68,8
RC,636,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,137173.68,89162.89499999999,274.88,316.11,16
RC,636,REGADENOSON 0.4 MG/5 ML IV SYRG,12162.6,7905.69,,,0
RC,636,REMDESIVIR 100 MG IV SOLR,10157.6,6602.44,7.91,9.1,16
RC,636,REMIFENTANIL 2 MG IV SOLR,1917.22,1246.19,,,0
RC,636,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG FOR OB",784.6,509.99,,,0
RC,636,RIMABOTULINUMTOXINB 5000 UNITS/ML IM SOLN,6350.8,4128.02,16.17,18.6,8
RC,636,RISANKIZUMAB-RZAA 60 MG/ML IV SOLN,86978.16,56535.8,18.22,20.95,8
RC,636,RITUXIMAB 10 MG/ML IV CONC,22548.480000000003,14656.51,96.27,110.71,16
RC,636,RITUXIMAB-ABBS 10 MG/ML IV SOLN,24579.36,15976.585,41.83,48.11,16
RC,636,RITUXIMAB-ARRX 10 MG/ML IV SOLN,25644.96,16669.225,48.12,55.34,16
RC,636,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SC SOLN",52612.65,34198.22,46.0,52.9,8
RC,636,RITUXIMAB-PVVR 10 MG/ML IV SOLN,24362.88,15835.869999999999,27.94,32.13,16
RC,636,ROCURONIUM 10 MG/ML IV SOLN,10386.4,6751.16,,,0
RC,636,ROMIDEPSIN 10 MG/2 ML IV SOLR,28787.85,18712.1,37.19,42.76,8
RC,636,ROMIPLOSTIM 125 MCG SC SOLR,20973.6,13632.84,,,0
RC,636,ROMIPLOSTIM 250 MCG SC SOLR,23594.94,15336.71,,,0
RC,636,ROMIPLOSTIM 500 MCG SC SOLR,47189.79,30673.36,,,0
RC,636,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SC SYRG,20482.8,13313.82,13.91,16.0,8
RC,636,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SC SYRG,11830.14,7689.59,13.91,16.0,8
RC,636,ROPIVACAINE (PF) 2 MG/ML (0.2 %) IJ SOLN,290.0,188.5,,,0
RC,636,ROPIVACAINE (PF) 5 MG/ML (0.5 %) IJ SOLN,10386.4,6751.16,,,0
RC,636,ROPIVACAINE 0.2 % PERIPHERAL NERVE BLOCK INFUSION,454.4,295.36,,,0
RC,636,ROPIVACAINE 0.2% BOLUS FROM BOTTLE OR PUMP (ANES-INTRAPROCEDURE),290.0,188.5,,,0
RC,636,ROPIVACAINE 0.2% IN 0.9% NACL 500 ML FOR PERIPHERAL NERVE CATETHER,784.0,509.6,,,0
RC,636,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.15 % EP SOLN,20482.8,13313.82,,,0
RC,636,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % EP SOLN,2048.0,1331.2,,,0
RC,636,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,22619.16,14702.45,43.17,49.64,8
RC,636,SACUBITRIL-VALSARTAN 24-26 MG PO TABS,10153.92,6600.05,13270.0,14761.0,2
RC,636,SALMETEROL 50 MCG/DOSE IN DSDV,3156.48,2051.71,,,0
RC,636,SECRETIN (HUMAN) 16 MCG IV SOLR,10281.6,6683.04,53.01,60.96,8
RC,636,SILTUXIMAB 400 MG IV SOLR,20482.8,13313.82,195.58,224.92,8
RC,636,SINCALIDE 5 MCG IJ SOLR,1983.73,1289.42,,,0
RC,636,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR,71806.77,46674.4,142.21,163.54,8
RC,636,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG,20482.8,13313.82,,,0
RC,636,SODIUM BICARBONATE 4.2 % IV SOLN,320.32,208.20999999999998,,,0
RC,636,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG,20482.8,13313.82,,,0
RC,636,SODIUM BICARBONATE 8.4 % IV SOLN,10386.4,6751.16,,,0
RC,636,SODIUM CHLORIDE 0.9 % IN NEBU,290.0,188.5,,,0
RC,636,SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP,290.0,188.5,,,0
RC,636,SODIUM CHLORIDE 3 % IN NEBU,10386.4,6751.16,,,0
RC,636,SODIUM CHLORIDE 3% IVPB,290.0,188.5,,,0
RC,636,SODIUM CHLORIDE 4 MEQ/ML IV SOLN,20482.8,13313.82,,,0
RC,636,SODIUM CHLORIDE 5% FOR APHERESIS ONLY,290.0,188.5,,,0
RC,636,SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN,474.08,308.15,,,0
RC,636,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IX SYRG,20482.8,13313.82,151.06,173.71,16
RC,636,SODIUM HYALURONATE (VISCOSUP) 30 MG/2 ML IX SYRG,20482.8,13313.82,153.05,176.01,8
RC,636,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,290.0,188.5,,,0
RC,636,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IV SOLN,1584.0,1029.6,,,0
RC,636,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,921.95,599.27,,,0
RC,636,SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN,10386.4,6751.16,,,0
RC,636,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,20482.8,13313.82,,,0
RC,636,SUGAMMADEX 100 MG/ML IV SOLN,1932.8,1256.32,,,0
RC,636,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN,290.0,188.5,,,0
RC,636,SULFUR HEXAFLUORIDE MICROSPHR 25 MG IV SUSR,20482.8,13313.82,,,0
RC,636,SUTIMLIMAB-JOME 50 MG/ML IV SOLN,17258.47,11218.01,22.57,25.96,8
RC,636,TACROLIMUS 0.75 MG PO TB24,6673.6,4337.84,,,0
RC,636,TACROLIMUS 1 MG PO TB24,2669.76,1735.34,,,0
RC,636,TAFASITAMAB-CXIX 200 MG IV SOLR,12316.5,8005.73,17.07,19.63,8
RC,636,TEBENTAFUSP-TEBN 100 MCG/0.5 ML IV SOLN,184320.0,119808.0,267.41,307.52,8
RC,636,TECLISTAMAB-CQYV 10 MG/ML SC SOLN,12847.33,8350.76,,,0
RC,636,TECLISTAMAB-CQYV 90 MG/ML SC SOLN,64889.92,42178.45,,,0
RC,636,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR,7546.77,4905.4,40.11,46.12,24
RC,636,TEPROTUMUMAB-TRBW 500 MG IV SOLR,153158.58,99553.08,428.2,492.43,8
RC,636,TERBUTALINE 1 MG/ML SC SOLN,290.0,188.5,,,0
RC,636,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,290.0,188.5,,,0
RC,636,TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG,10542.56,6852.665,,,0
RC,636,TETANUS IMMUNE GLOBULIN (PF) 250 UNITS/ML IM SYRG,8358.88,5433.27,724.42,833.08,8
RC,636,TETRACAINE HCL (PF) 1 % (10 MG/ML) IJ SOLN,1075.46,699.05,,,0
RC,636,THIAMINE HCL (VITAMIN B1) 100 MG/ML IJ SOLN,290.0,188.5,,,0
RC,636,THROMBIN (BOVINE) 5000 UNITS TP SOLR,591.36,384.38,,,0
RC,636,THYROTROPIN ALFA 0.9 MG IM SOLR,20482.8,13313.82,2581.7,2968.95,16
RC,636,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION IN MIST,290.0,188.5,,,0
RC,636,TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN,1804.0,1172.6,,,0
RC,636,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,64107.0,41669.55,226.12,260.04,8
RC,636,TIXAGEVIMAB 150 MG/1.5 ML IM SOLN,20482.8,13313.82,,,0
RC,636,TOBRAMYCIN 1.2 G SOLN FOR MIXTURE (INTRAPROCEDURE),959.04,623.38,,,0
RC,636,TOBRAMYCIN SULFATE 40 MG/ML IJ SOLN,290.44,188.785,,,0
RC,636,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN,21246.56,13810.26,7.42,8.54,8
RC,636,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,42493.12,27620.53,7.42,8.54,8
RC,636,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,8498.56,5524.06,7.42,8.54,8
RC,636,TOPOTECAN 4 MG IV SOLR,11284.84,7335.1449999999995,,,0
RC,636,TRABECTEDIN 1 MG IV SOLR,31031.82,20170.68,451.78,519.55,8
RC,636,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",290.0,188.5,,,0
RC,636,TRANEXAMIC ACID 650 MG PO TABS,1121.28,728.83,,,0
RC,636,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",290.0,188.5,,,0
RC,636,TRASTUZUMAB 150 MG IV SOLR,14025.78,9116.76,97.05,111.61,8
RC,636,TRASTUZUMAB-ANNS 150 MG IV SOLR,11176.56,7264.76,30.3,34.84,8
RC,636,TRASTUZUMAB-ANNS 420 MG IV SOLR,31294.08,20341.15,30.3,34.84,8
RC,636,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SC SOLN",42077.16,27350.15,79.43,91.34,8
RC,636,TRASTUZUMAB-QYYP 420 MG IV SOLR,19222.68,12494.74,23.87,27.45,24
RC,636,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,365180.4,237367.26,168.66,193.96,8
RC,636,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) IN NEBU,51746.21,33635.04,,,0
RC,636,TREPROSTINIL SODIUM 5 MG/ML IJ SOLN,18068.22,11744.34,69.5,79.93,8
RC,636,TRIAMCINOLONE ACETONIDE 10 MG/ML IJ SUSP,290.0,188.5,,,0
RC,636,TRIAMCINOLONE ACETONIDE 32 MG IX SSRR,14770.759999999998,9600.994999999999,22.1,25.41,24
RC,636,TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP,708.32,460.41,,,0
RC,636,TRIMETHOBENZAMIDE 100 MG/ML IM SOLN,722.24,469.46,,,0
RC,636,TRIPTORELIN PAMOATE 11.25 MG IM SUSR,18866.97,12263.53,581.16,668.34,8
RC,636,TRIPTORELIN PAMOATE 3.75 MG IM SUSR,11180.48,7267.31,581.16,668.34,8
RC,636,TUBERCULIN PPD 5 TUB. UNIT /0.1 ML ID SOLN,1641.28,1066.83,,,0
RC,636,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,20482.8,13313.82,,,0
RC,636,UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION IN DSDV,498.29,323.89,,,0
RC,636,USTEKINUMAB 130 MG/26 ML IV SOLN,18211.52,11837.49,16.15,18.57,8
RC,636,USTEKINUMAB 90 MG/ML SC SYRG,233470.62,151755.9,199.12,228.99,8
RC,636,VALBENAZINE 40 MG PO CAPS,20482.8,13313.82,,,0
RC,636,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN,290.0,188.5,,,0
RC,636,VANCOMYCIN 1000 MG IV SOLR,10386.4,6751.16,,,0
RC,636,VANCOMYCIN 1250 MG/250 ML PREMIX IVPB,10386.4,6751.16,,,0
RC,636,VANCOMYCIN 5 GRAM IV SOLR,294.4,191.36,,,0
RC,636,VANCOMYCIN 500 MG IV SOLR,290.0,188.5,,,0
RC,636,VANCOMYCIN 750 MG IV SOLR,290.0,188.5,,,0
RC,636,VANCOMYCIN IN DEXTROSE 5 % 1.25 GRAM/250 ML IV SOLN,10386.4,6751.16,,,0
RC,636,VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SC SUSR,20482.8,13313.82,,,0
RC,636,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,11627.93,7558.155,,,0
RC,636,VASOPRESSIN 0.2 UNITS/ML IV SOLN,596.8,387.92,,,0
RC,636,VASOPRESSIN 20 UNITS/ML IV SOLN,10837.689999999999,7044.5,,,0
RC,636,VECURONIUM BROMIDE 10 MG IV SOLR,290.0,188.5,,,0
RC,636,VEDOLIZUMAB 300 MG IV SOLR,84239.19,54755.47,27.72,31.88,8
RC,636,VELAGLUCERASE ALFA 400 UNITS IV SOLR,11862.16,7710.4,460.97,530.11,8
RC,636,VERAPAMIL 2.5 MG/ML IV SOLN,310.66,201.93,,,0
RC,636,VINBLASTINE 1 MG/ML IV SOLN,793.28,515.63,,,0
RC,636,VINCRISTINE 1 MG/ML IV SOLN,290.0,188.5,,,0
RC,636,VINORELBINE 50 MG/5 ML IV SOLN,924.24,600.755,,,0
RC,636,VITAMIN A PALMITATE 50000 UNITS/ML IM SOLN,20482.8,13313.82,,,0
RC,636,VORICONAZOLE 200 MG IV SOLR,324.16,210.7,,,0
RC,636,VUTRISIRAN 25 MG/0.5 ML SC SYRG,477404.0,310312.6,6133.8,7053.87,8
RC,636,ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR,625.225,406.395,,,0
RC,636,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,377.8,245.575,,,0
RC,636,ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK,540.5,351.325,,,0
RC,637,ABACAVIR 300 MG PO TABS,2083.0,1353.95,,,0
RC,637,ACARBOSE 100 MG PO TABS,580.8,377.52,,,0
RC,637,ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN,290.0,188.5,,,0
RC,637,ACETAMINOPHEN-CODEINE 300-30 MG PO TABS,383.4,249.21,,,0
RC,637,ACETAMINOPHEN-CODEINE 300-60 MG PO TABS,477.8,310.57,,,0
RC,637,ACETAZOLAMIDE 250 MG PO TABS,5382.4,3498.56,,,0
RC,637,ACYCLOVIR 200 MG PO CAPS,585.0,380.25,,,0
RC,637,ACYCLOVIR 800 MG PO TABS,869.0,564.85,,,0
RC,637,ALBUTEROL SULFATE 90 MCG/ACTUATION IN HFAA,290.0,188.5,,,0
RC,637,ALPRAZOLAM 0.25 MG PO TABS,290.0,188.5,,,0
RC,637,ALPRAZOLAM 0.5 MG PO TABS,290.0,188.5,,,0
RC,637,AMANTADINE HCL 100 MG PO CAPS,290.0,188.5,,,0
RC,637,AMMONIUM LACTATE 12 % TP LOTN,290.0,188.5,,,0
RC,637,AMOXICILLIN 250 MG PO CAPS,290.0,188.5,,,0
RC,637,AMOXICILLIN 250 MG/5 ML PO SUSR,290.0,188.5,,,0
RC,637,AMOXICILLIN 500 MG PO CAPS,457.0,297.05,,,0
RC,637,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,290.0,188.5,,,0
RC,637,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,804.8,523.12,,,0
RC,637,APIXABAN 2.5 MG PO TABS,1789.44,1163.135,,,0
RC,637,APIXABAN 5 MG PO TABS,1789.44,1163.135,,,0
RC,637,APRACLONIDINE 0.5 % OP DROP,695.2,451.88,,,0
RC,637,ARIPIPRAZOLE 10 MG PO TABS,360.72,234.465,,,0
RC,637,ARIPIPRAZOLE 15 MG PO TABS,290.0,188.5,,,0
RC,637,ARIPIPRAZOLE 2 MG PO TABS,1699.96,1104.975,,,0
RC,637,ARIPIPRAZOLE 5 MG PO TABS,3264.2,2121.73,,,0
RC,637,ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OP DROP,416.88,270.97,,,0
RC,637,ASPIRIN-DIPYRIDAMOLE 25-200 MG PO CM12,776.64,504.82,,,0
RC,637,ATORVASTATIN 10 MG PO TABS,290.0,188.5,,,0
RC,637,ATORVASTATIN 20 MG PO TABS,296.2,192.53,,,0
RC,637,ATORVASTATIN 40 MG PO TABS,345.6,224.64,,,0
RC,637,ATORVASTATIN 80 MG PO TABS,832.0,540.8,,,0
RC,637,ATOVAQUONE 750 MG/5 ML PO SUSP,364.88,237.17,,,0
RC,637,ATROPINE 1 % OP DROP,559.04,363.38,,,0
RC,637,AZATHIOPRINE 50 MG PO TABS,290.0,188.5,,,0
RC,637,AZELASTINE 137 MCG (0.1 %) NA SPRA,290.0,188.5,,,0
RC,637,AZITHROMYCIN 200 MG/5 ML PO SUSR,290.0,188.5,,,0
RC,637,AZITHROMYCIN 250 MG PO TABS,935.5999999999999,608.14,,,0
RC,637,BACITRACIN ZINC 500 UNIT/GRAM TP OINT,290.0,188.5,,,0
RC,637,"BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINT",290.0,188.5,,,0
RC,637,"BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM TP PACK",529.92,344.45,,,0
RC,637,BACLOFEN 25 MG/5 ML (5 MG/ML) PO SUSP,10821.12,7033.73,,,0
RC,637,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION IN HFAB,1631.98,1060.79,,,0
RC,637,BECLOMETHASONE DIPROPIONATE ORAL EMULSION,290.0,188.5,,,0
RC,637,BENZOCAINE 20 % MM SPRA,647.975,421.18000000000006,,,0
RC,637,BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MM GEL,290.0,188.5,,,0
RC,637,BICALUTAMIDE 50 MG PO TABS,1051.2,683.28,,,0
RC,637,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG PO TABS,62850.24,40852.66,,,0
RC,637,BRIMONIDINE 0.2 % OP DROP,290.0,188.5,,,0
RC,637,BUDESONIDE 0.5 MG IN NBSP,290.0,188.5,,,0
RC,637,BUDESONIDE 3 MG PO CECX,3292.8,2140.3199999999997,,,0
RC,637,BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION IN HFAA,454.7,295.56,,,0
RC,637,BUPRENORPHINE HCL 2 MG SL SUBL,290.0,188.5,,,0
RC,637,BUPRENORPHINE HCL 8 MG SL SUBL,290.0,188.5,,,0
RC,637,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,290.0,188.5,,,0
RC,637,BUPROPION HCL 150 MG PO TB24,315.15999999999997,204.85500000000002,,,0
RC,637,BUPROPION HCL 300 MG PO TB24,991.68,644.59,,,0
RC,637,BUTALBITAL-ACETAMINOP-CAF-COD 50-300-40-30 MG PO CAPS,9060.8,5889.52,,,0
RC,637,BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG PO TABS,642.6,417.69,,,0
RC,637,CABERGOLINE 0.5 MG PO TABS,580.99,377.64,,,0
RC,637,CAPSAICIN 0.1 % TP CREA,290.0,188.5,,,0
RC,637,CARBIDOPA-LEVODOPA 23.75-95 MG PO CPSR,6193.6,4025.84,,,0
RC,637,CEFDINIR 300 MG PO CAPS,671.04,436.175,,,0
RC,637,CEFUROXIME AXETIL 250 MG PO TABS,290.0,188.5,,,0
RC,637,CEFUROXIME AXETIL 500 MG PO TABS,1302.72,846.77,,,0
RC,637,CEPHALEXIN 250 MG PO CAPS,290.0,188.5,,,0
RC,637,CEPHALEXIN 250 MG/5 ML PO SUSR,342.4,222.56,,,0
RC,637,CEPHALEXIN 500 MG PO CAPS,1064.0,691.6,,,0
RC,637,CINACALCET 30 MG PO TABS,290.0,188.5,,,0
RC,637,CINACALCET 60 MG PO TABS,432.0,280.8,,,0
RC,637,CINACALCET 90 MG PO TABS,343.2,223.08,,,0
RC,637,CIPROFLOXACIN HCL 0.3 % OP DROP,290.0,188.5,,,0
RC,637,CIPROFLOXACIN HCL 250 MG PO TABS,4382.4,2848.56,,,0
RC,637,CIPROFLOXACIN HCL 500 MG PO TABS,459.2,298.48,,,0
RC,637,CITALOPRAM 10 MG/5 ML PO SOLN,994.56,646.46,,,0
RC,637,CLARITHROMYCIN 500 MG PO TABS,1104.96,718.225,,,0
RC,637,CLINDAMYCIN HCL 150 MG PO CAPS,313.8,203.97,,,0
RC,637,CLINDAMYCIN PHOSPHATE 2 % VA CREA,1295.36,841.98,,,0
RC,637,CLOBAZAM 10 MG PO TABS,584.0,379.6,,,0
RC,637,CLONAZEPAM 0.1 MG/ML ORAL SUSPENSION (IP ORDERING ONLY),290.0,188.5,,,0
RC,637,CLONAZEPAM 0.25 MG PO TBDL,563.0799999999999,366.0,,,0
RC,637,CLONAZEPAM 0.5 MG PO TABS,290.0,188.5,,,0
RC,637,CLONAZEPAM 1 MG PO TABS,290.0,188.5,,,0
RC,637,CLONAZEPAM 2 MG PO TABS,290.0,188.5,,,0
RC,637,CLONIDINE 0.1 MG/24 HR TD PTWK,290.0,188.5,,,0
RC,637,CLONIDINE 0.2 MG/24 HR TD PTWK,392.8,255.32,,,0
RC,637,CLONIDINE 0.3 MG/24 HR TD PTWK,499.49,324.67,,,0
RC,637,CLOPIDOGREL 300 MG PO TABS,3858.0,2507.7,,,0
RC,637,CLOPIDOGREL 75 MG PO TABS,429.0,278.85,,,0
RC,637,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TP CREA,290.0,188.5,,,0
RC,637,COBICISTAT 150 MG PO TABS,4691.52,3049.49,,,0
RC,637,CODEINE-GUAIFENESIN 10-100 MG/5 ML PO LIQD,290.0,188.5,,,0
RC,637,COLCHICINE 0.6 MG PO TABS,1217.8,791.57,,,0
RC,637,CONJUGATED ESTROGENS 0.625 MG/GRAM VA CREA,6869.76,4465.34,,,0
RC,637,CYCLOPHOSPHAMIDE 25 MG PO CAPS,7706.4,5009.16,,,0
RC,637,CYCLOPHOSPHAMIDE 50 MG PO CAPS,13226.4,8597.16,,,0
RC,637,CYCLOSPORINE 0.05 % OP DPET,290.0,188.5,,,0
RC,637,CYCLOSPORINE MODIFIED 100 MG PO CAPS,1128.04,733.225,,,0
RC,637,CYCLOSPORINE MODIFIED 25 MG PO CAPS,354.76,230.595,,,0
RC,637,DABIGATRAN ETEXILATE 150 MG PO CAPS,2809.92,1826.45,,,0
RC,637,DAPAGLIFLOZIN PROPANEDIOL 10 MG PO TABS,8940.0,5811.0,,,0
RC,637,DARUNAVIR 600 MG PO TABS,32172.48,20912.11,,,0
RC,637,DARUNAVIR 800 MG PO TABS,32172.0,20911.8,,,0
RC,637,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG PO TABS,70316.16,45705.5,,,0
RC,637,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NA SPRP,849.92,552.45,,,0
RC,637,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP DROP,803.36,522.18,,,0
RC,637,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG PO TABS,8889.0,5777.85,,,0
RC,637,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML PO SYRP,290.0,188.5,,,0
RC,637,DIAZEPAM 2 MG PO TABS,290.0,188.5,,,0
RC,637,DIAZEPAM 5 MG PO TABS,290.0,188.5,,,0
RC,637,DICLOFENAC SODIUM 1 % TP GEL,293.8,190.97,,,0
RC,637,DILTIAZEM HCL 120 MG PO CP24,290.0,188.5,,,0
RC,637,DILTIAZEM HCL 180 MG PO CP24,290.88,189.07,,,0
RC,637,DILTIAZEM HCL 240 MG PO CP24,321.12,208.73,,,0
RC,637,DILTIAZEM HCL 300 MG PO CP24,290.0,188.5,,,0
RC,637,DILTIAZEM HCL 360 MG PO CP24,62647.200000000004,40720.68,,,0
RC,637,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,692.8,450.32,,,0
RC,637,DIVALPROEX 125 MG PO CDRS,290.0,188.5,,,0
RC,637,DIVALPROEX 125 MG PO TBEC,290.0,188.5,,,0
RC,637,DIVALPROEX 250 MG PO TBEC,597.0,388.05,,,0
RC,637,DIVALPROEX 500 MG PO TBEC,290.0,188.5,,,0
RC,637,DOFETILIDE 125 MCG PO CAPS,4803.84,3122.5,,,0
RC,637,DOFETILIDE 500 MCG PO CAPS,680.64,442.42,,,0
RC,637,DOLUTEGRAVIR 50 MG PO TABS,34661.76,22530.14,,,0
RC,637,DORAVIRINE 100 MG PO TABS,1653.63,1074.86,,,0
RC,637,DORZOLAMIDE 2 % OP DROP,398.36,258.935,,,0
RC,637,DOXYCYCLINE HYCLATE 100 MG PO CAPS,1522.4,989.56,,,0
RC,637,DOXYCYCLINE HYCLATE 50 MG PO CAPS,301.6,196.04,,,0
RC,637,DRONABINOL 2.5 MG PO CAPS,2776.0,1804.4,,,0
RC,637,DRONEDARONE 400 MG PO TABS,11658.24,7577.86,,,0
RC,637,DULOXETINE 20 MG PO CPDR,431.56,280.515,,,0
RC,637,DULOXETINE 30 MG PO CPDR,1213.0,788.45,,,0
RC,637,DULOXETINE 60 MG PO CPDR,1120.0,728.0,,,0
RC,637,ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG PO TABS,62850.24,40852.66,,,0
RC,637,EMPAGLIFLOZIN 10 MG PO TABS,4472.16,2906.9,,,0
RC,637,EMPAGLIFLOZIN 25 MG PO TABS,4472.16,2906.9,,,0
RC,637,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG PO TABS,32830.08,21339.55,,,0
RC,637,ENALAPRIL MALEATE 10 MG PO TABS,761.6,495.04,,,0
RC,637,ENALAPRIL MALEATE 2.5 MG PO TABS,290.0,188.5,,,0
RC,637,ENALAPRIL MALEATE 20 MG PO TABS,868.8,564.72,,,0
RC,637,ENALAPRIL MALEATE 5 MG PO TABS,290.0,188.5,,,0
RC,637,ENTACAPONE 200 MG PO TABS,894.4,581.36,,,0
RC,637,ENTECAVIR 0.5 MG PO TABS,928.08,603.255,,,0
RC,637,EPLERENONE 25 MG PO TABS,326.88,212.47,,,0
RC,637,ERYTHROMYCIN 5 MG/GRAM (0.5 %) OP OINT,290.0,188.5,,,0
RC,637,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML PO SUSR,3640.0,2366.0,,,0
RC,637,ESCITALOPRAM OXALATE 20 MG PO TABS,680.0,442.0,,,0
RC,637,ESCITALOPRAM OXALATE 5 MG PO TABS,290.0,188.5,,,0
RC,637,ESTRADIOL 0.025 MG/24 HR TD PTWK,290.0,188.5,,,0
RC,637,ETHAMBUTOL 400 MG PO TABS,1163.2,756.08,,,0
RC,637,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG PO TABS,290.0,188.5,,,0
RC,637,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG PO TABS,302.11,196.37,,,0
RC,637,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG PO TABS,628.46,408.5,,,0
RC,637,EZETIMIBE 10 MG PO TABS,2168.0,1409.2,,,0
RC,637,FAMOTIDINE 40 MG/5 ML (8 MG/ML) PO SUSR,447.2,290.68,,,0
RC,637,FEBUXOSTAT 40 MG PO TABS,290.0,188.5,,,0
RC,637,FEBUXOSTAT 80 MG PO TABS,405.88,263.82,,,0
RC,637,FENOFIBRATE NANOCRYSTALLIZED 145 MG PO TABS,298.08,193.75,,,0
RC,637,FENOFIBRATE NANOCRYSTALLIZED 48 MG PO TABS,323.56,210.315,,,0
RC,637,FENTANYL 12 MCG/HR TD PT72,290.0,188.5,,,0
RC,637,FENTANYL 25 MCG/HR TD PT72,410.76,266.995,,,0
RC,637,FLUCONAZOLE 100 MG PO TABS,639.0,415.35,,,0
RC,637,FLUCONAZOLE 200 MG PO TABS,3024.0,1965.6,,,0
RC,637,FLUCONAZOLE 50 MG PO TABS,322.08,209.35,,,0
RC,637,FLUOROMETHOLONE 0.1 % OP DRPS,1154.4,750.36,,,0
RC,637,FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE IN DSDV,475.33,308.96,,,0
RC,637,FLUTICASONE FUROATE-VILANTEROL 200-25 MCG/DOSE IN DSDV,475.33,308.96,,,0
RC,637,FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE IN DSDV,339.25,220.51,,,0
RC,637,FLUTICASONE PROPIONATE 110 MCG/ACTUATION IN HFAA,1326.62,862.3,,,0
RC,637,FLUTICASONE PROPIONATE 220 MCG/ACTUATION IN HFAA,2615.425,1700.03,,,0
RC,637,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NA SPSN,290.0,188.5,,,0
RC,637,FORTIFIED TOBRAMYCIN 14 MG/ML OP DROPS,290.0,188.5,,,0
RC,637,FORTIFIED VANCOMYCIN 50 MG/ML OP DROPS,290.0,188.5,,,0
RC,637,GENTAMICIN 0.1 % TP OINT,588.72,382.67,,,0
RC,637,GRANISETRON HCL 1 MG PO TABS,681.64,443.065,,,0
RC,637,HOMEOPATHIC PRODUCTS TP OINT,290.0,188.5,,,0
RC,637,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,596.8,387.92,,,0
RC,637,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,449.8,292.37,,,0
RC,637,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,290.0,188.5,,,0
RC,637,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML PO SOLN,290.0,188.5,,,0
RC,637,HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) PO SYRP,290.0,188.5,,,0
RC,637,HYDROCORTISONE 1 % TP CREA,290.0,188.5,,,0
RC,637,HYDROCORTISONE 1 % TP OINT,290.0,188.5,,,0
RC,637,HYDROCORTISONE 10 MG PO TABS,628.0,408.2,,,0
RC,637,HYDROCORTISONE 2.5 % TP CREA,290.0,188.5,,,0
RC,637,HYDROCORTISONE 20 MG PO TABS,718.4,466.96,,,0
RC,637,HYDROCORTISONE 5 MG PO TABS,290.0,188.5,,,0
RC,637,HYDROCORTISONE-PRAMOXINE 1-1 % PR FOAM,2759.68,1793.79,,,0
RC,637,HYDROMORPHONE 2 MG PO TABS,290.0,188.5,,,0
RC,637,HYDROMORPHONE 4 MG PO TABS,320.2,208.13,,,0
RC,637,HYDROMORPHONE 8 MG PO TABS,931.2,605.28,,,0
RC,637,HYDROXYUREA 500 MG PO CAPS,290.0,188.5,,,0
RC,637,INDOMETHACIN 50 MG PR SUPP,96896.64,62982.82,,,0
RC,637,INSULIN GLARGINE 100 UNITS/ML SC SOLN,914.24,594.26,,,0
RC,637,INSULIN LISPRO 100 UNITS/ML SC SOLN,767.84,499.1,,,0
RC,637,INSULIN LISPRO 100 UNITS/ML SC SOLN (SLIDING SCALE),,,,,0
RC,637,INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SC SUSP,290.0,188.5,,,0
RC,637,INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SC SUSP,290.0,188.5,,,0
RC,637,INSULIN REGULAR HUMAN 100 UNITS/ML IJ SOLN,405.88,263.82,,,0
RC,637,IODINE STRONG (LUGOLS) 5 % PO SOLN,504.9,328.19,,,0
RC,637,IPRATROPIUM BROMIDE 17 MCG/ACTUATION IN HFAA,2287.02,1486.56,,,0
RC,637,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NA SPRY,290.0,188.5,,,0
RC,637,IRBESARTAN 300 MG PO TABS,375.84,244.3,,,0
RC,637,ITRACONAZOLE 100 MG PO CAPS,1166.88,758.47,,,0
RC,637,IVABRADINE 5 MG PO TABS,8885.76,5775.74,,,0
RC,637,IVERMECTIN 3 MG PO TABS,1227.84,798.1,,,0
RC,637,KETOROLAC 0.5 % OP DROP,290.0,188.5,,,0
RC,637,LACOSAMIDE 10 MG/ML PO SOLN,561.44,364.94,,,0
RC,637,LACOSAMIDE 200 MG PO TABS,10937.279999999999,7109.23,,,0
RC,637,LACOSAMIDE 50 MG PO TABS,1100.16,715.1,,,0
RC,637,LAMIVUDINE 100 MG PO TABS,8218.56,5342.06,,,0
RC,637,LAMIVUDINE 150 MG PO TABS,2019.36,1312.58,,,0
RC,637,LAMOTRIGINE 100 MG PO TABS,290.0,188.5,,,0
RC,637,LAMOTRIGINE 200 MG PO TABS,290.0,188.5,,,0
RC,637,LAMOTRIGINE 25 MG PO TABS,290.0,188.5,,,0
RC,637,LATANOPROST 0.005 % OP DROP,290.0,188.5,,,0
RC,637,LETROZOLE 2.5 MG PO TABS,290.0,188.5,,,0
RC,637,LEVOFLOXACIN 250 MG PO TABS,326.4,212.16,,,0
RC,637,LEVOFLOXACIN 250 MG/10 ML PO SOLN,7188.48,4672.51,,,0
RC,637,LEVOFLOXACIN 500 MG PO TABS,325.0,211.25,,,0
RC,637,LEVOFLOXACIN 750 MG PO TABS,472.2,306.93,,,0
RC,637,LIDOCAINE 4 % TP CREA,396.96,258.02,,,0
RC,637,LIDOCAINE 4 % TP PTMD,388.36,252.435,,,0
RC,637,LIDOCAINE 5 % TP OINT,1834.215,1192.24,,,0
RC,637,LIDOCAINE HCL 2 % MM JELP,290.0,188.5,,,0
RC,637,LIDOCAINE-PRILOCAINE 2.5-2.5 % TP CREA,290.0,188.5,,,0
RC,637,LINACLOTIDE 145 MCG PO CAPS,8059.68,5238.79,,,0
RC,637,LINACLOTIDE 290 MCG PO CAPS,8059.68,5238.79,,,0
RC,637,LINAGLIPTIN 5 MG PO TABS,13228.8,8598.72,,,0
RC,637,LINEZOLID 600 MG PO TABS,290.0,188.5,,,0
RC,637,"LIPASE-PROTEASE-AMYLASE 36,000-114,000- 180,000 UNIT PO CPDR",19249.6,12512.24,,,0
RC,637,LORAZEPAM 0.5 HALF-TAB = 0.25 MG,290.0,188.5,,,0
RC,637,LORAZEPAM 0.5 MG PO TABS,290.0,188.5,,,0
RC,637,LORAZEPAM 1 MG PO TABS,290.0,188.5,,,0
RC,637,LORAZEPAM 1 MG/ML ORAL SUSPENSION,290.0,188.5,,,0
RC,637,LORAZEPAM 2 MG PO TABS,290.0,188.5,,,0
RC,637,LOSARTAN 25 MG HALF-TAB = 12.5 MG,290.0,188.5,,,0
RC,637,LOSARTAN 25 MG PO TABS,2388.52,1552.54,,,0
RC,637,LOSARTAN 50 MG PO TABS,782.4,508.56,,,0
RC,637,LOTEPREDNOL ETABONATE 0.5 % OP DRPS,4742.08,3082.35,,,0
RC,637,LUBIPROSTONE 24 MCG PO CAPS,3187.68,2071.9900000000002,,,0
RC,637,LURASIDONE 40 MG PO TABS,20514.24,13334.26,,,0
RC,637,MAGIC MOUTHWASH (IP ORDERING ONLY),290.0,188.5,,,0
RC,637,MARAVIROC 300 MG PO TABS,25790.4,16763.76,,,0
RC,637,MEGESTROL 400 MG/10 ML (10 ML) PO SUSP,290.0,188.5,,,0
RC,637,MEMANTINE 10 MG PO TABS,444.2,288.73,,,0
RC,637,MEMANTINE 5 MG PO TABS,445.0,289.25,,,0
RC,637,MESALAMINE 400 MG PO CDTI,6971.04,4531.18,,,0
RC,637,METHADONE 10 MG PO TABS,334.6,217.49,,,0
RC,637,METHADONE 10 MG/ML PO CONC,294.24,191.26,,,0
RC,637,METHADONE 5 MG PO TABS,290.0,188.5,,,0
RC,637,METHOCARBAMOL 500 MG PO TABS,327.4,212.81,,,0
RC,637,METHOCARBAMOL 750 MG PO TABS,413.6,268.84000000000003,,,0
RC,637,METHOTREXATE SODIUM 2.5 MG PO TABS,2416.2,1570.53,,,0
RC,637,METHYLPHENIDATE HCL 5 MG PO TABS,290.0,188.5,,,0
RC,637,METHYLPHENIDATE HCL 5 MG/5 ML PO SOLN,290.0,188.5,,,0
RC,637,METOPROLOL (LOPRESSOR) ORAL SUSPENSION 10MG/ML,290.0,188.5,,,0
RC,637,METRONIDAZOLE 500 MG PO TABS,920.0,598.0,,,0
RC,637,MIDAZOLAM 2 MG/ML PO SYRP,290.0,188.5,,,0
RC,637,MIFEPRISTONE 200 MG PO TABS,688.0,447.2,,,0
RC,637,MODAFINIL 100 MG PO TABS,2229.64,1449.265,,,0
RC,637,MOMETASONE 50 MCG/ACTUATION NA SPRY,751.4,488.41,,,0
RC,637,MONTELUKAST 10 MG PO TABS,377.0,245.05,,,0
RC,637,MONTELUKAST 5 MG PO CHEW,290.0,188.5,,,0
RC,637,MORPHINE 10 MG/5 ML PO SOLN,290.0,188.5,,,0
RC,637,MORPHINE 100 MG PO TBSR,290.0,188.5,,,0
RC,637,MORPHINE 15 MG PO TABS,1124.8,731.12,,,0
RC,637,MORPHINE 15 MG PO TBSR,597.0,388.05,,,0
RC,637,MORPHINE 30 MG PO TBSR,1667.2,1083.68,,,0
RC,637,MUPIROCIN 2 % TP OINT,290.0,188.5,,,0
RC,637,MYCOPHENOLATE MOFETIL 200 MG/ML PO SUSR,16056.32,10436.61,,,0
RC,637,MYCOPHENOLATE MOFETIL 250 MG PO CAPS,928.0,603.2,,,0
RC,637,MYCOPHENOLATE MOFETIL 500 MG PO TABS,290.0,188.5,,,0
RC,637,MYCOPHENOLATE SODIUM 180 MG PO TBEC,309.15999999999997,200.95499999999998,,,0
RC,637,MYCOPHENOLATE SODIUM 360 MG PO TBEC,14553.6,9459.84,,,0
RC,637,NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP DROP,290.0,188.5,,,0
RC,637,NEBIVOLOL 10 MG PO TABS,298.08,193.75,,,0
RC,637,NEBIVOLOL 2.5 MG PO TABS,1004.64,653.0150000000001,,,0
RC,637,NEBIVOLOL 5 MG PO TABS,1066.96,693.525,,,0
RC,637,"NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TP OINT",290.0,188.5,,,0
RC,637,"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OP OINT",290.0,188.5,,,0
RC,637,"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OT DRPS",1187.36,771.78,,,0
RC,637,NEVIRAPINE 200 MG PO TABS,290.0,188.5,,,0
RC,637,NIACIN 500 MG PO TB24,470.88,306.07,,,0
RC,637,NITROFURANTOIN 100 MG PO CAPS,1910.4,1241.76,,,0
RC,637,NITROFURANTOIN 25 MG/5 ML PO SUSP,589.76,383.34,,,0
RC,637,NITROGLYCERIN 400 MCG/SPRAY TL SPRY,2788.45,1812.49,,,0
RC,637,NORFLURANE-PENTAFLUOROPROPANE TP SPRA,468.65,304.62,,,0
RC,637,NYSTATIN 100000 UNIT/GRAM TP POWD,290.0,188.5,,,0
RC,637,NYSTATIN 100000 UNITS/ML PO SUSP,290.0,188.5,,,0
RC,637,"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TP OINT",290.0,188.5,,,0
RC,637,OCTREOTIDE ACETATE 500 MCG/ML IJ SOLN,290.0,188.5,,,0
RC,637,OFLOXACIN 0.3 % OP DROP,290.0,188.5,,,0
RC,637,OLANZAPINE 10 MG PO TBDL,290.0,188.5,,,0
RC,637,OLANZAPINE 5 MG PO TBDL,1419.2,922.48,,,0
RC,637,OLOPATADINE 0.2 % OP DROP,290.0,188.5,,,0
RC,637,ONDANSETRON HCL 4 MG/5 ML PO SOLN,290.0,188.5,,,0
RC,637,OPIUM TINCTURE 10 MG/ML (MORPHINE) PO TINC,290.0,188.5,,,0
RC,637,OSELTAMIVIR 30 MG PO CAPS,891.36,579.385,,,0
RC,637,OSELTAMIVIR 75 MG PO CAPS,1277.08,830.1,,,0
RC,637,OXYBUTYNIN CHLORIDE 10 MG PO TR24,404.2,262.73,,,0
RC,637,OXYBUTYNIN CHLORIDE 5 MG PO TR24,449.6,292.24,,,0
RC,637,OXYCODONE 10 MG PO TR12,1338.56,870.06,,,0
RC,637,OXYCODONE 15 MG PO TABS,290.0,188.5,,,0
RC,637,OXYCODONE 20 MG PO TR12,7325.12,4761.33,,,0
RC,637,OXYCODONE 30 MG PO TABS,290.0,188.5,,,0
RC,637,OXYCODONE 5 MG PO TABS,539.2,350.48,,,0
RC,637,OXYCODONE 5 MG/5 ML PO SOLN,290.0,188.5,,,0
RC,637,OXYCODONE 80 MG PO TR12,21889.28,14228.029999999999,,,0
RC,637,OXYCODONE-ACETAMINOPHEN 10-325 MG PO TABS,1785.6,1160.64,,,0
RC,637,OXYCODONE-ACETAMINOPHEN 2.5-325 MG PO TABS,2430.4,1579.76,,,0
RC,637,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,446.6,290.28999999999996,,,0
RC,637,OXYCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,290.0,188.5,,,0
RC,637,Other Outpatient Services,918.41,596.9649999999999,,,0
RC,637,PANTOPRAZOLE 20 MG PO TBEC,290.0,188.5,,,0
RC,637,PANTOPRAZOLE 40 MG PO TBEC,364.8,237.12,,,0
RC,637,PANTOPRAZOLE ORAL SUSPENSION 2 MG/ML,290.0,188.5,,,0
RC,637,PAPAVERINE 30 MG/ML IJ SOLN,290.0,188.5,,,0
RC,637,PARICALCITOL 1 MCG PO CAPS,663.36,431.18,,,0
RC,637,PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM PO SOLR,320.0,208.0,,,0
RC,637,PENICILLIN V POTASSIUM 250 MG PO TABS,290.0,188.5,,,0
RC,637,PERMETHRIN 5 % TP CREA,395.52,257.09,,,0
RC,637,PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG PO TABS,1505.6,978.64,,,0
RC,637,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) PO ELIX,290.0,188.5,,,0
RC,637,PHENOBARBITAL 32.4 MG PO TABS,536.0,348.4,,,0
RC,637,PHENOBARBITAL 97.2 MG PO TABS,326.4,212.16,,,0
RC,637,PHENYLEPHRINE HCL 0.25 % NA SPRY,290.0,188.5,,,0
RC,637,PHENYLEPHRINE HCL 2.5 % OP DROP,912.9599999999999,593.425,,,0
RC,637,PHYTONADIONE (VITAMIN K1) 5 MG PO TABS,974.94,633.71,,,0
RC,637,PILOCARPINE HCL 1 % OP DROP,1169.52,760.19,,,0
RC,637,PILOCARPINE HCL 2 % OP DROP,1196.4,777.66,,,0
RC,637,PIOGLITAZONE 15 MG PO TABS,290.0,188.5,,,0
RC,637,PIOGLITAZONE 30 MG PO TABS,290.0,188.5,,,0
RC,637,PIOGLITAZONE 45 MG PO TABS,290.0,188.5,,,0
RC,637,"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OP DROP",290.0,188.5,,,0
RC,637,POSACONAZOLE 100 MG PO TBEC,656.06,426.44,,,0
RC,637,PRAMIPEXOLE 0.125 MG PO TABS,290.0,188.5,,,0
RC,637,PRAMIPEXOLE 0.25 MG PO TABS,290.0,188.5,,,0
RC,637,PRAMIPEXOLE 0.5 MG PO TABS,290.0,188.5,,,0
RC,637,PRAMIPEXOLE 1 MG PO TABS,290.0,188.5,,,0
RC,637,PRASUGREL 10 MG PO TABS,381.6,248.04,,,0
RC,637,PRAVASTATIN 10 MG PO TABS,355.68,231.19,,,0
RC,637,PRAVASTATIN 20 MG PO TABS,325.72,211.72,,,0
RC,637,PRAVASTATIN 40 MG PO TABS,1222.4,794.56,,,0
RC,637,PRAVASTATIN 80 MG PO TABS,2856.0,1856.4,,,0
RC,637,PREDNISOLONE ACETATE 1 % OP DRPS,659.68,428.79,,,0
RC,637,PREGABALIN 100 MG PO CAPS,771.4,501.41,,,0
RC,637,PREGABALIN 25 MG PO CAPS,589.92,383.45,,,0
RC,637,PREGABALIN 50 MG PO CAPS,1124.8,731.12,,,0
RC,637,PREGABALIN 75 MG PO CAPS,1145.6,744.64,,,0
RC,637,PROPARACAINE 0.5 % OP DROP,522.96,339.92,,,0
RC,637,PRUCALOPRIDE 2 MG PO TABS,8306.4,5399.16,,,0
RC,637,QUETIAPINE 100 MG PO TABS,656.2,426.53,,,0
RC,637,QUETIAPINE 200 MG PO TABS,626.6,407.29,,,0
RC,637,QUETIAPINE 25 MG PO TABS,350.6,227.89,,,0
RC,637,QUETIAPINE 25MG HALF-TAB = 12.5MG,290.0,188.5,,,0
RC,637,QUETIAPINE 300 MG PO TABS,376.0,244.4,,,0
RC,637,QUETIAPINE 50 MG PO TABS,896.0,582.4,,,0
RC,637,RACEPINEPHRINE 2.25 % IN NEBU,290.0,188.5,,,0
RC,637,RALOXIFENE 60 MG PO TABS,290.0,188.5,,,0
RC,637,RALTEGRAVIR 400 MG PO TABS,29766.72,19348.37,,,0
RC,637,RANOLAZINE 500 MG PO TB12,290.0,188.5,,,0
RC,637,RASAGILINE 1 MG PO TABS,3502.08,2276.35,,,0
RC,637,REPAGLINIDE 1 MG PO TABS,290.0,188.5,,,0
RC,637,REPAGLINIDE 2 MG PO TABS,290.0,188.5,,,0
RC,637,RIFAXIMIN 550 MG PO TABS,48705.6,31658.64,,,0
RC,637,RILPIVIRINE HCL 25 MG PO TABS,22112.64,14373.22,,,0
RC,637,RILUZOLE 50 MG PO TABS,595.2,386.88,,,0
RC,637,RISPERIDONE 0.5 MG PO TABS,294.4,191.36,,,0
RC,637,RISPERIDONE 0.5 MG PO TBDL,874.57,568.47,,,0
RC,637,RISPERIDONE 1 MG PO TABS,290.0,188.5,,,0
RC,637,RISPERIDONE 2 MG PO TABS,290.0,188.5,,,0
RC,637,RISPERIDONE 2 MG PO TBDL,290.0,188.5,,,0
RC,637,RISPERIDONE 3 MG PO TABS,305.6,198.64,,,0
RC,637,RITONAVIR 100 MG PO TABS,2415.84,1570.295,,,0
RC,637,RIVAROXABAN 10 MG PO TABS,290.0,188.5,,,0
RC,637,RIVAROXABAN 15 MG PO TABS,290.0,188.5,,,0
RC,637,RIVAROXABAN 2.5 MG PO TABS,290.0,188.5,,,0
RC,637,RIVAROXABAN 20 MG PO TABS,290.0,188.5,,,0
RC,637,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,290.0,188.5,,,0
RC,637,RIVASTIGMINE TARTRATE 1.5 MG PO CAPS,408.48,265.515,,,0
RC,637,RIVASTIGMINE TARTRATE 3 MG PO CAPS,522.24,339.46,,,0
RC,637,ROFLUMILAST 500 MCG PO TABS,6132.96,3986.42,,,0
RC,637,ROSUVASTATIN 10 MG PO TABS,290.0,188.5,,,0
RC,637,ROSUVASTATIN 20 MG PO TABS,1064.2,691.73,,,0
RC,637,ROSUVASTATIN 40 MG PO TABS,1036.2,673.53,,,0
RC,637,ROSUVASTATIN 5 MG PO TABS,890.6,578.89,,,0
RC,637,SACUBITRIL-VALSARTAN 24-26 MG HALF-TAB = 12-13 MG,290.0,188.5,,,0
RC,637,SACUBITRIL-VALSARTAN 24-26 MG PO TABS,10153.92,6600.05,,,0
RC,637,SACUBITRIL-VALSARTAN 49-51 MG PO TABS,10153.92,6600.05,,,0
RC,637,SACUBITRIL-VALSARTAN 97-103 MG PO TABS,10153.92,6600.05,,,0
RC,637,SCOPOLAMINE BASE 1 MG OVER 3 DAYS TD PT3D,963.71,626.41,,,0
RC,637,SELENIUM 200 MCG PO TABS,290.0,188.5,,,0
RC,637,SEVELAMER CARBONATE 0.8 GRAM PO PWPK,290.0,188.5,,,0
RC,637,SEVELAMER CARBONATE 2.4 GRAM PO PWPK,12117.88,7876.62,,,0
RC,637,SEVELAMER CARBONATE 800 MG PO TABS,1334.88,867.67,,,0
RC,637,SILDENAFIL (PULM.HYPERTENSION) 20 MG PO TABS,340.8,221.52,,,0
RC,637,SILODOSIN 4 MG PO CAPS,446.88,290.47,,,0
RC,637,SILODOSIN 8 MG PO CAPS,397.20000000000005,258.18,,,0
RC,637,SILVER SULFADIAZINE 1 % TP CREA,290.0,188.5,,,0
RC,637,SIROLIMUS 0.5 MG PO TABS,25622.4,16654.56,,,0
RC,637,SIROLIMUS 1 MG PO TABS,25765.8,16747.77,,,0
RC,637,SITAGLIPTIN PHOSPHATE 100 MG PO TABS,7523.56,4890.315,,,0
RC,637,SITAGLIPTIN PHOSPHATE 25 MG PO TABS,8343.4,5423.21,,,0
RC,637,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,14757.12,9592.13,,,0
RC,637,SOD BORATE-BORIC AC-NACL-WATER OP IRSL,290.0,188.5,,,0
RC,637,SODIUM BICARBONATE 650 MG PO TABS,493.0,320.45,,,0
RC,637,SODIUM CHLORIDE 0.65 % NA SPRA,290.0,188.5,,,0
RC,637,SODIUM CHLORIDE 5 % OP DROP,290.0,188.5,,,0
RC,637,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM PO PWPK,921.95,599.27,,,0
RC,637,SULFADIAZINE 500 MG PO TABS,14337.6,9319.44,,,0
RC,637,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML PO SUSP,290.0,188.5,,,0
RC,637,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG PO TABS,290.0,188.5,,,0
RC,637,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,290.0,188.5,,,0
RC,637,SULFASALAZINE 500 MG PO TABS,290.0,188.5,,,0
RC,637,SULFASALAZINE 500 MG PO TBEC,424.0,275.6,,,0
RC,637,SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SC SOLN,323.88,210.51999999999998,,,0
RC,637,TACROLIMUS 0.5 MG PO CAPS,1772.8000000000002,1152.32,,,0
RC,637,TACROLIMUS 1 MG PO CAPS,1112.2,722.93,,,0
RC,637,TACROLIMUS 1 MG PO CP24,1003.2,652.08,,,0
RC,637,TACROLIMUS 5 MG PO CAPS,12315.2,8004.88,,,0
RC,637,TADALAFIL 5 MG PO TABS,2293.24,1490.605,,,0
RC,637,TAMOXIFEN 10 MG PO TABS,702.4,456.56,,,0
RC,637,TAMSULOSIN 0.4 MG PO CAPS,388.79999999999995,252.72000000000003,,,0
RC,637,TAPENTADOL 100 MG PO TABS,28257.6,18367.44,,,0
RC,637,TAPENTADOL 50 MG PO TABS,18145.6,11794.64,,,0
RC,637,TELMISARTAN 20 MG PO TABS,290.0,188.5,,,0
RC,637,TELMISARTAN 40 MG PO TABS,290.0,188.5,,,0
RC,637,TELMISARTAN 80 MG PO TABS,290.0,188.5,,,0
RC,637,TEMAZEPAM 15 MG PO CAPS,290.0,188.5,,,0
RC,637,TEMAZEPAM 7.5 MG PO CAPS,1566.72,1018.37,,,0
RC,637,TENOFOVIR ALAFENAMIDE 25 MG PO TABS,22758.24,14792.86,,,0
RC,637,TENOFOVIR DISOPROXIL FUMARATE 300 MG PO TABS,1779.36,1156.58,,,0
RC,637,TERBINAFINE HCL 250 MG PO TABS,290.0,188.5,,,0
RC,637,TETRACAINE HCL (PF) 0.5 % OP DROP,290.0,188.5,,,0
RC,637,TETRAHYDROZOLINE 0.05 % OP DROP,290.0,188.5,,,0
RC,637,TICAGRELOR 60 MG PO TABS,6928.32,4503.41,,,0
RC,637,TICAGRELOR 90 MG PO TABS,11547.2,7505.68,,,0
RC,637,TIMOLOL MALEATE 0.25 % OP DROP,290.0,188.5,,,0
RC,637,TIMOLOL MALEATE 0.5 % OP DROP,290.0,188.5,,,0
RC,637,TOBRAMYCIN 0.3 % OP DROP,290.0,188.5,,,0
RC,637,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP DRPS,1239.36,805.58,,,0
RC,637,TOLTERODINE 2 MG PO CP24,2978.4,1935.96,,,0
RC,637,TOLTERODINE 2 MG PO TABS,367.68,238.99,,,0
RC,637,TOLTERODINE 4 MG PO CP24,2223.3599999999997,1445.185,,,0
RC,637,TOLVAPTAN 15 MG PO TABS,82815.36,53829.98,,,0
RC,637,TOPIRAMATE 100 MG PO TABS,641.6,417.04,,,0
RC,637,TOPIRAMATE 200 MG PO TABS,345.6,224.64,,,0
RC,637,TOPIRAMATE 25 MG PO TABS,364.8,237.12,,,0
RC,637,TRIAMCINOLONE ACETONIDE 0.1 % TP CREA,290.0,188.5,,,0
RC,637,TRIAMCINOLONE ACETONIDE 0.1 % TP OINT,290.0,188.5,,,0
RC,637,TRIFLURIDINE 1 % OP DROP,2921.88,1899.22,,,0
RC,637,TRIMETHOPRIM 100 MG PO TABS,2777.6,1805.44,,,0
RC,637,TROPICAMIDE 1 % OP DROP,385.0,250.25,,,0
RC,637,URSODIOL 250 MG PO TABS,1224.0,795.6,,,0
RC,637,VALACYCLOVIR 1 GRAM PO TABS,315.84,205.3,,,0
RC,637,VALACYCLOVIR 500 MG PO TABS,514.08,334.15,,,0
RC,637,VALGANCICLOVIR 450 MG PO TABS,16333.92,10617.05,,,0
RC,637,VALSARTAN 160 MG PO TABS,562.3199999999999,365.505,,,0
RC,637,VALSARTAN 40 MG PO TABS,290.0,188.5,,,0
RC,637,VALSARTAN 80 MG PO TABS,417.6,271.44,,,0
RC,637,VANCOMYCIN 125 MG PO CAPS,1490.88,969.07,,,0
RC,637,VANCOMYCIN ORAL SOLUTION 25 MG/ML,290.0,188.5,,,0
RC,637,VENLAFAXINE 150 MG PO CP24,391.96000000000004,254.775,,,0
RC,637,VENLAFAXINE 37.5 MG PO CP24,357.4,232.31,,,0
RC,637,VENLAFAXINE 37.5 MG PO TABS,303.4,197.20999999999998,,,0
RC,637,VENLAFAXINE 75 MG PO CP24,336.52,218.74,,,0
RC,637,VENLAFAXINE 75 MG PO TABS,290.0,188.5,,,0
RC,637,VERICIGUAT 2.5 MG PO TABS,10034.88,6522.67,,,0
RC,637,VORICONAZOLE 200 MG PO TABS,9846.24,6400.06,,,0
RC,637,VORICONAZOLE 50 MG PO TABS,290.0,188.5,,,0
RC,637,VORTIOXETINE 10 MG PO TABS,7664.64,4982.02,,,0
RC,637,VORTIOXETINE 5 MG PO TABS,7664.64,4982.02,,,0
RC,637,ZIPRASIDONE HCL 20 MG PO CAPS,2654.72,1725.57,,,0
RC,637,ZIPRASIDONE HCL 40 MG PO CAPS,3289.6,2138.24,,,0
RC,637,ZIPRASIDONE HCL 60 MG PO CAPS,2595.84,1687.3,,,0
RC,637,ZOLPIDEM 10 MG PO TABS,290.0,188.5,,,0
RC,637,ZOLPIDEM 5 MG PO TABS,290.0,188.5,,,0
RC,659,Other,19623.5,12755.27,,,0
RC,681,Level I,39402.8,25611.82,,,0
RC,681,Outpatient Emergency and Trauma Services,39402.8,25611.82,,,0
RC,681,Pediatric and Neonatal Services: Trauma,39402.77,25611.8,,,0
RC,681,Trauma,39402.785,25611.809999999998,43171.45,43211.44,2
RC,681,Trauma Activation,39402.77,25611.8,10452.88,11183.57,3
RC,681,Trauma Activation Fee,39402.77,25611.8,16857.88,26408.03,5
RC,681,Trauma Activation/Response,39402.77,25611.8,31078.96,31078.96,2
RC,682,Trauma,,,43171.45,43211.44,2
RC,682,Trauma Activation Fee,,,16857.88,26408.03,5
RC,682,Trauma Activation/Response,,,31078.96,31078.96,2
RC,683,Trauma,,,43171.45,43211.44,2
RC,683,Trauma Activation Fee,,,16857.88,26408.03,5
RC,683,Trauma Activation/Response,,,31078.96,31078.96,2
RC,684,Trauma,,,43171.45,43211.44,2
RC,684,Trauma Activation Fee,,,16857.88,26408.03,5
RC,684,Trauma Activation/Response,,,31078.96,31078.96,2
RC,689,Trauma,,,43171.45,43211.44,2
RC,689,Trauma Activation/Response,,,31078.96,31078.96,2
RC,700,EMERGENCY CARE LEVEL 1,,,705.0,763.0,2
RC,700,EMERGENCY CARE LEVEL 2,5680.04,3692.03,1720.0,1858.0,4
RC,700,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,700,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,700,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,700,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,700,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,700,Outpatient Surgical Group 5,54325.5,35311.58,19539.84,29009.34,1510
RC,700,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,535
RC,700,Outpatient Surgical Group 7,30306.95,19699.52,27131.25,40279.73,1485
RC,700,Outpatient Surgical Group 8,,,26436.26,39247.93,65
RC,700,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,560
RC,710,General,1658.71,1078.16,,,0
RC,710,Pediatric and Neonatal Services: Ambulatory Surgery,1658.71,1078.16,,,0
RC,720,General,24932.2,16205.93,,,0
RC,720,Labor Room/Delivery Services,24932.2,16205.93,,,0
RC,730,EKG and ECG,1095.1,711.81,,,0
RC,730,General,1095.1,711.81,,,0
RC,730,Holter Monitor/Telemetry,1095.1,711.81,,,0
RC,730,"Radiology, Pathology, and Diagnostic Tests",1095.1,711.81,,,0
RC,731,Holter Monitor/Telemetry,1074.29,698.29,,,0
RC,731,Holter monitor,1074.29,698.29,,,0
RC,731,"Radiology, Pathology, and Diagnostic Tests",1074.29,698.29,,,0
RC,732,Holter Monitor/Telemetry,7295.99,4742.39,,,0
RC,732,"Radiology, Pathology, and Diagnostic Tests",7295.99,4742.39,,,0
RC,732,Telemetry,7295.99,4742.39,,,0
RC,740,Electroencephalography,14563.5,9466.27,,,0
RC,740,General,14563.5,9466.27,,,0
RC,740,"Radiology, Pathology, and Diagnostic Tests",14563.5,9466.27,,,0
RC,740,Sleep Studies - Attended,11557.994999999999,7512.695,,,0
RC,740,Sleep Studies - Unattended,2524.82,1641.13,,,0
RC,750,Ambulatory Surgery,7503.89,4877.53,,,0
RC,750,Outpatient Surgical Group 0,3969.24,2580.01,2806.68,4166.87,4065
RC,750,Outpatient Surgical Group 1,6838.045,4444.73,9088.3,13492.72,8800
RC,750,Outpatient Surgical Group 2,12682.9,8243.885,12162.28,18056.43,5215
RC,750,Outpatient Surgical Group 3,13383.7,8699.404999999999,13899.75,20635.92,4845
RC,750,Outpatient Surgical Group 4,25241.3,16406.85,17187.58,25517.11,2835
RC,750,Outpatient Surgical Group 5,47616.9,30950.99,19539.84,29009.34,1510
RC,750,Outpatient Surgical Group 6,20418.3,13271.895,22453.45,33334.94,535
RC,750,Outpatient Surgical Group 7,30218.4,19641.96,27131.25,40279.73,1485
RC,750,Outpatient Surgical Group 8,7503.89,4877.53,26436.26,39247.93,65
RC,750,Outpatient Surgical Group 9,33237.4,21604.315000000002,36513.58,54208.97,560
RC,750,"Radiology, Pathology, and Diagnostic Tests",7503.89,4877.53,,,0
RC,760,Definitive Observation Unit,,,1500.0,1500.0,1
RC,761,Ambulatory Surgery,8829.34,5739.07,,,0
RC,761,Definitive Observation Unit,8829.34,5739.07,1500.0,1500.0,1
RC,762,Definitive Observation Unit,520.0,338.0,1500.0,1500.0,1
RC,762,Observation,520.0,338.0,,,0
RC,763,Definitive Observation Unit,,,1500.0,1500.0,1
RC,764,Definitive Observation Unit,,,1500.0,1500.0,1
RC,765,Definitive Observation Unit,,,1500.0,1500.0,1
RC,766,Definitive Observation Unit,,,1500.0,1500.0,1
RC,767,Definitive Observation Unit,,,1500.0,1500.0,1
RC,768,Definitive Observation Unit,,,1500.0,1500.0,1
RC,769,Definitive Observation Unit,,,1500.0,1500.0,1
RC,770,General,486.73,316.37,,,0
RC,771,Vaccine Administration,396.14,257.49,,,0
RC,771,Vaccine administration,396.14,257.49,,,0
RC,780,General,485.73,315.72,,,0
RC,790,Outpatient Surgical Group 0,3919.795,2547.87,2806.68,4166.87,4065
RC,790,Outpatient Surgical Group 1,6801.31,4420.85,9088.3,13492.72,8800
RC,790,Outpatient Surgical Group 2,12855.0,8355.75,12162.28,18056.43,5215
RC,790,Outpatient Surgical Group 3,13695.2,8901.88,13899.75,20635.92,4845
RC,790,Outpatient Surgical Group 4,25380.699999999997,16497.455,17187.58,25517.11,2835
RC,790,Outpatient Surgical Group 5,54325.5,35311.58,19539.84,29009.34,1510
RC,790,Outpatient Surgical Group 6,25927.2,16852.68,22453.45,33334.94,535
RC,790,Outpatient Surgical Group 7,30306.95,19699.52,27131.25,40279.73,1485
RC,790,Outpatient Surgical Group 8,,,26436.26,39247.93,65
RC,790,Outpatient Surgical Group 9,36031.5,23420.48,36513.58,54208.97,560
RC,801,Inpatient hemodialysis,22897.7,14883.5,,,0
RC,802,Inpatient peritoneal (non-CAPD),10131.1,6585.22,,,0
RC,811,Cadaveric Organ Acquisition Costs. NMDP Donor Search - includes transportation cost,486948.5,316516.53,,,0
RC,811,Living Donor,486948.5,316516.53,,,0
RC,811,Living Donor Inpatient Solid Organ Acquisition and Related Donor Costs from Admission to Discharge,486948.5,316516.53,,,0
RC,811,Living Donor Outpatient Solid Organ Acquisition and Related Donor Costs,486948.5,316516.53,,,0
RC,811,Living donor,486948.5,316516.53,,,0
RC,811,NMDP - Cell Search and Acquisition,486948.5,316516.53,,,0
RC,811,Solid Organ Acquisition Reimbursement for Heart when transplanted with a Kidney (Living donor).,486948.5,316516.53,130255.0,137419.03,3
RC,811,Solid Organ Acquisition Reimbursement for Liver when transplanted with a Kidney (Living donor).,486948.5,316516.53,117341.0,123794.76,3
RC,811,Solid Organ Acquisition Reimbursement for Lung when transplanted with a Kidney (Living donor).,486948.5,316516.53,166653.0,175818.92,3
RC,811,Solid Organ Acquisition Reimbursement for Multi-organ when transplanted with a Kidney (Living donor).,486948.5,316516.53,,,0
RC,811,Solid Organ Acquisition Reimbursement for Pancreas when transplanted with a Kidney (Living donor).,486948.5,316516.53,68946.0,72738.03,3
RC,812,Cadaver Donor,664314.0,431804.1,,,0
RC,812,Cadaver donor,664314.0,431804.1,,,0
RC,812,Cadaveric Organ Acquisition Costs. NMDP Donor Search - includes transportation cost,664314.0,431804.1,,,0
RC,812,NMDP - Cell Search and Acquisition,664314.0,431804.1,,,0
RC,812,Solid Organ Acquisition Reimbursement for Heart when transplanted with a Kidney (Deceased donor).,664314.0,431804.1,130255.0,137419.03,3
RC,812,Solid Organ Acquisition Reimbursement for Liver when transplanted with a Kidney (Deceased donor).,664314.0,431804.1,117341.0,123794.76,3
RC,812,Solid Organ Acquisition Reimbursement for Lung when transplanted with a Kidney (Deceased donor).,664314.0,431804.1,166653.0,175818.92,3
RC,812,Solid Organ Acquisition Reimbursement for Multi-organ when transplanted with a Kidney (Deceased donor).,664314.0,431804.1,,,0
RC,812,Solid Organ Acquisition Reimbursement for Pancreas when transplanted with a Kidney (Deceased donor).,664314.0,431804.1,68946.0,72738.03,3
RC,815,Cadaveric Organ Acquisition Costs. NMDP Donor Search - includes transportation cost,7980.3,5187.19,,,0
RC,815,NMDP - Cell Search and Acquisition,7980.3,5187.19,,,0
RC,815,Stem Cells - Allogeneic (Effective 1/1/17),7980.3,5187.19,,,0
RC,815,Stem cells - allogeneic (effective 1/1/17),7980.3,5187.19,,,0
RC,820,General,10688.3,6947.39,,,0
RC,820,Hemodialysis,10688.3,6947.39,,,0
RC,821,Composite or other rate,10688.3,6947.39,,,0
RC,821,Hemodialysis,10688.3,6947.39,,,0
RC,871,Cell Collection á,8187.66,5321.98,,,0
RC,872,Specialized Biologic Processing and Storage - Prior To Transport á,4420.69,2873.45,,,0
RC,873,Storage and Processing After Receipt of Cells from Manufacturer á,3793.25,2465.61,,,0
RC,874,Infusion of Modified Cells (Effective 4/1/19),2434.68,1582.54,,,0
RC,891,High Cost Drugs,1731275.0,1125328.75,,,0
RC,891,Special Processed Drugs -áFDAáApproved Cell Therapy (Effective 4/1/19),1731275.0,1125328.75,,,0
RC,900,General,1397.19,908.17,,,0
RC,900,Neuropsychological Testing and Biofeedback *for NON-PSYCHIATRIC disorders only,1397.19,908.17,,,0
RC,905,Psychiatry,,,450.0,450.0,1
RC,907,Psychiatry,,,450.0,450.0,1
RC,912,Psychiatry,,,450.0,450.0,1
RC,914,Individual therapy,584.32,379.81,,,0
RC,915,Group therapy,183.68,119.39,,,0
RC,916,Family therapy,342.94,222.91,,,0
RC,918,Neuropsychological Testing and Biofeedback *for NON-PSYCHIATRIC disorders only,845.42,549.52,,,0
RC,918,Testing,845.42,549.52,,,0
RC,920,General,1660.27,1079.18,,,0
RC,920,Other Diagnostic Services,1660.27,1079.18,,,0
RC,920,"Radiology, Pathology, and Diagnostic Tests",1660.27,1079.18,,,0
RC,920,Sleep Studies - Attended,5106.38,3319.15,,,0
RC,920,Sleep Studies - Unattended,2085.39,1355.5,,,0
RC,921,Peripheral Vascular Lab,3644.02,2368.61,,,0
RC,921,Peripheral vascular lab,3644.02,2368.61,,,0
RC,921,"Radiology, Pathology, and Diagnostic Tests",3644.02,2368.61,,,0
RC,922,Electromyelogram,3283.21,2134.09,,,0
RC,922,Electromyography (EMG),3283.21,2134.09,,,0
RC,922,"Radiology, Pathology, and Diagnostic Tests",3283.21,2134.09,,,0
RC,924,Allergy Testing,1037.19,674.17,,,0
RC,924,Allergy test,1037.19,674.17,,,0
RC,924,Clinical Laboratory,1037.19,674.17,,,0
RC,924,OUTPATIENT LAB,1037.19,674.17,,,0
RC,924,Pediatric and Neonatal Services: Laboratory Services,1037.19,674.17,,,0
RC,924,"Radiology, Pathology, and Diagnostic Tests",1037.19,674.17,,,0
RC,929,Sleep Studies - Attended,8552.49,5559.12,,,0
RC,929,Sleep Studies - Unattended,2305.105,1498.315,,,0
RC,940,General,1562.8,1015.82,,,0
RC,940,Other Therapeutic Services,1562.8,1015.82,,,0
RC,942,Education and Training,747.69,486.0,,,0
RC,942,Education/training,747.69,486.0,,,0
RC,943,Cardiac Rehabilitation Therapy,1555.78,1011.26,,,0
RC,943,Cardiac rehabilitation,1555.78,1011.26,,,0
RC,948,Pulmonary Rehabilitation,1140.92,741.59,,,0
RC,948,Pulmonary rehabilitation,1140.92,741.59,,,0
RC,976,RESPIRATORY THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,977,PHYSICAL THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,978,Outpatient Occupational Therapy,,,430.0,470.0,2
RC,979,SPEECH THERAPY - OUTPATIENT,,,430.0,470.0,2
RC,990,General,3161.0,2054.65,,,0
RC,9999,(D5W) DEXTROSE 5% IN WATER IV SOLP,,,13270.0,14761.0,26
RC,9999,0.9% NACL IV LINE FLUSH BAG,0.01,0.01,13270.0,14761.0,16
RC,9999,ACAMPROSATE 333 MG PO TBEC,,,13270.0,14761.0,4
RC,9999,ACARBOSE 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ACETAMINOPHEN 120 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,ACETAMINOPHEN 160 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
RC,9999,ACETAMINOPHEN 160 MG/5 ML PO SUSP,,,13270.0,14761.0,14
RC,9999,ACETAMINOPHEN 325 MG PO TABS,,,13270.0,14761.0,10
RC,9999,ACETAMINOPHEN 325 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,ACETAMINOPHEN 500 MG PO TABS,,,13270.0,14761.0,14
RC,9999,ACETAMINOPHEN 650 MG PO SOLN,,,13270.0,14761.0,8
RC,9999,ACETAMINOPHEN 650 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,ACETAMINOPHEN 80 MG PO CHEW,,,13270.0,14761.0,4
RC,9999,ACETAMINOPHEN 80 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,ACETAZOLAMIDE 500 MG PO CPSR,,,13270.0,14761.0,2
RC,9999,ACETYLCHOLINE 18.2 MCG/ML (ACH 10-4) INJECTION FOR INTRAPROCEDURE,,,13270.0,14761.0,2
RC,9999,ACETYLCYSTEINE 600 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,ACTIVATED CHARCOAL 25 GRAM/120 ML PO SUSP,,,13270.0,14761.0,4
RC,9999,ALEMTUZUMAB 30 MG/ML IV SOLN,,,2910.87,14761.0,11
RC,9999,ALENDRONATE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ALENDRONATE 35 MG PO TABS,,,13270.0,14761.0,4
RC,9999,ALFUZOSIN 10 MG PO TB24,,,13270.0,14761.0,2
RC,9999,ALLOPURINOL 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
RC,9999,ALLOPURINOL 100 MG PO TABS,,,13270.0,14761.0,14
RC,9999,ALLOPURINOL 300 MG PO TABS,,,13270.0,14761.0,10
RC,9999,ALLOPURINOL ORAL SUSPENSION 20 MG/ML,,,13270.0,14761.0,2
RC,9999,ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML PO SUSP,,,13270.0,14761.0,6
RC,9999,ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,ALUMINUM HYDROXIDE GEL 320 MG/5 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,AMILORIDE 5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,AMINOCAPROIC ACID 250 MG/ML (25 %) PO SOLN,,,13270.0,14761.0,2
RC,9999,AMIODARONE 100 MG PO TABS,,,13270.0,14761.0,8
RC,9999,AMIODARONE 200 MG PO TABS,,,13270.0,14761.0,12
RC,9999,AMITRIPTYLINE 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,AMITRIPTYLINE 100 MG PO TABS,,,13270.0,14761.0,2
RC,9999,AMITRIPTYLINE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,AMITRIPTYLINE 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,AMLODIPINE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,AMLODIPINE 2.5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,AMLODIPINE 5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,ANAGRELIDE 0.5 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,AQUAPHOR OINTMENT,,,13270.0,14761.0,4
RC,9999,ARTIFICIAL SALIVA (YERBAS-LYT) MM SPRA,,,13270.0,14761.0,4
RC,9999,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OP GEL,,,13270.0,14761.0,2
RC,9999,ASCORBIC ACID (VITAMIN C) 250 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ASCORBIC ACID (VITAMIN C) 500 MG PO TABS,,,13270.0,14761.0,4
RC,9999,ASPIRIN 300 MG PR SUPP,,,13270.0,14761.0,2
RC,9999,ASPIRIN 325 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ASPIRIN 325 MG PO TBEC,,,13270.0,14761.0,4
RC,9999,ASPIRIN 81 MG HALF-TAB = 40.5 MG,,,13270.0,14761.0,2
RC,9999,ASPIRIN 81 MG PO CHEW,,,13270.0,14761.0,10
RC,9999,ASPIRIN 81 MG PO TBEC,,,13270.0,14761.0,6
RC,9999,ASPIRIN 81 MG QUARTER-TAB = 20.25 MG,,,13270.0,14761.0,2
RC,9999,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ATENOLOL 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ATENOLOL 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
RC,9999,ATENOLOL 25 MG PO TABS,,,13270.0,14761.0,8
RC,9999,ATENOLOL 50 MG PO TABS,,,13270.0,14761.0,8
RC,9999,ATROPINE 0.4 MG/ML IJ SOLN,,,13270.0,14761.0,8
RC,9999,B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG PO TABS,,,13270.0,14761.0,4
RC,9999,B. ANIMALIS-VITAMIN D3 1 BILLION CELL- 10 MCG/5 DROPS PO DROP,,,13270.0,14761.0,2
RC,9999,BACLOFEN 10 MG PO TABS,,,13270.0,14761.0,12
RC,9999,BACLOFEN 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,BALANCED SALT SOLN NO.2 IRRIG. IO SOLN,,,13270.0,14761.0,4
RC,9999,BALSALAZIDE 750 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,BARIUM SULFATE 2 % (W/V) PO SUSP,,,13270.0,14761.0,8
RC,9999,BARIUM SULFATE 40 % (W/V) PO SUSP,,,13270.0,14761.0,8
RC,9999,"BARIUM SULFATE 40 % (W/V), 30% (W/W) PO PSTE",,,13270.0,14761.0,2
RC,9999,"BARIUM SULFATE 40 %(W/V), 29% (W/W)(1500 CPS) PO SUSP",,,13270.0,14761.0,2
RC,9999,"BARIUM SULFATE 40% W/V, 29% W/W (VARIBAR HONEY) ORAL SUSPENSION",,,13270.0,14761.0,2
RC,9999,BARIUM SULFATE 700 MG PO TABS,,,13270.0,14761.0,2
RC,9999,BARIUM SULFATE 81 % (W/W) PO POWD,,,13270.0,14761.0,2
RC,9999,BARIUM SULFATE 96 % (W/W) PO SUSR,,,13270.0,14761.0,2
RC,9999,BARIUM SULFATE 98 % PO SUSR,,,13270.0,14761.0,2
RC,9999,BENAZEPRIL 20 MG PO TABS,,,13270.0,14761.0,2
RC,9999,BENZONATATE 100 MG PO CAPS,,,13270.0,14761.0,14
RC,9999,BENZTROPINE 0.5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,BENZTROPINE 1 MG PO TABS,,,13270.0,14761.0,8
RC,9999,BETAMETHASONE DIPROPIONATE 0.05 % TP CREA,,,13270.0,14761.0,2
RC,9999,BETAMETHASONE DIPROPIONATE 0.05 % TP LOTN,,,13270.0,14761.0,2
RC,9999,BETAMETHASONE DIPROPIONATE 0.05 % TP OINT,,,13270.0,14761.0,2
RC,9999,BETAMETHASONE VALERATE 0.1 % TP CREA,,,13270.0,14761.0,2
RC,9999,BETAMETHASONE VALERATE 0.1 % TP LOTN,,,13270.0,14761.0,2
RC,9999,BETAMETHASONE VALERATE 0.1 % TP OINT,,,13270.0,14761.0,2
RC,9999,BETHANECHOL CHLORIDE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,BETHANECHOL CHLORIDE 25 MG PO TABS,,,13270.0,14761.0,10
RC,9999,BETHANECHOL CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,BICARB DIALY SOLN 11 WITHOUT K CA (2.5 MEQ/L) -MG (1.5 MEQ/L) HD SOLN,640.0,416.0,13270.0,14761.0,4
RC,9999,BISACODYL 10 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,BISACODYL 5 MG PO TBEC,,,13270.0,14761.0,4
RC,9999,BISMUTH SUBSALICYLATE 262 MG/15 ML PO SUSP,,,13270.0,14761.0,4
RC,9999,BLENDED ACUTE CARE,,,13270.0,14761.0,2
RC,9999,BROMOCRIPTINE 2.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,BUMETANIDE 0.5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,BUMETANIDE 1 MG PO TABS,,,13270.0,14761.0,12
RC,9999,BUPROPION 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
RC,9999,BUPROPION HCL 100 MG PO SR12,,,13270.0,14761.0,10
RC,9999,BUPROPION HCL 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,BUPROPION HCL 150 MG PO SR12,,,13270.0,14761.0,8
RC,9999,BUPROPION HCL 75 MG PO TABS,,,13270.0,14761.0,6
RC,9999,BUSPIRONE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,BUSPIRONE 15 MG PO TABS,,,13270.0,14761.0,8
RC,9999,BUSPIRONE 5 MG HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
RC,9999,BUSPIRONE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CAFFEINE 200 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CALAMINE-ZINC OXIDE 8-8 % TP LOTN,,,13270.0,14761.0,2
RC,9999,CALCITRIOL 0.25 MCG PO CAPS,,,13270.0,14761.0,8
RC,9999,CALCITRIOL 0.5 MCG PO CAPS,,,13270.0,14761.0,6
RC,9999,CALCITRIOL 1 MCG/ML PO SOLN,,,13270.0,14761.0,18
RC,9999,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO CAPS,,,13270.0,14761.0,8
RC,9999,CALCIUM ACETATE(PHOSPHAT BIND) 667 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CALCIUM CARBONATE 200 MG CALCIUM (500 MG) PO CHEW,,,13270.0,14761.0,8
RC,9999,CALCIUM CARBONATE 300 MG (750 MG) PO CHEW,,,13270.0,14761.0,2
RC,9999,"CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) PO TABS",,,13270.0,14761.0,6
RC,9999,"CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) PO SUSP",,,13270.0,14761.0,8
RC,9999,CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) PO TABS,,,13270.0,14761.0,4
RC,9999,CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) PO TABS,,,13270.0,14761.0,8
RC,9999,CALCIUM CITRATE 200 MG (950 MG) PO TABS,,,13270.0,14761.0,2
RC,9999,CAPTOPRIL 100 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CAPTOPRIL 12.5 MG HALF-TAB = 6.25 MG,,,13270.0,14761.0,2
RC,9999,CAPTOPRIL 12.5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CAPTOPRIL 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CAPTOPRIL 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CARBAMAZEPINE 100 MG PO CHEW,,,13270.0,14761.0,2
RC,9999,CARBAMAZEPINE 100 MG PO TB12,,,13270.0,14761.0,2
RC,9999,CARBAMAZEPINE 100 MG/5 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,CARBAMAZEPINE 200 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CARBAMAZEPINE 200 MG PO TB12,,,13270.0,14761.0,6
RC,9999,CARBAMAZEPINE 200 MG/10 ML PO SUSP,,,13270.0,14761.0,8
RC,9999,CARBAMAZEPINE 400 MG PO TB12,,,13270.0,14761.0,2
RC,9999,CARBAMIDE PEROXIDE 6.5 % OT DROP,,,13270.0,14761.0,4
RC,9999,CARBIDOPA 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CARBIDOPA-LEVODOPA 10-100 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CARBIDOPA-LEVODOPA 25-100 MG HALF-TAB = 12.5-50 MG,,,13270.0,14761.0,2
RC,9999,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,,,13270.0,14761.0,14
RC,9999,CARBIDOPA-LEVODOPA 25-100 MG PO TBDL,,,13270.0,14761.0,4
RC,9999,CARBIDOPA-LEVODOPA 25-100 MG PO TBSR,,,13270.0,14761.0,6
RC,9999,CARBIDOPA-LEVODOPA 25-250 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CARBIDOPA-LEVODOPA 50-200 MG PO TBSR,,,13270.0,14761.0,6
RC,9999,CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP DPET,290.0,188.5,13270.0,14761.0,2
RC,9999,CARBOXYMETHYLCELLULOSE SODIUM 1 % OP DPGE,,,13270.0,14761.0,2
RC,9999,CARISOPRODOL 350 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CARVEDILOL 12.5 MG PO TABS,,,13270.0,14761.0,12
RC,9999,CARVEDILOL 25 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CARVEDILOL 3.125 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CARVEDILOL 6.25 MG PO TABS,,,13270.0,14761.0,10
RC,9999,CELECOXIB 100 MG PO CAPS,,,13270.0,14761.0,10
RC,9999,CELECOXIB 200 MG PO CAPS,,,13270.0,14761.0,12
RC,9999,CETIRIZINE 1 MG/ML PO SOLN,,,13270.0,14761.0,2
RC,9999,CETIRIZINE 10 MG PO TABS,,,13270.0,14761.0,10
RC,9999,CETIRIZINE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CETIRIZINE 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,CHLORHEXIDINE GLUCONATE 0.12 % MM MWSH,,,13270.0,14761.0,4
RC,9999,CHLORHEXIDINE GLUCONATE 0.12% ORAL RINSE,,,13270.0,14761.0,4
RC,9999,CHLOROTHIAZIDE 250 MG/5 ML PO SUSP,,,13270.0,14761.0,4
RC,9999,CHLORPHENIRAMINE MALEATE 4 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CHLORPROMAZINE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CHLORPROMAZINE 25 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CHLORTHALIDONE 25 HALF-TAB = 12.5 MG,,,13270.0,14761.0,4
RC,9999,CHLORTHALIDONE 25 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) PO DROP,,,13270.0,14761.0,2
RC,9999,CHOLECALCIFEROL (VITAMIN D3) 1000 UNITS PO TABS,,,13270.0,14761.0,10
RC,9999,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) PO CAPS",,,13270.0,14761.0,2
RC,9999,CHOLECALCIFEROL (VITAMIN D3) 400 UNITS PO TABS,,,13270.0,14761.0,6
RC,9999,CHOLECALCIFEROL (VITAMIN D3) 5000 UNITS PO CAPS,,,13270.0,14761.0,4
RC,9999,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO POWD,,,13270.0,14761.0,4
RC,9999,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM PO PWPK,,,13270.0,14761.0,4
RC,9999,CHOLESTYRAMINE-ASPARTAME 4 GRAM PO PWPK,,,13270.0,14761.0,6
RC,9999,CILOSTAZOL 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CILOSTAZOL 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CIMETIDINE 400 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CITALOPRAM 10 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CITALOPRAM 20 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CITALOPRAM 40 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CLOBETASOL 0.05 % TP CREA,,,13270.0,14761.0,6
RC,9999,CLOBETASOL 0.05 % TP OINT,,,13270.0,14761.0,6
RC,9999,CLOMIPHENE CITRATE 50 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CLOMIPRAMINE 25 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,CLONIDINE HCL 0.1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CLONIDINE HCL 0.2 MG PO TABS,,,13270.0,14761.0,4
RC,9999,CLONIDINE HCL 0.3 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CLOZAPINE 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CLOZAPINE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,COAL TAR 0.5 % TP SHAM,,,13270.0,14761.0,2
RC,9999,COLCHICINE 0.6 HALF-TAB = 0.3 MG,,,13270.0,14761.0,4
RC,9999,COLESEVELAM 625 MG PO TABS,,,13270.0,14761.0,4
RC,9999,COLESTIPOL 5 GRAM PO PACK,,,13270.0,14761.0,4
RC,9999,CONJUGATED ESTROGENS 0.3 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CONJUGATED ESTROGENS 0.625 MG PO TABS,,,13270.0,14761.0,2
RC,9999,CYANOCOBALAMIN (VITAMIN B-12) 100 MCG PO TABS,,,13270.0,14761.0,4
RC,9999,CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG PO TABS,,,13270.0,14761.0,14
RC,9999,CYANOCOBALAMIN (VITAMIN B-12) 250 MCG PO TABS,,,13270.0,14761.0,2
RC,9999,CYANOCOBALAMIN (VITAMIN B-12) 500 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,CYCLOBENZAPRINE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,CYCLOBENZAPRINE 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,CYPROHEPTADINE 2 MG/5 ML PO SYRP,,,13270.0,14761.0,2
RC,9999,CYPROHEPTADINE 4 MG PO TABS,,,13270.0,14761.0,2
RC,9999,D10 %-0.45 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,2
RC,9999,D10W PEDIATRIC HYPOGLYCEMIA,,,13270.0,14761.0,6
RC,9999,D5 %-0.45 % SODIUM CHLORIDE IV SOLP,0.01,0.01,13270.0,14761.0,30
RC,9999,D5 %-0.9 % SODIUM CHLORIDE IV SOLP,,,13270.0,14761.0,8
RC,9999,DANAZOL 50 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DANTROLENE 25 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DAPSONE 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DAPSONE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DESIPRAMINE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DESIPRAMINE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DESMOPRESSIN 0.1 MG PO HALF-TAB = 0.05 MG,,,13270.0,14761.0,2
RC,9999,DESMOPRESSIN 0.1 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DEXAMETHASONE 0.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DEXAMETHASONE 0.5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,DEXAMETHASONE 1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DEXAMETHASONE 1.5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DEXAMETHASONE 2 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DEXAMETHASONE 4 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP,,,13270.0,14761.0,8
RC,9999,DEXTROSE 10% IN WATER (D10W) IV SOLP,,,13270.0,14761.0,16
RC,9999,DEXTROSE 20 % IN WATER (D20W) 20 % IV SOLP,,,13270.0,14761.0,4
RC,9999,DEXTROSE 5 % IN WATER (D5W) IV SOLP,,,13270.0,14761.0,14
RC,9999,DEXTROSE 5 %-LACTATED RINGERS IV SOLP,,,13270.0,14761.0,14
RC,9999,DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP,,,13270.0,14761.0,2
RC,9999,DEXTROSE 5%-1/4 NORMAL SALINE IV SOLP,,,13270.0,14761.0,4
RC,9999,DEXTROSE 50 % IN WATER (D50W) IV SOLP BAG,,,13270.0,14761.0,2
RC,9999,DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % PO SOLN,300.52,195.34,13270.0,14761.0,4
RC,9999,DIATRIZOATE MEGLUMINE & SODIUM 66-10 % PO SOLN (RADIANT),307.68,199.99,13270.0,14761.0,6
RC,9999,DICLOFENAC SODIUM 75 MG PO TBEC,,,13270.0,14761.0,2
RC,9999,DICYCLOMINE 10 MG PO CAPS,,,13270.0,14761.0,10
RC,9999,DICYCLOMINE 20 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DIGOXIN 125 MCG (0.125 MG) PO TABS,,,13270.0,14761.0,4
RC,9999,DIGOXIN 250 MCG (0.25 MG) PO TABS,,,13270.0,14761.0,8
RC,9999,DIGOXIN 50 MCG/ML (0.05 MG/ML) PO SOLN,,,13270.0,14761.0,4
RC,9999,DILTIAZEM HCL 120 MG PO CDCR,290.0,188.5,13270.0,14761.0,6
RC,9999,DILTIAZEM HCL 30 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DILTIAZEM HCL 60 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DILTIAZEM HCL 90 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DIMENHYDRINATE 50 MG/ML IJ SOLN,,,13270.0,14761.0,2
RC,9999,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO ELIX,,,13270.0,14761.0,2
RC,9999,DIPHENHYDRAMINE HCL 12.5 MG/5 ML PO LIQD,,,13270.0,14761.0,2
RC,9999,DIPHENHYDRAMINE HCL 25 MG PO CAPS,,,13270.0,14761.0,10
RC,9999,DIPHENHYDRAMINE HCL 50 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TP CREA,,,13270.0,14761.0,4
RC,9999,DISOPYRAMIDE PHOSPHATE 100 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DISOPYRAMIDE PHOSPHATE 150 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DISULFIRAM 250 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DOCUSATE SODIUM 100 MG PO CAPS,,,13270.0,14761.0,16
RC,9999,DOCUSATE SODIUM 250 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,DOCUSATE SODIUM 50 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,DOCUSATE SODIUM 50 MG/5 ML PO LIQD,,,13270.0,14761.0,6
RC,9999,DONEPEZIL 10 MG PO TABS,,,13270.0,14761.0,12
RC,9999,DONEPEZIL 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DOXAZOSIN 1 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DOXAZOSIN 2 MG PO TABS,,,13270.0,14761.0,6
RC,9999,DOXAZOSIN 4 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DOXAZOSIN 8 MG PO TABS,,,13270.0,14761.0,4
RC,9999,DOXEPIN 10 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,DOXEPIN 10 MG/ML PO CONC,,,13270.0,14761.0,2
RC,9999,DOXEPIN 25 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,DOXEPIN 50 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,DOXYLAMINE SUCCINATE 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,DRUG LEVEL REMINDER,,,13270.0,14761.0,2
RC,9999,DUTASTERIDE 0.5 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,ENOXAPARIN PER PHARMACY (FOR TRAUMA PROPHYLAXIS),,,13270.0,14761.0,2
RC,9999,"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) PO CAPS",,,13270.0,14761.0,2
RC,9999,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) PO DROP",,,13270.0,14761.0,4
RC,9999,ESCITALOPRAM OXALATE 10 MG PO TABS,,,13270.0,14761.0,12
RC,9999,ESMOLOL LOADING DOSE FROM BAG/PUMP,290.0,188.5,13270.0,14761.0,2
RC,9999,ESOMEPRAZOLE MAGNESIUM 20 MG PO CPDR,,,13270.0,14761.0,6
RC,9999,ESOMEPRAZOLE MAGNESIUM 40 MG PO CPDR,,,13270.0,14761.0,10
RC,9999,ESTRADIOL 0.01 % (0.1 MG/GRAM) VA CREA,,,13270.0,14761.0,6
RC,9999,ESTRADIOL 0.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ESTRADIOL 1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,ESTRADIOL 2 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ETHOSUXIMIDE 250 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,ETODOLAC 200 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,FAMOTIDINE 20 MG PO TABS,,,13270.0,14761.0,14
RC,9999,FELBAMATE 600 MG/5 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,FENTANYL BOLUS FROM PUMP FOR END OF LIFE/COMFORT PRL,,,13270.0,14761.0,2
RC,9999,FENTANYL CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
RC,9999,FENTANYL HIGH DOSE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
RC,9999,FERROUS GLUCONATE 324 MG (38 MG IRON) PO TABS,,,13270.0,14761.0,2
RC,9999,FERROUS SULFATE 15 MG/ML PO DROP,,,13270.0,14761.0,2
RC,9999,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML PO LIQD,,,13270.0,14761.0,4
RC,9999,FERROUS SULFATE 325 MG (65 MG IRON) PO TABS,,,13270.0,14761.0,8
RC,9999,FEXOFENADINE 180 MG PO TABS,,,13270.0,14761.0,10
RC,9999,FEXOFENADINE 30 MG/5 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,FEXOFENADINE 60 MG PO TABS,,,13270.0,14761.0,6
RC,9999,FINASTERIDE 5 MG PO TABS,,,13270.0,14761.0,10
RC,9999,FLAVORING AGENT (CSMC) PO PACK,,,13270.0,14761.0,2
RC,9999,FLECAINIDE 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,FLUDROCORTISONE 0.1 MG HALF-TAB = 0.05 MG,,,13270.0,14761.0,2
RC,9999,FLUDROCORTISONE 0.1 MG PO TABS,,,13270.0,14761.0,6
RC,9999,FLUOCINONIDE 0.05 % TP CREA,,,13270.0,14761.0,4
RC,9999,FLUORESCEIN 1 MG OP STRP,,,13270.0,14761.0,4
RC,9999,FLUOXETINE 10 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,FLUOXETINE 20 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,FLUOXETINE 20 MG/5 ML (4 MG/ML) PO SOLN,,,13270.0,14761.0,4
RC,9999,FLUPHENAZINE HCL 2.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,FLUPHENAZINE HCL 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,FLUVOXAMINE 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,FLUVOXAMINE 50 MG PO TABS,,,13270.0,14761.0,2
RC,9999,FOLIC ACID 1 MG PO TABS,,,13270.0,14761.0,16
RC,9999,FOLIC ACID 400 MCG PO TABS,,,13270.0,14761.0,2
RC,9999,FUROSEMIDE 10 MG/ML PO SOLN,,,13270.0,14761.0,2
RC,9999,FUROSEMIDE 20 MG HALF-TAB = 10 MG,,,13270.0,14761.0,2
RC,9999,FUROSEMIDE 20 MG PO TABS,,,13270.0,14761.0,12
RC,9999,FUROSEMIDE 40 MG PO TABS,,,13270.0,14761.0,8
RC,9999,FUROSEMIDE 80 MG PO TABS,,,13270.0,14761.0,8
RC,9999,GABAPENTIN 100 MG PO CAPS,,,13270.0,14761.0,8
RC,9999,GABAPENTIN 250 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
RC,9999,GABAPENTIN 250 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,GABAPENTIN 300 MG PO CAPS,,,13270.0,14761.0,16
RC,9999,GABAPENTIN 300 MG/6 ML (6 ML) PO SOLN,,,13270.0,14761.0,10
RC,9999,GABAPENTIN 400 MG PO CAPS,,,13270.0,14761.0,10
RC,9999,GALANTAMINE 4 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GALANTAMINE 8 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GEMFIBROZIL 600 MG PO TABS,,,13270.0,14761.0,4
RC,9999,GLIMEPIRIDE 1 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GLIMEPIRIDE 2 MG PO TABS,,,13270.0,14761.0,4
RC,9999,GLIMEPIRIDE 4 MG PO TABS,,,13270.0,14761.0,4
RC,9999,GLIPIZIDE 10 MG PO TABS,,,13270.0,14761.0,6
RC,9999,GLIPIZIDE 10 MG PO TR24,,,13270.0,14761.0,2
RC,9999,GLIPIZIDE 5 MG HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
RC,9999,GLIPIZIDE 5 MG PO TABS,,,13270.0,14761.0,10
RC,9999,GLIPIZIDE 5 MG PO TR24,,,13270.0,14761.0,2
RC,9999,GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML PO LIQD,,,13270.0,14761.0,2
RC,9999,GLUCOSE (TOLERANCE TEST) 100 GRAM/296 ML PO LIQD,,,13270.0,14761.0,2
RC,9999,GLUCOSE 4 GRAM PO CHEW HYPOGLYCEMIA PROTOCOL (USE DISPLAY NAME),,,13270.0,14761.0,2
RC,9999,GLUCOSE PO CHEW,,,13270.0,14761.0,8
RC,9999,GLYBURIDE 1.25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GLYBURIDE 5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GLYCERIN (ADULT) PR SUPP,,,13270.0,14761.0,6
RC,9999,GLYCERIN (CHILD) PR SUPP,,,13270.0,14761.0,6
RC,9999,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML PR SOLN,,,13270.0,14761.0,2
RC,9999,GLYCERIN-WITCH HAZEL 12.5-50 % TP PADM,,,13270.0,14761.0,2
RC,9999,GLYCOPYRROLATE 1 MG PO TABS,,,13270.0,14761.0,2
RC,9999,GLYCOPYRROLATE ORAL SOLUTION 0.2 MG/ML,,,13270.0,14761.0,2
RC,9999,GUAIFENESIN 100 MG/5 ML PO LIQD,,,13270.0,14761.0,4
RC,9999,GUAIFENESIN 200 MG PO TABS,,,13270.0,14761.0,4
RC,9999,GUAIFENESIN 600 MG PO TA12,,,13270.0,14761.0,6
RC,9999,GUANFACINE 1 MG PO HALF-TAB = 0.5 MG,,,13270.0,14761.0,2
RC,9999,GUANFACINE 1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,HALOPERIDOL 0.5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,HALOPERIDOL 1 MG PO TABS,,,13270.0,14761.0,6
RC,9999,HALOPERIDOL 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,HALOPERIDOL 2 MG PO TABS,,,13270.0,14761.0,6
RC,9999,HALOPERIDOL 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,HALOPERIDOL LACTATE 2 MG/ML PO CONC,,,13270.0,14761.0,2
RC,9999,HB FOLLOW-UP-NO CHARGE VISIT,,,13270.0,14761.0,2
RC,9999,HELP,,,13270.0,14761.0,2
RC,9999,HEPARIN PER PHARMACY PROTOCOL,,,13270.0,14761.0,2
RC,9999,HYDRALAZINE 10 MG HALF-TAB = 5 MG,,,13270.0,14761.0,2
RC,9999,HYDRALAZINE 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,HYDRALAZINE 25 MG PO TABS,,,13270.0,14761.0,10
RC,9999,HYDRALAZINE 50 MG PO TABS,,,13270.0,14761.0,8
RC,9999,HYDROCHLOROTHIAZIDE 12.5 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,HYDROCHLOROTHIAZIDE 25 MG PO TABS,,,13270.0,14761.0,8
RC,9999,HYDROCHLOROTHIAZIDE 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,HYDROGEN PEROXIDE 3 % MISC SOLN,,,13270.0,14761.0,2
RC,9999,HYDROMORPHONE 1MG/ML AND KETAMINE 1MG/ML CONT DOSE,,,13270.0,14761.0,2
RC,9999,HYDROMORPHONE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
RC,9999,HYDROMORPHONE HIGH DOSE CONTINUOUS DOSE (BASAL RATE),,,13270.0,14761.0,2
RC,9999,HYDROXYCHLOROQUINE 200 HALF-TAB = 100 MG,,,13270.0,14761.0,4
RC,9999,HYDROXYCHLOROQUINE 200 MG PO TABS,,,13270.0,14761.0,10
RC,9999,HYDROXYZINE HCL 10 MG PO TABS,,,13270.0,14761.0,6
RC,9999,HYDROXYZINE HCL 10 MG/5 ML PO SOLN,,,13270.0,14761.0,4
RC,9999,HYDROXYZINE HCL 25 MG PO TABS,,,13270.0,14761.0,8
RC,9999,HYDROXYZINE HCL 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,HYOSCYAMINE SULFATE 0.125 MG SL SUBL,,,13270.0,14761.0,4
RC,9999,IBUPROFEN 100 MG/5 ML PO SUSP,,,13270.0,14761.0,12
RC,9999,IBUPROFEN 200 MG PO TABS,,,13270.0,14761.0,2
RC,9999,IBUPROFEN 400 MG PO TABS,,,13270.0,14761.0,10
RC,9999,IBUPROFEN 600 MG PO TABS,,,13270.0,14761.0,4
RC,9999,IMIPRAMINE HCL 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,IMIPRAMINE HCL 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,INDAPAMIDE 1.25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,INDOMETHACIN 25 MG PO CAPS,,,13270.0,14761.0,8
RC,9999,INDOMETHACIN 50 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,IOHEXOL 350 MG IODINE/ML IV SOLN,,,,,0
RC,9999,IRBESARTAN 150 MG PO TABS,,,13270.0,14761.0,6
RC,9999,IRBESARTAN 75 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ISONIAZID 100 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ISONIAZID 300 MG PO TABS,,,13270.0,14761.0,8
RC,9999,ISOSORBIDE DINITRATE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,ISOSORBIDE DINITRATE 20 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ISOSORBIDE DINITRATE 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,ISOSORBIDE MONONITRATE 120 MG PO TB24,,,13270.0,14761.0,10
RC,9999,ISOSORBIDE MONONITRATE 30 MG PO TB24,,,13270.0,14761.0,10
RC,9999,ISOSORBIDE MONONITRATE 60 MG PO TB24,,,13270.0,14761.0,8
RC,9999,L NORGEST/E.ESTRADIOL-E.ESTRAD 0.15 MG-30 MCG (84)/10 MCG (7) PO 3MPK,,,13270.0,14761.0,2
RC,9999,LABETALOL 100 MG HALF-TAB = 50 MG,,,13270.0,14761.0,2
RC,9999,LABETALOL 100 MG PO TABS,,,13270.0,14761.0,8
RC,9999,LABETALOL 200 MG PO TABS,,,13270.0,14761.0,8
RC,9999,LABETALOL 300 MG PO TABS,,,13270.0,14761.0,10
RC,9999,LACTATED RINGERS IRRIGATION INTRAPROCEDURE,,,13270.0,14761.0,4
RC,9999,LACTATED RINGERS IV SOLP,,,13270.0,14761.0,10
RC,9999,LACTOBACILLUS REUTERI 100 MILLION CELL/5 DROP PO DRPS,,,13270.0,14761.0,2
RC,9999,LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELLS PO CAPS,,,13270.0,14761.0,4
RC,9999,LACTULOSE 20 GRAM/30 ML PO SOLN,,,13270.0,14761.0,20
RC,9999,LACTULOSE ENEMA,,,13270.0,14761.0,8
RC,9999,LANSOPRAZOLE 15 MG PO CPDR,,,13270.0,14761.0,2
RC,9999,LANSOPRAZOLE 30 MG PO CPDR,,,13270.0,14761.0,2
RC,9999,LANSOPRAZOLE ORAL SUSPENSION 3MG/ML,,,13270.0,14761.0,2
RC,9999,LEFLUNOMIDE 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,LEFLUNOMIDE 20 MG PO TABS,,,13270.0,14761.0,4
RC,9999,LET TOPICAL SOLUTION,,,13270.0,14761.0,2
RC,9999,LEVETIRACETAM 100 MG/ML PO SOLN,,,13270.0,14761.0,20
RC,9999,LEVETIRACETAM 250 MG PO TABS,,,13270.0,14761.0,10
RC,9999,LEVETIRACETAM 500 MG PO TABS,,,13270.0,14761.0,20
RC,9999,LEVETIRACETAM 500 MG PO TB24,,,13270.0,14761.0,4
RC,9999,LEVETIRACETAM 750 MG PO TB24,,,13270.0,14761.0,6
RC,9999,LEVOCARNITINE (WITH SUGAR) 100 MG/ML PO SOLN,,,13270.0,14761.0,2
RC,9999,LEVONORGESTREL-ETHINYL ESTRAD 0.1-20 MG-MCG PO TABS,,,13270.0,14761.0,4
RC,9999,LEVOTHYROXINE 100 MCG PO TABS,,,13270.0,14761.0,14
RC,9999,LEVOTHYROXINE 112 MCG PO TABS,,,13270.0,14761.0,10
RC,9999,LEVOTHYROXINE 125 MCG HALF-TAB = 62.5 MCG,,,13270.0,14761.0,2
RC,9999,LEVOTHYROXINE 125 MCG PO TABS,,,13270.0,14761.0,10
RC,9999,LEVOTHYROXINE 137 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,LEVOTHYROXINE 150 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,LEVOTHYROXINE 175 MCG PO TABS,,,13270.0,14761.0,10
RC,9999,LEVOTHYROXINE 200 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,LEVOTHYROXINE 25 MCG HALF-TAB = 12.5 MCG,,,13270.0,14761.0,2
RC,9999,LEVOTHYROXINE 25 MCG PO TABS,,,13270.0,14761.0,10
RC,9999,LEVOTHYROXINE 50 MCG PO TABS,,,13270.0,14761.0,12
RC,9999,LEVOTHYROXINE 75 MCG HALF-TAB = 37.5 MCG,,,13270.0,14761.0,2
RC,9999,LEVOTHYROXINE 75 MCG PO TABS,,,13270.0,14761.0,8
RC,9999,LEVOTHYROXINE 88 MCG HALF-TAB = 44 MCG,,,13270.0,14761.0,2
RC,9999,LEVOTHYROXINE 88 MCG PO TABS,,,13270.0,14761.0,8
RC,9999,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY BLUE TRAY,290.0,188.5,,,0
RC,9999,LIDOCAINE (PF) 10 MG/ML (1%) IJ SOLN IN BMT BIOPSY WHITE TRAY,,,,,0
RC,9999,LIOTHYRONINE 25 MCG HALF-TAB = 12.5 MCG,,,13270.0,14761.0,2
RC,9999,LIOTHYRONINE 25 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,LIOTHYRONINE 5 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,"LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT PO CPDR",,,13270.0,14761.0,4
RC,9999,"LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT PO CPDR",,,13270.0,14761.0,4
RC,9999,"LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT PO CPDR",,,13270.0,14761.0,8
RC,9999,LISINOPRIL 10 MG PO TABS,,,13270.0,14761.0,10
RC,9999,LISINOPRIL 2.5 MG PO TABS,,,13270.0,14761.0,10
RC,9999,LISINOPRIL 20 MG PO TABS,,,13270.0,14761.0,8
RC,9999,LISINOPRIL 40 MG PO TABS,,,13270.0,14761.0,12
RC,9999,LISINOPRIL 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,LITHIUM CARBONATE 150 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,LITHIUM CARBONATE 300 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,LITHIUM CARBONATE 300 MG PO TBSR,,,13270.0,14761.0,4
RC,9999,LITHIUM CARBONATE 450 MG PO TBSR,,,13270.0,14761.0,4
RC,9999,LOPERAMIDE 1 MG/7.5 ML PO LIQD,,,13270.0,14761.0,4
RC,9999,LOPERAMIDE 2 MG PO CAPS,,,13270.0,14761.0,8
RC,9999,LORATADINE 10 MG PO TABS,,,13270.0,14761.0,6
RC,9999,LORATADINE-PSEUDOEPHEDRINE 5-120 MG PO TB12,,,13270.0,14761.0,4
RC,9999,LOXAPINE SUCCINATE 25 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,LOXAPINE SUCCINATE 5 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,LYSINE 500 MG PO TABS,,,13270.0,14761.0,2
RC,9999,MAGNESIUM CHLORIDE 64 MG PO TBEC,,,13270.0,14761.0,2
RC,9999,MAGNESIUM CITRATE PO SOLN,,,13270.0,14761.0,8
RC,9999,MAGNESIUM HYDROXIDE 400 MG/5 ML PO SUSP,,,13270.0,14761.0,8
RC,9999,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) PO TABS,,,13270.0,14761.0,8
RC,9999,MAGNESIUM OXIDE-MG AA CHELATE 133 MG PO TABS,,,13270.0,14761.0,2
RC,9999,MAGNESIUM SULFATE LOADING DOSE FROM BAG/PUMP ANES-INTRAOP,,,13270.0,14761.0,2
RC,9999,MAGNESIUM SULFATE ORAL SOLUTION 4.06 MEQ/ML,,,13270.0,14761.0,2
RC,9999,MD TO DOSE WARFARIN,,,13270.0,14761.0,2
RC,9999,MECLIZINE 12.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,MECLIZINE 25 MG PO TABS,,,13270.0,14761.0,6
RC,9999,MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML PO OIL,,,13270.0,14761.0,2
RC,9999,MEDROXYPROGESTERONE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,MEDROXYPROGESTERONE 2.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,MEGESTROL 20 MG PO TABS,,,13270.0,14761.0,6
RC,9999,MEGESTROL 40 MG PO TABS,,,13270.0,14761.0,6
RC,9999,MELATONIN 1 MG PO TABS,,,13270.0,14761.0,12
RC,9999,MELATONIN 3 MG PO TABS,,,13270.0,14761.0,10
RC,9999,MELOXICAM 15 MG PO TABS,,,13270.0,14761.0,6
RC,9999,MELOXICAM 7.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,MENTHOL 3.2 MG MM LOZG,,,13270.0,14761.0,2
RC,9999,MENTHOL 5.8 MG MM LOZG,,,13270.0,14761.0,2
RC,9999,MENTHOL-ZINC OXIDE 0.44-20.6 % TP OINT,,,13270.0,14761.0,2
RC,9999,MESALAMINE 1.2 GRAM PO TBEC,,,13270.0,14761.0,8
RC,9999,MESALAMINE 250 MG PO CPSR,,,13270.0,14761.0,2
RC,9999,METFORMIN 1000 MG PO TABS,,,13270.0,14761.0,8
RC,9999,METFORMIN 500 MG PO TABS,,,13270.0,14761.0,10
RC,9999,METFORMIN 500 MG PO TB24,,,13270.0,14761.0,2
RC,9999,METFORMIN 750 MG PO TB24,,,13270.0,14761.0,2
RC,9999,METFORMIN 850 MG PO TABS,,,13270.0,14761.0,4
RC,9999,METHAZOLAMIDE 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,METHAZOLAMIDE 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,METHENAMINE HIPPURATE 1 GRAM PO TABS,,,13270.0,14761.0,2
RC,9999,METHIMAZOLE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,METHIMAZOLE 5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,METHYL SALICYLATE-MENTHOL 15-10 % TP CREA,,,13270.0,14761.0,4
RC,9999,METHYLCELLULOSE (LAXATIVE) PO POWD,,,13270.0,14761.0,2
RC,9999,METHYLPREDNISOLONE 4 MG PO DSPK,,,13270.0,14761.0,6
RC,9999,METHYLPREDNISOLONE 4 MG PO DSPK - ADDITIONAL DAYS,,,13270.0,14761.0,2
RC,9999,METHYLPREDNISOLONE 4 MG PO TABS,,,13270.0,14761.0,12
RC,9999,METOCLOPRAMIDE HCL 10 MG PO TABS,,,13270.0,14761.0,10
RC,9999,METOCLOPRAMIDE HCL 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,METOCLOPRAMIDE HCL 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,METOLAZONE 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,METOLAZONE 2.5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,METOLAZONE 5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,METOPROLOL SUCCINATE 100 MG PO TB24,,,13270.0,14761.0,10
RC,9999,METOPROLOL SUCCINATE 25 MG HALF-TAB = 12.5 MG PO TB24,,,13270.0,14761.0,2
RC,9999,METOPROLOL SUCCINATE 25 MG PO TB24,,,13270.0,14761.0,14
RC,9999,METOPROLOL SUCCINATE 50 MG PO TB24,,,13270.0,14761.0,14
RC,9999,METOPROLOL TARTRATE 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,METOPROLOL TARTRATE 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
RC,9999,METOPROLOL TARTRATE 25 MG PO TABS,,,13270.0,14761.0,10
RC,9999,METOPROLOL TARTRATE 50 MG PO TABS,,,13270.0,14761.0,10
RC,9999,MEXILETINE 150 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,MEXILETINE 200 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,MIDODRINE 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,MIDODRINE 2.5 MG PO TABS,,,13270.0,14761.0,8
RC,9999,MIDODRINE 5 MG PO TABS,,,13270.0,14761.0,14
RC,9999,MINERAL OIL PO OIL,,,13270.0,14761.0,2
RC,9999,MINERAL OIL PR ENEM,,,13270.0,14761.0,6
RC,9999,"MINERAL OIL, LIGHT STERILE MISC OIL",,,13270.0,14761.0,2
RC,9999,MINERAL OIL-CHONDRUS 2.5 ML/5 ML PO EMUL,,,13270.0,14761.0,2
RC,9999,MINOXIDIL 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,MINOXIDIL 2.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,MIRTAZAPINE 15 MG PO TABS,,,13270.0,14761.0,12
RC,9999,MIRTAZAPINE 15 MG PO TBDL,,,13270.0,14761.0,2
RC,9999,MIRTAZAPINE 30 MG PO TABS,,,13270.0,14761.0,8
RC,9999,MIRTAZAPINE 30 MG PO TBDL,,,13270.0,14761.0,6
RC,9999,MIRTAZAPINE 7.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,MISOPROSTOL 100 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,MISOPROSTOL 100MCG QUARTER-TAB = 25MCG,,,13270.0,14761.0,4
RC,9999,MISOPROSTOL 200 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,MODIFIED LANOLIN 100 % TP CREA,,,13270.0,14761.0,2
RC,9999,MOLNUPIRAVIR 200 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,MORPHINE 5 MG/ML HIGH DOSE PCA CONTINUOUS DOSE(BASAL),,,13270.0,14761.0,2
RC,9999,MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG PO TABS,,,13270.0,14761.0,6
RC,9999,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML PO LIQD,,,13270.0,14761.0,4
RC,9999,MULTIVITAMIN PO TABS,,,13270.0,14761.0,4
RC,9999,MULTIVITAMIN WITH FOLIC ACID 400 MCG PO TABS,,,13270.0,14761.0,4
RC,9999,MULTIVITAMIN WITH MINERALS PO TABS,,,13270.0,14761.0,4
RC,9999,NABUMETONE 750 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NADOLOL 20 MG PO HALF-TAB = 10 MG,,,13270.0,14761.0,2
RC,9999,NADOLOL 20 MG PO TABS,,,13270.0,14761.0,6
RC,9999,NADOLOL 40 MG PO TABS,,,13270.0,14761.0,4
RC,9999,NALTREXONE 50 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NAPROXEN 250 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NAPROXEN 375 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NATEGLINIDE 120 MG PO TABS,,,13270.0,14761.0,10
RC,9999,NATEGLINIDE 60 MG PO TABS,,,13270.0,14761.0,8
RC,9999,NIACIN 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,NIACIN 500 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NIACINAMIDE 500 MG PO TABS,,,13270.0,14761.0,2
RC,9999,NICOTINE (POLACRILEX) 2 MG BU GUM,,,13270.0,14761.0,2
RC,9999,NICOTINE (POLACRILEX) 4 MG BU GUM,,,13270.0,14761.0,2
RC,9999,NICOTINE 14 MG TD PT24,,,13270.0,14761.0,4
RC,9999,NICOTINE 21 MG TD PT24,,,13270.0,14761.0,6
RC,9999,NICOTINE 7 MG TD PT24,,,13270.0,14761.0,4
RC,9999,NIFEDIPINE 10 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,NIFEDIPINE 30 MG PO TR24,,,13270.0,14761.0,8
RC,9999,NIFEDIPINE 60 MG PO TR24,,,13270.0,14761.0,12
RC,9999,NIRMATRELVIR-RITONAVIR 150-100 MG PO DSPK,,,13270.0,14761.0,2
RC,9999,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG PO DSPK,,,13270.0,14761.0,6
RC,9999,NITROGLYCERIN 0.1 MG/HR TD PT24,,,13270.0,14761.0,2
RC,9999,NITROGLYCERIN 0.2 MG/HR TD PT24,,,13270.0,14761.0,2
RC,9999,NITROGLYCERIN 0.4 MG SL SUBL,,,13270.0,14761.0,6
RC,9999,NITROGLYCERIN 0.4 MG/HR TD PT24,,,13270.0,14761.0,2
RC,9999,NITROGLYCERIN 0.6 MG/HR TD PT24,,,13270.0,14761.0,2
RC,9999,NITROGLYCERIN 2 % TD OINT,,,13270.0,14761.0,8
RC,9999,NITROGLYCERIN OINTMENT 0.2% (IP ORDERING ONLY),,,13270.0,14761.0,2
RC,9999,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG PO TABS,,,13270.0,14761.0,8
RC,9999,NORETHINDRONE AC-ETH ESTRADIOL 1-20 MG-MCG PO TABS,,,13270.0,14761.0,4
RC,9999,NORETHINDRONE ACETATE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,NORETHINDRONE-ETHIN ESTRADIOL 0.4-35 MG-MCG PO TABS,,,13270.0,14761.0,4
RC,9999,NORETHINDRONE-ETHIN ESTRADIOL 1-35 MG-MCG PO TABS,,,13270.0,14761.0,4
RC,9999,NORGESTIMATE-ETHINYL ESTRADIOL 0.18/0.215/0.25 MG-25 MCG PO TABS,,,13270.0,14761.0,8
RC,9999,NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG PO TABS,,,13270.0,14761.0,4
RC,9999,NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG PO TABS,,,13270.0,14761.0,6
RC,9999,NORTRIPTYLINE 10 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,NORTRIPTYLINE 10 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,NORTRIPTYLINE 25 MG PO CAPS,,,13270.0,14761.0,8
RC,9999,OLANZAPINE 10 MG PO TABS,,,13270.0,14761.0,12
RC,9999,OLANZAPINE 2.5 MG PO TABS,,,13270.0,14761.0,24
RC,9999,OLANZAPINE 5 MG PO TABS,,,13270.0,14761.0,12
RC,9999,OLANZAPINE 7.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG PO CAPS",,,13270.0,14761.0,2
RC,9999,OMEPRAZOLE 20 MG PO CPDR,,,13270.0,14761.0,4
RC,9999,OXCARBAZEPINE 150 MG PO TABS,,,13270.0,14761.0,6
RC,9999,OXCARBAZEPINE 300 MG PO TABS,,,13270.0,14761.0,10
RC,9999,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) PO SUSP,,,13270.0,14761.0,2
RC,9999,OXYBUTYNIN CHLORIDE 5 MG PO TABS,,,13270.0,14761.0,14
RC,9999,OXYBUTYNIN CHLORIDE 5 MG/5 ML PO SYRP,,,13270.0,14761.0,2
RC,9999,OXYMETAZOLINE 0.05 % NA SPRY,,,13270.0,14761.0,10
RC,9999,Other Outpatient Services,145.005,94.255,,,0
RC,9999,PAROXETINE HCL 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PAROXETINE HCL 20 MG PO TABS,,,13270.0,14761.0,8
RC,9999,PAROXETINE HCL 30 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PATIENT'S OWN PUMP,,,13270.0,14761.0,2
RC,9999,PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML PO LIQD,,,13270.0,14761.0,2
RC,9999,PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML PO DROP,,,13270.0,14761.0,2
RC,9999,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML PO DROP,,,13270.0,14761.0,2
RC,9999,PEDIATRIC MULTIVITAMIN PO CHEW,,,13270.0,14761.0,4
RC,9999,PENTOXIFYLLINE 400 MG PO TBSR,,,13270.0,14761.0,4
RC,9999,PERPHENAZINE 2 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PERPHENAZINE 8 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PHENAZOPYRIDINE 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PHENAZOPYRIDINE 200 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PHENOL 1.4 % MM SPRA,,,13270.0,14761.0,10
RC,9999,PHENYTOIN 100 MG/4 ML PO SUSP,,,13270.0,14761.0,4
RC,9999,PHENYTOIN 50 MG PO CHEW,,,13270.0,14761.0,4
RC,9999,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,PHENYTOIN SODIUM EXTENDED 30 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IR SOLN,,,13270.0,14761.0,8
RC,9999,PILOCARPINE HCL 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PNV CMB#95-FERROUS FUMARATE-FA 28 MG IRON- 800 MCG PO TABS,,,13270.0,14761.0,2
RC,9999,POLYETHYLENE GLYCOL 3350 17 GRAM PO PWPK,,,13270.0,14761.0,8
RC,9999,POTASSIUM BICARB-CITRIC ACID 10 MEQ PO TBEF,,,13270.0,14761.0,8
RC,9999,POTASSIUM BICARB-CITRIC ACID 20 MEQ PO TBEF,,,13270.0,14761.0,12
RC,9999,POTASSIUM CHLORIDE 10 MEQ PO CPSR,,,13270.0,14761.0,8
RC,9999,POTASSIUM CHLORIDE 10 MEQ PO TBSR,,,13270.0,14761.0,2
RC,9999,POTASSIUM CHLORIDE 10 MEQ PO TBTQ,,,13270.0,14761.0,2
RC,9999,POTASSIUM CHLORIDE 20 MEQ PO TBTQ,,,13270.0,14761.0,14
RC,9999,POTASSIUM IODIDE 1 G/ML PO SOLN,,,13270.0,14761.0,6
RC,9999,"POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG PO PWPK",,,13270.0,14761.0,6
RC,9999,POVIDONE-IODINE 10 % TP OINT,,,13270.0,14761.0,2
RC,9999,PRAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,PRAZOSIN 2 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) PO SOLN,,,13270.0,14761.0,2
RC,9999,PREDNISONE 1 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PREDNISONE 10 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PREDNISONE 2.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PREDNISONE 20 MG PO TABS,,,13270.0,14761.0,8
RC,9999,PREDNISONE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PREDNISONE 5 MG/5 ML PO SOLN,,,13270.0,14761.0,2
RC,9999,PREDNISONE 5 MG/ML PO CONC,,,13270.0,14761.0,2
RC,9999,PREDNISONE 50 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PRIMAQUINE 26.3 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PRIMIDONE 250 MG PO TABS,,,13270.0,14761.0,12
RC,9999,PRIMIDONE 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PRISMASATE BK 0/3.5 CA+,,,13270.0,14761.0,2
RC,9999,PRISMASATE BK 4/0 CA+,,,13270.0,14761.0,4
RC,9999,PRISMASATE BK 4/2.5 CA+,,,13270.0,14761.0,4
RC,9999,PROBENECID 500 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PROCHLORPERAZINE 25 MG PR SUPP,,,13270.0,14761.0,4
RC,9999,PROCHLORPERAZINE MALEATE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PROCHLORPERAZINE MALEATE 5 MG PO HALF-TAB = 2.5 MG,,,13270.0,14761.0,2
RC,9999,PROCHLORPERAZINE MALEATE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PROGESTERONE MICRONIZED 100 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,PROMETHAZINE 12.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PROMETHAZINE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PROMETHAZINE 25 MG/ML IJ SOLN,,,13270.0,14761.0,2
RC,9999,PROMETHAZINE 6.25 MG/5 ML PO SYRP,,,13270.0,14761.0,2
RC,9999,PROMETHAZINE-DM 6.25-15 MG/5 ML PO SYRP,,,13270.0,14761.0,2
RC,9999,PROPAFENONE 150 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PROPAFENONE 225 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PROPRANOLOL 10 MG PO TABS,,,13270.0,14761.0,10
RC,9999,PROPRANOLOL 20 MG PO TABS,,,13270.0,14761.0,12
RC,9999,PROPRANOLOL 20 MG/5 ML (4 MG/ML) PO SOLN,,,13270.0,14761.0,2
RC,9999,PROPRANOLOL 40 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PROPRANOLOL 60 MG PO CS24,,,13270.0,14761.0,2
RC,9999,PROPYLTHIOURACIL 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,PROTRIPTYLINE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PSEUDOEPHEDRINE HCL 30 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PSEUDOEPHEDRINE HCL 60 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM PO PWPK,,,13270.0,14761.0,2
RC,9999,PUREFLOW RFP-402 BGK 0/3 CA SOLUTION,,,13270.0,14761.0,2
RC,9999,PUREFLOW RFP-404 BGK 4/2.5 CA SOLUTION,,,13270.0,14761.0,2
RC,9999,PYRAZINAMIDE 500 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TP SHAM,,,13270.0,14761.0,8
RC,9999,PYRIDOSTIGMINE BROMIDE 60 MG PO TABS,,,13270.0,14761.0,8
RC,9999,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML PO SYRP,,,13270.0,14761.0,10
RC,9999,PYRIDOXINE (VITAMIN B6) 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,PYRIDOXINE (VITAMIN B6) 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,PYRIDOXINE (VITAMIN B6) 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,QUININE SULFATE 324 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,RAMIPRIL 10 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,RAMIPRIL 5 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,REMOVE PATCH,,,13270.0,14761.0,2
RC,9999,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML IJ SYRG",,,13270.0,14761.0,4
RC,9999,RIBOFLAVIN (VITAMIN B2) 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,RIBOFLAVIN (VITAMIN B2) 25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,RINGER'S IV SOLP,,,13270.0,14761.0,2
RC,9999,RIZATRIPTAN 10 MG PO TBDL,,,13270.0,14761.0,4
RC,9999,RIZATRIPTAN 5 MG PO TBDL,,,13270.0,14761.0,4
RC,9999,ROPINIROLE 0.25 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ROPINIROLE 0.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,ROPINIROLE 1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,SACCHAROMYCES BOULARDII 250 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,SALIVA SUBSTITUTE COMBO NO.2 MM SOLN,,,13270.0,14761.0,2
RC,9999,SALSALATE 500 MG PO TABS,,,13270.0,14761.0,2
RC,9999,SELEGILINE HCL 5 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,SELENIUM 50 MCG PO TABS,,,13270.0,14761.0,2
RC,9999,SELENIUM SULFIDE 2.5 % TP LOTN,,,13270.0,14761.0,2
RC,9999,SENNOSIDES 8.6 MG PO TABS,,,13270.0,14761.0,12
RC,9999,SENNOSIDES 8.8 MG/5 ML PO SYRP,,,13270.0,14761.0,4
RC,9999,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,,,13270.0,14761.0,14
RC,9999,SERTRALINE 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SERTRALINE 25 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SERTRALINE 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SILVER NITRATE APPLICATORS 75-25 % TP STCK,,,13270.0,14761.0,6
RC,9999,SIMETHICONE 40 MG/0.6 ML PO DRPS,,,13270.0,14761.0,8
RC,9999,SIMETHICONE 80 MG PO CHEW,,,13270.0,14761.0,16
RC,9999,SIMVASTATIN 10 MG PO TABS,,,13270.0,14761.0,8
RC,9999,SIMVASTATIN 20 MG PO TABS,,,13270.0,14761.0,10
RC,9999,SIMVASTATIN 40 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SIMVASTATIN 5 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SIMVASTATIN 80 MG PO TABS,,,13270.0,14761.0,2
RC,9999,SOD BICARB-CITRIC AC-SIMETH 2.21-1.53 GRAM/4 GRAM PO GREP,,,13270.0,14761.0,2
RC,9999,"SOD PHOS DI, MONO-K PHOS MONO 250 MG PO TABS",,,13270.0,14761.0,4
RC,9999,SOD.CHLORID-POTASSIUM CHLORIDE 287-180-15 MG PO TABS,,,13270.0,14761.0,2
RC,9999,SODIUM CHLORIDE 0.45 % IV SOLP,,,13270.0,14761.0,8
RC,9999,SODIUM CHLORIDE 0.45 % IV SOLP (BOLUS),,,13270.0,14761.0,8
RC,9999,SODIUM CHLORIDE 0.9 % (FLUSH) IJ SYRG,,,13270.0,14761.0,10
RC,9999,SODIUM CHLORIDE 0.9 % IJ SOLN,,,13270.0,14761.0,8
RC,9999,SODIUM CHLORIDE 0.9 % IR SOLN,,,13270.0,14761.0,12
RC,9999,SODIUM CHLORIDE 0.9 % IV PGBK,,,13270.0,14761.0,18
RC,9999,SODIUM CHLORIDE 0.9 % IV SOLP,,,13270.0,14761.0,48
RC,9999,SODIUM CHLORIDE 0.9% FOR ECMO FLUSH IV SOL BOLUS FROM BAG,,,13270.0,14761.0,2
RC,9999,SODIUM CHLORIDE 0.9% INJECTION INTRAPROCEDURE,,,13270.0,14761.0,2
RC,9999,SODIUM CHLORIDE 0.9% IV MINI BAG PLUS 100 ML,,,13270.0,14761.0,4
RC,9999,SODIUM CHLORIDE 0.9% IV SOLN (FOR BLOOD TRANSFUSION),,,13270.0,14761.0,10
RC,9999,SODIUM CHLORIDE 1000 MG MISC TBSO,,,13270.0,14761.0,6
RC,9999,SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML PO SOLN,,,13270.0,14761.0,12
RC,9999,SODIUM PHOSPHATES 19-7 GRAM/118 ML PR ENEM,,,13270.0,14761.0,4
RC,9999,SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML PR ENEM,,,13270.0,14761.0,2
RC,9999,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML PO SUSP,,,13270.0,14761.0,2
RC,9999,SODIUM POLYSTYRENE SULF-SORBTL 30-40 GRAM/120 ML PR ENEM,,,13270.0,14761.0,2
RC,9999,SORBITOL 70 % MISC SOLN,,,13270.0,14761.0,2
RC,9999,SORBITOL-MANNITOL 2.7-0.54 GRAM/100 ML TUT SOLN,,,13270.0,14761.0,4
RC,9999,SOTALOL 120 MG HALF-TAB = 60 MG,,,13270.0,14761.0,2
RC,9999,SOTALOL 120 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SOTALOL 160 MG PO TABS,,,13270.0,14761.0,2
RC,9999,SOTALOL 80 MG HALF-TAB = 40 MG,,,13270.0,14761.0,2
RC,9999,SOTALOL 80 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SPIRONOLACTONE 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SPIRONOLACTONE 25 MG HALF-TAB = 12.5 MG,,,13270.0,14761.0,2
RC,9999,SPIRONOLACTONE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,SPIRONOLACTONE 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SUCRALFATE 1 GRAM PO TABS,,,13270.0,14761.0,18
RC,9999,SUCRALFATE 100 MG/ML PO SUSP,,,13270.0,14761.0,12
RC,9999,SUMATRIPTAN SUCCINATE 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,SUMATRIPTAN SUCCINATE 25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,SUMATRIPTAN SUCCINATE 50 MG PO TABS,,,13270.0,14761.0,6
RC,9999,TACROLIMUS CHANGE BAG REMINDER,,,13270.0,14761.0,2
RC,9999,TERAZOSIN 1 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,TERAZOSIN 2 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,TERAZOSIN 5 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,TERBUTALINE 2.5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,TERBUTALINE 5 MG PO TABS,,,13270.0,14761.0,4
RC,9999,THEOPHYLLINE 100 MG PO CP24,,,13270.0,14761.0,2
RC,9999,THEOPHYLLINE 300 MG PO TB12,,,13270.0,14761.0,2
RC,9999,THEOPHYLLINE 400 MG PO TB24,,,13270.0,14761.0,2
RC,9999,THIAMINE HCL (VITAMIN B1) 100 MG PO TABS,,,13270.0,14761.0,6
RC,9999,THIAMINE HCL (VITAMIN B1) 50 MG PO TABS,,,13270.0,14761.0,2
RC,9999,THYROID (PORK) 120 MG PO TABS,,,13270.0,14761.0,2
RC,9999,THYROID (PORK) 15 MG PO TABS,,,13270.0,14761.0,2
RC,9999,THYROID (PORK) 30 MG PO TABS,,,13270.0,14761.0,2
RC,9999,THYROID (PORK) 60 MG PO TABS,,,13270.0,14761.0,2
RC,9999,TIZANIDINE 2 MG PO TABS,,,13270.0,14761.0,6
RC,9999,TIZANIDINE 4 MG PO TABS,,,13270.0,14761.0,8
RC,9999,TOLNAFTATE 1 % TP CREA,,,13270.0,14761.0,4
RC,9999,TOLNAFTATE 1 % TP POWD,,,13270.0,14761.0,4
RC,9999,TORSEMIDE 10 MG PO TABS,,,13270.0,14761.0,4
RC,9999,TORSEMIDE 100 MG PO TABS,,,13270.0,14761.0,4
RC,9999,TORSEMIDE 20 MG PO TABS,,,13270.0,14761.0,6
RC,9999,TORSEMIDE 5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,TRACE ELEMENTS (TRALEMENT) ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN,,,13270.0,14761.0,4
RC,9999,TRAMADOL 50 MG HALF-TAB = 25 MG,,,13270.0,14761.0,2
RC,9999,TRAMADOL 50 MG PO TABS,,,13270.0,14761.0,12
RC,9999,TRANYLCYPROMINE 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,TRAZODONE 100 MG PO TABS,,,13270.0,14761.0,8
RC,9999,TRAZODONE 50 MG HALF-TAB = 25 MG,,,13270.0,14761.0,2
RC,9999,TRAZODONE 50 MG PO TABS,,,13270.0,14761.0,10
RC,9999,TRIAMCINOLONE ACETONIDE 0.025 % TP CREA,,,13270.0,14761.0,4
RC,9999,TRIAMCINOLONE ACETONIDE 0.025 % TP LOTN,,,13270.0,14761.0,4
RC,9999,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO CAPS,,,13270.0,14761.0,4
RC,9999,TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG PO TABS,,,13270.0,14761.0,4
RC,9999,TRIHEXYPHENIDYL 2 MG PO TABS,,,13270.0,14761.0,2
RC,9999,UREA 15 GRAM PO PWPK,,,13270.0,14761.0,8
RC,9999,URSODIOL 300 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) PO SOLN,,,13270.0,14761.0,2
RC,9999,VALPROIC ACID 250 MG PO CAPS,,,13270.0,14761.0,6
RC,9999,VANCOMYCIN PER PHARMACY PROTOCOL,,,13270.0,14761.0,2
RC,9999,VARENICLINE 1 MG PO TABS,,,13270.0,14761.0,2
RC,9999,VERAPAMIL 120 MG PO C24P,,,13270.0,14761.0,6
RC,9999,VERAPAMIL 120 MG PO TABS,,,13270.0,14761.0,4
RC,9999,VERAPAMIL 180 MG PO C24P,,,13270.0,14761.0,4
RC,9999,VERAPAMIL 180 MG PO TBSR,,,13270.0,14761.0,2
RC,9999,VERAPAMIL 240 MG PO C24P,,,13270.0,14761.0,4
RC,9999,VERAPAMIL 240 MG PO TBSR,,,13270.0,14761.0,2
RC,9999,VERAPAMIL 40 MG PO TABS,,,13270.0,14761.0,4
RC,9999,VERAPAMIL 80 MG PO TABS,,,13270.0,14761.0,2
RC,9999,"VIT C,E-ZN-COPPR-LUTEIN-ZEAXAN 250-90-40-1 MG PO CAPS",,,13270.0,14761.0,2
RC,9999,"VITAMIN A 3,000 MCG (10,000 UNIT) PO CAPS",,,13270.0,14761.0,2
RC,9999,VITAMIN B COMPLEX PO CAPS,,,13270.0,14761.0,6
RC,9999,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) PO CAPS",,,13270.0,14761.0,8
RC,9999,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML PO DROP",,,13270.0,14761.0,2
RC,9999,"VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) PO CAPS",,,13270.0,14761.0,4
RC,9999,VITAMIN E 268 MG (400 UNIT) PO CAPS,,,13270.0,14761.0,2
RC,9999,VITS A AND D-WHITE PET-LANOLIN TP OINT,,,13270.0,14761.0,2
RC,9999,WARFARIN 1 MG HALF-TAB = 0.5 MG,,,13270.0,14761.0,2
RC,9999,WARFARIN 1 MG PO TABS,,,13270.0,14761.0,4
RC,9999,WARFARIN 10 MG PO TABS,,,13270.0,14761.0,2
RC,9999,WARFARIN 2 MG PO TABS,,,13270.0,14761.0,4
RC,9999,WARFARIN 2.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,WARFARIN 3 MG PO TABS,,,13270.0,14761.0,2
RC,9999,WARFARIN 4 MG PO TABS,,,13270.0,14761.0,2
RC,9999,WARFARIN 5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,WARFARIN 6 MG PO TABS,,,13270.0,14761.0,4
RC,9999,WARFARIN 7.5 MG PO TABS,,,13270.0,14761.0,2
RC,9999,"WATER FOR INJECTION, STERILE IJ SOLN",,,13270.0,14761.0,14
RC,9999,"WATER FOR IRRIGATION, STERILE IR SOLN",,,13270.0,14761.0,8
RC,9999,WHITE PETROLATUM 41 % TP OINT,,,13270.0,14761.0,2
RC,9999,WHITE PETROLATUM-MINERAL OIL 83-15 % OP OINT,,,13270.0,14761.0,4
RC,9999,WHITE PETROLATUM-MINERAL OIL 94-3 % OP OINT,,,13270.0,14761.0,2
RC,9999,WHITE PETROLATUM-MINERAL OIL TP OINT,,,13270.0,14761.0,2
RC,9999,ZALEPLON 10 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,ZINC OXIDE 16 % TP OINT,,,13270.0,14761.0,2
RC,9999,ZINC OXIDE 20 % TP OINT,,,13270.0,14761.0,2
RC,9999,ZINC OXIDE-COD LIVER OIL 40 % TP PSTE,,,13270.0,14761.0,2
RC,9999,ZINC SULFATE 50 MG ZINC (220 MG) PO CAPS,,,13270.0,14761.0,10
RC,9999,ZONISAMIDE 100 MG PO CAPS,,,13270.0,14761.0,2
RC,9999,ZONISAMIDE 25 MG PO CAPS,,,13270.0,14761.0,2